NSG 300 EXAM 2 PREP: ADVANCED
HEALTH ASSESSMENT AND
PATHOPHYSIOLOGY
1. During a respiratory assessment, the nurse notes increased tactile fremitus over the right
lower lobe. Which condition is most likely responsible for this finding?
A. Pleural effusion
B. Lobar pneumonia
C. Pneumothorax
D. Chronic obstructive pulmonary disease
Answer: B
Conceptual Explanation: Tactile fremitus is increased when there is consolidation in the
lung tissue, such as in lobar pneumonia, because sound travels better through solid or
fluid-filled media than through air.
2. When auscultating heart sounds, the nurse identifies a ventricular gallop (S3) immediately
following S2. In which patient population is this finding most clinically significant for heart
failure?
A. A healthy 15-year-old athlete
,B. A 65-year-old with a history of hypertension
C. A pregnant woman in her third trimester
D. A 22-year-old with no medical history
Answer: B
Conceptual Explanation: While an S3 can be physiological in children, young adults, and
during pregnancy, in older adults it often indicates decreased ventricular compliance or
fluid overload, characteristic of heart failure.
3. While assessing the abdomen, the nurse performs the Murphy’s sign test. A positive result
is indicative of which condition?
A. Splenomegaly
B. Acute appendicitis
C. Acute cholecystitis
D. Peritonitis
Answer: C
Conceptual Explanation: Murphy’s sign is positive when a patient experiences sharp pain
and inspiration ceases as the nurse palpates the right upper quadrant under the liver
border; it is a classic sign of gallbladder inflammation.
, 4. A patient presents with a Glasgow Coma Scale (GCS) score of 7. How should the nurse
interpret this finding?
A. The patient is fully alert and oriented
B. The patient is in a deep coma or has a severe brain injury
C. The patient has a moderate head injury
D. The patient is lethargic but easily arousable
Answer: B
Conceptual Explanation: A GCS score of 8 or less is generally accepted as the definition of
a coma or severe brain injury, requiring immediate intervention such as airway protection.
5. During a neurological exam, the nurse asks the patient to identify a common object, such
as a key, placed in their hand while their eyes are closed. This tests for:
A. Stereognosis
B. Graphesthesia
C. Two-point discrimination
D. Proprioception
Answer: A
Conceptual Explanation: Stereognosis is the ability to recognize objects by feeling their
form, size, and weight with eyes closed, which tests the sensory cortex and posterior
columns.
HEALTH ASSESSMENT AND
PATHOPHYSIOLOGY
1. During a respiratory assessment, the nurse notes increased tactile fremitus over the right
lower lobe. Which condition is most likely responsible for this finding?
A. Pleural effusion
B. Lobar pneumonia
C. Pneumothorax
D. Chronic obstructive pulmonary disease
Answer: B
Conceptual Explanation: Tactile fremitus is increased when there is consolidation in the
lung tissue, such as in lobar pneumonia, because sound travels better through solid or
fluid-filled media than through air.
2. When auscultating heart sounds, the nurse identifies a ventricular gallop (S3) immediately
following S2. In which patient population is this finding most clinically significant for heart
failure?
A. A healthy 15-year-old athlete
,B. A 65-year-old with a history of hypertension
C. A pregnant woman in her third trimester
D. A 22-year-old with no medical history
Answer: B
Conceptual Explanation: While an S3 can be physiological in children, young adults, and
during pregnancy, in older adults it often indicates decreased ventricular compliance or
fluid overload, characteristic of heart failure.
3. While assessing the abdomen, the nurse performs the Murphy’s sign test. A positive result
is indicative of which condition?
A. Splenomegaly
B. Acute appendicitis
C. Acute cholecystitis
D. Peritonitis
Answer: C
Conceptual Explanation: Murphy’s sign is positive when a patient experiences sharp pain
and inspiration ceases as the nurse palpates the right upper quadrant under the liver
border; it is a classic sign of gallbladder inflammation.
, 4. A patient presents with a Glasgow Coma Scale (GCS) score of 7. How should the nurse
interpret this finding?
A. The patient is fully alert and oriented
B. The patient is in a deep coma or has a severe brain injury
C. The patient has a moderate head injury
D. The patient is lethargic but easily arousable
Answer: B
Conceptual Explanation: A GCS score of 8 or less is generally accepted as the definition of
a coma or severe brain injury, requiring immediate intervention such as airway protection.
5. During a neurological exam, the nurse asks the patient to identify a common object, such
as a key, placed in their hand while their eyes are closed. This tests for:
A. Stereognosis
B. Graphesthesia
C. Two-point discrimination
D. Proprioception
Answer: A
Conceptual Explanation: Stereognosis is the ability to recognize objects by feeling their
form, size, and weight with eyes closed, which tests the sensory cortex and posterior
columns.
