NSG 500 Advanced Health Assessment - Exam 2 Study Guide 2026 UPDATE
1. Which heart sound is considered a ‘ventricular gallop’ and is often associated with fluid
overload or heart failure in older adults?
A. S1
B. S2
C. S3
D. S4
Answer: C
Rationale: S3 is known as a ventricular gallop, occurring early in diastole during rapid
ventricular filling. While normal in children and athletes, it often indicates heart failure in
older adults.
2. When assessing for tactile fremitus, what finding would the nurse practitioner expect in a
patient with lobar pneumonia?
A. Absent fremitus
B. Decreased fremitus
C. Increased fremitus
D. Shifting fremitus
,Answer: C
Rationale: Tactile fremitus increases over areas of consolidation, such as pneumonia,
because sound travels better through solid or fluid-filled tissue than through air.
3. A positive Murphy sign is most suggestive of which condition?
A. Appendicitis
B. Acute cholecystitis
C. Splenomegaly
D. Nephrolithiasis
Answer: B
Rationale: Murphy’s sign is performed by palpating the right upper quadrant while the
patient inhales; a sharp halt in inspiration due to pain suggests gallbladder inflammation.
4. Which cranial nerve is primarily responsible for lateral movement of the eye?
A. CN VI (Abducens)
B. CN IV (Trochlear)
C. CN III (Oculomotor)
D. CN V (Trigeminal)
Answer: A
, Rationale: CN VI (Abducens) innervates the lateral rectus muscle, which abducts the eye
(moves it laterally).
5. A pulse that is documented as ‘2+’ on a scale of 0 to 4 is considered:
A. Absent
B. Weak or thready
C. Bounding
D. Normal/Expected
Answer: D
Rationale: On a standard 0-4 scale, 0 is absent, 1+ is weak, 2+ is normal, 3+ is increased,
and 4+ is bounding.
6. Where is Erb’s point located on the chest wall?
A. Second right intercostal space
B. Second left intercostal space
C. Fifth left intercostal space
D. Third left intercostal space
E. Fourth left intercostal space
Answer: D
1. Which heart sound is considered a ‘ventricular gallop’ and is often associated with fluid
overload or heart failure in older adults?
A. S1
B. S2
C. S3
D. S4
Answer: C
Rationale: S3 is known as a ventricular gallop, occurring early in diastole during rapid
ventricular filling. While normal in children and athletes, it often indicates heart failure in
older adults.
2. When assessing for tactile fremitus, what finding would the nurse practitioner expect in a
patient with lobar pneumonia?
A. Absent fremitus
B. Decreased fremitus
C. Increased fremitus
D. Shifting fremitus
,Answer: C
Rationale: Tactile fremitus increases over areas of consolidation, such as pneumonia,
because sound travels better through solid or fluid-filled tissue than through air.
3. A positive Murphy sign is most suggestive of which condition?
A. Appendicitis
B. Acute cholecystitis
C. Splenomegaly
D. Nephrolithiasis
Answer: B
Rationale: Murphy’s sign is performed by palpating the right upper quadrant while the
patient inhales; a sharp halt in inspiration due to pain suggests gallbladder inflammation.
4. Which cranial nerve is primarily responsible for lateral movement of the eye?
A. CN VI (Abducens)
B. CN IV (Trochlear)
C. CN III (Oculomotor)
D. CN V (Trigeminal)
Answer: A
, Rationale: CN VI (Abducens) innervates the lateral rectus muscle, which abducts the eye
(moves it laterally).
5. A pulse that is documented as ‘2+’ on a scale of 0 to 4 is considered:
A. Absent
B. Weak or thready
C. Bounding
D. Normal/Expected
Answer: D
Rationale: On a standard 0-4 scale, 0 is absent, 1+ is weak, 2+ is normal, 3+ is increased,
and 4+ is bounding.
6. Where is Erb’s point located on the chest wall?
A. Second right intercostal space
B. Second left intercostal space
C. Fifth left intercostal space
D. Third left intercostal space
E. Fourth left intercostal space
Answer: D
