NSG 351 Final Exam V3 | NSG 351 Health
Assessment | Actual Q&A with Rationale
(NSG351 Final Exam) | James Madison
University
1. When conducting a physical examination, which part of the hand is most sensitive and best
suited for assessing the temperature of the patient’s skin?
A. Ulnar surface
B. Dorsal surface (back of the hand)
C. Fingertips
D. Palmar surface
Answer: B
Rationale: The dorsal surface of the hand is preferred for temperature assessment because
the skin is thinner and more sensitive to thermal changes than the palms. This technique
allows the nurse to accurately detect differences in warmth or coolness across symmetric
body parts. Using the correct part of the hand ensures precision during the palpation phase
of the physical exam.
2. The nurse is auscultating the lungs of a healthy adult. Which type of breath sound is
expected to be heard over most of the peripheral lung fields?
A. Bronchial
,B. Tracheal
C. Bronchovesicular
D. Vesicular
Answer: D
Rationale: Vesicular breath sounds are soft, low-pitched sounds heard over the majority of
the lung surface where air flows through smaller bronchioles and alveoli. They are
characterized by an inspiratory phase that is significantly longer than the expiratory phase.
Hearing these sounds in the periphery is a normal finding in healthy pulmonary
assessment.
3. During a cardiac assessment, the nurse knows that the first heart sound (S1) is produced by
which physiological event?
A. Closure of the aortic valve
B. Opening of the mitral valve
C. Closure of the semilunar valves
D. Closure of the atrioventricular (AV) valves
Answer: D
Rationale: The S1 heart sound, often described as ‘lub’, marks the beginning of systole and
is caused by the closure of the mitral and tricuspid valves. This closure prevents the
, backflow of blood into the atria when the ventricles contract. It is typically loudest at the
apex of the heart during auscultation.
4. When performing an abdominal assessment, in what order should the nurse perform the
physical examination techniques?
A. Inspection, Palpation, Percussion, Auscultation
B. Inspection, Auscultation, Percussion, Palpation
C. Inspection, Percussion, Palpation, Auscultation
D. Auscultation, Inspection, Palpation, Percussion
Answer: B
Rationale: The specific sequence of inspection, auscultation, percussion, and palpation is
unique to the abdominal exam to prevent false findings. Palpation and percussion can
stimulate bowel activity or cause pain, which may alter the natural frequency of bowel
sounds if done before auscultation. Following this order ensures the most accurate
assessment of the gastrointestinal system.
5. A nurse asks a patient to smile, frown, and puff out their cheeks. Which cranial nerve is
being primarily assessed with these actions?
A. Cranial Nerve V (Trigeminal)
B. Cranial Nerve VII (Facial)
C. Cranial Nerve X (Vagus)
Assessment | Actual Q&A with Rationale
(NSG351 Final Exam) | James Madison
University
1. When conducting a physical examination, which part of the hand is most sensitive and best
suited for assessing the temperature of the patient’s skin?
A. Ulnar surface
B. Dorsal surface (back of the hand)
C. Fingertips
D. Palmar surface
Answer: B
Rationale: The dorsal surface of the hand is preferred for temperature assessment because
the skin is thinner and more sensitive to thermal changes than the palms. This technique
allows the nurse to accurately detect differences in warmth or coolness across symmetric
body parts. Using the correct part of the hand ensures precision during the palpation phase
of the physical exam.
2. The nurse is auscultating the lungs of a healthy adult. Which type of breath sound is
expected to be heard over most of the peripheral lung fields?
A. Bronchial
,B. Tracheal
C. Bronchovesicular
D. Vesicular
Answer: D
Rationale: Vesicular breath sounds are soft, low-pitched sounds heard over the majority of
the lung surface where air flows through smaller bronchioles and alveoli. They are
characterized by an inspiratory phase that is significantly longer than the expiratory phase.
Hearing these sounds in the periphery is a normal finding in healthy pulmonary
assessment.
3. During a cardiac assessment, the nurse knows that the first heart sound (S1) is produced by
which physiological event?
A. Closure of the aortic valve
B. Opening of the mitral valve
C. Closure of the semilunar valves
D. Closure of the atrioventricular (AV) valves
Answer: D
Rationale: The S1 heart sound, often described as ‘lub’, marks the beginning of systole and
is caused by the closure of the mitral and tricuspid valves. This closure prevents the
, backflow of blood into the atria when the ventricles contract. It is typically loudest at the
apex of the heart during auscultation.
4. When performing an abdominal assessment, in what order should the nurse perform the
physical examination techniques?
A. Inspection, Palpation, Percussion, Auscultation
B. Inspection, Auscultation, Percussion, Palpation
C. Inspection, Percussion, Palpation, Auscultation
D. Auscultation, Inspection, Palpation, Percussion
Answer: B
Rationale: The specific sequence of inspection, auscultation, percussion, and palpation is
unique to the abdominal exam to prevent false findings. Palpation and percussion can
stimulate bowel activity or cause pain, which may alter the natural frequency of bowel
sounds if done before auscultation. Following this order ensures the most accurate
assessment of the gastrointestinal system.
5. A nurse asks a patient to smile, frown, and puff out their cheeks. Which cranial nerve is
being primarily assessed with these actions?
A. Cranial Nerve V (Trigeminal)
B. Cranial Nerve VII (Facial)
C. Cranial Nerve X (Vagus)
