NSG 3600 EXAM 2: PRACTICE EXAM WITH 100
QUESTIONS AND DETAILED ANSWERS AND
RATIONALE UPDATED 2026
A nurse is conducting a health history with a 58-year-old male. Which statement by the patient
requires the nurse to explore further for cardiovascular risk factors?
A. "I take a daily multivitamin."
B. "My father had a heart attack at age 52."
C. "I walk 30 minutes most days of the week."
D. "I eat fish twice a week."
Answer: B
Rationale: A first-degree relative with premature coronary artery disease (men <55, women <65) is a
major non-modifiable risk factor. Options A, C, and D reflect protective or neutral behaviors.
During a physical assessment, the nurse notes jugular venous distention (JVD) at 45 degrees. This
finding most likely indicates:
A. Dehydration
B. Right-sided heart failure
C. Hypovolemia
D. Normal venous return
Answer: B
Rationale: JVD at 30–45 degrees suggests elevated right atrial pressure, commonly seen in right-
sided heart failure, fluid overload, or cardiac tamponade. Dehydration and hypovolemia cause flat
neck veins.
Which technique is correct when auscultating lung sounds?
A. Use the bell of the stethoscope over anterior chest
B. Ask the patient to breathe through the nose
,C. Listen to one full respiratory cycle at each site
D. Compare left and right sides simultaneously
Answer: C
Rationale: Listening to at least one full cycle at each location ensures accurate sound identification.
The diaphragm is used for lung sounds, mouth breathing is preferred, and sides are compared
sequentially, not simultaneously.
A patient presents with a 2-cm, raised, erythematous lesion with irregular borders. The nurse should
document this as a:
A. Macule
B. Papule
C. Plaque
D. Nodule
Answer: C
Rationale: A plaque is a raised, solid lesion >1 cm, often formed by coalescing papules. Macules are
flat; papules are <1 cm; nodules are deeper and firmer.
When assessing cranial nerve XII, the nurse should ask the patient to:
A. Shrug shoulders against resistance
B. Stick out the tongue
C. Smile and show teeth
D. Close eyes tightly
Answer: B
Rationale: CN XII (hypoglossal) controls tongue movement. Shrugging tests CN XI, smiling tests CN
VII, and eye closure tests CN VII.
A nurse palpates a pulse that is bounding and easily felt. This should be documented as:
A. 1+
B. 2+
C. 3+
D. 4+
Answer: C
,Rationale: Pulse amplitude scale: 0=absent, 1+=diminished, 2+=normal, 3+=full/bounding,
4+=aneurysmal. A bounding pulse is 3+.
Which finding during a abdominal assessment requires immediate follow-up?
A. Bowel sounds every 10 seconds
B. Tympany over most of the abdomen
C. Bruit over the aorta
D. Soft, non-tender abdomen
Answer: C
Rationale: An abdominal bruit may indicate renal artery stenosis or aortic aneurysm and requires
further evaluation. Normal bowel sounds occur every 5–15 seconds; tympany is normal over gas-
filled areas; a soft, non-tender abdomen is expected.
The nurse is assessing a patient with suspected meningitis. Which sign is tested by flexing the hip
and knee, then extending the knee?
A. Brudzinski sign
B. Kernig sign
C. Babinski sign
D. Romberg test
Answer: B
Rationale: Kernig sign tests for meningeal irritation; pain/resistance on knee extension is positive.
Brudzinski tests neck flexion causing hip/knee flexion. Babinski tests plantar reflex. Romberg tests
balance.
A patient reports "ringing in the ears." The nurse should document this as:
A. Vertigo
B. Tinnitus
C. Presbycusis
D. Otalgia
Answer: B
Rationale: Tinnitus is perception of sound without external stimulus. Vertigo is spinning sensation;
presbycusis is age-related hearing loss; otalgia is ear pain.
, During a skin assessment, the nurse notes blanching erythema that does not return to baseline after
pressure. This indicates:
A. Stage 1 pressure injury
B. Stage 2 pressure injury
C. Deep tissue injury
D. Normal capillary refill
Answer: A
Rationale: Stage 1 pressure injury presents as non-blanchable erythema on intact skin. Stage 2
involves partial-thickness loss; deep tissue injury appears purple/maroon; normal skin blanches and
returns quickly.
Which vital sign change is expected in a patient with hyperthyroidism?
A. Bradycardia
B. Hypotension
C. Tachycardia
D. Hypothermia
Answer: C
Rationale: Hyperthyroidism increases metabolic rate, causing tachycardia, hypertension, and heat
intolerance. Bradycardia and hypothermia occur in hypothyroidism.
The nurse is preparing to assess the apical pulse. The stethoscope should be placed at:
A. 2nd intercostal space, right sternal border
B. 4th intercostal space, left sternal border
C. 5th intercostal space, midclavicular line
D. 2nd intercostal space, left sternal border
Answer: C
Rationale: The apical pulse (point of maximal impulse) is best heard at the 5th ICS, midclavicular line.
Other locations correspond to aortic, tricuspid, and pulmonic areas.
A patient has a respiratory rate of 8 breaths/min with shallow depth. The nurse should document
this as:
A. Tachypnea
B. Bradypnea
QUESTIONS AND DETAILED ANSWERS AND
RATIONALE UPDATED 2026
A nurse is conducting a health history with a 58-year-old male. Which statement by the patient
requires the nurse to explore further for cardiovascular risk factors?
A. "I take a daily multivitamin."
B. "My father had a heart attack at age 52."
C. "I walk 30 minutes most days of the week."
D. "I eat fish twice a week."
Answer: B
Rationale: A first-degree relative with premature coronary artery disease (men <55, women <65) is a
major non-modifiable risk factor. Options A, C, and D reflect protective or neutral behaviors.
During a physical assessment, the nurse notes jugular venous distention (JVD) at 45 degrees. This
finding most likely indicates:
A. Dehydration
B. Right-sided heart failure
C. Hypovolemia
D. Normal venous return
Answer: B
Rationale: JVD at 30–45 degrees suggests elevated right atrial pressure, commonly seen in right-
sided heart failure, fluid overload, or cardiac tamponade. Dehydration and hypovolemia cause flat
neck veins.
Which technique is correct when auscultating lung sounds?
A. Use the bell of the stethoscope over anterior chest
B. Ask the patient to breathe through the nose
,C. Listen to one full respiratory cycle at each site
D. Compare left and right sides simultaneously
Answer: C
Rationale: Listening to at least one full cycle at each location ensures accurate sound identification.
The diaphragm is used for lung sounds, mouth breathing is preferred, and sides are compared
sequentially, not simultaneously.
A patient presents with a 2-cm, raised, erythematous lesion with irregular borders. The nurse should
document this as a:
A. Macule
B. Papule
C. Plaque
D. Nodule
Answer: C
Rationale: A plaque is a raised, solid lesion >1 cm, often formed by coalescing papules. Macules are
flat; papules are <1 cm; nodules are deeper and firmer.
When assessing cranial nerve XII, the nurse should ask the patient to:
A. Shrug shoulders against resistance
B. Stick out the tongue
C. Smile and show teeth
D. Close eyes tightly
Answer: B
Rationale: CN XII (hypoglossal) controls tongue movement. Shrugging tests CN XI, smiling tests CN
VII, and eye closure tests CN VII.
A nurse palpates a pulse that is bounding and easily felt. This should be documented as:
A. 1+
B. 2+
C. 3+
D. 4+
Answer: C
,Rationale: Pulse amplitude scale: 0=absent, 1+=diminished, 2+=normal, 3+=full/bounding,
4+=aneurysmal. A bounding pulse is 3+.
Which finding during a abdominal assessment requires immediate follow-up?
A. Bowel sounds every 10 seconds
B. Tympany over most of the abdomen
C. Bruit over the aorta
D. Soft, non-tender abdomen
Answer: C
Rationale: An abdominal bruit may indicate renal artery stenosis or aortic aneurysm and requires
further evaluation. Normal bowel sounds occur every 5–15 seconds; tympany is normal over gas-
filled areas; a soft, non-tender abdomen is expected.
The nurse is assessing a patient with suspected meningitis. Which sign is tested by flexing the hip
and knee, then extending the knee?
A. Brudzinski sign
B. Kernig sign
C. Babinski sign
D. Romberg test
Answer: B
Rationale: Kernig sign tests for meningeal irritation; pain/resistance on knee extension is positive.
Brudzinski tests neck flexion causing hip/knee flexion. Babinski tests plantar reflex. Romberg tests
balance.
A patient reports "ringing in the ears." The nurse should document this as:
A. Vertigo
B. Tinnitus
C. Presbycusis
D. Otalgia
Answer: B
Rationale: Tinnitus is perception of sound without external stimulus. Vertigo is spinning sensation;
presbycusis is age-related hearing loss; otalgia is ear pain.
, During a skin assessment, the nurse notes blanching erythema that does not return to baseline after
pressure. This indicates:
A. Stage 1 pressure injury
B. Stage 2 pressure injury
C. Deep tissue injury
D. Normal capillary refill
Answer: A
Rationale: Stage 1 pressure injury presents as non-blanchable erythema on intact skin. Stage 2
involves partial-thickness loss; deep tissue injury appears purple/maroon; normal skin blanches and
returns quickly.
Which vital sign change is expected in a patient with hyperthyroidism?
A. Bradycardia
B. Hypotension
C. Tachycardia
D. Hypothermia
Answer: C
Rationale: Hyperthyroidism increases metabolic rate, causing tachycardia, hypertension, and heat
intolerance. Bradycardia and hypothermia occur in hypothyroidism.
The nurse is preparing to assess the apical pulse. The stethoscope should be placed at:
A. 2nd intercostal space, right sternal border
B. 4th intercostal space, left sternal border
C. 5th intercostal space, midclavicular line
D. 2nd intercostal space, left sternal border
Answer: C
Rationale: The apical pulse (point of maximal impulse) is best heard at the 5th ICS, midclavicular line.
Other locations correspond to aortic, tricuspid, and pulmonic areas.
A patient has a respiratory rate of 8 breaths/min with shallow depth. The nurse should document
this as:
A. Tachypnea
B. Bradypnea
