NUR 2356 MDC 1 EXAM 2 2026/2027 | Multidimensional Care I
Quiz Bank | Rasmussen College | Pass Guaranteed - A+
Graded
SECTION 1: HEALTH ASSESSMENT & PHYSICAL EXAMINATION (25
Questions)
Q1: A 72-year-old patient is admitted with confusion. During the health history interview,
the nurse asks, "Can you tell me what brought you to the hospital today?" This is an
example of which interviewing technique?
A. Closed-ended questioning requiring a yes/no response
B. Open-ended questioning encouraging the patient to share information in their own
words
C. Leading question suggesting the expected answer
D. Confrontational question challenging the patient's perception
Correct Answer: B
Rationale: Open-ended questions begin with words like "what," "how," or "can you
describe" and allow patients to respond freely without limiting the response. This
technique establishes rapport, gathers comprehensive data, and encourages the patient
to prioritize their concerns. Closed-ended questions (A) would begin with "did" or "is"
and limit responses. Leading questions (C) suggest answers, and confrontational
questions (D) challenge the patient and damage therapeutic communication.
[CORRECT]
Q2: During a general survey, the nurse notes a patient has labored breathing, uses
accessory neck muscles, and sits leaning forward with hands on knees. This position is
known as:
,A. Orthopneic position, typically assumed to ease breathing in respiratory distress
B. Fowler's position, used to promote cardiac output
C. Trendelenburg position, used to increase cerebral perfusion
D. Prone position, used to improve ventilation-perfusion matching
Correct Answer: A
Rationale: The tripod or orthopneic position (leaning forward with arms supported on
knees or a table) is adopted by patients experiencing severe respiratory distress to
maximize chest expansion and use accessory muscles of respiration. This position
stabilizes the shoulder girdle and allows the diaphragm to function more efficiently.
Fowler's position (B) is a semi-recumbent bed position; Trendelenburg (C) is head-down;
prone (D) is lying face-down. [CORRECT]
Q3: The nurse is assessing a patient's skin and notes decreased skin turgor with tenting
that remains elevated after pinching. This finding is most consistent with:
A. Fluid volume excess and interstitial edema
B. Fluid volume deficit and dehydration
C. Normal age-related skin changes in an elderly patient
D. Peripheral vascular disease and arterial insufficiency
Correct Answer: B
Rationale: Poor skin turgor with tenting (skin remaining elevated after being pinched) is
a classic sign of fluid volume deficit and dehydration, indicating decreased interstitial
fluid and loss of tissue elasticity. While elderly patients may have some decreased
elasticity, pronounced tenting is abnormal and indicates dehydration. Fluid volume
excess (A) presents with edema; peripheral vascular disease (D) presents with cool,
pale skin and diminished pulses. [CORRECT]
Q4: During assessment of the temporal artery, the nurse palpates a pulse and notes it is
easily felt but not forceful. Using the standard pulse grading scale, this pulse would be
graded as:
A. 0 - absent, not palpable
B. 1+ - weak, thready, difficult to palpate
,C. 2+ - normal, easily palpable, not forceful
D. 3+ - full, increased, bounding
Correct Answer: C
Rationale: The standard pulse grading scale is: 0 = absent; 1+ = weak/thready; 2+ =
normal/easily palpable; 3+ = full/bounding; 4+ = forceful. A pulse that is easily felt but
not forceful is grade 2+, which is the expected normal finding. A 1+ pulse (B) would be
difficult to palpate and suggest poor perfusion; 3+ (D) would be bounding and suggest
fluid volume excess or other conditions. [CORRECT]
Q5: A patient reports chest pain. The nurse uses the PQRST method to assess the pain.
Which component of PQRST addresses "What makes the pain better or worse?"
A. P - Provocation/Palliation
B. Q - Quality
C. R - Radiation
D. S - Severity
Correct Answer: A
Rationale: The PQRST pain assessment mnemonic stands for: P =
Provocation/Palliation (what provokes or relieves the pain); Q = Quality (description like
sharp, dull, burning); R = Region/Radiation (location and where it spreads); S = Severity
(intensity using a 0-10 scale); T = Timing (onset, duration, frequency). Understanding
what palliates or provokes pain is essential for differential diagnosis and treatment
planning. [CORRECT]
Q6: The nurse is performing a respiratory assessment and auscultates breath sounds
over the peripheral lung fields that are soft, low-pitched, and heard during inspiration
without a pause. These are:
A. Bronchial breath sounds, heard over the trachea
B. Bronchovesicular breath sounds, heard over the mainstem bronchi
C. Vesicular breath sounds, heard over peripheral lung fields
D. Adventitious breath sounds indicating pathology
Correct Answer: C
, Rationale: Vesicular breath sounds are the normal sounds heard over the peripheral lung
fields. They are soft, low-pitched, heard primarily during inspiration, and have no pause
between inspiration and expiration. Bronchial sounds (A) are loud, high-pitched, and
heard over the trachea with a pause between phases. Bronchovesicular sounds (B) are
medium-pitched and heard over the mainstem bronchi. Adventitious sounds (D) are
abnormal and include crackles, wheezes, and rhonchi. [CORRECT]
Q7: During cardiovascular assessment, the nurse auscultates the heart and hears an
extra sound immediately after S2 during diastole. This is most consistent with:
A. S3 gallop, heard in early diastole and associated with heart failure
B. S4 gallop, heard in late diastole and associated with stiff ventricle
C. A systolic murmur indicating valvular regurgitation
D. A normal physiologic split S2 during inspiration
Correct Answer: A
Rationale: The S3 sound is an extra heart sound heard in early diastole immediately
after S2, producing a "Kentucky" rhythm (lub-dub-da). It is caused by rapid ventricular
filling and is normal in children and young adults but pathologic in adults over 40,
indicating heart failure or volume overload. S4 (B) occurs in late diastole before S1;
systolic murmurs (C) occur between S1 and S2; a split S2 (D) is a normal variation of
the second heart sound. [CORRECT]
Q8: The nurse is assessing a patient's abdomen and begins by auscultating bowel
sounds before palpating. The rationale for this sequence is:
A. Palpation before auscultation may alter bowel sound frequency and character
B. Auscultation must be performed before inspection to avoid patient anxiety
C. The American Nurses Association requires auscultation as the first step
D. Palpation causes peristalsis to increase, making sounds easier to hear
Correct Answer: A
Rationale: The correct sequence for abdominal assessment is inspection, auscultation,
percussion, then palpation. Palpation before auscultation can alter bowel sound
Quiz Bank | Rasmussen College | Pass Guaranteed - A+
Graded
SECTION 1: HEALTH ASSESSMENT & PHYSICAL EXAMINATION (25
Questions)
Q1: A 72-year-old patient is admitted with confusion. During the health history interview,
the nurse asks, "Can you tell me what brought you to the hospital today?" This is an
example of which interviewing technique?
A. Closed-ended questioning requiring a yes/no response
B. Open-ended questioning encouraging the patient to share information in their own
words
C. Leading question suggesting the expected answer
D. Confrontational question challenging the patient's perception
Correct Answer: B
Rationale: Open-ended questions begin with words like "what," "how," or "can you
describe" and allow patients to respond freely without limiting the response. This
technique establishes rapport, gathers comprehensive data, and encourages the patient
to prioritize their concerns. Closed-ended questions (A) would begin with "did" or "is"
and limit responses. Leading questions (C) suggest answers, and confrontational
questions (D) challenge the patient and damage therapeutic communication.
[CORRECT]
Q2: During a general survey, the nurse notes a patient has labored breathing, uses
accessory neck muscles, and sits leaning forward with hands on knees. This position is
known as:
,A. Orthopneic position, typically assumed to ease breathing in respiratory distress
B. Fowler's position, used to promote cardiac output
C. Trendelenburg position, used to increase cerebral perfusion
D. Prone position, used to improve ventilation-perfusion matching
Correct Answer: A
Rationale: The tripod or orthopneic position (leaning forward with arms supported on
knees or a table) is adopted by patients experiencing severe respiratory distress to
maximize chest expansion and use accessory muscles of respiration. This position
stabilizes the shoulder girdle and allows the diaphragm to function more efficiently.
Fowler's position (B) is a semi-recumbent bed position; Trendelenburg (C) is head-down;
prone (D) is lying face-down. [CORRECT]
Q3: The nurse is assessing a patient's skin and notes decreased skin turgor with tenting
that remains elevated after pinching. This finding is most consistent with:
A. Fluid volume excess and interstitial edema
B. Fluid volume deficit and dehydration
C. Normal age-related skin changes in an elderly patient
D. Peripheral vascular disease and arterial insufficiency
Correct Answer: B
Rationale: Poor skin turgor with tenting (skin remaining elevated after being pinched) is
a classic sign of fluid volume deficit and dehydration, indicating decreased interstitial
fluid and loss of tissue elasticity. While elderly patients may have some decreased
elasticity, pronounced tenting is abnormal and indicates dehydration. Fluid volume
excess (A) presents with edema; peripheral vascular disease (D) presents with cool,
pale skin and diminished pulses. [CORRECT]
Q4: During assessment of the temporal artery, the nurse palpates a pulse and notes it is
easily felt but not forceful. Using the standard pulse grading scale, this pulse would be
graded as:
A. 0 - absent, not palpable
B. 1+ - weak, thready, difficult to palpate
,C. 2+ - normal, easily palpable, not forceful
D. 3+ - full, increased, bounding
Correct Answer: C
Rationale: The standard pulse grading scale is: 0 = absent; 1+ = weak/thready; 2+ =
normal/easily palpable; 3+ = full/bounding; 4+ = forceful. A pulse that is easily felt but
not forceful is grade 2+, which is the expected normal finding. A 1+ pulse (B) would be
difficult to palpate and suggest poor perfusion; 3+ (D) would be bounding and suggest
fluid volume excess or other conditions. [CORRECT]
Q5: A patient reports chest pain. The nurse uses the PQRST method to assess the pain.
Which component of PQRST addresses "What makes the pain better or worse?"
A. P - Provocation/Palliation
B. Q - Quality
C. R - Radiation
D. S - Severity
Correct Answer: A
Rationale: The PQRST pain assessment mnemonic stands for: P =
Provocation/Palliation (what provokes or relieves the pain); Q = Quality (description like
sharp, dull, burning); R = Region/Radiation (location and where it spreads); S = Severity
(intensity using a 0-10 scale); T = Timing (onset, duration, frequency). Understanding
what palliates or provokes pain is essential for differential diagnosis and treatment
planning. [CORRECT]
Q6: The nurse is performing a respiratory assessment and auscultates breath sounds
over the peripheral lung fields that are soft, low-pitched, and heard during inspiration
without a pause. These are:
A. Bronchial breath sounds, heard over the trachea
B. Bronchovesicular breath sounds, heard over the mainstem bronchi
C. Vesicular breath sounds, heard over peripheral lung fields
D. Adventitious breath sounds indicating pathology
Correct Answer: C
, Rationale: Vesicular breath sounds are the normal sounds heard over the peripheral lung
fields. They are soft, low-pitched, heard primarily during inspiration, and have no pause
between inspiration and expiration. Bronchial sounds (A) are loud, high-pitched, and
heard over the trachea with a pause between phases. Bronchovesicular sounds (B) are
medium-pitched and heard over the mainstem bronchi. Adventitious sounds (D) are
abnormal and include crackles, wheezes, and rhonchi. [CORRECT]
Q7: During cardiovascular assessment, the nurse auscultates the heart and hears an
extra sound immediately after S2 during diastole. This is most consistent with:
A. S3 gallop, heard in early diastole and associated with heart failure
B. S4 gallop, heard in late diastole and associated with stiff ventricle
C. A systolic murmur indicating valvular regurgitation
D. A normal physiologic split S2 during inspiration
Correct Answer: A
Rationale: The S3 sound is an extra heart sound heard in early diastole immediately
after S2, producing a "Kentucky" rhythm (lub-dub-da). It is caused by rapid ventricular
filling and is normal in children and young adults but pathologic in adults over 40,
indicating heart failure or volume overload. S4 (B) occurs in late diastole before S1;
systolic murmurs (C) occur between S1 and S2; a split S2 (D) is a normal variation of
the second heart sound. [CORRECT]
Q8: The nurse is assessing a patient's abdomen and begins by auscultating bowel
sounds before palpating. The rationale for this sequence is:
A. Palpation before auscultation may alter bowel sound frequency and character
B. Auscultation must be performed before inspection to avoid patient anxiety
C. The American Nurses Association requires auscultation as the first step
D. Palpation causes peristalsis to increase, making sounds easier to hear
Correct Answer: A
Rationale: The correct sequence for abdominal assessment is inspection, auscultation,
percussion, then palpation. Palpation before auscultation can alter bowel sound
