NUR 216 EXAM 3 ACCURATE QUESTIONS
AND ANSWERS (VERIFIED ANSWERS) |
LATEST (2026/2027) UPDATED
VERSION | 100% GUARANTEED PASS
{JUST RELEASED}
1. A nurse is assessing a client's cranial nerves. Which of the following client
actions is an indication that cranial nerve 1 is intact?
A. The client can stick their tongue out
B. The client can smile symmetrically
C. The client can hear whispered words
D. The client can identify a minty scent - ANSWER ✓ D. The client can
identify a minty scent
Rationale - Cranial nerve 1, the olfactory nerve, controls the sense of smell.
To test this nerve's function, the nurse should ask the client to identify a
nonirritating aroma, such as mint or coffee
2. A nurse is performing a respiratory assessment on a client. The nurse
auscultates a wet, popping sound upon inspiration of the clients breathing.
The nurse should identify this observation as which of the following findings?
, A. Crackles
B. Stridor
C. Wheezes
D. Friction Rub - ANSWER ✓ A. Crackles
Rationale - crackles, sometimes called rales, are wet, popping sounds
created by air moving through liquid or by collapsed alveoli snapping open on
inspiration. They are most common at the end of inspiration of breathing.
3. A nurse is performing a cardiovascular assessment on a client which of the
following findings should the nurse expect?
A. A continuous sensation of vibration felt over the second and third left
intercostal spaces
B. A high-pitched, scraping sound heard in the third intercostal space to
the left of the sternum
C. A brief thump felt near the fourth or fifth intercostal space near the left
mid clavicular line
D. A whooshing or swishing sound over the second intercostal space
along the left arsenal border - ANSWER ✓ C. A brief thump felt near the
fourth or fifth intercostal space near the left mid clavicular line
, Rationale - This is where you would inspect and palpate for the point of
maximal impulse. Also called an apical pulse station, it occurs as the Apex of
the heart bumps against the chest wall with each heartbeat. The apical
impulse is not always visible but can be felt as a brief thump. This is an
expected finding and should be performed when you are preparing to
auscultate the apical pulse.
4. The nurse is preparing to perform a comprehensive physical assessment on a
client. Which of the following actions should the nurse plan to take first?
A. Document accurate data
B. Develop a plan of care
C. Validate previous data
D. Evaluate outcomes of care - ANSWER ✓ B. Develop a plan of care
Rationale - The first action the nurse should take using the nursing process is
to assess the client and develop a plan of care. The nursing process follow
the steps of assessment, analysis, planning, implementation, and evaluation.
5. A nurse is palpating a tender area of a clients abdomen. The nurse slowly
applies pressure over the area with their fingertips, then quickly releases it.
The client reports increased pain on the release of pressure. Which of the
findings should the nurse document?
A. Borborygmi
B. Rebound Tenderness
C. Tympany
, D. Abdominal Guarding - ANSWER ✓ B. Rebound Tenderness
Rationale - The nurse should document that the client is experiencing
rebound tenderness, which is an increase in pain when deep palpation over a
tender area is released. Rebound tenderness is in the right lower quadrant at
McBurney's point (one-third the distance from the anterior iliac crest to the
umbilicus) is an indication of acute appendicitis.
6. A nurse is performing a physical examination of the spine for an older adult
client. The nurse should identify that which of the following findings is
common with aging?
A. Lordosis
B. Kyphosis
C. Ankylosis
D. Scoliosis - ANSWER ✓ B. Kyphosis
Rationale - kyphosis, a pronounced "hunchback" curvature of the spine, is an
abnormal angulation of the posterior curve of the thoracic spine, usually a
result of osteoporosis. It is most common in older adults and tends to increase
with aging. This pronounced convexity of the thoracic spine is also common in
older clients who have had vertebral fractures.
7. Disorders in which parts of the ear usually result in earaches?
A. Inner and middle ear
B. Inner and external ear
AND ANSWERS (VERIFIED ANSWERS) |
LATEST (2026/2027) UPDATED
VERSION | 100% GUARANTEED PASS
{JUST RELEASED}
1. A nurse is assessing a client's cranial nerves. Which of the following client
actions is an indication that cranial nerve 1 is intact?
A. The client can stick their tongue out
B. The client can smile symmetrically
C. The client can hear whispered words
D. The client can identify a minty scent - ANSWER ✓ D. The client can
identify a minty scent
Rationale - Cranial nerve 1, the olfactory nerve, controls the sense of smell.
To test this nerve's function, the nurse should ask the client to identify a
nonirritating aroma, such as mint or coffee
2. A nurse is performing a respiratory assessment on a client. The nurse
auscultates a wet, popping sound upon inspiration of the clients breathing.
The nurse should identify this observation as which of the following findings?
, A. Crackles
B. Stridor
C. Wheezes
D. Friction Rub - ANSWER ✓ A. Crackles
Rationale - crackles, sometimes called rales, are wet, popping sounds
created by air moving through liquid or by collapsed alveoli snapping open on
inspiration. They are most common at the end of inspiration of breathing.
3. A nurse is performing a cardiovascular assessment on a client which of the
following findings should the nurse expect?
A. A continuous sensation of vibration felt over the second and third left
intercostal spaces
B. A high-pitched, scraping sound heard in the third intercostal space to
the left of the sternum
C. A brief thump felt near the fourth or fifth intercostal space near the left
mid clavicular line
D. A whooshing or swishing sound over the second intercostal space
along the left arsenal border - ANSWER ✓ C. A brief thump felt near the
fourth or fifth intercostal space near the left mid clavicular line
, Rationale - This is where you would inspect and palpate for the point of
maximal impulse. Also called an apical pulse station, it occurs as the Apex of
the heart bumps against the chest wall with each heartbeat. The apical
impulse is not always visible but can be felt as a brief thump. This is an
expected finding and should be performed when you are preparing to
auscultate the apical pulse.
4. The nurse is preparing to perform a comprehensive physical assessment on a
client. Which of the following actions should the nurse plan to take first?
A. Document accurate data
B. Develop a plan of care
C. Validate previous data
D. Evaluate outcomes of care - ANSWER ✓ B. Develop a plan of care
Rationale - The first action the nurse should take using the nursing process is
to assess the client and develop a plan of care. The nursing process follow
the steps of assessment, analysis, planning, implementation, and evaluation.
5. A nurse is palpating a tender area of a clients abdomen. The nurse slowly
applies pressure over the area with their fingertips, then quickly releases it.
The client reports increased pain on the release of pressure. Which of the
findings should the nurse document?
A. Borborygmi
B. Rebound Tenderness
C. Tympany
, D. Abdominal Guarding - ANSWER ✓ B. Rebound Tenderness
Rationale - The nurse should document that the client is experiencing
rebound tenderness, which is an increase in pain when deep palpation over a
tender area is released. Rebound tenderness is in the right lower quadrant at
McBurney's point (one-third the distance from the anterior iliac crest to the
umbilicus) is an indication of acute appendicitis.
6. A nurse is performing a physical examination of the spine for an older adult
client. The nurse should identify that which of the following findings is
common with aging?
A. Lordosis
B. Kyphosis
C. Ankylosis
D. Scoliosis - ANSWER ✓ B. Kyphosis
Rationale - kyphosis, a pronounced "hunchback" curvature of the spine, is an
abnormal angulation of the posterior curve of the thoracic spine, usually a
result of osteoporosis. It is most common in older adults and tends to increase
with aging. This pronounced convexity of the thoracic spine is also common in
older clients who have had vertebral fractures.
7. Disorders in which parts of the ear usually result in earaches?
A. Inner and middle ear
B. Inner and external ear
