NURS 6512 ADVANCED HEALTH
ASSESSMENT FINAL EXAM PREP
QUESTIONS AND VERIFIED ANSWERS |
100% CORRECT | GRADE A+
1. When assessing for tactile fremitus, the nurse practitioner expects to find the most intense
vibrations over which area?
A. The lung bases
B. The periphery of the lungs
C. The lower lobes posteriorly
D. The second intercostal space near the sternum
Answer: D
Conceptual Explanation: Tactile fremitus is most intense over the trachea and major
bronchi, specifically the second intercostal space near the sternum, because these areas are
closest to the source of sound.
2. A 65-year-old patient presents with a history of smoking and complains of a new,
persistent cough. During the physical exam, the NP notes a dull percussion note over the right
lower lobe. What is the most likely interpretation?
A. Normal lung tissue
,B. Pneumothorax
C. Emphysema
D. Pneumonia or consolidation
Answer: D
Conceptual Explanation: Dullness to percussion replaces resonance when fluid or solid
tissue replaces air-containing lung or occupies the pleural space, as seen in pneumonia,
pleural effusion, or tumors.
3. Which of the following physical exam findings is most suggestive of a tension
pneumothorax?
A. Tracheal deviation toward the affected side
B. Increased tactile fremitus
C. Tracheal deviation toward the unaffected side
D. Dullness to percussion
Answer: C
Conceptual Explanation: In a tension pneumothorax, air builds up in the pleural space,
increasing pressure and shifting the mediastinum and trachea toward the opposite
(unaffected) side.
, 4. During a cardiac assessment, the NP hears a low-pitched, mid-diastolic murmur at the apex
with the bell of the stethoscope. This most likely represents:
A. Mitral regurgitation
B. Aortic stenosis
C. Mitral stenosis
D. Aortic regurgitation
Answer: C
Conceptual Explanation: Mitral stenosis typically produces a low-pitched rumble heard in
mid-diastole at the apex, best heard with the bell of the stethoscope.
5. When grading a heart murmur, a grade 4/6 murmur is defined as:
A. Moderately loud with a palpable thrill
B. Very faint, heard only with effort
C. Loud with a thrill and heard with the stethoscope partially off the chest
D. Very loud with a thrill, heard with the stethoscope off the chest
Answer: A
Conceptual Explanation: Grade 4 murmurs are loud and are the first grade where a
palpable thrill is present.
6. A patient exhibits a positive Murphy sign. This finding is most clinical suggestive of:
A. Acute cholecystitis
ASSESSMENT FINAL EXAM PREP
QUESTIONS AND VERIFIED ANSWERS |
100% CORRECT | GRADE A+
1. When assessing for tactile fremitus, the nurse practitioner expects to find the most intense
vibrations over which area?
A. The lung bases
B. The periphery of the lungs
C. The lower lobes posteriorly
D. The second intercostal space near the sternum
Answer: D
Conceptual Explanation: Tactile fremitus is most intense over the trachea and major
bronchi, specifically the second intercostal space near the sternum, because these areas are
closest to the source of sound.
2. A 65-year-old patient presents with a history of smoking and complains of a new,
persistent cough. During the physical exam, the NP notes a dull percussion note over the right
lower lobe. What is the most likely interpretation?
A. Normal lung tissue
,B. Pneumothorax
C. Emphysema
D. Pneumonia or consolidation
Answer: D
Conceptual Explanation: Dullness to percussion replaces resonance when fluid or solid
tissue replaces air-containing lung or occupies the pleural space, as seen in pneumonia,
pleural effusion, or tumors.
3. Which of the following physical exam findings is most suggestive of a tension
pneumothorax?
A. Tracheal deviation toward the affected side
B. Increased tactile fremitus
C. Tracheal deviation toward the unaffected side
D. Dullness to percussion
Answer: C
Conceptual Explanation: In a tension pneumothorax, air builds up in the pleural space,
increasing pressure and shifting the mediastinum and trachea toward the opposite
(unaffected) side.
, 4. During a cardiac assessment, the NP hears a low-pitched, mid-diastolic murmur at the apex
with the bell of the stethoscope. This most likely represents:
A. Mitral regurgitation
B. Aortic stenosis
C. Mitral stenosis
D. Aortic regurgitation
Answer: C
Conceptual Explanation: Mitral stenosis typically produces a low-pitched rumble heard in
mid-diastole at the apex, best heard with the bell of the stethoscope.
5. When grading a heart murmur, a grade 4/6 murmur is defined as:
A. Moderately loud with a palpable thrill
B. Very faint, heard only with effort
C. Loud with a thrill and heard with the stethoscope partially off the chest
D. Very loud with a thrill, heard with the stethoscope off the chest
Answer: A
Conceptual Explanation: Grade 4 murmurs are loud and are the first grade where a
palpable thrill is present.
6. A patient exhibits a positive Murphy sign. This finding is most clinical suggestive of:
A. Acute cholecystitis
