NURS 5220 ADVANCED HEALTH
ASSESSMENT AND DIAGNOSTIC
REASONING - EXAM 2 QUESTIONS AND
CORRECT ANSWERS WITH
EXPLANATIONS JUST RELEASED
1. When assessing for a carotid bruit, which is the most appropriate action for the examiner
to take?
A. Ask the patient to take a deep breath and hold it.
B. Use the diaphragm of the stethoscope at the base of the neck.
C. Palpate both carotid arteries simultaneously before auscultating.
D. Ask the patient to exhale and briefly hold their breath.
Answer: D
Conceptual Explanation: Asking the patient to hold their breath after exhalation prevents
breath sounds from mimicking or masking a bruit during auscultation.
2. A 65-year-old patient presents with peripheral edema and a Jugular Venous Pressure (JVP)
of 5 cm above the sternal angle. This finding most likely indicates:
A. Left-sided heart failure
B. Normal cardiovascular function
,C. Dehydration
D. Right-sided heart failure
Answer: D
Conceptual Explanation: An elevated JVP (typically >3 cm above the sternal angle) is a
highly specific sign of increased right atrial pressure, often seen in right-sided heart failure.
3. During cardiac auscultation, you hear a high-pitched, scratchy sound that is best heard at
the left lower sternal border while the patient leans forward. This is most likely:
A. Aortic stenosis
B. Mitral regurgitation
C. Pericardial friction rub
D. Physiological S3
Answer: C
Conceptual Explanation: A pericardial friction rub is characterized by a high-pitched,
scratchy, or leathery sound and is typically best heard with the patient leaning forward in
expiration.
4. Which physical exam finding is most consistent with a diagnosis of pneumothorax?
A. Hyperresonance to percussion on the affected side
B. Dullness to percussion over the affected area
C. Increased tactile fremitus on the affected side
, D. Bronchial breath sounds in the periphery
Answer: A
Conceptual Explanation: Pneumothorax involves air in the pleural space, which results in
hyperresonance to percussion and decreased or absent breath sounds.
5. A patient exhibits ‘egophony’ during a pulmonary exam. When the patient says ‘ee,’ the
sound heard through the stethoscope is ‘ay.’ This indicates:
A. Normal lung tissue
B. Pneumothorax
C. Pleural effusion
D. Lobar consolidation
Answer: D
Conceptual Explanation: Egophony (E to A change) occurs over areas of lung
consolidation, such as in lobar pneumonia, where solid tissue transmits sound better than
air.
6. While performing an abdominal assessment, you palpate deeply in the LLQ and the patient
feels pain in the RLQ. This is known as:
A. Murphy’s sign
B. Obturator sign
C. Psoas sign
ASSESSMENT AND DIAGNOSTIC
REASONING - EXAM 2 QUESTIONS AND
CORRECT ANSWERS WITH
EXPLANATIONS JUST RELEASED
1. When assessing for a carotid bruit, which is the most appropriate action for the examiner
to take?
A. Ask the patient to take a deep breath and hold it.
B. Use the diaphragm of the stethoscope at the base of the neck.
C. Palpate both carotid arteries simultaneously before auscultating.
D. Ask the patient to exhale and briefly hold their breath.
Answer: D
Conceptual Explanation: Asking the patient to hold their breath after exhalation prevents
breath sounds from mimicking or masking a bruit during auscultation.
2. A 65-year-old patient presents with peripheral edema and a Jugular Venous Pressure (JVP)
of 5 cm above the sternal angle. This finding most likely indicates:
A. Left-sided heart failure
B. Normal cardiovascular function
,C. Dehydration
D. Right-sided heart failure
Answer: D
Conceptual Explanation: An elevated JVP (typically >3 cm above the sternal angle) is a
highly specific sign of increased right atrial pressure, often seen in right-sided heart failure.
3. During cardiac auscultation, you hear a high-pitched, scratchy sound that is best heard at
the left lower sternal border while the patient leans forward. This is most likely:
A. Aortic stenosis
B. Mitral regurgitation
C. Pericardial friction rub
D. Physiological S3
Answer: C
Conceptual Explanation: A pericardial friction rub is characterized by a high-pitched,
scratchy, or leathery sound and is typically best heard with the patient leaning forward in
expiration.
4. Which physical exam finding is most consistent with a diagnosis of pneumothorax?
A. Hyperresonance to percussion on the affected side
B. Dullness to percussion over the affected area
C. Increased tactile fremitus on the affected side
, D. Bronchial breath sounds in the periphery
Answer: A
Conceptual Explanation: Pneumothorax involves air in the pleural space, which results in
hyperresonance to percussion and decreased or absent breath sounds.
5. A patient exhibits ‘egophony’ during a pulmonary exam. When the patient says ‘ee,’ the
sound heard through the stethoscope is ‘ay.’ This indicates:
A. Normal lung tissue
B. Pneumothorax
C. Pleural effusion
D. Lobar consolidation
Answer: D
Conceptual Explanation: Egophony (E to A change) occurs over areas of lung
consolidation, such as in lobar pneumonia, where solid tissue transmits sound better than
air.
6. While performing an abdominal assessment, you palpate deeply in the LLQ and the patient
feels pain in the RLQ. This is known as:
A. Murphy’s sign
B. Obturator sign
C. Psoas sign
