NUR 3490 Exam 1 – 2026 Update Foundations of
Medical-Surgical Nursing & Health Assessment Actual
Exam 2026/2027 Complete Exam-Style Questions with
Detailed Rationales | 100% Verified | Pass Guaranteed
– A+ Graded
Foundations of Health Assessment & Clinical Decision-Making –
Questions 1–15
Q1: When performing a physical examination of the abdomen, which sequence of
assessment techniques is correct?
A. Palpation, percussion, auscultation, inspection
B. Inspection, auscultation, palpation, percussion [CORRECT]
C. Percussion, inspection, palpation, auscultation
D. Auscultation, palpation, inspection, percussion
Correct Answer: B
Rationale: The best answer is B. For the abdomen, you always inspect first, then
auscultate before you touch anything, because palpation and percussion can alter bowel
sounds and give you a false reading. Once you've listened, palpation and percussion
follow in either order, but auscultation must come before manipulation.
Q2: Which of the following vital sign ranges is considered normal for a healthy adult at
rest?
,A. Temperature 36.5–37.5°C (97.7–99.5°F), HR 60–100 bpm, RR 12–20 breaths/min, BP
<140/90 mmHg
B. Temperature 35.8–36.2°C, HR 50–90 bpm, RR 10–18 breaths/min, BP <150/90 mmHg
C. Temperature 36.0–37.0°C (96.8–98.6°F), HR 60–100 bpm, RR 12–20 breaths/min, BP
<120/80 mmHg [CORRECT]
D. Temperature 37.0–38.0°C, HR 70–110 bpm, RR 16–24 breaths/min, BP <130/85
mmHg
Correct Answer: C
Rationale: The best answer is C. Normal body temperature typically runs around 36°C
to 37°C (though 98.6°F is just an average), heart rate sits between 60 and 100 beats per
minute, respiratory rate is 12 to 20, and while "normal" BP is ideally under 120/80, the
classic textbook normal range for a healthy adult at rest centers on these parameters.
Q3: A nurse documents: "Patient reports sharp chest pain rated 8/10 that worsens with
deep breathing." This statement is an example of which type of data?
A. Objective data obtained through physical examination
B. Subjective data obtained from the patient's self-report [CORRECT]
C. Secondary data obtained from the family member
D. Tertiary data obtained from the medical record
Correct Answer: B
Rationale: The best answer is B. Anything the patient tells you—symptoms, feelings,
pain ratings, descriptions of their experience—is subjective data because it comes from
their personal perspective and cannot be measured or observed directly by someone
else.
,Q4: During a cardiovascular assessment, the nurse auscultates the mitral valve area.
Where should the stethoscope be placed?
A. Second intercostal space at the right sternal border
B. Second intercostal space at the left sternal border
C. Fourth or fifth intercostal space at the left midclavicular line [CORRECT]
D. Third intercostal space at the left sternal border
Correct Answer: C
Rationale: The best answer is C. The mitral valve, also called the apical area, is best
heard at the point of maximal impulse, which is typically around the fifth intercostal
space at the left midclavicular line. The other locations correspond to the aortic,
pulmonic, and tricuspid areas.
Q5: A 42-year-old patient arrives for a routine physical. The nurse notes clubbing of the
fingernails. This finding is most commonly associated with which underlying condition?
A. Chronic liver disease
B. Chronic hypoxemia or cardiopulmonary disease [CORRECT]
C. Acute renal failure
D. Hyperthyroidism
Correct Answer: B
Rationale: The best answer is B. Clubbing develops gradually when tissues are deprived
of adequate oxygen over a long time, so you'll see it in conditions like COPD, cystic
fibrosis, lung cancer, or congenital heart disease. It is not an acute finding and does not
point to renal or thyroid disorders.
, Q6: The nurse is assessing a patient who has been vomiting for three days. Which
assessment finding warrants the most immediate follow-up?
A. Dry mucous membranes and poor skin turgor
B. Capillary refill time of 3 seconds
C. Heart rate of 118 bpm with orthostatic hypotension [CORRECT]
D. Decreased bowel sounds in all quadrants
Correct Answer: C
Rationale: The best answer is C. While all these findings matter, a tachycardic heart rate
combined with orthostatic hypotension tells you the patient has moved beyond mild
dehydration into significant intravascular volume depletion, which can progress to
hypovolemic shock if not addressed quickly. This is the finding that demands immediate
fluid resuscitation and provider notification.
Q7: During a respiratory assessment, the nurse hears high-pitched musical sounds
during expiration that are prolonged. How should this finding be documented?
A. Crackles heard bilaterally at the lung bases
B. Wheezes noted on expiration [CORRECT]
C. Rhonchi auscultated in the upper lobes
D. Pleural friction rub over the anterior chest
Correct Answer: B
Rationale: The best answer is B. Wheezes are exactly what you just described—high-
pitched, musical, whistling sounds that occur when airways are narrowed, and they are
typically more pronounced during expiration because that is when airway compression
is greatest. Crackles sound like popping or bubbling, rhonchi are lower-pitched and
rattling, and a pleural rub sounds like leather rubbing together.
Medical-Surgical Nursing & Health Assessment Actual
Exam 2026/2027 Complete Exam-Style Questions with
Detailed Rationales | 100% Verified | Pass Guaranteed
– A+ Graded
Foundations of Health Assessment & Clinical Decision-Making –
Questions 1–15
Q1: When performing a physical examination of the abdomen, which sequence of
assessment techniques is correct?
A. Palpation, percussion, auscultation, inspection
B. Inspection, auscultation, palpation, percussion [CORRECT]
C. Percussion, inspection, palpation, auscultation
D. Auscultation, palpation, inspection, percussion
Correct Answer: B
Rationale: The best answer is B. For the abdomen, you always inspect first, then
auscultate before you touch anything, because palpation and percussion can alter bowel
sounds and give you a false reading. Once you've listened, palpation and percussion
follow in either order, but auscultation must come before manipulation.
Q2: Which of the following vital sign ranges is considered normal for a healthy adult at
rest?
,A. Temperature 36.5–37.5°C (97.7–99.5°F), HR 60–100 bpm, RR 12–20 breaths/min, BP
<140/90 mmHg
B. Temperature 35.8–36.2°C, HR 50–90 bpm, RR 10–18 breaths/min, BP <150/90 mmHg
C. Temperature 36.0–37.0°C (96.8–98.6°F), HR 60–100 bpm, RR 12–20 breaths/min, BP
<120/80 mmHg [CORRECT]
D. Temperature 37.0–38.0°C, HR 70–110 bpm, RR 16–24 breaths/min, BP <130/85
mmHg
Correct Answer: C
Rationale: The best answer is C. Normal body temperature typically runs around 36°C
to 37°C (though 98.6°F is just an average), heart rate sits between 60 and 100 beats per
minute, respiratory rate is 12 to 20, and while "normal" BP is ideally under 120/80, the
classic textbook normal range for a healthy adult at rest centers on these parameters.
Q3: A nurse documents: "Patient reports sharp chest pain rated 8/10 that worsens with
deep breathing." This statement is an example of which type of data?
A. Objective data obtained through physical examination
B. Subjective data obtained from the patient's self-report [CORRECT]
C. Secondary data obtained from the family member
D. Tertiary data obtained from the medical record
Correct Answer: B
Rationale: The best answer is B. Anything the patient tells you—symptoms, feelings,
pain ratings, descriptions of their experience—is subjective data because it comes from
their personal perspective and cannot be measured or observed directly by someone
else.
,Q4: During a cardiovascular assessment, the nurse auscultates the mitral valve area.
Where should the stethoscope be placed?
A. Second intercostal space at the right sternal border
B. Second intercostal space at the left sternal border
C. Fourth or fifth intercostal space at the left midclavicular line [CORRECT]
D. Third intercostal space at the left sternal border
Correct Answer: C
Rationale: The best answer is C. The mitral valve, also called the apical area, is best
heard at the point of maximal impulse, which is typically around the fifth intercostal
space at the left midclavicular line. The other locations correspond to the aortic,
pulmonic, and tricuspid areas.
Q5: A 42-year-old patient arrives for a routine physical. The nurse notes clubbing of the
fingernails. This finding is most commonly associated with which underlying condition?
A. Chronic liver disease
B. Chronic hypoxemia or cardiopulmonary disease [CORRECT]
C. Acute renal failure
D. Hyperthyroidism
Correct Answer: B
Rationale: The best answer is B. Clubbing develops gradually when tissues are deprived
of adequate oxygen over a long time, so you'll see it in conditions like COPD, cystic
fibrosis, lung cancer, or congenital heart disease. It is not an acute finding and does not
point to renal or thyroid disorders.
, Q6: The nurse is assessing a patient who has been vomiting for three days. Which
assessment finding warrants the most immediate follow-up?
A. Dry mucous membranes and poor skin turgor
B. Capillary refill time of 3 seconds
C. Heart rate of 118 bpm with orthostatic hypotension [CORRECT]
D. Decreased bowel sounds in all quadrants
Correct Answer: C
Rationale: The best answer is C. While all these findings matter, a tachycardic heart rate
combined with orthostatic hypotension tells you the patient has moved beyond mild
dehydration into significant intravascular volume depletion, which can progress to
hypovolemic shock if not addressed quickly. This is the finding that demands immediate
fluid resuscitation and provider notification.
Q7: During a respiratory assessment, the nurse hears high-pitched musical sounds
during expiration that are prolonged. How should this finding be documented?
A. Crackles heard bilaterally at the lung bases
B. Wheezes noted on expiration [CORRECT]
C. Rhonchi auscultated in the upper lobes
D. Pleural friction rub over the anterior chest
Correct Answer: B
Rationale: The best answer is B. Wheezes are exactly what you just described—high-
pitched, musical, whistling sounds that occur when airways are narrowed, and they are
typically more pronounced during expiration because that is when airway compression
is greatest. Crackles sound like popping or bubbling, rhonchi are lower-pitched and
rattling, and a pleural rub sounds like leather rubbing together.
