NSG 351 Exam 2 V1 | NSG 351 Health
Assessment | Actual Q&A with Rationale
(NSG351 Exam 2) | James Madison
University
1. During a thoracic assessment, the nurse identifies the sternal angle, also known as the
Angle of Louis. Which of the following is true regarding this landmark?
A. It is continuous with the first rib.
B. It is located at the fifth intercostal space.
C. It marks the site of tracheal bifurcation.
D. It corresponds with the tip of the xiphoid process.
Answer: C
Rationale: The Angle of Louis is the articulation of the manubrium and the body of the
sternum. It is a vital landmark because it marks the site of tracheal bifurcation into the
right and left main bronchi. Furthermore, it corresponds with the upper border of the atria
of the heart.
2. A patient presents with a suspected melanoma. When evaluating the lesion using the
ABCDE mnemonic, what does the ‘D’ represent?
A. Depth
B. Diameter
,C. Density
D. Discoloration
Answer: B
Rationale: In the ABCDE mnemonic for skin cancer assessment, ‘D’ stands for Diameter. A
lesion is concerning if its diameter is greater than 6 mm, which is roughly the size of a
pencil eraser. Assessing diameter along with asymmetry, border, color, and evolution helps
clinicians screen for malignant melanoma.
3. While auscultating the lungs of a patient with pleuritis, the nurse hears a coarse, low-
pitched sound that occurs during both inspiration and expiration. How should this be
documented?
A. Pleural friction rub
B. Fine crackles
C. Wheezes
D. Stridor
Answer: A
Rationale: A pleural friction rub is caused by the inflammation of pleural surfaces rubbing
against each other. It produces a dry, grating sound that is heard during both phases of
respiration. This finding is distinct from crackles, which are usually heard only during
inspiration.
, 4. When palpating the carotid arteries, which technique is most appropriate to prevent a
reduction in cerebral blood flow?
A. Palpate both arteries simultaneously.
B. Palpate only one carotid artery at a time.
C. Use the thumb to feel the pulse.
D. Apply firm pressure to the carotid sinus.
Answer: B
Rationale: Palpating one carotid artery at a time is essential to avoid compromising
arterial blood flow to the brain. Simultaneous palpation or excessive pressure on the
carotid sinus could induce bradycardia or syncope. This safety measure ensures the patient
remains stable during the cardiovascular assessment.
5. The nurse is assessing a patient for tactile fremitus. Which condition would the nurse
expect to cause increased tactile fremitus?
A. Pneumothorax
B. Emphysema
C. Pleural effusion
D. Pneumonia
Answer: D
Assessment | Actual Q&A with Rationale
(NSG351 Exam 2) | James Madison
University
1. During a thoracic assessment, the nurse identifies the sternal angle, also known as the
Angle of Louis. Which of the following is true regarding this landmark?
A. It is continuous with the first rib.
B. It is located at the fifth intercostal space.
C. It marks the site of tracheal bifurcation.
D. It corresponds with the tip of the xiphoid process.
Answer: C
Rationale: The Angle of Louis is the articulation of the manubrium and the body of the
sternum. It is a vital landmark because it marks the site of tracheal bifurcation into the
right and left main bronchi. Furthermore, it corresponds with the upper border of the atria
of the heart.
2. A patient presents with a suspected melanoma. When evaluating the lesion using the
ABCDE mnemonic, what does the ‘D’ represent?
A. Depth
B. Diameter
,C. Density
D. Discoloration
Answer: B
Rationale: In the ABCDE mnemonic for skin cancer assessment, ‘D’ stands for Diameter. A
lesion is concerning if its diameter is greater than 6 mm, which is roughly the size of a
pencil eraser. Assessing diameter along with asymmetry, border, color, and evolution helps
clinicians screen for malignant melanoma.
3. While auscultating the lungs of a patient with pleuritis, the nurse hears a coarse, low-
pitched sound that occurs during both inspiration and expiration. How should this be
documented?
A. Pleural friction rub
B. Fine crackles
C. Wheezes
D. Stridor
Answer: A
Rationale: A pleural friction rub is caused by the inflammation of pleural surfaces rubbing
against each other. It produces a dry, grating sound that is heard during both phases of
respiration. This finding is distinct from crackles, which are usually heard only during
inspiration.
, 4. When palpating the carotid arteries, which technique is most appropriate to prevent a
reduction in cerebral blood flow?
A. Palpate both arteries simultaneously.
B. Palpate only one carotid artery at a time.
C. Use the thumb to feel the pulse.
D. Apply firm pressure to the carotid sinus.
Answer: B
Rationale: Palpating one carotid artery at a time is essential to avoid compromising
arterial blood flow to the brain. Simultaneous palpation or excessive pressure on the
carotid sinus could induce bradycardia or syncope. This safety measure ensures the patient
remains stable during the cardiovascular assessment.
5. The nurse is assessing a patient for tactile fremitus. Which condition would the nurse
expect to cause increased tactile fremitus?
A. Pneumothorax
B. Emphysema
C. Pleural effusion
D. Pneumonia
Answer: D
