National University NUR 304 Module 2 (pdf) | 2026/2027 |Advanced
Health Assessment Q&A | Nursing
1. A graduate nursing student is performing an advanced cardiac
assessment. Which of the following is the correct order for the cardiac
examination?
A) Inspection, palpation, percussion, auscultation
B) Inspection, auscultation, palpation, percussion
C) Palpation, inspection, percussion, auscultation
D) Auscultation, inspection, palpation, percussion
Correct Answer: Inspection, palpation, percussion, auscultation
Rationale: The standard sequence for a cardiac examination is inspection,
palpation, percussion, and auscultation. Inspection allows for observation of
visible pulsations, palpation for the apical pulse and thrills, percussion for
cardiac borders, and auscultation for heart sounds. This systematic order
prevents missing subtle findings.
2. An advanced practice nurse is auscultating heart sounds and notes a split
S2 that widens during inspiration and narrows during expiration. This finding
is best described as:
A) Paradoxical splitting
B) Fixed splitting
C) Physiological splitting
D) Reversed splitting
Correct Answer: Physiological splitting
Rationale: Physiological splitting of S2 is a normal finding where the pulmonic
valve closes later than the aortic valve during inspiration due to increased
,venous return. This split is best heard at the pulmonic area and disappears
with expiration, distinguishing it from fixed or paradoxical splitting which
indicate pathology.
3. When assessing the jugular venous pressure (JVP), the nurse practitioner
should position the patient at which of the following angles to obtain the
most accurate measurement?
A) 0 degrees (supine)
B) 45 degrees
C) 90 degrees (sitting upright)
D) 30 degrees
Correct Answer: 45 degrees
Rationale: The JVP is best assessed with the patient positioned at a 45-
degree angle, which allows the internal jugular vein to become visible as a
pulsation in the neck. This position provides the most accurate estimation of
right atrial pressure, as the venous column is at the correct height for
visualization.
4. A nurse practitioner is assessing a patient's carotid arteries. Which of the
following techniques is most appropriate for this examination?
A) Palpate both carotid arteries simultaneously to compare amplitude
B) Auscultate each carotid artery for bruits using the bell of the stethoscope
C) Palpate one carotid artery at a time gently to avoid vagal stimulation
D) Percuss the carotid arteries to assess for tenderness
Correct Answer: Palpate one carotid artery at a time gently to avoid vagal
stimulation
,Rationale: Carotid arteries should be palpated one at a time, gently, to
prevent excessive vagal stimulation which can cause bradycardia or
syncope. Auscultation for bruits is also performed, but palpation must be
done with caution and never simultaneously.
5. An advanced practice nurse is assessing a patient for peripheral arterial
disease. Which of the following findings is most concerning for this condition?
A) Bilateral, symmetric, palpable pedal pulses
B) Cool, pale extremities with diminished pulses
C) Warm, pink extremities with visible varicose veins
D) Pitting edema in the lower extremities
Correct Answer: Cool, pale extremities with diminished pulses
Rationale: Peripheral arterial disease (PAD) is characterized by reduced
arterial blood flow, leading to cool, pale skin, diminished or absent pulses,
and possible dependent rubor. Warm, pink skin with symmetric pulses is
normal; varicose veins and edema suggest venous insufficiency.
6. A nurse is performing an Allen test before radial artery cannulation. Which
of the following describes the correct procedure for this test?
A) Compress both the radial and ulnar arteries, then release the radial artery
and observe for color return
B) Compress both the radial and ulnar arteries, then release the ulnar artery
and observe for color return
C) Compress the radial artery only and observe for color return
D) Compress the ulnar artery only and observe for color return
Correct Answer: Compress both the radial and ulnar arteries, then release
the ulnar artery and observe for color return
, Rationale: The Allen test assesses the patency of the ulnar artery as a
collateral supply to the hand. Both arteries are compressed, the hand is
blanched, and then the ulnar artery is released. If color returns to the hand
within 5-15 seconds, the ulnar artery is patent.
7. An advanced practice nurse is assessing a patient's peripheral pulses and
notes a pulse that is easily palpable and described as "bounding." This pulse
should be documented on a 0-4+ scale as:
A) 1+
B) 2+
C) 3+
D) 4+
Correct Answer: 4+
Rationale: Pulse strength is graded on a 0-4+ scale: 0 = absent, 1+ =
diminished/thready, 2+ = normal, 3+ = full/increased, and 4+ = bounding. A
bounding pulse is a strong, easily palpable pulse that is consistent with a 4+
grade.
8. A nurse practitioner is auscultating the lungs and hears high-pitched,
musical sounds during both inspiration and expiration. These sounds are best
described as:
A) Crackles
B) Wheezes
C) Rhonchi
D) Stridor
Correct Answer: Wheezes
Health Assessment Q&A | Nursing
1. A graduate nursing student is performing an advanced cardiac
assessment. Which of the following is the correct order for the cardiac
examination?
A) Inspection, palpation, percussion, auscultation
B) Inspection, auscultation, palpation, percussion
C) Palpation, inspection, percussion, auscultation
D) Auscultation, inspection, palpation, percussion
Correct Answer: Inspection, palpation, percussion, auscultation
Rationale: The standard sequence for a cardiac examination is inspection,
palpation, percussion, and auscultation. Inspection allows for observation of
visible pulsations, palpation for the apical pulse and thrills, percussion for
cardiac borders, and auscultation for heart sounds. This systematic order
prevents missing subtle findings.
2. An advanced practice nurse is auscultating heart sounds and notes a split
S2 that widens during inspiration and narrows during expiration. This finding
is best described as:
A) Paradoxical splitting
B) Fixed splitting
C) Physiological splitting
D) Reversed splitting
Correct Answer: Physiological splitting
Rationale: Physiological splitting of S2 is a normal finding where the pulmonic
valve closes later than the aortic valve during inspiration due to increased
,venous return. This split is best heard at the pulmonic area and disappears
with expiration, distinguishing it from fixed or paradoxical splitting which
indicate pathology.
3. When assessing the jugular venous pressure (JVP), the nurse practitioner
should position the patient at which of the following angles to obtain the
most accurate measurement?
A) 0 degrees (supine)
B) 45 degrees
C) 90 degrees (sitting upright)
D) 30 degrees
Correct Answer: 45 degrees
Rationale: The JVP is best assessed with the patient positioned at a 45-
degree angle, which allows the internal jugular vein to become visible as a
pulsation in the neck. This position provides the most accurate estimation of
right atrial pressure, as the venous column is at the correct height for
visualization.
4. A nurse practitioner is assessing a patient's carotid arteries. Which of the
following techniques is most appropriate for this examination?
A) Palpate both carotid arteries simultaneously to compare amplitude
B) Auscultate each carotid artery for bruits using the bell of the stethoscope
C) Palpate one carotid artery at a time gently to avoid vagal stimulation
D) Percuss the carotid arteries to assess for tenderness
Correct Answer: Palpate one carotid artery at a time gently to avoid vagal
stimulation
,Rationale: Carotid arteries should be palpated one at a time, gently, to
prevent excessive vagal stimulation which can cause bradycardia or
syncope. Auscultation for bruits is also performed, but palpation must be
done with caution and never simultaneously.
5. An advanced practice nurse is assessing a patient for peripheral arterial
disease. Which of the following findings is most concerning for this condition?
A) Bilateral, symmetric, palpable pedal pulses
B) Cool, pale extremities with diminished pulses
C) Warm, pink extremities with visible varicose veins
D) Pitting edema in the lower extremities
Correct Answer: Cool, pale extremities with diminished pulses
Rationale: Peripheral arterial disease (PAD) is characterized by reduced
arterial blood flow, leading to cool, pale skin, diminished or absent pulses,
and possible dependent rubor. Warm, pink skin with symmetric pulses is
normal; varicose veins and edema suggest venous insufficiency.
6. A nurse is performing an Allen test before radial artery cannulation. Which
of the following describes the correct procedure for this test?
A) Compress both the radial and ulnar arteries, then release the radial artery
and observe for color return
B) Compress both the radial and ulnar arteries, then release the ulnar artery
and observe for color return
C) Compress the radial artery only and observe for color return
D) Compress the ulnar artery only and observe for color return
Correct Answer: Compress both the radial and ulnar arteries, then release
the ulnar artery and observe for color return
, Rationale: The Allen test assesses the patency of the ulnar artery as a
collateral supply to the hand. Both arteries are compressed, the hand is
blanched, and then the ulnar artery is released. If color returns to the hand
within 5-15 seconds, the ulnar artery is patent.
7. An advanced practice nurse is assessing a patient's peripheral pulses and
notes a pulse that is easily palpable and described as "bounding." This pulse
should be documented on a 0-4+ scale as:
A) 1+
B) 2+
C) 3+
D) 4+
Correct Answer: 4+
Rationale: Pulse strength is graded on a 0-4+ scale: 0 = absent, 1+ =
diminished/thready, 2+ = normal, 3+ = full/increased, and 4+ = bounding. A
bounding pulse is a strong, easily palpable pulse that is consistent with a 4+
grade.
8. A nurse practitioner is auscultating the lungs and hears high-pitched,
musical sounds during both inspiration and expiration. These sounds are best
described as:
A) Crackles
B) Wheezes
C) Rhonchi
D) Stridor
Correct Answer: Wheezes
