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NSG 3160 EXAM 3 – COMPLETE PRACTICE QUESTION BANK WITH DETAILED RATIONALES

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Are you preparing for the NSG 3160 Health Assessment Exam 3? This all-in-one study guide provides everything you need to pass with confidence. Featuring 350 practice questions with detailed rationales, this resource covers every critical topic tested on the actual NSG 3160 Exam 3. What's Inside This Complete NSG 3160 Study Guide: SECTION 1: CARDIOVASCULAR ASSESSMENT (100+ Questions) Cardiac Anatomy & Physiology: Right side of heart: Pumps blood to the lungs (pulmonary circulation) Left side of heart: Pumps blood to the body (systemic circulation) Septum: Wall that separates the two pumps of the heart AV Valves: Separate atria and ventricles Right AV valve: Tricuspid valve (5th ICS, left sternal border) Left AV valve: Mitral valve (5th ICS, left midclavicular line) Semilunar (SL) Valves: Between ventricles and arteries Aortic valve: 2nd right intercostal space Pulmonic valve: 2nd left intercostal space Cardiac Cycle & Heart Sounds: Diastole: Ventricles relax and heart fills with blood (2/3 of cardiac cycle) Systole: Ventricles contract and pump blood (1/3 of cardiac cycle) S1 ("Lub"): Closure of AV valves (mitral and tricuspid) S2 ("Dub"): Closure of semilunar valves (aortic and pulmonic) S3: Caused by increased ventricular filling pressure - normal in children/young adults, pathological in older adults S4: Occurs at end of diastole (presystole) - always pathological in adults (stiff, noncompliant ventricle) Summation Sounds: Both pathological S3 and S4 present (quadruple rhythm) Cardiac Valves - Auscultation Locations: Aortic Valve: 2nd right intercostal space Pulmonic Valve: 2nd left intercostal space Erb's Point: 3rd left intercostal space (best for aortic regurgitation) Tricuspid Valve: Left lower sternal border (5th ICS) Mitral Valve: 5th ICS, left midclavicular line (apex) Assessment Techniques: Jugular Venous Pressure (JVP): Patient at 45 degrees, normal ≤ 3 cm above sternal angle Apical Impulse: Palpate left of sternal border down midclavicular line between 4th and 5th ICS Carotid Artery: Located in groove between trachea and sternomastoid muscle (palpate only one at a time) Thrill: Palpable vibration (feels like purring cat) - indicates turbulent blood flow Heave/Lift: Sustained impulse from ventricular hypertrophy Bruit: Audible vascular sound indicating turbulent blood flow Pericardial Friction Rub: High-pitched, scratchy sound heard with diaphragm Murmurs: Grade Scale: 1-6 (1 = very faint, 6 = loud with palpable thrill) Mitral Regurgitation: Pansystolic, best heard at apex Mitral Stenosis: Low-pitched diastolic rumble, best heard at apex (left lateral position) - most common cause: Rheumatic fever Tricuspid Regurgitation: Pansystolic, best heard at left lower sternal border Aortic Stenosis: Systolic ejection murmur, best heard at 2nd right ICS - common cause in older adults: Calcific degeneration Aortic Regurgitation: Early diastolic decrescendo, best heard at Erb's point Aortic Stenosis Classic Triad: Angina, Syncope, Heart Failure Cardiac Valvular Disease: Mitral Regurgitation: Blood regurgitates into left atria during systole - symptoms: fatigue, palpitations, orthopnea Mitral Stenosis: Calcified mitral valve doesn't open properly - left atria enlargement and increased pressure Tricuspid Regurgitation: Backflow of blood into right atria - objective findings: engorged pulsating neck veins, enlarged liver Hemodynamics: Cardiac Output (CO): Amount of blood pumped in 1 minute (4-6 L/min) Formula: CO = Stroke Volume × Heart Rate Preload: Volume of blood in ventricles at end-diastole Afterload: Pressure against which heart must pump to eject blood ECG Interpretation: P Wave: Atrial depolarization PR Interval: Beginning of P wave to beginning of QRS complex QRS Complex: Ventricular depolarization T Wave: Ventricular repolarization SA Node: "Pacemaker" of the heart Automaticity: Heart's ability to contract by itself, independent of signals Coronary Artery Disease & Heart Failure: Modifiable Risk Factors: Smoking, obesity, hypertension, high cholesterol, diabetes Non-modifiable Risk Factors: Age, gender, family history Most common cause of heart failure in US: Coronary artery disease Left-sided heart failure: Pulmonary congestion, dyspnea Right-sided heart failure: Peripheral edema, JVD, hepatomegaly Most common rhythm disturbance in elderly: Atrial fibrillation (irregularly irregular pulse) Peripheral Vascular Assessment: Peripheral Artery Disease (PAD): Cool, pale extremities with diminished pulses; intermittent claudication Chronic Venous Insufficiency: Brownish discoloration, edema, lower extremity ulcers Allen Test: Assesses patency of radial and ulnar arteries Chest Pain Assessment: Pericarditis: Pain worse when lying flat, improves sitting up/leaning forward Pulmonary Embolism: Sharp, stabbing pain that worsens with deep breath Pneumonia: Sharp, stabbing pain associated with cough Pneumothorax: Acute, sudden, sharp chest pain GI-related: Burning sensation with eating large meals SECTION 2: RESPIRATORY ASSESSMENT (70+ Questions) Breath Sounds: Wheezes: Continuous, high-pitched, musical sounds during expiration (asthma, COPD) Fine Crackles: Discontinuous, high-pitched, brief sounds on inspiration (pulmonary fibrosis, heart failure) Coarse Crackles: Discontinuous, low-pitched, bubbling sounds (secretions in larger airways) Rhonchi: Low-pitched, snoring/rattling sounds, often clearing with cough (secretions) Stridor: High-pitched, crowing sound on inspiration - upper airway obstruction (emergency) Bronchial Breath Sounds: Heard over consolidation (lobar pneumonia) Percussion Findings: Resonance: Normal finding over healthy lung tissue Dullness: Consolidation (pneumonia) or pleural effusion Hyperresonance: Pneumothorax or emphysema Tactile Fremitus: Palpable vibration felt on chest wall during speech Increased: Lobar pneumonia (consolidation) Decreased/Absent: Pleural effusion or pneumothorax Breathing Patterns: Cheyne-Stokes: Periods of apnea alternating with hyperventilation Kussmaul: Rapid, deep, gasping breathing (metabolic acidosis, DKA) Respiratory Conditions: COPD: Decreased breath sounds, prolonged expiration - most common cause: Smoking Emphysema: Barrel chest, "pink puffers" Chronic Bronchitis: "Blue bloaters" (cyanosis, peripheral edema) Pneumonia: Fever, productive cough, crackles - most common cause: Streptococcus pneumoniae Pulmonary Edema: Fine crackles at lung bases Pulmonary Embolism: Sudden pleuritic chest pain, dyspnea, tachypnea, tachycardia - most common risk factor: Immobilization Asthma: Wheezing, dyspnea (especially expiration) Pneumothorax: Sudden sharp chest pain, hyperresonance Pleural Effusion: Dullness, decreased breath sounds - most common cause: Heart failure Tuberculosis: Chronic cough, night sweats, weight loss Lung Cancer: Persistent cough (most common symptom) Atelectasis: Mucus plugging (most common cause) - decreased breath sounds with crackles Additional Respiratory Assessment: Normal Respiratory Rate: 12-20 breaths/min Normal SpO2: 95-100% SpO2 88%: Moderate hypoxemia Ortopnea: Difficulty breathing when lying flat Paroxysmal Nocturnal Dyspnea (PND): Sudden awakening from sleep with severe shortness of breath High Fowler's Position: Best for severe dyspnea SECTION 3: ABDOMINAL ASSESSMENT (60+ Questions) Assessment Order: Normal order: Inspection, Auscultation, Percussion, Palpation Bowel Sounds: Normal 5-30 per minute Silent Bowel Sounds: Listen for at least 5 minutes before reporting absent Hyperactive: Diarrhea or early intestinal obstruction Hypoactive/Absent: Peritonitis or paralytic ileus Abdominal Landmarks & Findings: Ascites: Fluid in abdominal cavity - dullness across abdomen Hepatomegaly: Firm, nodular edge 3 cm below right costal margin Costovertebral Angle Tenderness: Kidney inflammation/infection Special Signs: Murphy's Sign: Pain in right upper quadrant during inspiration - positive for Cholecystitis McBurney's Point: Right lower quadrant (midway between umbilicus and ASIS) - tenderness suggests Appendicitis Rebound Tenderness: Rapidly releasing pressure after deep palpation - peritoneal irritation Psoas Sign: Pain on right hip extension - Appendicitis Obturator Sign: Pain on internal rotation of right hip - Appendicitis Appendicitis: Periumbilical pain that migrates to right lower quadrant Abdominal Conditions: Cholecystitis: Right upper quadrant pain, especially after fatty meals - elevated alkaline phosphatase, bilirubin Pancreatitis: Epigastric pain radiating to back - elevated amylase, lipase - most common cause: Gallstones Peptic Ulcer: Epigastric pain relieved by food - most common cause of upper GI bleeding Diverticulitis: Left lower quadrant pain Cirrhosis: Ascites, jaundice, spider angiomas - most common cause: Alcohol abuse Hepatitis: Right upper quadrant pain, jaundice, fatigue - Hepatitis C most common in US Peritonitis: Rigid, board-like abdomen with rebound tenderness - most common cause: Perforated ulcer Small Bowel Obstruction: Abdominal distension, vomiting - most common cause: Adhesions Large Bowel Obstruction: Constipation, distension - most common cause: Cancer Stool Characteristics: Melena (Black, tarry): Upper GI bleeding Bright Red Blood Per Rectum: Lower GI bleeding Clay-colored Stool: Biliary obstruction Steatorrhea (Fatty): Malabsorption Currant Jelly Stools: Intussusception (in children) Most common cause of acute diarrhea: Viral infection Pediatric Abdominal Conditions: Pyloric Stenosis: Projectile vomiting in newborns Umbilical Cord: Falls off in 10-14 days Intussusception: Most often idiopathic in children Meckel's Diverticulum: Painless rectal bleeding, located 2 feet proximal to ileocecal valve SECTION 4: MUSCULOSKELETAL ASSESSMENT (40+ Questions) Deep Tendon Reflexes (DTRs): Grading Scale: 0-4+ 0: Absent despite reinforcement 1+: Diminished 2+: Normal 3+: Brisk 4+: Hyperactive with clonus Decreased DTRs: Lower motor neuron lesion Increased DTRs: Upper motor neuron lesion Spinal Levels for Reflexes: Biceps Reflex: C5-C6 Triceps Reflex: C7-C8 Patellar Reflex: L2-L4 Achilles Reflex: S1-S2 Musculoskeletal Conditions: Osteoarthritis: Joint pain worsens with activity, improves with rest - Heberden's nodes Rheumatoid Arthritis: Symmetrical joint pain, morning stiffness 1 hour - Swan neck deformities Gout: Sudden severe pain in great toe - most common cause: decreased uric acid excretion Osteoporosis: Pathological fractures - most common fracture: Vertebral - leading cause of fractures in older adults Hip Fracture: External rotation and shortening of affected leg Carpal Tunnel Syndrome: Numbness/tingling in thumb, index, middle fingers - positive Phalen's test, positive Tinel's sign - most common cause: Repetitive wrist motion Rotator Cuff Injury: Shoulder pain with abduction Low Back Pain: Most common cause: Muscle strain Herniated Disc (L4-L5): Lower back pain radiating to leg (sciatica) - positive straight leg raise test - pain worsens with flexion Spinal Stenosis: Pain worsens with extension, improves with flexion Fibromyalgia: Widespread musculoskeletal pain with tender points Polymyalgia Rheumatica: Pain and stiffness in shoulders and hips Fracture: Pain, swelling, deformity - X-ray for diagnosis Muscle Atrophy: Most common cause: Disuse Myasthenia Gravis: Muscle weakness worse with activity, improves with rest - worse in morning, improves with activity Foot Drop: Peroneal nerve injury (most common cause) - difficulty with dorsiflexion SECTION 5: NEUROLOGICAL ASSESSMENT (40+ Questions) Glasgow Coma Scale (GCS): Components: Eye opening, motor response, verbal response Normal Score: 15 Score ≤ 8: Severe neurological impairment/coma Neurological Conditions: Stroke: Sudden onset of neurological deficits - most common type: Ischemic (87%) - most common cause: Atherosclerosis Hemorrhagic Stroke: Sudden severe headache, neurological deficits - most common cause: Hypertension TIA: Temporary deficits resolving within 24 hours Subarachnoid Hemorrhage: "Worst headache of my life" - most common cause: Ruptured aneurysm Seizure Disorder: Episodic alterations in consciousness/behavior - most common in adults: Complex partial seizure Parkinson's Disease: Tremor at rest, rigidity, bradykinesia - most common cause: Idiopathic Multiple Sclerosis: Relapsing-remitting neurological symptoms - most common initial symptom: Visual disturbances Alzheimer's Disease: Gradual memory loss and cognitive decline - most common cause of dementia Brain Tumor: Gradual headache and neurological deficits - most common type in adults: Metastatic Spinal Cord Injury: Loss of motor and sensory function below level of injury - most common cause: Motor vehicle accidents Peripheral Neuropathy: Symmetrical distal sensory loss and weakness - most common cause: Diabetes mellitus Guillain-Barré Syndrome: Ascending paralysis - autoimmune response (often post-infection) Bell's Palsy: Unilateral facial weakness - most commonly idiopathic Migraine: Unilateral, throbbing headache with nausea, photophobia Tension Headache: Most common type of headache Cluster Headache: Severe, unilateral headache with autonomic symptoms Meningitis: Headache, fever, nuchal rigidity (stiff neck) SECTION 6: MENTAL STATUS ASSESSMENT (40+ Questions) Mental Status Disorders: Delirium: Acute onset of fluctuating confusion - most common cause in hospitalized patients: Medications Dementia: Gradual onset of cognitive decline - most common cause: Alzheimer's disease Depression: Depressed mood, anhedonia, sleep/appetite changes - most common in older adults: Grief - most common psychiatric disorder in older adults Generalized Anxiety Disorder: Excessive worry about multiple events - most common anxiety disorder Panic Disorder: Recurrent, unexpected panic attacks Schizophrenia: Delusions, hallucinations - most common hallucination: Auditory Bipolar Disorder: Episodes of mania and depression PTSD: Flashbacks, hypervigilance Personality Disorders: Chronic, pervasive maladaptive behavior patterns Most common: Obsessive-compulsive personality disorder Borderline: Instability in relationships, mood, self-image Antisocial: Disregard for rights of others Eating Disorders: Anorexia Nervosa: Severe food restriction, fear of weight gain Bulimia Nervosa: Binge eating followed by purging Other Mental Health Conditions: Somatoform Disorder: Physical symptoms without organic cause Conversion Disorder: Neurological symptoms without organic cause Hypochondriasis: Fear of serious illness despite medical reassurance Sleep Disorders: Insomnia: Most common sleep disorder Obstructive Sleep Apnea: Snoring, daytime sleepiness - most common type Narcolepsy: Excessive daytime sleepiness, cataplexy Restless Leg Syndrome: Urge to move legs, especially at night Substance Use Disorders: Alcohol Use Disorder: Loss of control over alcohol use - most common withdrawal symptom: Tremors Delirium Tremens: Severe confusion, hallucinations, autonomic instability Genitourinary Conditions: Erectile Dysfunction: Most common cause: Vascular disease Urinary Incontinence: Most common in older adults: Urge incontinence Stress Incontinence: Leakage with coughing, sneezing, laughing Urge Incontinence: Sudden urge with leakage Overflow Incontinence: Constant dribbling Functional Incontinence: Due to mobility/cognitive impairment Initial intervention for new-onset incontinence: Comprehensive assessment Who This Study Guide Is For: NSG 3160 Health Assessment Exam 3 candidates Nursing students in health assessment courses RN and BSN students Nursing program exam preparation Pre-nursing and nursing school students Healthcare students studying health assessment NCLEX preparation Anyone needing comprehensive health assessment review Why Choose This Study Guide: 350 Realistic Practice Questions - Modeled after actual NSG 3160 Exam 3 content Detailed Rationales - Understand WHY each answer is correct Topic Organization - Study efficiently by subject area Evidence-Based Answers - Aligned with current nursing standards Updated Content - Current for 2026 exam cycle Exam-Style Format - Multiple choice with clear correct answers Comprehensive Coverage - All NSG 3160 Exam 3 domains included Frequently Tested Topics: Cardiovascular assessment (heart sounds, murmurs, valves) Cardiac cycle and hemodynamics ECG interpretation fundamentals Coronary artery disease risk factors Heart failure assessment Peripheral vascular assessment Respiratory assessment (breath sounds, percussion) Pulmonary conditions (COPD, pneumonia, PE, asthma) Abdominal assessment (organs, special signs, bowel sounds) Musculoskeletal assessment (reflexes, joint conditions) Neurological assessment (GCS, stroke, neurological disorders) Mental status assessment (delirium, dementia, psychiatric disorders) Special assessment techniques Nursing process and documentation What Students Are Saying: "This guide was essential for passing my NSG 3160 Exam 3 on the first attempt! The detailed rationales helped me understand the 'why' behind each answer." - Jennifer R., Nursing Student "Comprehensive and perfectly organized. Every topic I needed was covered. Highly recommend for any nursing student." - Michael T., Nursing Student "The practice questions were very similar to what I saw on the actual NSG 3160 exam. This guide saved me hours of study time." - Sarah M., Nursing Student Product Details: Format: Digital PDF Download Questions: 350 with detailed rationales Pages: Comprehensive coverage (over 160 pages) Last Updated: 2026

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NSG 3160 EXAM 3 – COMPLETE PRACTICE
QUESTION BANK WITH DETAILED
RATIONALES



Section 1: Cardiovascular Assessment (Questions 1–100)




1. What are the modifiable risk factors for coronary artery disease (CAD)?
A. Age, gender, family history
B. Smoking, obesity, hypertension, high cholesterol, diabetes
C. Race, ethnicity, socioeconomic status
D. Stress, anxiety, depression


Correct Answer: B
Rationale: Modifiable risk factors for CAD include smoking, obesity,
hypertension, high cholesterol, and diabetes. Age, gender, and family history
are nonmodifiable risk factors.




2. Does chest pain always indicate a cardiac problem? What should the nurse
ask a patient experiencing chest pain?
A. Yes; ask about the severity of pain

,B. No; ask if the pain is sudden and what brings it on
C. No; ask only about the location of pain
D. Yes; ask about the duration of pain


Correct Answer: B
Rationale: Chest pain does not always indicate a cardiac problem. The nurse
should assess for sudden onset and precipitating factors to differentiate
cardiac from noncardiac causes.




3. What causes the S1 heart sound ("Lub")?
A. Closure of the semilunar valves
B. Closure of the atrioventricular (AV) valves
C. Opening of the AV valves
D. Closure of the aortic valve


Correct Answer: B
Rationale: S1 is caused by the closure of the AV valves (mitral and tricuspid)
at the start of systole. It serves as a reference point for timing all cardiac
sounds.




4. What causes the S2 heart sound ("Dub")?
A. Closure of the AV valves

,B. Opening of the semilunar valves
C. Closure of the semilunar valves (aortic and pulmonic)
D. Closure of the mitral valve


Correct Answer: C
Rationale: S2 is caused by the closure of the semilunar valves (aortic and
pulmonic) at the end of systole.




5. A nurse assesses a patient's jugular venous pressure (JVP). The patient is
positioned supine with the head of bed at 30 degrees. The nurse sees
pulsations 4 cm above the sternal angle. What is the most appropriate
interpretation?
A. Normal finding
B. Elevated JVP
C. Low JVP
D. Inconsistent with patient position


Correct Answer: B
Rationale: Normal JVP is ≤3 cm above the sternal angle. 4 cm suggests
elevated right atrial pressure (e.g., heart failure, fluid overload).

, 6. During a cardiovascular assessment, the nurse palpates the chest wall and
feels a vibration over the aortic area during systole. This finding is
documented as:
A. Heave
B. Thrill
C. Lift
D. Bruit


Correct Answer: B
Rationale: A thrill is a palpable vibration indicating turbulent blood flow.
Heaves/lifts are sustained impulses from ventricular hypertrophy. Bruits are
audible vascular sounds.




7. A patient reports chest pain that is worse when lying flat and improves
when sitting up and leaning forward. This presentation is most suggestive of:
A. Myocardial infarction
B. Pericarditis
C. Aortic dissection
D. Pulmonary embolism


Correct Answer: B
Rationale: Pericarditis classically causes pleuritic chest pain that worsens
supine and improves with sitting/leaning forward.

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