NSG 351 Exam 2 V2 | NSG 351 Health
Assessment | Actual Q&A with Rationale
(NSG351 Exam 2) | James Madison
University
1. During a cardiac assessment, the nurse auscultates the heart at the apex. Which sound is
expected to be loudest in this location?
A. S2
B. S3
C. S1
D. S4
Answer: C
Rationale: The S1 heart sound corresponds to the closure of the atrioventricular valves
and is heard loudest at the apex. In contrast, S2 is loudest at the base of the heart due to the
closure of the semilunar valves. Understanding these landmarks is essential for accurate
cardiac cycle differentiation.
2. The nurse is preparing to assess a patient’s abdomen. What is the correct sequence of
assessment techniques to prevent altering clinical findings?
A. Inspection, Palpation, Percussion, Auscultation
B. Inspection, Percussion, Palpation, Auscultation
,C. Auscultation, Inspection, Percussion, Palpation
D. Inspection, Auscultation, Percussion, Palpation
Answer: D
Rationale: In abdominal assessment, auscultation must follow inspection but precede
percussion and palpation. This order is critical because physical manipulation of the
abdomen can increase peristalsis and result in false bowel sound recordings. Following this
standardized sequence ensures the most accurate representation of the patient’s
gastrointestinal status.
3. When palpating for tactile fremitus, the nurse notes increased vibrations over the right
lower lobe. Which condition is most likely associated with this finding?
A. Pneumothorax
B. Pneumonia
C. Pleural effusion
D. Emphysema
Answer: B
Rationale: Increased tactile fremitus occurs with consolidation of lung tissue, as seen in
pneumonia. Solid or fluid-filled tissue conducts sound vibrations more effectively than air-
filled tissue. Conversely, conditions like pneumothorax or emphysema would decrease
fremitus due to excess air blocking the transmission of sound.
, 4. A patient presents with a deep vein thrombosis (DVT). Which of the following is a classic
symptom the nurse would expect to find during the peripheral vascular assessment?
A. Cool, pale skin
B. Decreased pedal pulses
C. Unilateral edema and warmth
D. Bilateral pitting edema
Answer: C
Rationale: A deep vein thrombosis typically presents as unilateral swelling, redness, and
warmth in the affected extremity. While decreased pulses are associated with arterial
disease, venous issues cause congestion and edema. The nurse must prioritize this finding
as it represents a potential emergency due to the risk of pulmonary embolism.
5. Which anatomical landmark is used to locate the second intercostal space for cardiac
auscultation?
A. Xiphoid process
B. Suprasternal notch
C. Midclavicular line
D. Angle of Louis (Sternal Angle)
Answer: D
Assessment | Actual Q&A with Rationale
(NSG351 Exam 2) | James Madison
University
1. During a cardiac assessment, the nurse auscultates the heart at the apex. Which sound is
expected to be loudest in this location?
A. S2
B. S3
C. S1
D. S4
Answer: C
Rationale: The S1 heart sound corresponds to the closure of the atrioventricular valves
and is heard loudest at the apex. In contrast, S2 is loudest at the base of the heart due to the
closure of the semilunar valves. Understanding these landmarks is essential for accurate
cardiac cycle differentiation.
2. The nurse is preparing to assess a patient’s abdomen. What is the correct sequence of
assessment techniques to prevent altering clinical findings?
A. Inspection, Palpation, Percussion, Auscultation
B. Inspection, Percussion, Palpation, Auscultation
,C. Auscultation, Inspection, Percussion, Palpation
D. Inspection, Auscultation, Percussion, Palpation
Answer: D
Rationale: In abdominal assessment, auscultation must follow inspection but precede
percussion and palpation. This order is critical because physical manipulation of the
abdomen can increase peristalsis and result in false bowel sound recordings. Following this
standardized sequence ensures the most accurate representation of the patient’s
gastrointestinal status.
3. When palpating for tactile fremitus, the nurse notes increased vibrations over the right
lower lobe. Which condition is most likely associated with this finding?
A. Pneumothorax
B. Pneumonia
C. Pleural effusion
D. Emphysema
Answer: B
Rationale: Increased tactile fremitus occurs with consolidation of lung tissue, as seen in
pneumonia. Solid or fluid-filled tissue conducts sound vibrations more effectively than air-
filled tissue. Conversely, conditions like pneumothorax or emphysema would decrease
fremitus due to excess air blocking the transmission of sound.
, 4. A patient presents with a deep vein thrombosis (DVT). Which of the following is a classic
symptom the nurse would expect to find during the peripheral vascular assessment?
A. Cool, pale skin
B. Decreased pedal pulses
C. Unilateral edema and warmth
D. Bilateral pitting edema
Answer: C
Rationale: A deep vein thrombosis typically presents as unilateral swelling, redness, and
warmth in the affected extremity. While decreased pulses are associated with arterial
disease, venous issues cause congestion and edema. The nurse must prioritize this finding
as it represents a potential emergency due to the risk of pulmonary embolism.
5. Which anatomical landmark is used to locate the second intercostal space for cardiac
auscultation?
A. Xiphoid process
B. Suprasternal notch
C. Midclavicular line
D. Angle of Louis (Sternal Angle)
Answer: D
