NSG 500 EXAM 2 – ADVANCED HEALTH
ASSESSMENT (2026/2027) QUESTIONS
AND ANSWERS
1. When assessing a patient for a suspected pneumothorax, which percussion note would the
advanced practice nurse expect to hear over the affected lung area?
A. Hyperresonance
B. Dullness
C. Resonance
D. Tympany
Answer: A
Conceptual Explanation: Hyperresonance is a lower-pitched, booming sound found when
too much air is present, such as in pneumothorax or emphysema.
2. An S3 heart sound is frequently considered a normal finding in children and young adults;
however, in an older adult, it often indicates:
A. Ventricular hypertrophy
B. Heart failure or fluid overload
,C. Reduced ventricular filling
D. Increased myocardial contractility
Answer: B
Conceptual Explanation: In adults over 40, an S3 (ventricular gallop) is usually
pathological and indicates decreased ventricular compliance or fluid overload, as seen in
heart failure.
3. During an abdominal assessment, the nurse practitioner elicits sharp pain and a sudden
halt in inspiration when palpating the right upper quadrant under the costal margin. This is a
positive:
A. Rovsing’s sign
B. Murphy’s sign
C. McBurney’s sign
D. Psoas sign
Answer: B
Conceptual Explanation: Murphy’s sign is used to assess for cholecystitis. A positive test
is indicated by sharp pain and inspiration arrest when the gallbladder is palpated during a
deep breath.
, 4. When evaluating tactile fremitus, the nurse practitioner notes increased fremitus over the
right lower lobe. This finding is most consistent with:
A. Lobar pneumonia
B. Pleural effusion
C. Pneumothorax
D. Bronchial obstruction
Answer: A
Conceptual Explanation: Tactile fremitus increases with lung consolidation (e.g.,
pneumonia) because sound travels better through solid or fluid-filled tissue than through
air.
5. A 65-year-old male presents with a history of hypertension. During auscultation of the
heart, a low-pitched, late diastolic sound is heard just before S1 at the apex. This sound is:
A. S3
B. Midsystolic click
C. S4
D. Opening snap
Answer: C
Conceptual Explanation: S4 is a late diastolic sound (atrial gallop) that occurs just before
S1, often associated with decreased ventricular compliance found in hypertension or CAD.
ASSESSMENT (2026/2027) QUESTIONS
AND ANSWERS
1. When assessing a patient for a suspected pneumothorax, which percussion note would the
advanced practice nurse expect to hear over the affected lung area?
A. Hyperresonance
B. Dullness
C. Resonance
D. Tympany
Answer: A
Conceptual Explanation: Hyperresonance is a lower-pitched, booming sound found when
too much air is present, such as in pneumothorax or emphysema.
2. An S3 heart sound is frequently considered a normal finding in children and young adults;
however, in an older adult, it often indicates:
A. Ventricular hypertrophy
B. Heart failure or fluid overload
,C. Reduced ventricular filling
D. Increased myocardial contractility
Answer: B
Conceptual Explanation: In adults over 40, an S3 (ventricular gallop) is usually
pathological and indicates decreased ventricular compliance or fluid overload, as seen in
heart failure.
3. During an abdominal assessment, the nurse practitioner elicits sharp pain and a sudden
halt in inspiration when palpating the right upper quadrant under the costal margin. This is a
positive:
A. Rovsing’s sign
B. Murphy’s sign
C. McBurney’s sign
D. Psoas sign
Answer: B
Conceptual Explanation: Murphy’s sign is used to assess for cholecystitis. A positive test
is indicated by sharp pain and inspiration arrest when the gallbladder is palpated during a
deep breath.
, 4. When evaluating tactile fremitus, the nurse practitioner notes increased fremitus over the
right lower lobe. This finding is most consistent with:
A. Lobar pneumonia
B. Pleural effusion
C. Pneumothorax
D. Bronchial obstruction
Answer: A
Conceptual Explanation: Tactile fremitus increases with lung consolidation (e.g.,
pneumonia) because sound travels better through solid or fluid-filled tissue than through
air.
5. A 65-year-old male presents with a history of hypertension. During auscultation of the
heart, a low-pitched, late diastolic sound is heard just before S1 at the apex. This sound is:
A. S3
B. Midsystolic click
C. S4
D. Opening snap
Answer: C
Conceptual Explanation: S4 is a late diastolic sound (atrial gallop) that occurs just before
S1, often associated with decreased ventricular compliance found in hypertension or CAD.
