NURS 6512 Exam 2 V1 | NURS 6512
Advanced Health Assessment | Actual
Q&A with Rationale (NURS6512 Exam 2) |
Walden University
1. When conducting an abdominal examination, which sequence of physical assessment
techniques should the advanced practice nurse follow?
A. Inspection, Palpation, Percussion, Auscultation
B. Inspection, Percussion, Palpation, Auscultation
C. Inspection, Auscultation, Percussion, Palpation
D. Auscultation, Inspection, Percussion, Palpation
Answer: C
Rationale: The correct order for abdominal assessment is inspection followed by
auscultation to ensure bowel sounds are not artificially induced or altered by manipulation.
Percussion and palpation are performed last as they can stimulate peristalsis and
potentially skew findings. Adhering to this specific clinical sequence is vital for an accurate
abdominal diagnosis.
2. A patient presents with a lobar pneumonia. During the respiratory assessment, the nurse
practitioner would expect to find which of the following regarding tactile fremitus?
A. Decreased tactile fremitus
,B. Variable tactile fremitus
C. Absent tactile fremitus
D. Increased tactile fremitus
Answer: D
Rationale: Tactile fremitus is increased in conditions where the lung tissue is consolidated,
such as in lobar pneumonia. The solid medium of the consolidated lung conducts vibrations
from the bronchial tree to the chest wall more effectively than air-filled tissue. This finding
helps differentiate pneumonia from conditions like pleural effusion where fremitus would
be decreased.
3. The second heart sound (S2) is primarily caused by the closure of which heart valves?
A. Mitral and Tricuspid
B. Tricuspid and Pulmonic
C. Mitral and Aortic
D. Aortic and Pulmonic
Answer: D
Rationale: S2 marks the beginning of diastole and is produced by the closure of the
semilunar valves, which include the aortic and pulmonic valves. This sound occurs when
the ventricles finish contracting and the pressure in the great vessels exceeds the pressure
in the ventricles. Recognizing the components of S2 is essential for identifying physiological
or pathological splitting.
, 4. During a breast examination, the nurse practitioner notes skin thickening and large pores,
resembling the skin of an orange. This finding is known as:
A. Fibroadenoma
B. Peau d’orange
C. Mastitis
D. Paget disease
Answer: B
Rationale: Peau d’orange is a classic physical sign where the skin becomes edematous and
the hair follicles appear recessed, giving it an orange-peel texture. This clinical finding is
often associated with lymphatic obstruction and is a significant indicator of inflammatory
breast cancer. Detailed inspection of the skin surface is a critical component of the
advanced breast assessment.
5. The nurse practitioner is assessing a patient for gallbladder disease. Which physical exam
maneuver involves palpating the right upper quadrant while the patient takes a deep breath?
A. Rovsing’s sign
B. Murphy’s sign
C. Psoas sign
D. McBurney’s sign
Answer: B
Advanced Health Assessment | Actual
Q&A with Rationale (NURS6512 Exam 2) |
Walden University
1. When conducting an abdominal examination, which sequence of physical assessment
techniques should the advanced practice nurse follow?
A. Inspection, Palpation, Percussion, Auscultation
B. Inspection, Percussion, Palpation, Auscultation
C. Inspection, Auscultation, Percussion, Palpation
D. Auscultation, Inspection, Percussion, Palpation
Answer: C
Rationale: The correct order for abdominal assessment is inspection followed by
auscultation to ensure bowel sounds are not artificially induced or altered by manipulation.
Percussion and palpation are performed last as they can stimulate peristalsis and
potentially skew findings. Adhering to this specific clinical sequence is vital for an accurate
abdominal diagnosis.
2. A patient presents with a lobar pneumonia. During the respiratory assessment, the nurse
practitioner would expect to find which of the following regarding tactile fremitus?
A. Decreased tactile fremitus
,B. Variable tactile fremitus
C. Absent tactile fremitus
D. Increased tactile fremitus
Answer: D
Rationale: Tactile fremitus is increased in conditions where the lung tissue is consolidated,
such as in lobar pneumonia. The solid medium of the consolidated lung conducts vibrations
from the bronchial tree to the chest wall more effectively than air-filled tissue. This finding
helps differentiate pneumonia from conditions like pleural effusion where fremitus would
be decreased.
3. The second heart sound (S2) is primarily caused by the closure of which heart valves?
A. Mitral and Tricuspid
B. Tricuspid and Pulmonic
C. Mitral and Aortic
D. Aortic and Pulmonic
Answer: D
Rationale: S2 marks the beginning of diastole and is produced by the closure of the
semilunar valves, which include the aortic and pulmonic valves. This sound occurs when
the ventricles finish contracting and the pressure in the great vessels exceeds the pressure
in the ventricles. Recognizing the components of S2 is essential for identifying physiological
or pathological splitting.
, 4. During a breast examination, the nurse practitioner notes skin thickening and large pores,
resembling the skin of an orange. This finding is known as:
A. Fibroadenoma
B. Peau d’orange
C. Mastitis
D. Paget disease
Answer: B
Rationale: Peau d’orange is a classic physical sign where the skin becomes edematous and
the hair follicles appear recessed, giving it an orange-peel texture. This clinical finding is
often associated with lymphatic obstruction and is a significant indicator of inflammatory
breast cancer. Detailed inspection of the skin surface is a critical component of the
advanced breast assessment.
5. The nurse practitioner is assessing a patient for gallbladder disease. Which physical exam
maneuver involves palpating the right upper quadrant while the patient takes a deep breath?
A. Rovsing’s sign
B. Murphy’s sign
C. Psoas sign
D. McBurney’s sign
Answer: B
