NUR612/NUR 612 Exam 1 V3 | Advanced
Nursing II Q&A with Rationale | William
Paterson University
1. When assessing a patient’s skin, which finding for a mole would be most concerning for
melanoma?
A. Irregular borders with notched or blurred edges
B. A diameter of 4 mm measured at the widest point
C. A uniform dark brown color throughout the lesion
D. A symmetrical oval shape appearing on the trunk
Answer: A
Rationale: The ABCDE criteria for melanoma include Asymmetry, Border irregularity,
Color variegation, Diameter greater than 6 mm, and Evolution. Irregular borders suggest
that the melanocytes are proliferating at different rates in different directions, which is
characteristic of malignancy. A uniform color and small diameter are generally signs of
benign nevi.
2. A provider is auscultating the heart at the left 5th intercostal space, midclavicular line.
Which valve is being primarily assessed?
A. Aortic valve
B. Mitral valve
,C. Tricuspid valve
D. Pulmonic valve
Answer: B
Rationale: The mitral valve is best auscultated at the apex of the heart, which is located at
the 5th intercostal space at the midclavicular line. This is also the location where the point
of maximal impulse (PMI) is typically felt during the physical exam. Correct placement is
vital for identifying murmurs such as mitral regurgitation or mitral stenosis.
3. Which cranial nerve is being tested when the provider asks the patient to shrug their
shoulders against resistance?
A. Cranial Nerve X (Vagus)
B. Cranial Nerve XI (Spinal Accessory)
C. Cranial Nerve XII (Hypoglossal)
D. Cranial Nerve IX (Glossopharyngeal)
Answer: B
Rationale: Cranial Nerve XI, the Spinal Accessory nerve, innervates the trapezius and
sternocleidomastoid muscles. Testing shoulder shrugging and head turning against
resistance allows the provider to assess the strength and symmetry of these muscles.
Weakness or asymmetry may indicate a peripheral nerve lesion or central nervous system
pathology.
, 4. During a lung assessment, the provider notes increased tactile fremitus over the right
lower lobe. This finding is most consistent with:
A. Lobar pneumonia
B. Pleural effusion
C. Pneumothorax
D. Chronic obstructive pulmonary disease (COPD)
Answer: A
Rationale: Tactile fremitus is increased when there is consolidation in the lung tissue, such
as in lobar pneumonia, because sound travels better through solid or fluid-filled media than
through air. Conversely, conditions like pneumothorax or pleural effusion decrease
fremitus because they create a barrier between the lung and the chest wall. COPD typically
results in decreased fremitus due to hyperinflation of the lungs.
5. Which of the following describes the correct technique for the Weber test?
A. Placing a vibrating tuning fork on the midline of the skull
B. Placing a vibrating tuning fork on the mastoid bone
C. Whispering numbers into one ear while masking the other
D. Comparing air conduction to bone conduction times
Answer: A
Nursing II Q&A with Rationale | William
Paterson University
1. When assessing a patient’s skin, which finding for a mole would be most concerning for
melanoma?
A. Irregular borders with notched or blurred edges
B. A diameter of 4 mm measured at the widest point
C. A uniform dark brown color throughout the lesion
D. A symmetrical oval shape appearing on the trunk
Answer: A
Rationale: The ABCDE criteria for melanoma include Asymmetry, Border irregularity,
Color variegation, Diameter greater than 6 mm, and Evolution. Irregular borders suggest
that the melanocytes are proliferating at different rates in different directions, which is
characteristic of malignancy. A uniform color and small diameter are generally signs of
benign nevi.
2. A provider is auscultating the heart at the left 5th intercostal space, midclavicular line.
Which valve is being primarily assessed?
A. Aortic valve
B. Mitral valve
,C. Tricuspid valve
D. Pulmonic valve
Answer: B
Rationale: The mitral valve is best auscultated at the apex of the heart, which is located at
the 5th intercostal space at the midclavicular line. This is also the location where the point
of maximal impulse (PMI) is typically felt during the physical exam. Correct placement is
vital for identifying murmurs such as mitral regurgitation or mitral stenosis.
3. Which cranial nerve is being tested when the provider asks the patient to shrug their
shoulders against resistance?
A. Cranial Nerve X (Vagus)
B. Cranial Nerve XI (Spinal Accessory)
C. Cranial Nerve XII (Hypoglossal)
D. Cranial Nerve IX (Glossopharyngeal)
Answer: B
Rationale: Cranial Nerve XI, the Spinal Accessory nerve, innervates the trapezius and
sternocleidomastoid muscles. Testing shoulder shrugging and head turning against
resistance allows the provider to assess the strength and symmetry of these muscles.
Weakness or asymmetry may indicate a peripheral nerve lesion or central nervous system
pathology.
, 4. During a lung assessment, the provider notes increased tactile fremitus over the right
lower lobe. This finding is most consistent with:
A. Lobar pneumonia
B. Pleural effusion
C. Pneumothorax
D. Chronic obstructive pulmonary disease (COPD)
Answer: A
Rationale: Tactile fremitus is increased when there is consolidation in the lung tissue, such
as in lobar pneumonia, because sound travels better through solid or fluid-filled media than
through air. Conversely, conditions like pneumothorax or pleural effusion decrease
fremitus because they create a barrier between the lung and the chest wall. COPD typically
results in decreased fremitus due to hyperinflation of the lungs.
5. Which of the following describes the correct technique for the Weber test?
A. Placing a vibrating tuning fork on the midline of the skull
B. Placing a vibrating tuning fork on the mastoid bone
C. Whispering numbers into one ear while masking the other
D. Comparing air conduction to bone conduction times
Answer: A
