NSG 3100 - Exam 2 (2026/2027) Page 1
EXAM 2: NSG3100 / NSG 3100 (LATEST UPDATE)
FUNDAMENTAL CONCEPTS & SKILLS FOR NURSING PRACTICE I
QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT | GRADE A - GALEN
Galen College of Nursing | Aligned with NCLEX-PN/RN Test Plan, QSEN Competencies, and Fundamentals of Nursing
Standards (2026/2027 Edition)
TOTAL QUESTIONS SECTIONS COGNITIVE LEVELS ALIGNED STANDARDS
100 Questions 8 Sections 20% Recall | 50% Application | 30% Analysis
NCLEX-PN/RN, QSEN, ANA, Fundamentals of Nursing 2026/2027
Section 1: Health Assessment & Physical Examination (Q1-Q15)
Q1: A nurse is preparing to perform a routine physical assessment on an adult patient admitted with
pneumonia. Which sequence of assessment techniques should the nurse use for most body systems, excluding
the abdomen?
A. Palpation, percussion, auscultation, inspection
B. Auscultation, palpation, percussion, inspection
C. Inspection, palpation, percussion, auscultation *[CORRECT]*
D. Inspection, auscultation, palpation, percussion
Correct Answer: C
Rationale: The standard sequence for physical assessment of most body systems is inspection, palpation, percussion, and
auscultation (IPPA). The abdomen is the exception, where auscultation precedes palpation and percussion because bowel
sounds can be altered by manual manipulation. The NSG 3100 curriculum emphasizes mastering the IPPA sequence as
foundational to the head-to-toe assessment, consistent with NCLEX-RN test plan Health Promotion and Maintenance
content.
Q2: During a general survey, the nurse observes a patient who appears older than the stated age, has poor
personal hygiene, and exhibits noticeable asymmetry of the face when smiling. Which action should the nurse
take first?
A. Document the findings and continue with the head-to-toe assessment
B. Notify the healthcare provider immediately about facial asymmetry
C. Perform a focused neurological assessment including cranial nerves VII and facial symmetry
*[CORRECT]*
D. Ask the patient about personal hygiene practices and living situation
Correct Answer: C
Rationale: Facial asymmetry noted during general survey is a significant finding that may indicate cranial nerve VII
(facial nerve) dysfunction, Bell's palsy, or stroke. The priority nursing action is to perform a focused neurological
assessment to gather additional data before notifying the provider. NSG 3100 teaches that the general survey is a critical
first step that often directs the depth of subsequent focused assessments, aligning with QSEN Patient-Centered Care
competencies.
Galen College of Nursing - NSG 3100 Fundamental Concepts & Skills for Nursing Practice I
,NSG 3100 - Exam 2 (2026/2027) Page 2
Q3: A nurse is assessing four patients on a medical-surgical unit at the beginning of a shift. Which patient
should the nurse assess first?
A. A 68-year-old with a respiratory rate of 22 breaths/min and pulse oximetry of 94% on room air
B. A 54-year-old with a blood pressure of 168/98 mmHg reporting a mild headache
C. A 72-year-old with new-onset confusion and a respiratory rate of 28 breaths/min *[CORRECT]*
D. A 45-year-old with a temperature of 100.4°F (38°C) and a heart rate of 92 beats/min
Correct Answer: C
Rationale: The 72-year-old with new-onset confusion and tachypnea (28 breaths/min) presents the greatest risk for acute
deterioration. New-onset confusion in an older adult is a red flag for hypoxia, sepsis, or a cerebrovascular event, and
tachypnea above 24 breaths/min is associated with impending respiratory failure. Using the airway-breathing-circulation
(ABC) framework and acute vs. chronic priority setting, this patient requires immediate evaluation. The NCLEX-RN test
plan emphasizes prioritization through the Manage Care category.
Q4: A nurse is performing a cranial nerve assessment on a patient. Which finding indicates normal function of
cranial nerve II (optic nerve)?
A. Patient can puff both cheeks symmetrically
B. Patient can read a newspaper held at 14 inches with each eye *[CORRECT]*
C. Patient's tongue protrudes midline without deviation
D. Patient can identify sugar placed on the anterior tongue
Correct Answer: B
Rationale: Cranial nerve II (optic nerve) is responsible for vision. Assessing visual acuity using a Snellen chart,
near-vision card (Jaeger), or asking the patient to read printed material evaluates CN II function. Puffing cheeks assesses
CN VII (facial), tongue protrusion evaluates CN XII (hypoglossal), and taste identification tests CN VII and CN IX
(glossopharyngeal). The NSG 3100 curriculum requires students to differentiate cranial nerve functions during the
neurological assessment.
Q5: A nurse is preparing to auscultate a patient's heart sounds. The nurse places the stethoscope at the fifth
intercostal space, midclavicular line. Which heart valve is best heard at this location?
A. Aortic valve
B. Pulmonic valve
C. Tricuspid valve
D. Mitral valve *[CORRECT]*
Correct Answer: D
Rationale: The mitral valve (also called the apical impulse or point of maximal impulse, PMI) is best auscultated at the
fifth intercostal space, midclavicular line. The aortic area is the second intercostal space right sternal border; pulmonic is
second intercostal space left sternal border; tricuspid is at the fourth or fifth intercostal space at the left sternal border.
NSG 3100 teaches the anatomic landmarks for cardiac auscultation as a fundamental cardiovascular assessment skill,
consistent with NCLEX standards.
Galen College of Nursing - NSG 3100 Fundamental Concepts & Skills for Nursing Practice I
,NSG 3100 - Exam 2 (2026/2027) Page 3
Q6: A patient is admitted with a head injury. The nurse documents the patient as 'alert and oriented x2.'
Based on this documentation, which information can the nurse conclude?
A. The patient is oriented to person and place but not time *[CORRECT]*
B. The patient is oriented to time and place but not person
C. The patient responds to painful stimuli only
D. The patient opens eyes to voice but does not speak
Correct Answer: A
Rationale: Orientation is typically assessed in the order of person, place, and time, with time being the first to be lost and
person the last. A patient who is 'alert and oriented x2' is oriented to two of the three dimensions, most commonly person
and place. Time orientation is most often the first to be impaired with neurological conditions. The NSG 3100 curriculum
specifies standardized mental status documentation to ensure accurate communication across the healthcare team,
aligning with QSEN Safety and Teamwork competencies.
Q7: A nurse is assessing a patient with a suspected deep vein thrombosis (DVT) in the left leg. Which
assessment finding should the nurse report to the healthcare provider immediately?
A. Patient reports a dull ache in the calf that worsens with ambulation
B. Left calf circumference is 1 cm larger than the right calf
C. Patient reports sudden onset of chest pain and shortness of breath *[CORRECT]*
D. Left leg is warm to the touch with mild erythema noted
Correct Answer: C
Rationale: Sudden onset of chest pain and shortness of breath in a patient with suspected DVT suggests a pulmonary
embolism (PE), a life-threatening complication requiring immediate intervention. PE is a medical emergency that can
rapidly progress to respiratory failure and death. The other findings are consistent with DVT but do not represent
immediate life-threatening emergencies. The NSG 3100 curriculum emphasizes recognizing complications of immobility
and using ABC prioritization, consistent with NCLEX-RN Physiological Adaptation content.
Q8: A nurse is performing an abdominal assessment on a patient with complaints of nausea and abdominal
pain. Which statement by the nurse indicates the correct technique for this assessment?
A. 'I will inspect, palpate, percuss, and auscultate the abdomen in that order.'
B. 'I will auscultate the abdomen before palpation and percussion to avoid altering bowel sounds.'
*[CORRECT]*
C. 'I will palpate any painful areas first, then assess the remaining quadrants.'
D. 'I will use deep palpation to identify organomegaly before light palpation.'
Correct Answer: B
Rationale: For abdominal assessment, the sequence is inspection, auscultation, percussion, and palpation. Auscultation
must precede palpation and percussion because manual manipulation can stimulate or alter bowel sounds, producing
inaccurate findings. Additionally, painful areas should be palpated last to prevent muscle guarding throughout the
assessment. The NSG 3100 curriculum identifies the abdominal exam as the key exception to the IPPA sequence, reflecting
evidence-based assessment practice.
Galen College of Nursing - NSG 3100 Fundamental Concepts & Skills for Nursing Practice I
, NSG 3100 - Exam 2 (2026/2027) Page 4
Q9: A nurse is documenting normal vital signs for a resting adult patient. Which set of vital signs should the
nurse document as within the expected reference range?
A. Temperature 97.4°F (36.3°C) oral; pulse 110 beats/min; respirations 22 breaths/min; blood pressure 142/92
mmHg
B. Temperature 98.6°F (37°C) oral; pulse 78 beats/min; respirations 14 breaths/min; blood pressure
118/76 mmHg *[CORRECT]*
C. Temperature 99.8°F (37.7°C) oral; pulse 88 beats/min; respirations 18 breaths/min; blood pressure 134/88
mmHg
D. Temperature 100.4°F (38°C) oral; pulse 92 beats/min; respirations 20 breaths/min; blood pressure 150/96
mmHg
Correct Answer: B
Rationale: Expected reference ranges for an adult are: oral temperature 97.5°F to 99.5°F (36.4°C to 37.5°C); pulse 60 to
100 beats/min; respirations 12 to 20 breaths/min; blood pressure less than 120/80 mmHg for normal, with elevated
starting at 121-129 systolic. Option B is the only set within all expected ranges. The NSG 3100 curriculum requires
students to identify deviations from normal vital sign ranges to inform clinical decision-making.
Q10: A nurse is assessing a patient's hearing using the Weber test. The nurse places a vibrating tuning fork on
the midline of the patient's skull. The patient reports the sound is louder in the left ear. How should the nurse
interpret this finding?
A. The patient has a conductive hearing loss in the right ear
B. The patient has a conductive hearing loss in the left ear *[CORRECT]*
C. The patient has sensorineural hearing loss in the right ear
D. The patient has normal hearing bilaterally
Correct Answer: B
Rationale: In the Weber test, sound lateralizing to one ear suggests conductive hearing loss on that side (because bone
conduction is preserved while air conduction is impaired, so sound is perceived as louder) OR sensorineural hearing loss
on the opposite side. Sound lateralizing to the left ear indicates either conductive loss on the left or sensorineural loss on
the right. Among the options provided, conductive hearing loss in the left ear is the correct interpretation. The Rinne test
would be needed to differentiate further. NSG 3100 covers Weber and Rinne testing as fundamental HEENT assessment
techniques.
Q11: A nurse is performing a HEENT assessment on an older adult patient. Which finding should the nurse
identify as an expected age-related change rather than an abnormal finding?
A. Asymmetric pupils with a difference of 1 mm in size
B. Yellowish-gray rings around the corneas bilaterally *[CORRECT]*
C. Deviation of the tongue to the right side when protruded
D. Inability to hear high-pitched tones in both ears
Correct Answer: B
Rationale: Arcus senilis, a yellowish-gray ring around the cornea, is an expected age-related change in older adults and is
not associated with visual impairment. Asymmetric pupils (anisocoria greater than 0.5 mm difference) requires further
evaluation. Tongue deviation suggests cranial nerve XII dysfunction. While presbycusis (high-frequency hearing loss) is
age-related, the broader HEENT context makes option B the most clearly expected finding. NSG 3100 curriculum
emphasizes distinguishing age-related changes from pathological findings to avoid unnecessary testing.
Galen College of Nursing - NSG 3100 Fundamental Concepts & Skills for Nursing Practice I
EXAM 2: NSG3100 / NSG 3100 (LATEST UPDATE)
FUNDAMENTAL CONCEPTS & SKILLS FOR NURSING PRACTICE I
QUESTIONS AND VERIFIED ANSWERS | 100% CORRECT | GRADE A - GALEN
Galen College of Nursing | Aligned with NCLEX-PN/RN Test Plan, QSEN Competencies, and Fundamentals of Nursing
Standards (2026/2027 Edition)
TOTAL QUESTIONS SECTIONS COGNITIVE LEVELS ALIGNED STANDARDS
100 Questions 8 Sections 20% Recall | 50% Application | 30% Analysis
NCLEX-PN/RN, QSEN, ANA, Fundamentals of Nursing 2026/2027
Section 1: Health Assessment & Physical Examination (Q1-Q15)
Q1: A nurse is preparing to perform a routine physical assessment on an adult patient admitted with
pneumonia. Which sequence of assessment techniques should the nurse use for most body systems, excluding
the abdomen?
A. Palpation, percussion, auscultation, inspection
B. Auscultation, palpation, percussion, inspection
C. Inspection, palpation, percussion, auscultation *[CORRECT]*
D. Inspection, auscultation, palpation, percussion
Correct Answer: C
Rationale: The standard sequence for physical assessment of most body systems is inspection, palpation, percussion, and
auscultation (IPPA). The abdomen is the exception, where auscultation precedes palpation and percussion because bowel
sounds can be altered by manual manipulation. The NSG 3100 curriculum emphasizes mastering the IPPA sequence as
foundational to the head-to-toe assessment, consistent with NCLEX-RN test plan Health Promotion and Maintenance
content.
Q2: During a general survey, the nurse observes a patient who appears older than the stated age, has poor
personal hygiene, and exhibits noticeable asymmetry of the face when smiling. Which action should the nurse
take first?
A. Document the findings and continue with the head-to-toe assessment
B. Notify the healthcare provider immediately about facial asymmetry
C. Perform a focused neurological assessment including cranial nerves VII and facial symmetry
*[CORRECT]*
D. Ask the patient about personal hygiene practices and living situation
Correct Answer: C
Rationale: Facial asymmetry noted during general survey is a significant finding that may indicate cranial nerve VII
(facial nerve) dysfunction, Bell's palsy, or stroke. The priority nursing action is to perform a focused neurological
assessment to gather additional data before notifying the provider. NSG 3100 teaches that the general survey is a critical
first step that often directs the depth of subsequent focused assessments, aligning with QSEN Patient-Centered Care
competencies.
Galen College of Nursing - NSG 3100 Fundamental Concepts & Skills for Nursing Practice I
,NSG 3100 - Exam 2 (2026/2027) Page 2
Q3: A nurse is assessing four patients on a medical-surgical unit at the beginning of a shift. Which patient
should the nurse assess first?
A. A 68-year-old with a respiratory rate of 22 breaths/min and pulse oximetry of 94% on room air
B. A 54-year-old with a blood pressure of 168/98 mmHg reporting a mild headache
C. A 72-year-old with new-onset confusion and a respiratory rate of 28 breaths/min *[CORRECT]*
D. A 45-year-old with a temperature of 100.4°F (38°C) and a heart rate of 92 beats/min
Correct Answer: C
Rationale: The 72-year-old with new-onset confusion and tachypnea (28 breaths/min) presents the greatest risk for acute
deterioration. New-onset confusion in an older adult is a red flag for hypoxia, sepsis, or a cerebrovascular event, and
tachypnea above 24 breaths/min is associated with impending respiratory failure. Using the airway-breathing-circulation
(ABC) framework and acute vs. chronic priority setting, this patient requires immediate evaluation. The NCLEX-RN test
plan emphasizes prioritization through the Manage Care category.
Q4: A nurse is performing a cranial nerve assessment on a patient. Which finding indicates normal function of
cranial nerve II (optic nerve)?
A. Patient can puff both cheeks symmetrically
B. Patient can read a newspaper held at 14 inches with each eye *[CORRECT]*
C. Patient's tongue protrudes midline without deviation
D. Patient can identify sugar placed on the anterior tongue
Correct Answer: B
Rationale: Cranial nerve II (optic nerve) is responsible for vision. Assessing visual acuity using a Snellen chart,
near-vision card (Jaeger), or asking the patient to read printed material evaluates CN II function. Puffing cheeks assesses
CN VII (facial), tongue protrusion evaluates CN XII (hypoglossal), and taste identification tests CN VII and CN IX
(glossopharyngeal). The NSG 3100 curriculum requires students to differentiate cranial nerve functions during the
neurological assessment.
Q5: A nurse is preparing to auscultate a patient's heart sounds. The nurse places the stethoscope at the fifth
intercostal space, midclavicular line. Which heart valve is best heard at this location?
A. Aortic valve
B. Pulmonic valve
C. Tricuspid valve
D. Mitral valve *[CORRECT]*
Correct Answer: D
Rationale: The mitral valve (also called the apical impulse or point of maximal impulse, PMI) is best auscultated at the
fifth intercostal space, midclavicular line. The aortic area is the second intercostal space right sternal border; pulmonic is
second intercostal space left sternal border; tricuspid is at the fourth or fifth intercostal space at the left sternal border.
NSG 3100 teaches the anatomic landmarks for cardiac auscultation as a fundamental cardiovascular assessment skill,
consistent with NCLEX standards.
Galen College of Nursing - NSG 3100 Fundamental Concepts & Skills for Nursing Practice I
,NSG 3100 - Exam 2 (2026/2027) Page 3
Q6: A patient is admitted with a head injury. The nurse documents the patient as 'alert and oriented x2.'
Based on this documentation, which information can the nurse conclude?
A. The patient is oriented to person and place but not time *[CORRECT]*
B. The patient is oriented to time and place but not person
C. The patient responds to painful stimuli only
D. The patient opens eyes to voice but does not speak
Correct Answer: A
Rationale: Orientation is typically assessed in the order of person, place, and time, with time being the first to be lost and
person the last. A patient who is 'alert and oriented x2' is oriented to two of the three dimensions, most commonly person
and place. Time orientation is most often the first to be impaired with neurological conditions. The NSG 3100 curriculum
specifies standardized mental status documentation to ensure accurate communication across the healthcare team,
aligning with QSEN Safety and Teamwork competencies.
Q7: A nurse is assessing a patient with a suspected deep vein thrombosis (DVT) in the left leg. Which
assessment finding should the nurse report to the healthcare provider immediately?
A. Patient reports a dull ache in the calf that worsens with ambulation
B. Left calf circumference is 1 cm larger than the right calf
C. Patient reports sudden onset of chest pain and shortness of breath *[CORRECT]*
D. Left leg is warm to the touch with mild erythema noted
Correct Answer: C
Rationale: Sudden onset of chest pain and shortness of breath in a patient with suspected DVT suggests a pulmonary
embolism (PE), a life-threatening complication requiring immediate intervention. PE is a medical emergency that can
rapidly progress to respiratory failure and death. The other findings are consistent with DVT but do not represent
immediate life-threatening emergencies. The NSG 3100 curriculum emphasizes recognizing complications of immobility
and using ABC prioritization, consistent with NCLEX-RN Physiological Adaptation content.
Q8: A nurse is performing an abdominal assessment on a patient with complaints of nausea and abdominal
pain. Which statement by the nurse indicates the correct technique for this assessment?
A. 'I will inspect, palpate, percuss, and auscultate the abdomen in that order.'
B. 'I will auscultate the abdomen before palpation and percussion to avoid altering bowel sounds.'
*[CORRECT]*
C. 'I will palpate any painful areas first, then assess the remaining quadrants.'
D. 'I will use deep palpation to identify organomegaly before light palpation.'
Correct Answer: B
Rationale: For abdominal assessment, the sequence is inspection, auscultation, percussion, and palpation. Auscultation
must precede palpation and percussion because manual manipulation can stimulate or alter bowel sounds, producing
inaccurate findings. Additionally, painful areas should be palpated last to prevent muscle guarding throughout the
assessment. The NSG 3100 curriculum identifies the abdominal exam as the key exception to the IPPA sequence, reflecting
evidence-based assessment practice.
Galen College of Nursing - NSG 3100 Fundamental Concepts & Skills for Nursing Practice I
, NSG 3100 - Exam 2 (2026/2027) Page 4
Q9: A nurse is documenting normal vital signs for a resting adult patient. Which set of vital signs should the
nurse document as within the expected reference range?
A. Temperature 97.4°F (36.3°C) oral; pulse 110 beats/min; respirations 22 breaths/min; blood pressure 142/92
mmHg
B. Temperature 98.6°F (37°C) oral; pulse 78 beats/min; respirations 14 breaths/min; blood pressure
118/76 mmHg *[CORRECT]*
C. Temperature 99.8°F (37.7°C) oral; pulse 88 beats/min; respirations 18 breaths/min; blood pressure 134/88
mmHg
D. Temperature 100.4°F (38°C) oral; pulse 92 beats/min; respirations 20 breaths/min; blood pressure 150/96
mmHg
Correct Answer: B
Rationale: Expected reference ranges for an adult are: oral temperature 97.5°F to 99.5°F (36.4°C to 37.5°C); pulse 60 to
100 beats/min; respirations 12 to 20 breaths/min; blood pressure less than 120/80 mmHg for normal, with elevated
starting at 121-129 systolic. Option B is the only set within all expected ranges. The NSG 3100 curriculum requires
students to identify deviations from normal vital sign ranges to inform clinical decision-making.
Q10: A nurse is assessing a patient's hearing using the Weber test. The nurse places a vibrating tuning fork on
the midline of the patient's skull. The patient reports the sound is louder in the left ear. How should the nurse
interpret this finding?
A. The patient has a conductive hearing loss in the right ear
B. The patient has a conductive hearing loss in the left ear *[CORRECT]*
C. The patient has sensorineural hearing loss in the right ear
D. The patient has normal hearing bilaterally
Correct Answer: B
Rationale: In the Weber test, sound lateralizing to one ear suggests conductive hearing loss on that side (because bone
conduction is preserved while air conduction is impaired, so sound is perceived as louder) OR sensorineural hearing loss
on the opposite side. Sound lateralizing to the left ear indicates either conductive loss on the left or sensorineural loss on
the right. Among the options provided, conductive hearing loss in the left ear is the correct interpretation. The Rinne test
would be needed to differentiate further. NSG 3100 covers Weber and Rinne testing as fundamental HEENT assessment
techniques.
Q11: A nurse is performing a HEENT assessment on an older adult patient. Which finding should the nurse
identify as an expected age-related change rather than an abnormal finding?
A. Asymmetric pupils with a difference of 1 mm in size
B. Yellowish-gray rings around the corneas bilaterally *[CORRECT]*
C. Deviation of the tongue to the right side when protruded
D. Inability to hear high-pitched tones in both ears
Correct Answer: B
Rationale: Arcus senilis, a yellowish-gray ring around the cornea, is an expected age-related change in older adults and is
not associated with visual impairment. Asymmetric pupils (anisocoria greater than 0.5 mm difference) requires further
evaluation. Tongue deviation suggests cranial nerve XII dysfunction. While presbycusis (high-frequency hearing loss) is
age-related, the broader HEENT context makes option B the most clearly expected finding. NSG 3100 curriculum
emphasizes distinguishing age-related changes from pathological findings to avoid unnecessary testing.
Galen College of Nursing - NSG 3100 Fundamental Concepts & Skills for Nursing Practice I
