NSG 351 Final Exam V2 | NSG 351 Health
Assessment | Actual Q&A with Rationale
(NSG351 Final Exam) | James Madison
University
1. When conducting an abdominal assessment, in which order should the physical
examination techniques be performed to ensure accurate findings?
A. Inspection, percussion, palpation, auscultation
B. Auscultation, inspection, palpation, percussion
C. Palpation, percussion, inspection, auscultation
D. Inspection, auscultation, percussion, palpation
Answer: D
Rationale: The abdominal assessment requires a specific order to prevent the manual
alteration of bowel sounds. Auscultation is performed immediately after inspection
because percussion and palpation can stimulate peristalsis and create false auditory
findings. This standardized sequence ensures that the nurse captures the patient’s baseline
gastrointestinal activity accurately.
2. During a respiratory assessment, a nurse notes high-pitched, musical whistling sounds
heard primarily during expiration. How should these sounds be documented?
A. Pleural friction rub
,B. Crackles
C. Rhonchi
D. Wheezes
Answer: D
Rationale: Wheezes are adventitious breath sounds caused by air squeezing through
narrowed or obstructed airways. These sounds are characteristically high-pitched and
musical, often associated with conditions such as asthma or chronic obstructive pulmonary
disease. Proper documentation allows the healthcare team to monitor changes in airway
patency and response to bronchodilators.
3. When assessing the heart, where is the second heart sound (S2) typically heard the
loudest?
A. At the apex of the heart
B. At the base of the heart
C. At the fifth intercostal space, left midclavicular line
D. At the fourth intercostal space, left sternal border
Answer: B
Rationale: The S2 sound is produced by the closure of the semilunar valves, which include
the aortic and pulmonic valves. This sound marks the end of systole and the beginning of
, diastole in the cardiac cycle. It is most prominent at the base of the heart, specifically in the
second intercostal space at the right and left sternal borders.
4. A nurse is testing a patient’s visual acuity using a Snellen chart. What does a result of 20/40
indicate?
A. The patient can see at 40 feet what a normal eye sees at 20 feet
B. The patient has perfect vision in the right eye
C. The patient is legally blind
D. The patient can see at 20 feet what a normal eye sees at 40 feet
Answer: D
Rationale: Visual acuity is expressed as a fraction where the top number represents the
distance the patient is standing from the chart. The bottom number indicates the distance
at which a person with normal vision could read the same line. Therefore, a patient with
20/40 vision has reduced acuity, needing to be much closer to see what others see from
further away.
5. Which cranial nerve is primarily responsible for the sensory perception of smell?
A. Cranial Nerve II
B. Cranial Nerve I
C. Cranial Nerve V
D. Cranial Nerve X
Assessment | Actual Q&A with Rationale
(NSG351 Final Exam) | James Madison
University
1. When conducting an abdominal assessment, in which order should the physical
examination techniques be performed to ensure accurate findings?
A. Inspection, percussion, palpation, auscultation
B. Auscultation, inspection, palpation, percussion
C. Palpation, percussion, inspection, auscultation
D. Inspection, auscultation, percussion, palpation
Answer: D
Rationale: The abdominal assessment requires a specific order to prevent the manual
alteration of bowel sounds. Auscultation is performed immediately after inspection
because percussion and palpation can stimulate peristalsis and create false auditory
findings. This standardized sequence ensures that the nurse captures the patient’s baseline
gastrointestinal activity accurately.
2. During a respiratory assessment, a nurse notes high-pitched, musical whistling sounds
heard primarily during expiration. How should these sounds be documented?
A. Pleural friction rub
,B. Crackles
C. Rhonchi
D. Wheezes
Answer: D
Rationale: Wheezes are adventitious breath sounds caused by air squeezing through
narrowed or obstructed airways. These sounds are characteristically high-pitched and
musical, often associated with conditions such as asthma or chronic obstructive pulmonary
disease. Proper documentation allows the healthcare team to monitor changes in airway
patency and response to bronchodilators.
3. When assessing the heart, where is the second heart sound (S2) typically heard the
loudest?
A. At the apex of the heart
B. At the base of the heart
C. At the fifth intercostal space, left midclavicular line
D. At the fourth intercostal space, left sternal border
Answer: B
Rationale: The S2 sound is produced by the closure of the semilunar valves, which include
the aortic and pulmonic valves. This sound marks the end of systole and the beginning of
, diastole in the cardiac cycle. It is most prominent at the base of the heart, specifically in the
second intercostal space at the right and left sternal borders.
4. A nurse is testing a patient’s visual acuity using a Snellen chart. What does a result of 20/40
indicate?
A. The patient can see at 40 feet what a normal eye sees at 20 feet
B. The patient has perfect vision in the right eye
C. The patient is legally blind
D. The patient can see at 20 feet what a normal eye sees at 40 feet
Answer: D
Rationale: Visual acuity is expressed as a fraction where the top number represents the
distance the patient is standing from the chart. The bottom number indicates the distance
at which a person with normal vision could read the same line. Therefore, a patient with
20/40 vision has reduced acuity, needing to be much closer to see what others see from
further away.
5. Which cranial nerve is primarily responsible for the sensory perception of smell?
A. Cranial Nerve II
B. Cranial Nerve I
C. Cranial Nerve V
D. Cranial Nerve X
