NURS 5220 Exam 2 V2 | NURS 5220
Advanced Health Assessment and
Diagnostic Reasoning Review | Actual
Q&A with Rationale (NURS5220 Exam 2) |
The University of Texas at Arlington
1. A 68-year-old patient presents with a harsh, midsystolic crescendo-decrescendo murmur
heard best at the right second intercostal space. Which condition is most likely?
A. Mitral Valve Prolapse
B. Aortic Stenosis
C. Mitral Regurgitation
D. Aortic Regurgitation
Answer: B
Rationale: Aortic stenosis presents as a systolic murmur at the base of the heart. This
sound often radiates to the carotid arteries because of the direction of blood flow. Precise
localization to the right upper sternal border is a hallmark of this valvular disorder.
2. During a physical examination, the clinician notes increased tactile fremitus over the right
lower lobe. What is the most probable underlying pathology?
A. Pleural Effusion
B. Pneumothorax
,C. Lobar Pneumonia
D. Emphysema
Answer: C
Rationale: Consolidation in the lung tissue from pneumonia increases the density of the
medium. Denser tissue conducts sound vibrations more effectively than air-filled or fluid-
separated spaces. This finding is differentiated from effusion, which typically decreases
fremitus.
3. A patient exhibits sharp pain upon inspiration while the clinician applies pressure under
the right costal margin. This clinical finding is known as:
A. Murphy’s Sign
B. McBurney’s Sign
C. Psoas Sign
D. Rovsing’s Sign
Answer: A
Rationale: Murphy’s sign is highly suggestive of acute cholecystitis. The pain occurs when
the inflamed gallbladder descends and contacts the clinician’s hand during deep
inspiration. A positive test results in a sudden halt in the patient’s inspiratory effort.
, 4. A patient is unable to puff out their cheeks or smile symmetrically. Which cranial nerve is
most likely affected?
A. CN VII (Facial)
B. CN VI (Abducens)
C. CN V (Trigeminal)
D. CN IX (Glossopharyngeal)
Answer: A
Rationale: The Facial nerve controls the muscles of facial expression. Testing involves
observing for symmetry during movements like smiling, frowning, and closing the eyes
tightly. Weakness in these areas indicates a peripheral or central lesion of the seventh
nerve.
5. To assess for a torn meniscus in the knee, the clinician performs a test involving internal
and external rotation of the knee during flexion and extension. This is called:
A. Bulge Sign
B. Lachman Test
C. McMurray Test
D. Valgus Stress Test
Answer: C
Advanced Health Assessment and
Diagnostic Reasoning Review | Actual
Q&A with Rationale (NURS5220 Exam 2) |
The University of Texas at Arlington
1. A 68-year-old patient presents with a harsh, midsystolic crescendo-decrescendo murmur
heard best at the right second intercostal space. Which condition is most likely?
A. Mitral Valve Prolapse
B. Aortic Stenosis
C. Mitral Regurgitation
D. Aortic Regurgitation
Answer: B
Rationale: Aortic stenosis presents as a systolic murmur at the base of the heart. This
sound often radiates to the carotid arteries because of the direction of blood flow. Precise
localization to the right upper sternal border is a hallmark of this valvular disorder.
2. During a physical examination, the clinician notes increased tactile fremitus over the right
lower lobe. What is the most probable underlying pathology?
A. Pleural Effusion
B. Pneumothorax
,C. Lobar Pneumonia
D. Emphysema
Answer: C
Rationale: Consolidation in the lung tissue from pneumonia increases the density of the
medium. Denser tissue conducts sound vibrations more effectively than air-filled or fluid-
separated spaces. This finding is differentiated from effusion, which typically decreases
fremitus.
3. A patient exhibits sharp pain upon inspiration while the clinician applies pressure under
the right costal margin. This clinical finding is known as:
A. Murphy’s Sign
B. McBurney’s Sign
C. Psoas Sign
D. Rovsing’s Sign
Answer: A
Rationale: Murphy’s sign is highly suggestive of acute cholecystitis. The pain occurs when
the inflamed gallbladder descends and contacts the clinician’s hand during deep
inspiration. A positive test results in a sudden halt in the patient’s inspiratory effort.
, 4. A patient is unable to puff out their cheeks or smile symmetrically. Which cranial nerve is
most likely affected?
A. CN VII (Facial)
B. CN VI (Abducens)
C. CN V (Trigeminal)
D. CN IX (Glossopharyngeal)
Answer: A
Rationale: The Facial nerve controls the muscles of facial expression. Testing involves
observing for symmetry during movements like smiling, frowning, and closing the eyes
tightly. Weakness in these areas indicates a peripheral or central lesion of the seventh
nerve.
5. To assess for a torn meniscus in the knee, the clinician performs a test involving internal
and external rotation of the knee during flexion and extension. This is called:
A. Bulge Sign
B. Lachman Test
C. McMurray Test
D. Valgus Stress Test
Answer: C
