NSG 300 EXAM 2 COMPREHENSIVE
PREP QUESTIONS AND ANSWERS
1. When assessing a patient with chronic obstructive pulmonary disease (COPD), the nurse
notes a barrel chest. This clinical finding is primarily caused by which of the following?
A. Hypertrophy of the accessory muscles of respiration
B. Chronic inflammation of the bronchial tree
C. Air trapping in the alveoli leading to hyperinflation
D. Weakness of the intercostal muscles
Answer: C
Conceptual Explanation: A barrel chest is characterized by an increased anteroposterior
diameter, typically resulting from long-term air trapping and hyperinflation of the lungs
seen in emphysema and COPD.
2. During cardiac auscultation, the nurse hears a high-pitched, scratchy sound at the left
lower sternal border that persists when the patient holds their breath. This is most likely:
A. A pericardial friction rub
B. A pleural friction rub
,C. A Grade III systolic murmur
D. A physiological S3 heart sound
Answer: A
Conceptual Explanation: A pericardial friction rub is high-pitched and scratchy. Unlike a
pleural rub, it does not disappear when the patient holds their breath because it is related
to the heart beating, not respiration.
3. When performing a physical assessment on the abdomen, what is the correct sequence of
techniques?
A. Inspection, Palpation, Percussion, Auscultation
B. Auscultation, Inspection, Palpation, Percussion
C. Inspection, Auscultation, Percussion, Palpation
D. Percussion, Auscultation, Inspection, Palpation
Answer: C
Conceptual Explanation: In abdominal assessment, auscultation follows inspection to
ensure that bowel sounds are not altered by the manipulation of the abdomen during
percussion or palpation.
4. The nurse is testing a patient’s Cranial Nerve V (Trigeminal). Which of the following actions
is appropriate for this test?
A. Palpating the temporal and masseter muscles while the patient clenches their teeth
, B. Testing the gag reflex with a tongue depressor
C. Asking the patient to smile and puff out their cheeks
D. Asking the patient to identify different scents
Answer: A
Conceptual Explanation: Cranial Nerve V (Trigeminal) has both motor and sensory
functions. The motor component is tested by assessing the strength of the masseter and
temporal muscles during jaw clenching.
5. A patient presents with ‘pitting edema’ in the lower extremities. The nurse notes a deep
indentation that remains for a short time (approx 10-15 seconds) after pressure is released.
How should this be documented?
A. 3+ Edema
B. 2+ Edema
C. 1+ Edema
D. 4+ Edema
Answer: A
Conceptual Explanation: 3+ edema is defined as a deep pit (6mm) that remains for a
short time and the leg looks swollen. 2+ is a mild pit that subsides rapidly, and 4+ is a very
deep pit that lasts a long time.
PREP QUESTIONS AND ANSWERS
1. When assessing a patient with chronic obstructive pulmonary disease (COPD), the nurse
notes a barrel chest. This clinical finding is primarily caused by which of the following?
A. Hypertrophy of the accessory muscles of respiration
B. Chronic inflammation of the bronchial tree
C. Air trapping in the alveoli leading to hyperinflation
D. Weakness of the intercostal muscles
Answer: C
Conceptual Explanation: A barrel chest is characterized by an increased anteroposterior
diameter, typically resulting from long-term air trapping and hyperinflation of the lungs
seen in emphysema and COPD.
2. During cardiac auscultation, the nurse hears a high-pitched, scratchy sound at the left
lower sternal border that persists when the patient holds their breath. This is most likely:
A. A pericardial friction rub
B. A pleural friction rub
,C. A Grade III systolic murmur
D. A physiological S3 heart sound
Answer: A
Conceptual Explanation: A pericardial friction rub is high-pitched and scratchy. Unlike a
pleural rub, it does not disappear when the patient holds their breath because it is related
to the heart beating, not respiration.
3. When performing a physical assessment on the abdomen, what is the correct sequence of
techniques?
A. Inspection, Palpation, Percussion, Auscultation
B. Auscultation, Inspection, Palpation, Percussion
C. Inspection, Auscultation, Percussion, Palpation
D. Percussion, Auscultation, Inspection, Palpation
Answer: C
Conceptual Explanation: In abdominal assessment, auscultation follows inspection to
ensure that bowel sounds are not altered by the manipulation of the abdomen during
percussion or palpation.
4. The nurse is testing a patient’s Cranial Nerve V (Trigeminal). Which of the following actions
is appropriate for this test?
A. Palpating the temporal and masseter muscles while the patient clenches their teeth
, B. Testing the gag reflex with a tongue depressor
C. Asking the patient to smile and puff out their cheeks
D. Asking the patient to identify different scents
Answer: A
Conceptual Explanation: Cranial Nerve V (Trigeminal) has both motor and sensory
functions. The motor component is tested by assessing the strength of the masseter and
temporal muscles during jaw clenching.
5. A patient presents with ‘pitting edema’ in the lower extremities. The nurse notes a deep
indentation that remains for a short time (approx 10-15 seconds) after pressure is released.
How should this be documented?
A. 3+ Edema
B. 2+ Edema
C. 1+ Edema
D. 4+ Edema
Answer: A
Conceptual Explanation: 3+ edema is defined as a deep pit (6mm) that remains for a
short time and the leg looks swollen. 2+ is a mild pit that subsides rapidly, and 4+ is a very
deep pit that lasts a long time.
