NUR 504 APEA FINAL STUDY GUIDE | COMPREHENSIVE NURSING EXAM REVIEW,
PRACTICE QUESTIONS & ANSWERS 2026/2027
hilar area. - ANS ✔✔Retractions are observed in all the following areas except the:
Supraventricular area
hilar area.
intercostal area
costal marginal area.
the child's febrile state. - ANS ✔✔A 3 year-old presents with a history of fever and cough over the past
24 hours. Findings on exam reveal: temperature of 102°F, apical heart rate of 157 beats/minute, and
respiratory rate of 40 breaths/minute. Tachypnea in this child is most likely related to
Paradoxical respirations.
the child's febrile state.
the child's age.
an airway obstruction.
standing on the side rather than directly behind the patient. - ANS ✔✔When percussing the lower
posterior chest, begin by:
standing on the side rather than directly behind the patient.
having the patient lie supine on the examining table.
carefully palpating any area the patient has reported pain.
using the ball or the ulnar surface of the hand
ask the patient to take a deep breathe and note any delay in expansion during inhalation. - ANS ✔✔The
palpation technique used to assess respiratory expansion of the chest is placing the hands on the eight
or tenth ribs posteriorly with the thumbs close to the vertebrae, sliding the hand medially and grasping a
small fold of skin between the thumbs. Then
ask the patient to cough and note chest expansion.
ask the patient to take a deep breathe and note any delay in expansion during inhalation.
have the patient hold his breath for 15 seconds then note chest expansion.
have the patient exhale forcefully noting expansion on expiration.
Blood streaked material often originates from the gastrointestinal tract. - ANS ✔✔When trying to
differentiate between hemoptysis or blood streaked material, which one of the following observations is
correct?
Hemoptysis is seen frequently in infants, children, and adolescents with allergic rhinitis.
Blood originating in the stomach is usually brighter than blood originating from the respiratory tract.
Hemoptysis is common in children with cystic fibrosis.
Blood streaked material often originates from the gastrointestinal tract.
Resonant. - ANS ✔✔When percussing the chest in a patient who has left sided heart failure, the sound
emanated would be:
Resonant.
dull tympany.
Diffusely
, hyper resonant
Scapular line. - ANS ✔✔The line that extends through the inferior angle of the scapula when the arms
are at the sides of the body is the:
mid vertebral line
Scapular line.
midclavicular line
mid-spinal line
Bronchiectasis. - ANS ✔✔condition associated with a chronic cough that produces copious amounts of
purulent sputum is most likely:
tracheobronchitis.
chronic bronchitis.
Bronchiectasis.
laryngitis.
chronic obstructive pulmonary disease (COPD) - ANS ✔✔A patient who walked into the examination
room, may be observed to be sitting and leaning forward in his chair. Lips were pursed during exhalation
and arms are supported on the table. This position could be consistent with patients who have:
pneumonia.
chronic obstructive pulmonary disease (COPD)
asthma
croup.
vesicular - ANS ✔✔Breath sounds heard over the periphery of the lung fields are:
bronchial.
abnormal.
bronchovesicular.
vesicular
Percuss the areas over the scapulae. - ANS ✔✔When percussing the posterior chest, which one of the
following techniques would be omitted?
-When comparing two areas on the chest, use the same percussion technique in both areas.
-Percuss one side of the chest then the other at each level.
-Percuss the areas over the scapulae.
-If a louder note is needed, apply more pressure with the pleximeter finger.
vesicular with late inspiratory crackles in the dependent portions of the lungs and resonant on
percussion. - ANS ✔✔When auscultating breath sounds in a patient who has left sided heart failure, the
breath sounds are:
-vesicular with late inspiratory crackles in the dependent portions of the lungs and resonant on
percussion.
bronchial with late inspiratory crackles over the involved area and dull on percussion.
vesicular without adventitious sounds and resonant on percussion.
Incorrect: decreased with some audible wheezes and diffusely
hyperresonant on percussion.
PRACTICE QUESTIONS & ANSWERS 2026/2027
hilar area. - ANS ✔✔Retractions are observed in all the following areas except the:
Supraventricular area
hilar area.
intercostal area
costal marginal area.
the child's febrile state. - ANS ✔✔A 3 year-old presents with a history of fever and cough over the past
24 hours. Findings on exam reveal: temperature of 102°F, apical heart rate of 157 beats/minute, and
respiratory rate of 40 breaths/minute. Tachypnea in this child is most likely related to
Paradoxical respirations.
the child's febrile state.
the child's age.
an airway obstruction.
standing on the side rather than directly behind the patient. - ANS ✔✔When percussing the lower
posterior chest, begin by:
standing on the side rather than directly behind the patient.
having the patient lie supine on the examining table.
carefully palpating any area the patient has reported pain.
using the ball or the ulnar surface of the hand
ask the patient to take a deep breathe and note any delay in expansion during inhalation. - ANS ✔✔The
palpation technique used to assess respiratory expansion of the chest is placing the hands on the eight
or tenth ribs posteriorly with the thumbs close to the vertebrae, sliding the hand medially and grasping a
small fold of skin between the thumbs. Then
ask the patient to cough and note chest expansion.
ask the patient to take a deep breathe and note any delay in expansion during inhalation.
have the patient hold his breath for 15 seconds then note chest expansion.
have the patient exhale forcefully noting expansion on expiration.
Blood streaked material often originates from the gastrointestinal tract. - ANS ✔✔When trying to
differentiate between hemoptysis or blood streaked material, which one of the following observations is
correct?
Hemoptysis is seen frequently in infants, children, and adolescents with allergic rhinitis.
Blood originating in the stomach is usually brighter than blood originating from the respiratory tract.
Hemoptysis is common in children with cystic fibrosis.
Blood streaked material often originates from the gastrointestinal tract.
Resonant. - ANS ✔✔When percussing the chest in a patient who has left sided heart failure, the sound
emanated would be:
Resonant.
dull tympany.
Diffusely
, hyper resonant
Scapular line. - ANS ✔✔The line that extends through the inferior angle of the scapula when the arms
are at the sides of the body is the:
mid vertebral line
Scapular line.
midclavicular line
mid-spinal line
Bronchiectasis. - ANS ✔✔condition associated with a chronic cough that produces copious amounts of
purulent sputum is most likely:
tracheobronchitis.
chronic bronchitis.
Bronchiectasis.
laryngitis.
chronic obstructive pulmonary disease (COPD) - ANS ✔✔A patient who walked into the examination
room, may be observed to be sitting and leaning forward in his chair. Lips were pursed during exhalation
and arms are supported on the table. This position could be consistent with patients who have:
pneumonia.
chronic obstructive pulmonary disease (COPD)
asthma
croup.
vesicular - ANS ✔✔Breath sounds heard over the periphery of the lung fields are:
bronchial.
abnormal.
bronchovesicular.
vesicular
Percuss the areas over the scapulae. - ANS ✔✔When percussing the posterior chest, which one of the
following techniques would be omitted?
-When comparing two areas on the chest, use the same percussion technique in both areas.
-Percuss one side of the chest then the other at each level.
-Percuss the areas over the scapulae.
-If a louder note is needed, apply more pressure with the pleximeter finger.
vesicular with late inspiratory crackles in the dependent portions of the lungs and resonant on
percussion. - ANS ✔✔When auscultating breath sounds in a patient who has left sided heart failure, the
breath sounds are:
-vesicular with late inspiratory crackles in the dependent portions of the lungs and resonant on
percussion.
bronchial with late inspiratory crackles over the involved area and dull on percussion.
vesicular without adventitious sounds and resonant on percussion.
Incorrect: decreased with some audible wheezes and diffusely
hyperresonant on percussion.
