NURS 5220 ADVANCED HEALTH
ASSESSMENT AND DIAGNOSTIC
REASONING — EXAM 2 QUESTIONS
AND CORRECT ANSWERS WITH
EXPLANATIONS JUST RELEASED
1. A 72-year-old male presents with exertional dyspnea and syncope. On auscultation, a harsh
systolic crescendo-decrescendo murmur is heard at the second right intercostal space,
radiating to the carotids. Which diagnosis is most likely?
A. Mitral Regurgitation
B. Pulmonic Stenosis
C. Aortic Stenosis
D. Aortic Regurgitation
Answer: C
Conceptual Explanation: Aortic stenosis classically presents with a harsh systolic
crescendo-decrescendo murmur at the right upper sternal border that radiates to the
carotid arteries.
,2. During a physical examination, the clinician notes a low-pitched extra heart sound heard in
early diastole at the apex using the bell of the stethoscope. This finding is most consistent
with:
A. S3 heart sound
B. S4 heart sound
C. Mitral opening snap
D. Pericardial friction rub
Answer: A
Conceptual Explanation: S3, or the ventricular gallop, occurs during the rapid ventricular
filling phase of early diastole and is often associated with heart failure or volume overload.
3. Which physical examination finding is most specific for a diagnosis of pleural effusion
during lung percussion and auscultation?
A. Hyperresonance and increased tactile fremitus
B. Resonance and vesicular breath sounds
C. Dullness to percussion and increased tactile fremitus
D. Dullness to percussion and decreased tactile fremitus
Answer: D
, Conceptual Explanation: Pleural effusion causes dullness to percussion because of the
fluid and decreased tactile fremitus because the fluid blocks the transmission of sound
from the lung to the chest wall.
4. A patient presents with sharp, stabbing chest pain that is relieved by leaning forward. A
high-pitched, scratchy sound is heard at the left lower sternal border during both systole and
diastole. What is the most likely diagnosis?
A. Acute Myocardial Infarction
B. Pneumothorax
C. Pleural Effusion
D. Acute Pericarditis
Answer: D
Conceptual Explanation: Acute pericarditis typically presents with pleuritic chest pain
relieved by sitting up and leaning forward, and the hallmark physical sign is a pericardial
friction rub.
5. When assessing Jugular Venous Pressure (JVP), the vertical distance is measured from the
sternal angle. What is considered the upper limit of normal for this measurement?
A. 3-4 cm
B. 1-2 cm
C. 5-6 cm
ASSESSMENT AND DIAGNOSTIC
REASONING — EXAM 2 QUESTIONS
AND CORRECT ANSWERS WITH
EXPLANATIONS JUST RELEASED
1. A 72-year-old male presents with exertional dyspnea and syncope. On auscultation, a harsh
systolic crescendo-decrescendo murmur is heard at the second right intercostal space,
radiating to the carotids. Which diagnosis is most likely?
A. Mitral Regurgitation
B. Pulmonic Stenosis
C. Aortic Stenosis
D. Aortic Regurgitation
Answer: C
Conceptual Explanation: Aortic stenosis classically presents with a harsh systolic
crescendo-decrescendo murmur at the right upper sternal border that radiates to the
carotid arteries.
,2. During a physical examination, the clinician notes a low-pitched extra heart sound heard in
early diastole at the apex using the bell of the stethoscope. This finding is most consistent
with:
A. S3 heart sound
B. S4 heart sound
C. Mitral opening snap
D. Pericardial friction rub
Answer: A
Conceptual Explanation: S3, or the ventricular gallop, occurs during the rapid ventricular
filling phase of early diastole and is often associated with heart failure or volume overload.
3. Which physical examination finding is most specific for a diagnosis of pleural effusion
during lung percussion and auscultation?
A. Hyperresonance and increased tactile fremitus
B. Resonance and vesicular breath sounds
C. Dullness to percussion and increased tactile fremitus
D. Dullness to percussion and decreased tactile fremitus
Answer: D
, Conceptual Explanation: Pleural effusion causes dullness to percussion because of the
fluid and decreased tactile fremitus because the fluid blocks the transmission of sound
from the lung to the chest wall.
4. A patient presents with sharp, stabbing chest pain that is relieved by leaning forward. A
high-pitched, scratchy sound is heard at the left lower sternal border during both systole and
diastole. What is the most likely diagnosis?
A. Acute Myocardial Infarction
B. Pneumothorax
C. Pleural Effusion
D. Acute Pericarditis
Answer: D
Conceptual Explanation: Acute pericarditis typically presents with pleuritic chest pain
relieved by sitting up and leaning forward, and the hallmark physical sign is a pericardial
friction rub.
5. When assessing Jugular Venous Pressure (JVP), the vertical distance is measured from the
sternal angle. What is considered the upper limit of normal for this measurement?
A. 3-4 cm
B. 1-2 cm
C. 5-6 cm
