NURS 612 Exam 2 – Comprehensive
Practice Test
Module: Respiratory Assessment
1. A patient presents with a cough. Which historical question is most pertinent to
determining the cause?
A) "What is your daily fluid intake?"
B) "What is the nature of your cough?"
C) "Have you ever had pneumonia before?"
D) "What are your typical stress levels?"
Rationale: Determining if the cough is dry, productive, hacking, or brassy helps narrow the
differential diagnosis. The nature of the cough is a key initial historical data point .
2. You are assessing a patient's respirations. They are breathing at a rate of 10
breaths per minute but are deep and regular. This is documented as:
A) Tachypnea
B) Bradypnea
C) Hyperventilation
D) Apnea
Rationale: Bradypnea is the term for a respiratory rate of less than 12 breaths per minute .
3. A patient with a history of heart failure is noted to have a breathing pattern of
crescendo-decrescendo respirations followed by a period of apnea. This is known
as:
A) Biot respirations
B) Kussmaul respirations
C) Cheyne-Stokes respirations
D) Apneustic breathing
Rationale: Cheyne-Stokes is characterized by a regular, cyclic waxing and waning of
,respiratory depth, alternating with periods of apnea, often seen in patients with severe
cardiac or neurological conditions .
4. A patient with severe metabolic acidosis is likely to exhibit which type of
respiratory pattern?
A) Hypopnea
B) Kussmaul respirations
C) Biot respirations
D) Bradypnea
Rationale: Kussmaul respirations are deep and labored, often rapid, as the body attempts to
compensate for acidosis by "blowing off" carbon dioxide .
5. When inspecting the chest of a patient with a chronic respiratory condition, the
nurse notes a localized prominence of the ribs. This finding is best documented
during which step of the assessment?
A) Palpation for tactile fremitus
B) Auscultation of breath sounds
C) Inspection of thoracic landmarks
D) Percussion of lung fields
Rationale: Inspection of the chest includes observing the shape and symmetry, thoracic
landmarks (like ribs), and skin characteristics .
Module: Cardiac Assessment
6. Dextrocardia is a condition best characterized by:
A) An enlarged right side of the heart.
B) The heart being positioned to the right, either rotated or displaced.
C) The heart being positioned to the left of the stomach.
D) A congenital absence of the pericardium.
Rationale: Dextrocardia refers to the heart being situated in the right hemithorax, which may
be due to displacement or congenital malposition .
7. While auscultating the heart of an obese patient, the examiner should expect
the heart sounds to be:
A) Louder and closer.
B) Softer and more distant.
C) Louder and more distant.
D) Unchanged compared to a non-obese patient.
Rationale: Increased adipose tissue in the chest wall acts as an insulator, dampening the
transmission of sound and making heart sounds seem softer and more distant .
, 8. An examiner is unable to palpate a patient's apical pulse, and the heart sounds
are very faint. This should prompt the examiner to consider:
A) Congestive heart failure.
B) Mitral valve regurgitation.
C) Pleural or pericardial fluid.
D) Aortic stenosis.
Rationale: Fluid in the pleural or pericardial space can significantly dampen the transmission
of cardiac pulsations and sounds, making them difficult to palpate and auscultate .
9. A patient reports a several-week history of fever and shows clinical symptoms of
congestive heart failure. Which disease process should be high on the differential?
A) Myocarditis
B) Bacterial endocarditis
C) Cardiac tamponade
D) Acute myocardial infarction
Rationale: The combination of prolonged fever and signs of heart failure is classic for
infective endocarditis, which can damage heart valves and lead to failure .
10. In most adults, the apical impulse (PMI) should be visible and palpable at the:
A) Midaxillary line in the fifth right intercostal space.
B) Midclavicular line in the fifth left intercostal space.
C) Sternal notch.
D) Fourth intercostal space, left sternal border.
Rationale: The PMI is normally located at or near the midclavicular line in the 5th left
intercostal space. Displacement from this location can indicate cardiac enlargement .
11. While palpating the precordium, a heave is identified with lateral displacement
of the apical pulse. Such a finding may indicate:
A) Mitral regurgitation.
B) Aortic stenosis.
C) Left ventricular enlargement.
D) Pericarditis.
Rationale: A heave (or lift) is a sustained, forceful thrusting sensation. When accompanied by
a laterally displaced PMI, it is a strong indicator of left ventricular hypertrophy .
12. The examiner suspects a patient has pulmonary hypertension. What
auscultatory findings are consistent with this?
A) Decreased intensity of S1; increased intensity of S2.
B) A loud S3 gallop.
C) Paradoxic splitting of S1 and S2.
D) A pericardial friction rub.
Practice Test
Module: Respiratory Assessment
1. A patient presents with a cough. Which historical question is most pertinent to
determining the cause?
A) "What is your daily fluid intake?"
B) "What is the nature of your cough?"
C) "Have you ever had pneumonia before?"
D) "What are your typical stress levels?"
Rationale: Determining if the cough is dry, productive, hacking, or brassy helps narrow the
differential diagnosis. The nature of the cough is a key initial historical data point .
2. You are assessing a patient's respirations. They are breathing at a rate of 10
breaths per minute but are deep and regular. This is documented as:
A) Tachypnea
B) Bradypnea
C) Hyperventilation
D) Apnea
Rationale: Bradypnea is the term for a respiratory rate of less than 12 breaths per minute .
3. A patient with a history of heart failure is noted to have a breathing pattern of
crescendo-decrescendo respirations followed by a period of apnea. This is known
as:
A) Biot respirations
B) Kussmaul respirations
C) Cheyne-Stokes respirations
D) Apneustic breathing
Rationale: Cheyne-Stokes is characterized by a regular, cyclic waxing and waning of
,respiratory depth, alternating with periods of apnea, often seen in patients with severe
cardiac or neurological conditions .
4. A patient with severe metabolic acidosis is likely to exhibit which type of
respiratory pattern?
A) Hypopnea
B) Kussmaul respirations
C) Biot respirations
D) Bradypnea
Rationale: Kussmaul respirations are deep and labored, often rapid, as the body attempts to
compensate for acidosis by "blowing off" carbon dioxide .
5. When inspecting the chest of a patient with a chronic respiratory condition, the
nurse notes a localized prominence of the ribs. This finding is best documented
during which step of the assessment?
A) Palpation for tactile fremitus
B) Auscultation of breath sounds
C) Inspection of thoracic landmarks
D) Percussion of lung fields
Rationale: Inspection of the chest includes observing the shape and symmetry, thoracic
landmarks (like ribs), and skin characteristics .
Module: Cardiac Assessment
6. Dextrocardia is a condition best characterized by:
A) An enlarged right side of the heart.
B) The heart being positioned to the right, either rotated or displaced.
C) The heart being positioned to the left of the stomach.
D) A congenital absence of the pericardium.
Rationale: Dextrocardia refers to the heart being situated in the right hemithorax, which may
be due to displacement or congenital malposition .
7. While auscultating the heart of an obese patient, the examiner should expect
the heart sounds to be:
A) Louder and closer.
B) Softer and more distant.
C) Louder and more distant.
D) Unchanged compared to a non-obese patient.
Rationale: Increased adipose tissue in the chest wall acts as an insulator, dampening the
transmission of sound and making heart sounds seem softer and more distant .
, 8. An examiner is unable to palpate a patient's apical pulse, and the heart sounds
are very faint. This should prompt the examiner to consider:
A) Congestive heart failure.
B) Mitral valve regurgitation.
C) Pleural or pericardial fluid.
D) Aortic stenosis.
Rationale: Fluid in the pleural or pericardial space can significantly dampen the transmission
of cardiac pulsations and sounds, making them difficult to palpate and auscultate .
9. A patient reports a several-week history of fever and shows clinical symptoms of
congestive heart failure. Which disease process should be high on the differential?
A) Myocarditis
B) Bacterial endocarditis
C) Cardiac tamponade
D) Acute myocardial infarction
Rationale: The combination of prolonged fever and signs of heart failure is classic for
infective endocarditis, which can damage heart valves and lead to failure .
10. In most adults, the apical impulse (PMI) should be visible and palpable at the:
A) Midaxillary line in the fifth right intercostal space.
B) Midclavicular line in the fifth left intercostal space.
C) Sternal notch.
D) Fourth intercostal space, left sternal border.
Rationale: The PMI is normally located at or near the midclavicular line in the 5th left
intercostal space. Displacement from this location can indicate cardiac enlargement .
11. While palpating the precordium, a heave is identified with lateral displacement
of the apical pulse. Such a finding may indicate:
A) Mitral regurgitation.
B) Aortic stenosis.
C) Left ventricular enlargement.
D) Pericarditis.
Rationale: A heave (or lift) is a sustained, forceful thrusting sensation. When accompanied by
a laterally displaced PMI, it is a strong indicator of left ventricular hypertrophy .
12. The examiner suspects a patient has pulmonary hypertension. What
auscultatory findings are consistent with this?
A) Decreased intensity of S1; increased intensity of S2.
B) A loud S3 gallop.
C) Paradoxic splitting of S1 and S2.
D) A pericardial friction rub.
