GCU NSG 316 EXAM 2: ADVANCED
HEALTH ASSESSMENT QUESTIONS
AND ANSWERS
1. When assessing a patient with suspected consolidation in the lower lobe of the right lung,
the nurse expects to find which of the following during tactile fremitus?
A. Decreased fremitus
B. Absent fremitus
C. Increased fremitus
D. Normal vocal resonance
Answer: C
Conceptual Explanation: Consolidation of lung tissue, such as in pneumonia, increases the
density of the lung, which enhances the transmission of vibrations, resulting in increased
tactile fremitus.
,2. During cardiac auscultation, the nurse hears a high-pitched, scratchy sound that is best
heard with the diaphragm at the left lower sternal border while the patient is leaning
forward. This is most likely:
A. A Grade II mitral murmur
B. A pericardial friction rub
C. An S3 gallop
D. An ejection click
Answer: B
Conceptual Explanation: A pericardial friction rub is high-pitched and scratchy, caused by
inflammation of the pericardial sac, and is loudest when the patient leans forward to bring
the heart closer to the chest wall.
3. Which assessment technique is correct when the nurse is evaluating a patient for the
presence of a fluid wave to detect ascites?
A. Percuss from the umbilicus to the flanks and mark the transition from tympany to
dullness.
B. Perform deep palpation in all four quadrants to feel for shifting masses.
C. Place one hand on the flank and strike the opposite flank with the other hand while an
assistant places a hand on the midline.
D. Apply pressure to the McBurney point and observe for guarding.
, Answer: C
Conceptual Explanation: The fluid wave test involves tapping one flank while feeling for a
wave on the other; the midline hand prevents adipose tissue vibration from mimicking
fluid movement.
4. A patient presents with a ‘blowing’ holosystolic murmur heard best at the apex and
radiating to the left axilla. Which valve is most likely involved?
A. Aortic valve
B. Mitral valve
C. Tricuspid valve
D. Pulmonic valve
Answer: B
Conceptual Explanation: Mitral regurgitation typically produces a holosystolic murmur at
the apex that often radiates to the axilla.
5. During a neurological exam, the nurse asks the patient to identify a familiar object, such as
a key, placed in their hand while their eyes are closed. This tests for:
A. Graphesthesia
B. Two-point discrimination
C. Stereognosis
D. Extinction phenomenon
HEALTH ASSESSMENT QUESTIONS
AND ANSWERS
1. When assessing a patient with suspected consolidation in the lower lobe of the right lung,
the nurse expects to find which of the following during tactile fremitus?
A. Decreased fremitus
B. Absent fremitus
C. Increased fremitus
D. Normal vocal resonance
Answer: C
Conceptual Explanation: Consolidation of lung tissue, such as in pneumonia, increases the
density of the lung, which enhances the transmission of vibrations, resulting in increased
tactile fremitus.
,2. During cardiac auscultation, the nurse hears a high-pitched, scratchy sound that is best
heard with the diaphragm at the left lower sternal border while the patient is leaning
forward. This is most likely:
A. A Grade II mitral murmur
B. A pericardial friction rub
C. An S3 gallop
D. An ejection click
Answer: B
Conceptual Explanation: A pericardial friction rub is high-pitched and scratchy, caused by
inflammation of the pericardial sac, and is loudest when the patient leans forward to bring
the heart closer to the chest wall.
3. Which assessment technique is correct when the nurse is evaluating a patient for the
presence of a fluid wave to detect ascites?
A. Percuss from the umbilicus to the flanks and mark the transition from tympany to
dullness.
B. Perform deep palpation in all four quadrants to feel for shifting masses.
C. Place one hand on the flank and strike the opposite flank with the other hand while an
assistant places a hand on the midline.
D. Apply pressure to the McBurney point and observe for guarding.
, Answer: C
Conceptual Explanation: The fluid wave test involves tapping one flank while feeling for a
wave on the other; the midline hand prevents adipose tissue vibration from mimicking
fluid movement.
4. A patient presents with a ‘blowing’ holosystolic murmur heard best at the apex and
radiating to the left axilla. Which valve is most likely involved?
A. Aortic valve
B. Mitral valve
C. Tricuspid valve
D. Pulmonic valve
Answer: B
Conceptual Explanation: Mitral regurgitation typically produces a holosystolic murmur at
the apex that often radiates to the axilla.
5. During a neurological exam, the nurse asks the patient to identify a familiar object, such as
a key, placed in their hand while their eyes are closed. This tests for:
A. Graphesthesia
B. Two-point discrimination
C. Stereognosis
D. Extinction phenomenon
