Wilkes University NSG 500 Advanced Health
Assessment | Exam 3 Q&A with Detailed
Rationales (2026 Update)
SECTION A: EXAMINATION TECHNIQUES & GENERAL
ASSESSMENT (Questions 1-25)
1. What is the correct order of steps for a physical examination of ALL body
systems EXCEPT the abdomen?
A. Palpate, inspect, percuss, auscultate
B. Inspect, palpate, percuss, auscultate
C. Auscultate, inspect, palpate, percuss
D. Inspect, palpate, auscultate, percuss
Answer: B. Inspect, palpate, percuss, auscultate
Rationale: The standard sequence for physical examination is inspection, palpation,
percussion, and auscultation (IPPA). The abdomen is the only exception where
auscultation is performed before palpation and percussion to avoid altering bowel sounds .
,2. Auscultation should be carried out last, except when examining which body
area?
A. The neck
B. The heart
C. The lungs
D. The abdomen
Answer: D. The abdomen
Rationale: The abdomen is the exception to the standard IPPA sequence. Auscultation is
performed before percussion and palpation because manipulating the abdomen can alter
bowel sounds, leading to inaccurate assessment .
3. During percussion, the downward snap of the striking fingers should originate
from which joint?
A. The elbow
B. The shoulder
C. The wrist
D. The finger joints
Answer: C. The wrist
Rationale: The striking motion in indirect percussion originates from the wrist, not the
elbow or shoulder. This allows for a quick, sharp, and controlled downward snap that
produces the best acoustic response .
4. To perform indirect percussion, the examiner should place which part of the
hand on the body surface?
,A. The palmar surface of the nondominant hand with fingers together
B. The palmar surface of the nondominant hand with fingers slightly spread apart
C. The ulnar surface of the nondominant hand with fingers together
D. The ulnar surface of the nondominant hand with fingers slightly spread apart
Answer: B. The palmar surface of the nondominant hand with fingers slightly
spread apart
Rationale: In indirect percussion, the palmar surface of the nondominant hand
(pleximeter) is placed firmly against the body surface with fingers slightly spread. The
middle finger of the dominant hand strikes the distal interphalangeal joint of the
pleximeter finger .
5. Which technique should the examiner use to facilitate assessment when breath
sounds and heart sounds are difficult to distinguish?
A. Anticipate the next sounds
B. Isolate each cycle segment
C. Listen to all sounds together
D. Move the stethoscope clockwise
Answer: B. Isolate each cycle segment
Rationale: When sounds are difficult to distinguish, isolating each cycle segment (e.g.,
listening to the first heart sound, then the second, then respirations separately) helps
differentiate overlapping sounds and improves diagnostic accuracy .
6. Which technique helps reduce visual distractions and improve auditory focus
during auscultation?
, A. Asking patients to describe their symptoms
B. Closing your eyes
C. Performing auscultation before percussion
D. Using an aneroid manometer
Answer: B. Closing your eyes
Rationale: Closing your eyes during auscultation helps reduce visual distractions and
allows you to focus more intently on the auditory information, thereby limiting your
perceptual field and improving your ability to detect subtle sounds .
7. What is the primary purpose of the whispered pectoriloquy test?
A. To assess for consolidation in the lungs
B. To evaluate diaphragmatic excursion
C. To detect pleural effusion
D. To assess bronchial breath sounds
Answer: A. To assess for consolidation in the lungs
Rationale: Whispered pectoriloquy tests for lung consolidation. When the patient whispers,
the sound is transmitted clearly through consolidated tissue, indicating pneumonia or
other causes of consolidation .
8. What does the term 'stridor' indicate during respiratory assessment?
A. Normal breath sounds
B. A low-pitched wheeze in the lung bases
C. A high-pitched wheezing sound indicating airway obstruction
D. Crackles in the lung apices
Assessment | Exam 3 Q&A with Detailed
Rationales (2026 Update)
SECTION A: EXAMINATION TECHNIQUES & GENERAL
ASSESSMENT (Questions 1-25)
1. What is the correct order of steps for a physical examination of ALL body
systems EXCEPT the abdomen?
A. Palpate, inspect, percuss, auscultate
B. Inspect, palpate, percuss, auscultate
C. Auscultate, inspect, palpate, percuss
D. Inspect, palpate, auscultate, percuss
Answer: B. Inspect, palpate, percuss, auscultate
Rationale: The standard sequence for physical examination is inspection, palpation,
percussion, and auscultation (IPPA). The abdomen is the only exception where
auscultation is performed before palpation and percussion to avoid altering bowel sounds .
,2. Auscultation should be carried out last, except when examining which body
area?
A. The neck
B. The heart
C. The lungs
D. The abdomen
Answer: D. The abdomen
Rationale: The abdomen is the exception to the standard IPPA sequence. Auscultation is
performed before percussion and palpation because manipulating the abdomen can alter
bowel sounds, leading to inaccurate assessment .
3. During percussion, the downward snap of the striking fingers should originate
from which joint?
A. The elbow
B. The shoulder
C. The wrist
D. The finger joints
Answer: C. The wrist
Rationale: The striking motion in indirect percussion originates from the wrist, not the
elbow or shoulder. This allows for a quick, sharp, and controlled downward snap that
produces the best acoustic response .
4. To perform indirect percussion, the examiner should place which part of the
hand on the body surface?
,A. The palmar surface of the nondominant hand with fingers together
B. The palmar surface of the nondominant hand with fingers slightly spread apart
C. The ulnar surface of the nondominant hand with fingers together
D. The ulnar surface of the nondominant hand with fingers slightly spread apart
Answer: B. The palmar surface of the nondominant hand with fingers slightly
spread apart
Rationale: In indirect percussion, the palmar surface of the nondominant hand
(pleximeter) is placed firmly against the body surface with fingers slightly spread. The
middle finger of the dominant hand strikes the distal interphalangeal joint of the
pleximeter finger .
5. Which technique should the examiner use to facilitate assessment when breath
sounds and heart sounds are difficult to distinguish?
A. Anticipate the next sounds
B. Isolate each cycle segment
C. Listen to all sounds together
D. Move the stethoscope clockwise
Answer: B. Isolate each cycle segment
Rationale: When sounds are difficult to distinguish, isolating each cycle segment (e.g.,
listening to the first heart sound, then the second, then respirations separately) helps
differentiate overlapping sounds and improves diagnostic accuracy .
6. Which technique helps reduce visual distractions and improve auditory focus
during auscultation?
, A. Asking patients to describe their symptoms
B. Closing your eyes
C. Performing auscultation before percussion
D. Using an aneroid manometer
Answer: B. Closing your eyes
Rationale: Closing your eyes during auscultation helps reduce visual distractions and
allows you to focus more intently on the auditory information, thereby limiting your
perceptual field and improving your ability to detect subtle sounds .
7. What is the primary purpose of the whispered pectoriloquy test?
A. To assess for consolidation in the lungs
B. To evaluate diaphragmatic excursion
C. To detect pleural effusion
D. To assess bronchial breath sounds
Answer: A. To assess for consolidation in the lungs
Rationale: Whispered pectoriloquy tests for lung consolidation. When the patient whispers,
the sound is transmitted clearly through consolidated tissue, indicating pneumonia or
other causes of consolidation .
8. What does the term 'stridor' indicate during respiratory assessment?
A. Normal breath sounds
B. A low-pitched wheeze in the lung bases
C. A high-pitched wheezing sound indicating airway obstruction
D. Crackles in the lung apices
