NURS 6512 Exam 2 V3 | NURS 6512
Advanced Health Assessment | Actual
Q&A with Rationale (NURS6512 Exam 2) |
Walden University
1. During a cardiac assessment, the clinician hears a low-pitched extra heart sound occurring
early in diastole. This finding in a 70-year-old patient is most likely indicative of which
condition?
A. A normal physiological variation in the elderly
B. Atrial gallop (S4) suggesting hypertension
C. Ventricular gallop (S3) suggesting heart failure
D. Mitral valve prolapse with a mid-systolic click
Answer: C
Rationale: An S3 heart sound is often referred to as a ventricular gallop and occurs
immediately after S2 when the AV valves open and blood rushes into a distended ventricle.
In older adults, this sound is frequently a sign of ventricular overfilling or decreased
myocardial compliance, often associated with heart failure. The clinician should correlate
this finding with other symptoms like dyspnea or crackles.
2. When performing a clinical breast examination, which specific anatomical location is most
critical to palpate because it is the site where the majority of breast cancers are discovered?
A. The lower inner quadrant
,B. The periareolar region
C. The upper outer quadrant and Tail of Spence
D. The inframammary ridge
Answer: C
Rationale: Statistical data consistently show that the upper outer quadrant, which includes
the axillary tail of Spence, contains the highest volume of glandular tissue. Consequently,
this area is the most common site for malignant neoplasms to develop. Thorough palpation
from the clavicle to the inframammary fold and from the sternum to the midaxillary line is
essential for a complete exam.
3. A patient presents with sudden onset of chest pain and shortness of breath. On physical
exam, the clinician notes decreased tactile fremitus and hyperresonance upon percussion of
the left lung fields. What is the most likely diagnosis?
A. Lobar pneumonia
B. Pleural effusion
C. Pneumothorax
D. Congestive heart failure
Answer: C
Rationale: Hyperresonance occurs when there is an abnormal accumulation of air in the
pleural space, which displaces the lung tissue. Tactile fremitus is decreased because the air
, acts as a barrier to the transmission of vocal vibrations to the chest wall. These clinical
signs combined with acute respiratory distress are classic indicators of a collapsed lung.
4. Which physical examination technique is used to assess the patency of the ulnar and radial
arteries before performing an arterial blood gas draw?
A. The Phalen test
B. The Allen test
C. The Murphy sign
D. The Homan sign
Answer: B
Rationale: The Allen test is a diagnostic tool used to evaluate the adequacy of collateral
circulation in the hand. The clinician compresses both the radial and ulnar arteries while
the patient makes a fist, then releases one artery to observe for the return of color. This
procedure ensures that if one artery is damaged during a puncture, the other can
sufficiently supply the hand.
5. A 55-year-old male presents with complaints of pain in his calves when walking two blocks,
which is relieved by rest. This clinical presentation is most consistent with:
A. Intermittent claudication
B. Deep vein thrombosis
C. Venous insufficiency
Advanced Health Assessment | Actual
Q&A with Rationale (NURS6512 Exam 2) |
Walden University
1. During a cardiac assessment, the clinician hears a low-pitched extra heart sound occurring
early in diastole. This finding in a 70-year-old patient is most likely indicative of which
condition?
A. A normal physiological variation in the elderly
B. Atrial gallop (S4) suggesting hypertension
C. Ventricular gallop (S3) suggesting heart failure
D. Mitral valve prolapse with a mid-systolic click
Answer: C
Rationale: An S3 heart sound is often referred to as a ventricular gallop and occurs
immediately after S2 when the AV valves open and blood rushes into a distended ventricle.
In older adults, this sound is frequently a sign of ventricular overfilling or decreased
myocardial compliance, often associated with heart failure. The clinician should correlate
this finding with other symptoms like dyspnea or crackles.
2. When performing a clinical breast examination, which specific anatomical location is most
critical to palpate because it is the site where the majority of breast cancers are discovered?
A. The lower inner quadrant
,B. The periareolar region
C. The upper outer quadrant and Tail of Spence
D. The inframammary ridge
Answer: C
Rationale: Statistical data consistently show that the upper outer quadrant, which includes
the axillary tail of Spence, contains the highest volume of glandular tissue. Consequently,
this area is the most common site for malignant neoplasms to develop. Thorough palpation
from the clavicle to the inframammary fold and from the sternum to the midaxillary line is
essential for a complete exam.
3. A patient presents with sudden onset of chest pain and shortness of breath. On physical
exam, the clinician notes decreased tactile fremitus and hyperresonance upon percussion of
the left lung fields. What is the most likely diagnosis?
A. Lobar pneumonia
B. Pleural effusion
C. Pneumothorax
D. Congestive heart failure
Answer: C
Rationale: Hyperresonance occurs when there is an abnormal accumulation of air in the
pleural space, which displaces the lung tissue. Tactile fremitus is decreased because the air
, acts as a barrier to the transmission of vocal vibrations to the chest wall. These clinical
signs combined with acute respiratory distress are classic indicators of a collapsed lung.
4. Which physical examination technique is used to assess the patency of the ulnar and radial
arteries before performing an arterial blood gas draw?
A. The Phalen test
B. The Allen test
C. The Murphy sign
D. The Homan sign
Answer: B
Rationale: The Allen test is a diagnostic tool used to evaluate the adequacy of collateral
circulation in the hand. The clinician compresses both the radial and ulnar arteries while
the patient makes a fist, then releases one artery to observe for the return of color. This
procedure ensures that if one artery is damaged during a puncture, the other can
sufficiently supply the hand.
5. A 55-year-old male presents with complaints of pain in his calves when walking two blocks,
which is relieved by rest. This clinical presentation is most consistent with:
A. Intermittent claudication
B. Deep vein thrombosis
C. Venous insufficiency
