NUR612/NUR 612 Exam 2 V1 | Advanced
Nursing II Q&A with Rationale | William
Paterson University
1. When performing a respiratory assessment, a nurse practitioner notes increased tactile
fremitus over the lower right lobe. Which condition is most likely associated with this
finding?
A. Pleural effusion
B. Pneumothorax
C. Lobar pneumonia
D. Emphysema
Answer: C
Rationale: Increased tactile fremitus occurs when there is consolidation in the lung tissue,
such as in lobar pneumonia. Liquid or solid medium transmits vibrations more efficiently
than air-filled spaces. In contrast, conditions like pneumothorax or pleural effusion
decrease or eliminate vibrations because they push the lung away from the chest wall.
2. A 65-year-old male presents with a chief complaint of calf pain that occurs after walking
two blocks and is relieved by rest. This clinical presentation is most consistent with:
A. Deep vein thrombosis
B. Intermittent claudication
,C. Venous insufficiency
D. Raynaud’s disease
Answer: B
Rationale: Intermittent claudication is a hallmark symptom of peripheral arterial disease
caused by inadequate oxygen delivery to exercising muscles. The pain is predictable with
exertion and resolves quickly with rest as demand decreases. Venous issues typically
present with swelling or aching that is relieved by elevation rather than rest alone.
3. During an abdominal examination, the provider asks the patient to take a deep breath
while palpating the right upper quadrant. The patient abruptly stops inhaling due to pain.
This is known as:
A. Murphy’s sign
B. Psoas sign
C. Rovsing’s sign
D. McBurney’s sign
Answer: A
Rationale: Murphy’s sign is used to assess for acute cholecystitis by putting pressure on
the gallbladder area during inspiration. As the liver and gallbladder descend, they strike
the palpating hand, causing the patient to catch their breath. A positive result is highly
suggestive of gallbladder inflammation rather than appendicitis.
, 4. When auscultating the heart of a 70-year-old patient, the nurse practitioner identifies an
S3 gallop. In this age group, an S3 is most frequently associated with:
A. Aortic stenosis
B. Decreased ventricular compliance during atrial contraction
C. Ventricular volume overload or heart failure
D. Normal physiological aging
Answer: C
Rationale: The S3 heart sound occurs early in diastole during the rapid filling phase and is
often called a ventricular gallop. While normal in children and athletes, it indicates fluid
volume overload or heart failure in older adults. It is best heard at the apex with the bell of
the stethoscope in the left lateral decubitus position.
5. A patient exhibits a blowing, decrescendo diastolic murmur heard best at the second right
intercostal space while leaning forward. This likely indicates:
A. Mitral stenosis
B. Aortic regurgitation
C. Aortic stenosis
D. Mitral regurgitation
Answer: B
Nursing II Q&A with Rationale | William
Paterson University
1. When performing a respiratory assessment, a nurse practitioner notes increased tactile
fremitus over the lower right lobe. Which condition is most likely associated with this
finding?
A. Pleural effusion
B. Pneumothorax
C. Lobar pneumonia
D. Emphysema
Answer: C
Rationale: Increased tactile fremitus occurs when there is consolidation in the lung tissue,
such as in lobar pneumonia. Liquid or solid medium transmits vibrations more efficiently
than air-filled spaces. In contrast, conditions like pneumothorax or pleural effusion
decrease or eliminate vibrations because they push the lung away from the chest wall.
2. A 65-year-old male presents with a chief complaint of calf pain that occurs after walking
two blocks and is relieved by rest. This clinical presentation is most consistent with:
A. Deep vein thrombosis
B. Intermittent claudication
,C. Venous insufficiency
D. Raynaud’s disease
Answer: B
Rationale: Intermittent claudication is a hallmark symptom of peripheral arterial disease
caused by inadequate oxygen delivery to exercising muscles. The pain is predictable with
exertion and resolves quickly with rest as demand decreases. Venous issues typically
present with swelling or aching that is relieved by elevation rather than rest alone.
3. During an abdominal examination, the provider asks the patient to take a deep breath
while palpating the right upper quadrant. The patient abruptly stops inhaling due to pain.
This is known as:
A. Murphy’s sign
B. Psoas sign
C. Rovsing’s sign
D. McBurney’s sign
Answer: A
Rationale: Murphy’s sign is used to assess for acute cholecystitis by putting pressure on
the gallbladder area during inspiration. As the liver and gallbladder descend, they strike
the palpating hand, causing the patient to catch their breath. A positive result is highly
suggestive of gallbladder inflammation rather than appendicitis.
, 4. When auscultating the heart of a 70-year-old patient, the nurse practitioner identifies an
S3 gallop. In this age group, an S3 is most frequently associated with:
A. Aortic stenosis
B. Decreased ventricular compliance during atrial contraction
C. Ventricular volume overload or heart failure
D. Normal physiological aging
Answer: C
Rationale: The S3 heart sound occurs early in diastole during the rapid filling phase and is
often called a ventricular gallop. While normal in children and athletes, it indicates fluid
volume overload or heart failure in older adults. It is best heard at the apex with the bell of
the stethoscope in the left lateral decubitus position.
5. A patient exhibits a blowing, decrescendo diastolic murmur heard best at the second right
intercostal space while leaning forward. This likely indicates:
A. Mitral stenosis
B. Aortic regurgitation
C. Aortic stenosis
D. Mitral regurgitation
Answer: B
