NUR 6111 Exam 1 V3 | NUR 6111
Advanced Practice Nursing I | Q&A with
Rationale (NUR6111 Exam 1) | William
Paterson University
1. A 45-year-old patient presents with a ‘crunching’ sound during movement of the knee
joint. The Advanced Practice Nurse (APN) should document this finding as:
A. Borborygmi
B. Clonus
C. Fremitus
D. Crepitus
Answer: D
Rationale: Crepitus is a palpable or audible crunching or grating sensation produced by
motion of the joint or tendons. It is commonly associated with osteoarthritis or the
degradation of cartilage within the joint space. The APN must distinguish this from normal
joint popping, which is usually not accompanied by pain or consistent grating.
2. During a respiratory assessment, the APN notes a high-pitched, musical sound heard
primarily during expiration. This finding is most likely:
A. Stridor
B. Coarse crackles
,C. Wheezing
D. Pleural friction rub
Answer: C
Rationale: Wheezing is characterized by continuous high-pitched musical sounds caused
by air flowing through narrowed or obstructed airways. This is a hallmark finding in
conditions such as asthma or chronic obstructive pulmonary disease (COPD). Stridor,
conversely, is usually inspiratory and indicates upper airway obstruction, while crackles
represent fluid in the alveoli.
3. When assessing a patient for possible appendicitis, the APN performs deep palpation in the
left lower quadrant, which results in pain in the right lower quadrant. This is known as:
A. Murphy’s sign
B. McBurney’s sign
C. Rovsing’s sign
D. Psoas sign
Answer: C
Rationale: Rovsing’s sign is positive when pressure on the left lower quadrant elicits pain
in the right lower quadrant, suggesting peritoneal irritation at McBurney’s point. This
phenomenon occurs because the displacement of gas or pressure shifts against the
inflamed appendix. This test is a critical component of the physical examination for acute
abdomen and surgical consultation.
, 4. Which of the following describes the correct technique for assessing the thyroid gland
using a posterior approach?
A. Have the patient flex the neck forward and to the right while you use your right hand to
palpate the right lobe.
B. Stand in front of the patient and use the thumbs to displace the trachea.
C. Ask the patient to hyperextend the neck to make the thyroid more visible.
D. Palpate only the isthmus as the lobes are normally non-palpable in all adults.
Answer: A
Rationale: In the posterior approach, the clinician stands behind the patient and asks them
to tip the head slightly forward and to the side being examined to relax the
sternocleidomastoid muscle. The clinician then uses the fingers of one hand to push the
trachea toward the side being palpated while the other hand feels for the lobe as the
patient swallows. Hyperextension is avoided as it tightens the neck muscles, making
palpation difficult.
5. A patient presents with a suspicious skin lesion. The APN applies the ABCDE rule for
melanoma. What does the ‘D’ represent?
A. Depth
B. Density
C. Diameter
D. Discoloration
Advanced Practice Nursing I | Q&A with
Rationale (NUR6111 Exam 1) | William
Paterson University
1. A 45-year-old patient presents with a ‘crunching’ sound during movement of the knee
joint. The Advanced Practice Nurse (APN) should document this finding as:
A. Borborygmi
B. Clonus
C. Fremitus
D. Crepitus
Answer: D
Rationale: Crepitus is a palpable or audible crunching or grating sensation produced by
motion of the joint or tendons. It is commonly associated with osteoarthritis or the
degradation of cartilage within the joint space. The APN must distinguish this from normal
joint popping, which is usually not accompanied by pain or consistent grating.
2. During a respiratory assessment, the APN notes a high-pitched, musical sound heard
primarily during expiration. This finding is most likely:
A. Stridor
B. Coarse crackles
,C. Wheezing
D. Pleural friction rub
Answer: C
Rationale: Wheezing is characterized by continuous high-pitched musical sounds caused
by air flowing through narrowed or obstructed airways. This is a hallmark finding in
conditions such as asthma or chronic obstructive pulmonary disease (COPD). Stridor,
conversely, is usually inspiratory and indicates upper airway obstruction, while crackles
represent fluid in the alveoli.
3. When assessing a patient for possible appendicitis, the APN performs deep palpation in the
left lower quadrant, which results in pain in the right lower quadrant. This is known as:
A. Murphy’s sign
B. McBurney’s sign
C. Rovsing’s sign
D. Psoas sign
Answer: C
Rationale: Rovsing’s sign is positive when pressure on the left lower quadrant elicits pain
in the right lower quadrant, suggesting peritoneal irritation at McBurney’s point. This
phenomenon occurs because the displacement of gas or pressure shifts against the
inflamed appendix. This test is a critical component of the physical examination for acute
abdomen and surgical consultation.
, 4. Which of the following describes the correct technique for assessing the thyroid gland
using a posterior approach?
A. Have the patient flex the neck forward and to the right while you use your right hand to
palpate the right lobe.
B. Stand in front of the patient and use the thumbs to displace the trachea.
C. Ask the patient to hyperextend the neck to make the thyroid more visible.
D. Palpate only the isthmus as the lobes are normally non-palpable in all adults.
Answer: A
Rationale: In the posterior approach, the clinician stands behind the patient and asks them
to tip the head slightly forward and to the side being examined to relax the
sternocleidomastoid muscle. The clinician then uses the fingers of one hand to push the
trachea toward the side being palpated while the other hand feels for the lobe as the
patient swallows. Hyperextension is avoided as it tightens the neck muscles, making
palpation difficult.
5. A patient presents with a suspicious skin lesion. The APN applies the ABCDE rule for
melanoma. What does the ‘D’ represent?
A. Depth
B. Density
C. Diameter
D. Discoloration
