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NU 136 EXAM 2 PHYSICAL ASSESSMENT ACTUAL
EXAM [ QUESTION 1- 200] AND ANSWERS UPDATED
2026/2027| 100% VERIFIED|DETAILED RATIONALES –
PASS GUARANTEED A+ GRADED |INSTANT
DOWNLOAD
Introduction:
Welcome to the comprehensive practice examination for NU 136 Exam 2 Physical Assessment.
This rigorous practice resource has been meticulously designed to bridge classroom theory and
clinical application, empowering nursing students to master foundational and advanced health
assessment techniques. This resource covers critical body systems typically evaluated during the
second major milestone of nursing education, including the cardiovascular, respiratory,
gastrointestinal, peripheral vascular, and neurological systems. Engaging with these original,
scenario-based questions is essential for cultivating clinical judgment, honing physical
examination skills, and understanding the physiological rationale behind normal and abnormal
clinical findings. By thoroughly testing your ability to analyze subjective data and objective
physical examination cues, this set prepares you to excel on high-stakes nursing exams and lays
a steadfast groundwork for safe, patient-centered clinical practice. Each question features an
advanced clinical scenario crafted to mirror actual testing standards, accompanied by detailed,
evidence-based rationales that reinforce core anatomical and pathophysiological concepts
essential for every aspiring registered nurse.
Core Domains Covered:
1. Cardiovascular System Assessment: Evaluation of heart sounds, apical impulse localization,
detection of murmurs, and assessment for jugular venous distention.
2. Respiratory System Assessment: Inspection, palpation, percussion, and auscultation of breath
sounds, identifying adventitious findings such as crackles, wheezes, and rhonchi.
3. Peripheral Vascular and Lymphatic Assessment: Evaluation of peripheral pulses, capillary
refill, edema grading, arterial insufficiency signs, and deep vein thrombosis screening.
4. Gastrointestinal System Assessment: Systematic inspection, auscultation of bowel sounds,
light and deep palpation, and percussion techniques for abdominal organs.
5. Neurological System Assessment: Examination of cranial nerves, deep tendon reflexes,
sensory function, cerebellar coordination, and mental status evaluation.
6. Integumentary, Head, Eyes, Ears, Nose, and Throat (HEENT) Assessment: Inspection of skin
lesions, pupillary light reflex, otoscopic ear exam, and assessment of oropharyngeal structures.
7. Musculoskeletal System Assessment: Range of motion testing, muscle strength grading, spinal
alignment, and joint stability evaluations.
8. Comprehensive Health History and Clinical Documentation: Gathering focused subjective
data, synthesizing clinical cues, and recognizing priority nursing interventions based on
assessment findings.
,Page |2
Questions 1 - 100
Question 1: During a cardiovascular assessment, the nurse auscultates the second heart sound
(S2) at the base of the heart. Which physiological event produces this sound?
A) Closure of the mitral and tricuspid valves
B) Closure of the aortic and pulmonic valves
C) Opening of the aortic and pulmonic valves
D) Rapid ventricular filling during early diastole
Rationale: The second heart sound (S2) marks the end of systole and is produced by the closure
of the semilunar valves, specifically the aortic and pulmonic valves. Option A describes the
production of the first heart sound (S1), which marks the beginning of systole. Option C
describes valve opening, which is normally silent. Option D corresponds to the production of an
S3 gallop sound, which occurs during rapid passive ventricular filling in early diastole.
Question 2: A nurse is performing a respiratory assessment on an adult client and notes
hyperresonance upon percussion over the left lower posterior thorax. Which condition is most
consistent with this finding?
A) Lobar pneumonia with consolidation
B) Pleural effusion with fluid accumulation
C) Emphysema or hyperinflation of the lung
D) Pulmonary atelectasis of the lower lobe
Rationale: Hyperresonance is a lower-pitched, booming sound that indicates an excessive
amount of air in the thorax, commonly found with conditions like emphysema or pneumothorax.
Options A, B, and D involve tissue consolidation, fluid accumulation, or alveolar collapse, all of
which produce a dull percussion note rather than hyperresonance.
Question 3: While assessing a patient's peripheral vascular system, the nurse compresses the nail
bed of the great toe, notes blanching, and observes that the color returns in four seconds. How
should the nurse document this finding?
A) Normal capillary refill time indicating adequate peripheral perfusion
B) Delayed capillary refill time suggesting peripheral arterial impairment
C) Normal venous return time indicating absence of deep vein thrombosis
D) Abnormal capillary refill indicative of dependent edema
Rationale: A normal capillary refill time is typically less than or equal to two seconds. A refill
time of four seconds is considered delayed, suggesting compromised peripheral arterial
circulation or poor peripheral perfusion. Option A is incorrect because the normal threshold is
exceeded. Options C and D misinterpret the clinical significance of capillary refill testing, which
evaluates arterial flow rather than venous thrombosis or edema.
Question 4: A nurse is preparing to assess a patient's abdomen. Which sequence of physical
assessment techniques should the nurse implement?
A) Inspection, palpation, percussion, auscultation
B) Auscultation, inspection, percussion, palpation
C) Inspection, auscultation, percussion, palpation
D) Palpation, percussion, auscultation, inspection
Rationale: The correct sequence for an abdominal examination is inspection followed by
auscultation, percussion, and finally palpation. Auscultation must precede percussion and
,Page |3
palpation because manipulating the abdomen can alter bowel motility and falsely increase or
decrease bowel sounds. Option C follows this critical clinical rule.
Question 5: The nurse is testing cranial nerve V (Trigeminal nerve) during a neurological
examination. Which technique is most appropriate for assessing the sensory function of this
nerve?
A) Asking the patient to smile, frown, and puff out both cheeks
B) Touching the patient's forehead, cheeks, and chin with a wisp of cotton
C) Testing the patient's ability to identify sweet and salty tastes on the tongue
D) Having the patient clench their teeth while the nurse palpates the temporal muscles
Rationale: Cranial nerve V has both motor and sensory functions. Its sensory branches
ophthalmic, maxillary, and mandibular are assessed by light touch with a wisp of cotton across
the forehead, cheeks, and chin. Option A assesses cranial nerve VII (Facial). Option C assesses
cranial nerve VII and IX for taste. Option D assesses the motor function of cranial nerve V.
Question 6: A client presents with a firm, deeply pigmented, asymmetrical skin lesion with
irregular borders measuring seven millimeters in diameter. Which tool should the nurse use to
guide further assessment of this lesion?
A) The Glascow Coma Scale
B) The ABCDE mnemonic for skin cancer evaluation
C) The Braden Scale for pressure injury risk
D) The PQRST mnemonic for pain assessment
Rationale: The ABCDE criteria (Asymmetry, Border irregularity, Color variation, Diameter
greater than six millimeters, and Evolving/Elevation) are specifically designed to assess
suspicious skin lesions for potential malignant melanoma. Option A assesses level of
consciousness. Option C assesses risk for pressure ulcers. Option D evaluates pain
characteristics.
Question 7: When evaluating deep tendon reflexes in an adult client, the nurse elicits a response
that is brisk, hyperactive, and accompanied by clonus in the left patellar tendon. How should the
nurse grade this reflex?
A) 1+
B) 2+
C) 3+
D) 4+
Rationale: Deep tendon reflexes are graded on a scale from 0 to 4+. A grade of 4+ indicates
very brisk, hyperactive reflexes with clonus, which is abnormal and often indicates central
nervous system disease. A grade of 2+ is normal, 1+ is diminished, and 3+ is brisker than
average but without clonus.
Question 8: A nurse auscultates the chest of a client with heart failure and hears an extra heart
sound occurring just before S1, sounding like a "Tennessee" rhythm. What is this sound called?
A) An opening snap
B) An aortic ejection click
C) An atrial gallop or S4
D) A ventricular gallop or S3
, Page |4
Rationale: An S4 heart sound, or atrial gallop, occurs late in diastole just before S1 when the
atria contract against a non-compliant, stiff ventricle. It is phonetically described as sounding
like "Ten-nes-see". An S3 sound corresponds to a "Kentucky" rhythm occurring early in diastole.
Question 9: During a respiratory examination, the nurse asks the patient to say the words
"ninety-nine" repeatedly while auscultating the chest wall. The voice sounds exceptionally clear
and distinct over the right lower lobe. What is the clinical term for this finding?
A) Egophony
B) Bronchophony
C) Whispered pectoriloquy
D) Vesicular resonance
Rationale: Bronchophony occurs when spoken words are heard with unusual clarity, intensity,
and distinctness through the stethoscope chestpiece, typically indicating lung consolidation such
as pneumonia. Egophony involves the spoken "E" sound changing to a nasal "A" sound.
Whispered pectoriloquy occurs when whispered words are heard with extreme clarity.
Question 10: The nurse is evaluating peripheral edema in a patient with chronic venous
insufficiency. When pressing firmly over the medial malleolus for five seconds, an indentation
measuring six millimeters remains for nearly a minute before rebounding. How should this
edema be graded?
A) 1+
B) 2+
C) 3+
D) 4+
Rationale: Edema grading is based on depth and rebound time: 1+ is mild pitting (two
millimeters) with no perceptible distortion; 2+ is moderate pitting (four millimeters) with rapid
rebound; 3+ is deep pitting (six millimeters) lasting up to a minute; and 4+ is very deep pitting
(eight millimeters) lasting two minutes or longer.
Question 11: A nurse assesses a patient's thyroid gland using the posterior approach. What is the
correct anatomical positioning and action for the nurse?
A) Standing in front of the patient and palpating with both thumbs while the patient swallows
water.
B) Standing behind the patient, placing fingers below the cricoid cartilage, and asking the
patient to swallow
C) Auscultating the lateral lobes of the thyroid with the diaphragm of the stethoscope for bruits
without palpation.
D) Instructing the patient to hyperextend the neck fully while the nurse presses firmly on the
thyroid isthmus.
Rationale: The posterior approach is standard for thyroid palpation; the nurse stands behind the
client, loops fingers below the cricoid cartilage to feel the isthmus, and asks the client to swallow
to help the thyroid tissue rise under the examining fingers. Hyperextending the neck too far can
tighten muscles and hinder accurate palpation.
Question 12: Which physical assessment finding is considered a normal variant in an older adult
client during a neurological and musculoskeletal evaluation?
NU 136 EXAM 2 PHYSICAL ASSESSMENT ACTUAL
EXAM [ QUESTION 1- 200] AND ANSWERS UPDATED
2026/2027| 100% VERIFIED|DETAILED RATIONALES –
PASS GUARANTEED A+ GRADED |INSTANT
DOWNLOAD
Introduction:
Welcome to the comprehensive practice examination for NU 136 Exam 2 Physical Assessment.
This rigorous practice resource has been meticulously designed to bridge classroom theory and
clinical application, empowering nursing students to master foundational and advanced health
assessment techniques. This resource covers critical body systems typically evaluated during the
second major milestone of nursing education, including the cardiovascular, respiratory,
gastrointestinal, peripheral vascular, and neurological systems. Engaging with these original,
scenario-based questions is essential for cultivating clinical judgment, honing physical
examination skills, and understanding the physiological rationale behind normal and abnormal
clinical findings. By thoroughly testing your ability to analyze subjective data and objective
physical examination cues, this set prepares you to excel on high-stakes nursing exams and lays
a steadfast groundwork for safe, patient-centered clinical practice. Each question features an
advanced clinical scenario crafted to mirror actual testing standards, accompanied by detailed,
evidence-based rationales that reinforce core anatomical and pathophysiological concepts
essential for every aspiring registered nurse.
Core Domains Covered:
1. Cardiovascular System Assessment: Evaluation of heart sounds, apical impulse localization,
detection of murmurs, and assessment for jugular venous distention.
2. Respiratory System Assessment: Inspection, palpation, percussion, and auscultation of breath
sounds, identifying adventitious findings such as crackles, wheezes, and rhonchi.
3. Peripheral Vascular and Lymphatic Assessment: Evaluation of peripheral pulses, capillary
refill, edema grading, arterial insufficiency signs, and deep vein thrombosis screening.
4. Gastrointestinal System Assessment: Systematic inspection, auscultation of bowel sounds,
light and deep palpation, and percussion techniques for abdominal organs.
5. Neurological System Assessment: Examination of cranial nerves, deep tendon reflexes,
sensory function, cerebellar coordination, and mental status evaluation.
6. Integumentary, Head, Eyes, Ears, Nose, and Throat (HEENT) Assessment: Inspection of skin
lesions, pupillary light reflex, otoscopic ear exam, and assessment of oropharyngeal structures.
7. Musculoskeletal System Assessment: Range of motion testing, muscle strength grading, spinal
alignment, and joint stability evaluations.
8. Comprehensive Health History and Clinical Documentation: Gathering focused subjective
data, synthesizing clinical cues, and recognizing priority nursing interventions based on
assessment findings.
,Page |2
Questions 1 - 100
Question 1: During a cardiovascular assessment, the nurse auscultates the second heart sound
(S2) at the base of the heart. Which physiological event produces this sound?
A) Closure of the mitral and tricuspid valves
B) Closure of the aortic and pulmonic valves
C) Opening of the aortic and pulmonic valves
D) Rapid ventricular filling during early diastole
Rationale: The second heart sound (S2) marks the end of systole and is produced by the closure
of the semilunar valves, specifically the aortic and pulmonic valves. Option A describes the
production of the first heart sound (S1), which marks the beginning of systole. Option C
describes valve opening, which is normally silent. Option D corresponds to the production of an
S3 gallop sound, which occurs during rapid passive ventricular filling in early diastole.
Question 2: A nurse is performing a respiratory assessment on an adult client and notes
hyperresonance upon percussion over the left lower posterior thorax. Which condition is most
consistent with this finding?
A) Lobar pneumonia with consolidation
B) Pleural effusion with fluid accumulation
C) Emphysema or hyperinflation of the lung
D) Pulmonary atelectasis of the lower lobe
Rationale: Hyperresonance is a lower-pitched, booming sound that indicates an excessive
amount of air in the thorax, commonly found with conditions like emphysema or pneumothorax.
Options A, B, and D involve tissue consolidation, fluid accumulation, or alveolar collapse, all of
which produce a dull percussion note rather than hyperresonance.
Question 3: While assessing a patient's peripheral vascular system, the nurse compresses the nail
bed of the great toe, notes blanching, and observes that the color returns in four seconds. How
should the nurse document this finding?
A) Normal capillary refill time indicating adequate peripheral perfusion
B) Delayed capillary refill time suggesting peripheral arterial impairment
C) Normal venous return time indicating absence of deep vein thrombosis
D) Abnormal capillary refill indicative of dependent edema
Rationale: A normal capillary refill time is typically less than or equal to two seconds. A refill
time of four seconds is considered delayed, suggesting compromised peripheral arterial
circulation or poor peripheral perfusion. Option A is incorrect because the normal threshold is
exceeded. Options C and D misinterpret the clinical significance of capillary refill testing, which
evaluates arterial flow rather than venous thrombosis or edema.
Question 4: A nurse is preparing to assess a patient's abdomen. Which sequence of physical
assessment techniques should the nurse implement?
A) Inspection, palpation, percussion, auscultation
B) Auscultation, inspection, percussion, palpation
C) Inspection, auscultation, percussion, palpation
D) Palpation, percussion, auscultation, inspection
Rationale: The correct sequence for an abdominal examination is inspection followed by
auscultation, percussion, and finally palpation. Auscultation must precede percussion and
,Page |3
palpation because manipulating the abdomen can alter bowel motility and falsely increase or
decrease bowel sounds. Option C follows this critical clinical rule.
Question 5: The nurse is testing cranial nerve V (Trigeminal nerve) during a neurological
examination. Which technique is most appropriate for assessing the sensory function of this
nerve?
A) Asking the patient to smile, frown, and puff out both cheeks
B) Touching the patient's forehead, cheeks, and chin with a wisp of cotton
C) Testing the patient's ability to identify sweet and salty tastes on the tongue
D) Having the patient clench their teeth while the nurse palpates the temporal muscles
Rationale: Cranial nerve V has both motor and sensory functions. Its sensory branches
ophthalmic, maxillary, and mandibular are assessed by light touch with a wisp of cotton across
the forehead, cheeks, and chin. Option A assesses cranial nerve VII (Facial). Option C assesses
cranial nerve VII and IX for taste. Option D assesses the motor function of cranial nerve V.
Question 6: A client presents with a firm, deeply pigmented, asymmetrical skin lesion with
irregular borders measuring seven millimeters in diameter. Which tool should the nurse use to
guide further assessment of this lesion?
A) The Glascow Coma Scale
B) The ABCDE mnemonic for skin cancer evaluation
C) The Braden Scale for pressure injury risk
D) The PQRST mnemonic for pain assessment
Rationale: The ABCDE criteria (Asymmetry, Border irregularity, Color variation, Diameter
greater than six millimeters, and Evolving/Elevation) are specifically designed to assess
suspicious skin lesions for potential malignant melanoma. Option A assesses level of
consciousness. Option C assesses risk for pressure ulcers. Option D evaluates pain
characteristics.
Question 7: When evaluating deep tendon reflexes in an adult client, the nurse elicits a response
that is brisk, hyperactive, and accompanied by clonus in the left patellar tendon. How should the
nurse grade this reflex?
A) 1+
B) 2+
C) 3+
D) 4+
Rationale: Deep tendon reflexes are graded on a scale from 0 to 4+. A grade of 4+ indicates
very brisk, hyperactive reflexes with clonus, which is abnormal and often indicates central
nervous system disease. A grade of 2+ is normal, 1+ is diminished, and 3+ is brisker than
average but without clonus.
Question 8: A nurse auscultates the chest of a client with heart failure and hears an extra heart
sound occurring just before S1, sounding like a "Tennessee" rhythm. What is this sound called?
A) An opening snap
B) An aortic ejection click
C) An atrial gallop or S4
D) A ventricular gallop or S3
, Page |4
Rationale: An S4 heart sound, or atrial gallop, occurs late in diastole just before S1 when the
atria contract against a non-compliant, stiff ventricle. It is phonetically described as sounding
like "Ten-nes-see". An S3 sound corresponds to a "Kentucky" rhythm occurring early in diastole.
Question 9: During a respiratory examination, the nurse asks the patient to say the words
"ninety-nine" repeatedly while auscultating the chest wall. The voice sounds exceptionally clear
and distinct over the right lower lobe. What is the clinical term for this finding?
A) Egophony
B) Bronchophony
C) Whispered pectoriloquy
D) Vesicular resonance
Rationale: Bronchophony occurs when spoken words are heard with unusual clarity, intensity,
and distinctness through the stethoscope chestpiece, typically indicating lung consolidation such
as pneumonia. Egophony involves the spoken "E" sound changing to a nasal "A" sound.
Whispered pectoriloquy occurs when whispered words are heard with extreme clarity.
Question 10: The nurse is evaluating peripheral edema in a patient with chronic venous
insufficiency. When pressing firmly over the medial malleolus for five seconds, an indentation
measuring six millimeters remains for nearly a minute before rebounding. How should this
edema be graded?
A) 1+
B) 2+
C) 3+
D) 4+
Rationale: Edema grading is based on depth and rebound time: 1+ is mild pitting (two
millimeters) with no perceptible distortion; 2+ is moderate pitting (four millimeters) with rapid
rebound; 3+ is deep pitting (six millimeters) lasting up to a minute; and 4+ is very deep pitting
(eight millimeters) lasting two minutes or longer.
Question 11: A nurse assesses a patient's thyroid gland using the posterior approach. What is the
correct anatomical positioning and action for the nurse?
A) Standing in front of the patient and palpating with both thumbs while the patient swallows
water.
B) Standing behind the patient, placing fingers below the cricoid cartilage, and asking the
patient to swallow
C) Auscultating the lateral lobes of the thyroid with the diaphragm of the stethoscope for bruits
without palpation.
D) Instructing the patient to hyperextend the neck fully while the nurse presses firmly on the
thyroid isthmus.
Rationale: The posterior approach is standard for thyroid palpation; the nurse stands behind the
client, loops fingers below the cricoid cartilage to feel the isthmus, and asks the client to swallow
to help the thyroid tissue rise under the examining fingers. Hyperextending the neck too far can
tighten muscles and hinder accurate palpation.
Question 12: Which physical assessment finding is considered a normal variant in an older adult
client during a neurological and musculoskeletal evaluation?
