NU 650 TEST PAPER EXAM 2026/2027 QUESTIONS AND
SOLUTIONS RATED A+
✔✔Which of the following symptoms would you expect from a young adolescent in the
early phase of appendicitis?
A. Abdominal pain two hours after eating
B. CVA tenderness
C. Severe RLQ pain with pallor and sweating
D. Constipation - ✔✔C
✔✔An 85 y.o. woman is brought to the urgent care center for possible aspiration
pneumonia. The NP understands that, based on normal anatomy adventitious lung
sounds will most likely be heard in which of the following areas?
A. left upper lobe
B. left middle & lower lobes
C. right upper lobe
D. Right middle and lower lobes - ✔✔D
✔✔Barrel chest is an abnormal chest configuration that may occur in which of the
following disorders?
A. COPD
B. Pneumonia
C. Pneumothorax
D. TBA - ✔✔A
✔✔Bronchovesticular sounds are heard normally at which location?
A. second intercostal space anteriorly bilaterally
B. base of lungs bilaterally, posteriorly
C. laterally at the midaxillary line, bilaterally
D. Bilaterally at the mid-clabicular line, 5th intercostal space - ✔✔A
✔✔Normally when the lung fields are percussed the resulting sound is described as
_______:
A. hyperresonant
B. resonant
C. tympanic
D. Dull - ✔✔B
✔✔The NP will nose a history of chronic cough based on the patients report of
symptoms lasting for:
A. 1 week
B. 4 weeks
C. 6 weeks
D. 10 weeks - ✔✔D
,✔✔When compared to wheezes and rhonchi, the NP notes that on auscultation,
crackles are:
A. musical in quality
B. prolonged sounds, typically persisting throughout the respiratory cycle
C. intermittent and discontinuous sounds
D. Relatively low-pitched with a snoring quality - ✔✔C
✔✔Which breath sound is normally heard over the sternal notch?
A. Bronchial
B. Bronchovesicular
C. Vesicular
D. Tracheal - ✔✔A
✔✔Which of the following findings will alert the NP to include pneumonia as a
differential diagnosis?
A. decreased tactile fremitus
B. symmetrical chest expansion/lung excursion
C. hyperresonance with percussion
D. positive bronchophony - ✔✔D
✔✔Which of the following is an expected change of aging?
A. supraclavicular retractions with inspiration
B. Kyphosis
C. There is a decrease of the elastic properties within lungs
D. Pectus excavatum - ✔✔C
✔✔Which of the following statements represents a general goal for the comprehensive
or focused physical examination?
a. Avoid unnecessary changes in position
b. Maximize patient comfort
c. Enhance clinical efficiency
d. all of the above - ✔✔D
✔✔Crackles auscultated sound description: - ✔✔Discontinuous
Non-musical
Like dots in time
✔✔Wheezes auscultated sound description: - ✔✔High pitched with hissing or shrill
quality
Continuous
✔✔Rhonchi auscultated sound description: - ✔✔Continuous
Low pitched with snoring quality
, ✔✔Vesicular breath sound characteristics: - ✔✔Inspiration longer than expiration
Heard over most lung tissue
✔✔Tracheal breath sound characteristics: - ✔✔Inspiration & expiration almost equal
Relatively high pitched
Intensity of expiration very loud
✔✔Bronchovesicular breath sound characteristics: - ✔✔Inspiration and expiration
almost equal, and heard in the first and second interspaces anteriorly and between the
scapulae
✔✔Bronchial breath sound characteristics: - ✔✔Expiration longer than inspiration
Heard over large proximal airways
✔✔You are performing a thorough cardiac examination. Which of the following
chambers of the heart can you assess by palpation?
A) Left atrium
B) Right atrium
C) Right ventricle
D) Sinus node - ✔✔C
✔✔What is responsible for the inspiratory splitting of S2?
A) Closure of aortic, then pulmonic valves
B) Closure of mitral, then tricuspid valves
C) Closure of aortic, then tricuspid valves
D) Closure of mitral, then pulmonic valves - ✔✔A
✔✔A 25-year-old optical technician comes to your clinic for evaluation of fatigue. As
part of your physical examination, you listen to her heart and hear a murmur only at the
cardiac apex. Which valve is most likely to be involved, based on the location of the
murmur?
A) Mitral
B) Tricuspid
C) Aortic
D) Pulmonic - ✔✔A
✔✔A 58-year-old teacher presents to your clinic complaining of breathlessness with
activity. The patient has no chronic conditions and takes no medications, herbs, or
supplements. Which of the following symptoms is appropriate to ask about in the
cardiovascular review of systems?
A) Abdominal pain
B) Orthopnea
C) Hematochezia
D) Tenesmus - ✔✔B
SOLUTIONS RATED A+
✔✔Which of the following symptoms would you expect from a young adolescent in the
early phase of appendicitis?
A. Abdominal pain two hours after eating
B. CVA tenderness
C. Severe RLQ pain with pallor and sweating
D. Constipation - ✔✔C
✔✔An 85 y.o. woman is brought to the urgent care center for possible aspiration
pneumonia. The NP understands that, based on normal anatomy adventitious lung
sounds will most likely be heard in which of the following areas?
A. left upper lobe
B. left middle & lower lobes
C. right upper lobe
D. Right middle and lower lobes - ✔✔D
✔✔Barrel chest is an abnormal chest configuration that may occur in which of the
following disorders?
A. COPD
B. Pneumonia
C. Pneumothorax
D. TBA - ✔✔A
✔✔Bronchovesticular sounds are heard normally at which location?
A. second intercostal space anteriorly bilaterally
B. base of lungs bilaterally, posteriorly
C. laterally at the midaxillary line, bilaterally
D. Bilaterally at the mid-clabicular line, 5th intercostal space - ✔✔A
✔✔Normally when the lung fields are percussed the resulting sound is described as
_______:
A. hyperresonant
B. resonant
C. tympanic
D. Dull - ✔✔B
✔✔The NP will nose a history of chronic cough based on the patients report of
symptoms lasting for:
A. 1 week
B. 4 weeks
C. 6 weeks
D. 10 weeks - ✔✔D
,✔✔When compared to wheezes and rhonchi, the NP notes that on auscultation,
crackles are:
A. musical in quality
B. prolonged sounds, typically persisting throughout the respiratory cycle
C. intermittent and discontinuous sounds
D. Relatively low-pitched with a snoring quality - ✔✔C
✔✔Which breath sound is normally heard over the sternal notch?
A. Bronchial
B. Bronchovesicular
C. Vesicular
D. Tracheal - ✔✔A
✔✔Which of the following findings will alert the NP to include pneumonia as a
differential diagnosis?
A. decreased tactile fremitus
B. symmetrical chest expansion/lung excursion
C. hyperresonance with percussion
D. positive bronchophony - ✔✔D
✔✔Which of the following is an expected change of aging?
A. supraclavicular retractions with inspiration
B. Kyphosis
C. There is a decrease of the elastic properties within lungs
D. Pectus excavatum - ✔✔C
✔✔Which of the following statements represents a general goal for the comprehensive
or focused physical examination?
a. Avoid unnecessary changes in position
b. Maximize patient comfort
c. Enhance clinical efficiency
d. all of the above - ✔✔D
✔✔Crackles auscultated sound description: - ✔✔Discontinuous
Non-musical
Like dots in time
✔✔Wheezes auscultated sound description: - ✔✔High pitched with hissing or shrill
quality
Continuous
✔✔Rhonchi auscultated sound description: - ✔✔Continuous
Low pitched with snoring quality
, ✔✔Vesicular breath sound characteristics: - ✔✔Inspiration longer than expiration
Heard over most lung tissue
✔✔Tracheal breath sound characteristics: - ✔✔Inspiration & expiration almost equal
Relatively high pitched
Intensity of expiration very loud
✔✔Bronchovesicular breath sound characteristics: - ✔✔Inspiration and expiration
almost equal, and heard in the first and second interspaces anteriorly and between the
scapulae
✔✔Bronchial breath sound characteristics: - ✔✔Expiration longer than inspiration
Heard over large proximal airways
✔✔You are performing a thorough cardiac examination. Which of the following
chambers of the heart can you assess by palpation?
A) Left atrium
B) Right atrium
C) Right ventricle
D) Sinus node - ✔✔C
✔✔What is responsible for the inspiratory splitting of S2?
A) Closure of aortic, then pulmonic valves
B) Closure of mitral, then tricuspid valves
C) Closure of aortic, then tricuspid valves
D) Closure of mitral, then pulmonic valves - ✔✔A
✔✔A 25-year-old optical technician comes to your clinic for evaluation of fatigue. As
part of your physical examination, you listen to her heart and hear a murmur only at the
cardiac apex. Which valve is most likely to be involved, based on the location of the
murmur?
A) Mitral
B) Tricuspid
C) Aortic
D) Pulmonic - ✔✔A
✔✔A 58-year-old teacher presents to your clinic complaining of breathlessness with
activity. The patient has no chronic conditions and takes no medications, herbs, or
supplements. Which of the following symptoms is appropriate to ask about in the
cardiovascular review of systems?
A) Abdominal pain
B) Orthopnea
C) Hematochezia
D) Tenesmus - ✔✔B
