NUR 6001 Exam 2
Advanced Health Assessment
William Paterson University (WPU)
2026/2027 | Newly Released
Verified Q & A with Rationales |100% Guaranteed Pass | Graded A+
Q1: A 68-year-old male presents for a cardiovascular assessment. On auscultation, you hear a
holosystolic murmur best heard at the apex that radiates to the axilla. The murmur intensity is
grade III/VI. Which valvular lesion is most consistent with these findings?
A. Aortic stenosis
B. Mitral regurgitation
C. Tricuspid regurgitation
D. Pulmonic stenosis
Correct Answer: B
Rationale: Correct because mitral regurgitation (MR) produces a holosystolic (pansystolic)
murmur heard best at the apex (5th intercostal space, midclavicular line) that characteristically
radiates to the axilla. Aortic stenosis is a crescendo-decrescendo systolic murmur at the right
2nd intercostal space radiating to the carotids, tricuspid regurgitation is holosystolic at the left
lower sternal border, and pulmonic stenosis is a crescendo-decrescendo murmur at the left 2nd
intercostal space. Recognizing murmur location, timing, and radiation is essential for WPU
NUR 6001 Exam 2.
Q2: During respiratory assessment, you hear continuous, high-pitched musical sounds
predominantly during expiration in a patient with a history of asthma. The sounds are
polyphonic (multiple pitches). Which adventitious breath sound does this describe?
A. Fine crackles
B. Monophonic wheezes
C. Polyphonic wheezes
D. Stridor
,Correct Answer: C
Rationale: Correct because polyphonic wheezes are continuous, high-pitched musical sounds
heard primarily during expiration (though they may become inspiratory and expiratory with
worsening obstruction) and are caused by air passing through diffusely narrowed airways, as
seen in asthma and COPD. The presence of multiple pitches indicates diffuse airway narrowing
rather than a single fixed obstruction. Fine crackles are discontinuous popping sounds,
monophonic wheezes suggest a single airway obstruction, and stridor is a high-pitched
inspiratory sound indicating upper airway obstruction.
Q3: A 45-year-old female presents with severe right upper quadrant pain, fever, and nausea.
During abdominal assessment, you palpate below the right costal margin at the midclavicular
line and ask the patient to take a deep breath. The patient abruptly stops inhaling due to pain.
Which sign is this, and what does it indicate?
A. Rovsing's sign; appendicitis
B. Murphy's sign; acute cholecystitis
C. McBurney's sign; appendicitis
D. Psoas sign; retrocecal appendicitis
Correct Answer: B
Rationale: Correct because Murphy's sign is positive when the patient experiences inspiratory
arrest (abrupt cessation of inspiration) during deep palpation of the right upper quadrant at the
midclavicular line (gallbladder point), indicating acute cholecystitis. The inflamed gallbladder
descends during inspiration and contacts the examining hand, causing pain. Rovsing's sign
involves LLQ palpation causing RLQ pain, McBurney's point is a specific location for
appendicitis tenderness, and the psoas sign involves pain with right hip extension.
Q4: A nurse performs an Ankle-Brachial Index (ABI) on a patient with leg claudication. The
highest brachial systolic pressure is 140 mmHg. The highest ankle systolic pressure (dorsalis
pedis) is 105 mmHg. What is the ABI, and how should it be interpreted?
A. ABI = 0.75; severe peripheral arterial disease (PAD)
B. ABI = 0.75; moderate peripheral arterial disease (PAD)
C. ABI = 1.33; normal
D. ABI = 0.95; borderline PAD
Correct Answer: B
Rationale: Correct because the ABI is calculated as the highest ankle systolic pressure divided by
the highest brachial systolic pressure: 105 ÷ 140 = 0.75. An ABI of 0.41–0.90 indicates moderate
, PAD. An ABI ≤ 0.40 indicates severe PAD, 0.91–0.99 is borderline/mild PAD, 1.0–1.4 is normal,
and ≥ 1.4 suggests non-compressible vessels. This calculation and interpretation is a high-yield
WPU NUR 6001 Exam 2 skill.
Q5: During respiratory assessment, you percuss the right lower lung field and note a dull sound.
Tactile fremitus is increased over the same area. Which condition is most consistent with these
findings?
A. Pneumothorax
B. Pleural effusion
C. Consolidation (e.g., pneumonia)
D. Emphysema
Correct Answer: C
Rationale: Correct because consolidation produces dullness to percussion (because fluid/solid
tissue replaces air) and increased tactile fremitus (because sound transmits better through
consolidated tissue than through air). Pneumothorax produces hyperresonance and decreased
fremitus, pleural effusion produces dullness but decreased fremitus (fluid blocks transmission),
and emphysema produces hyperresonance with decreased fremitus. This combination of
findings is a classic WPU exam pattern for identifying consolidation.
Q6: On cardiovascular assessment, the nurse palpates the Point of Maximal Impulse (PMI) and
finds it displaced laterally to the left anterior axillary line, measuring 4 cm in diameter. Which
condition does this most likely indicate?
A. Left ventricular hypertrophy from chronic hypertension
B. Left ventricular enlargement from volume overload (e.g., mitral regurgitation)
C. Right ventricular hypertrophy from pulmonary hypertension
D. Normal PMI variation
Correct Answer: B
Rationale: Correct because lateral displacement of the PMI beyond the left midclavicular line
with an increased diameter (>3 cm) indicates left ventricular enlargement (dilation), which
occurs with volume overload states such as mitral regurgitation, aortic regurgitation, or heart
failure. Left ventricular hypertrophy from pressure overload (e.g., aortic stenosis, hypertension)
causes inferior and lateral displacement with a sustained (prolonged duration) impulse but not
necessarily lateral displacement alone. A normal PMI is ≤2–3 cm at the 5th intercostal space,
left midclavicular line.
Advanced Health Assessment
William Paterson University (WPU)
2026/2027 | Newly Released
Verified Q & A with Rationales |100% Guaranteed Pass | Graded A+
Q1: A 68-year-old male presents for a cardiovascular assessment. On auscultation, you hear a
holosystolic murmur best heard at the apex that radiates to the axilla. The murmur intensity is
grade III/VI. Which valvular lesion is most consistent with these findings?
A. Aortic stenosis
B. Mitral regurgitation
C. Tricuspid regurgitation
D. Pulmonic stenosis
Correct Answer: B
Rationale: Correct because mitral regurgitation (MR) produces a holosystolic (pansystolic)
murmur heard best at the apex (5th intercostal space, midclavicular line) that characteristically
radiates to the axilla. Aortic stenosis is a crescendo-decrescendo systolic murmur at the right
2nd intercostal space radiating to the carotids, tricuspid regurgitation is holosystolic at the left
lower sternal border, and pulmonic stenosis is a crescendo-decrescendo murmur at the left 2nd
intercostal space. Recognizing murmur location, timing, and radiation is essential for WPU
NUR 6001 Exam 2.
Q2: During respiratory assessment, you hear continuous, high-pitched musical sounds
predominantly during expiration in a patient with a history of asthma. The sounds are
polyphonic (multiple pitches). Which adventitious breath sound does this describe?
A. Fine crackles
B. Monophonic wheezes
C. Polyphonic wheezes
D. Stridor
,Correct Answer: C
Rationale: Correct because polyphonic wheezes are continuous, high-pitched musical sounds
heard primarily during expiration (though they may become inspiratory and expiratory with
worsening obstruction) and are caused by air passing through diffusely narrowed airways, as
seen in asthma and COPD. The presence of multiple pitches indicates diffuse airway narrowing
rather than a single fixed obstruction. Fine crackles are discontinuous popping sounds,
monophonic wheezes suggest a single airway obstruction, and stridor is a high-pitched
inspiratory sound indicating upper airway obstruction.
Q3: A 45-year-old female presents with severe right upper quadrant pain, fever, and nausea.
During abdominal assessment, you palpate below the right costal margin at the midclavicular
line and ask the patient to take a deep breath. The patient abruptly stops inhaling due to pain.
Which sign is this, and what does it indicate?
A. Rovsing's sign; appendicitis
B. Murphy's sign; acute cholecystitis
C. McBurney's sign; appendicitis
D. Psoas sign; retrocecal appendicitis
Correct Answer: B
Rationale: Correct because Murphy's sign is positive when the patient experiences inspiratory
arrest (abrupt cessation of inspiration) during deep palpation of the right upper quadrant at the
midclavicular line (gallbladder point), indicating acute cholecystitis. The inflamed gallbladder
descends during inspiration and contacts the examining hand, causing pain. Rovsing's sign
involves LLQ palpation causing RLQ pain, McBurney's point is a specific location for
appendicitis tenderness, and the psoas sign involves pain with right hip extension.
Q4: A nurse performs an Ankle-Brachial Index (ABI) on a patient with leg claudication. The
highest brachial systolic pressure is 140 mmHg. The highest ankle systolic pressure (dorsalis
pedis) is 105 mmHg. What is the ABI, and how should it be interpreted?
A. ABI = 0.75; severe peripheral arterial disease (PAD)
B. ABI = 0.75; moderate peripheral arterial disease (PAD)
C. ABI = 1.33; normal
D. ABI = 0.95; borderline PAD
Correct Answer: B
Rationale: Correct because the ABI is calculated as the highest ankle systolic pressure divided by
the highest brachial systolic pressure: 105 ÷ 140 = 0.75. An ABI of 0.41–0.90 indicates moderate
, PAD. An ABI ≤ 0.40 indicates severe PAD, 0.91–0.99 is borderline/mild PAD, 1.0–1.4 is normal,
and ≥ 1.4 suggests non-compressible vessels. This calculation and interpretation is a high-yield
WPU NUR 6001 Exam 2 skill.
Q5: During respiratory assessment, you percuss the right lower lung field and note a dull sound.
Tactile fremitus is increased over the same area. Which condition is most consistent with these
findings?
A. Pneumothorax
B. Pleural effusion
C. Consolidation (e.g., pneumonia)
D. Emphysema
Correct Answer: C
Rationale: Correct because consolidation produces dullness to percussion (because fluid/solid
tissue replaces air) and increased tactile fremitus (because sound transmits better through
consolidated tissue than through air). Pneumothorax produces hyperresonance and decreased
fremitus, pleural effusion produces dullness but decreased fremitus (fluid blocks transmission),
and emphysema produces hyperresonance with decreased fremitus. This combination of
findings is a classic WPU exam pattern for identifying consolidation.
Q6: On cardiovascular assessment, the nurse palpates the Point of Maximal Impulse (PMI) and
finds it displaced laterally to the left anterior axillary line, measuring 4 cm in diameter. Which
condition does this most likely indicate?
A. Left ventricular hypertrophy from chronic hypertension
B. Left ventricular enlargement from volume overload (e.g., mitral regurgitation)
C. Right ventricular hypertrophy from pulmonary hypertension
D. Normal PMI variation
Correct Answer: B
Rationale: Correct because lateral displacement of the PMI beyond the left midclavicular line
with an increased diameter (>3 cm) indicates left ventricular enlargement (dilation), which
occurs with volume overload states such as mitral regurgitation, aortic regurgitation, or heart
failure. Left ventricular hypertrophy from pressure overload (e.g., aortic stenosis, hypertension)
causes inferior and lateral displacement with a sustained (prolonged duration) impulse but not
necessarily lateral displacement alone. A normal PMI is ≤2–3 cm at the 5th intercostal space,
left midclavicular line.
