NUR612/NUR 612 Exam 2 V2 | Advanced
Nursing II Q&A with Rationale | William
Paterson University
1. A 65-year-old patient presents with shortness of breath and an extra heart sound heard in
early diastole. This sound is most likely:
A. S1
B. S3
C. S2
D. S4
Answer: B
Rationale: The S3 heart sound occurs in early diastole during the rapid ventricular filling
phase. It is often a sign of fluid volume overload or heart failure in older adults. In children
and young adults, it can be a normal physiological finding.
2. Which physical exam finding is most consistent with a diagnosis of pleural effusion?
A. Hyperresonance on percussion
B. Wheezing
C. Increased tactile fremitus
D. Dullness on percussion
,Answer: D
Rationale: Dullness to percussion occurs when fluid or solid tissue replaces air-containing
lung space. Pleural effusion involves fluid in the pleural space, which dampens vibrations
and sound. This results in decreased tactile fremitus and a dull percussion note.
3. A 4-year-old child presents with a barking cough and inspiratory stridor. What is the most
likely diagnosis?
A. Asthma
B. Bronchiolitis
C. Croup
D. Epiglottitis
Answer: C
Rationale: Croup, or laryngotracheobronchitis, is characterized by subglottic swelling that
causes a barking cough. It typically presents with inspiratory stridor and varying degrees of
respiratory distress. It is most common in children between 6 months and 3 years of age.
4. During a cardiac assessment, a grade III/VI pansystolic murmur is heard loudest at the apex
and radiates to the axilla. This suggests:
A. Mitral regurgitation
B. Aortic stenosis
C. Aortic regurgitation
, D. Mitral stenosis
Answer: A
Rationale: Mitral regurgitation produces a pansystolic or holosystolic murmur heard best
at the apex. This murmur often radiates to the left axilla due to the direction of the
regurgitant jet. It occurs when the mitral valve fails to close completely during systole.
5. Which assessment technique is used to evaluate for possible appendicitis by applying
pressure to the left lower quadrant?
A. Murphy’s sign
B. McBurney’s point tenderness
C. Psoas sign
D. Rovsing’s sign
Answer: D
Rationale: Rovsing’s sign is positive when pressure applied to the left lower quadrant
causes pain in the right lower quadrant. This occurs because the pressure causes shifted
gas to distend the inflamed cecum and appendix. It is a classic physical exam finding used
to support a diagnosis of appendicitis.
6. An infant is noted to have a palpable ‘olive-shaped’ mass in the epigastrium and projectile
vomiting. This is suggestive of:
A. Intussusception
Nursing II Q&A with Rationale | William
Paterson University
1. A 65-year-old patient presents with shortness of breath and an extra heart sound heard in
early diastole. This sound is most likely:
A. S1
B. S3
C. S2
D. S4
Answer: B
Rationale: The S3 heart sound occurs in early diastole during the rapid ventricular filling
phase. It is often a sign of fluid volume overload or heart failure in older adults. In children
and young adults, it can be a normal physiological finding.
2. Which physical exam finding is most consistent with a diagnosis of pleural effusion?
A. Hyperresonance on percussion
B. Wheezing
C. Increased tactile fremitus
D. Dullness on percussion
,Answer: D
Rationale: Dullness to percussion occurs when fluid or solid tissue replaces air-containing
lung space. Pleural effusion involves fluid in the pleural space, which dampens vibrations
and sound. This results in decreased tactile fremitus and a dull percussion note.
3. A 4-year-old child presents with a barking cough and inspiratory stridor. What is the most
likely diagnosis?
A. Asthma
B. Bronchiolitis
C. Croup
D. Epiglottitis
Answer: C
Rationale: Croup, or laryngotracheobronchitis, is characterized by subglottic swelling that
causes a barking cough. It typically presents with inspiratory stridor and varying degrees of
respiratory distress. It is most common in children between 6 months and 3 years of age.
4. During a cardiac assessment, a grade III/VI pansystolic murmur is heard loudest at the apex
and radiates to the axilla. This suggests:
A. Mitral regurgitation
B. Aortic stenosis
C. Aortic regurgitation
, D. Mitral stenosis
Answer: A
Rationale: Mitral regurgitation produces a pansystolic or holosystolic murmur heard best
at the apex. This murmur often radiates to the left axilla due to the direction of the
regurgitant jet. It occurs when the mitral valve fails to close completely during systole.
5. Which assessment technique is used to evaluate for possible appendicitis by applying
pressure to the left lower quadrant?
A. Murphy’s sign
B. McBurney’s point tenderness
C. Psoas sign
D. Rovsing’s sign
Answer: D
Rationale: Rovsing’s sign is positive when pressure applied to the left lower quadrant
causes pain in the right lower quadrant. This occurs because the pressure causes shifted
gas to distend the inflamed cecum and appendix. It is a classic physical exam finding used
to support a diagnosis of appendicitis.
6. An infant is noted to have a palpable ‘olive-shaped’ mass in the epigastrium and projectile
vomiting. This is suggestive of:
A. Intussusception
