NR 667 CEA FNP Capstone Practicum and Intensive Final Exam with
Accurate Questions & Correct Answers (Verified Answers) and Full Deep
Expert Rationales | Latest (2026/2027) Updated Version {JUST RELEASED}
- Chamberlian College Of Nursing
1. The nurse practitioner assessing the patient with a rapid cardiac rhythm may
assess for a pulse deficit by auscultating the patient's heart while watching the EKG
rhythm. Where would the S1 heart sounds correlate with the electrocardiographic
waves?
a. At the end of the T wave
b. At the start of the T wave
c. Peak of the R wave
d. At the start of the P wave
Correct Answer: c. Peak of the R wave
Expert Rationale: The S1 heart sound corresponds to the closure of the mitral and
tricuspid valves, which occurs at the beginning of ventricular systole. On the ECG, this
correlates with the peak of the R wave, which represents the onset of ventricular
depolarization and the beginning of systole. Understanding this correlation helps the
practitioner assess for pulse deficits and other cardiac abnormalities.
2. Michael, a 72-year-old male patient who previously presented with stable cardiac-
type chest pain has underwent a stress test. He presents today to review the stress
test results, which show EKG findings of ST segment depression during the exam in
leads V3 and V4 as well as some concurrent chest discomfort. Based on these
findings, which of the following are NOT priority medical decisions?
a. Prescribe metoprolol (Lopressor) 12.5mg PO BID
b. Prescribe aspirin 81mg PO daily
c. Refer to cardiology for angiography
,d. Check for thyroid dysfunction
Correct Answer: d. Check for thyroid dysfunction
Expert Rationale: The stress test findings of ST segment depression with concurrent
chest discomfort indicate myocardial ischemia, likely coronary artery disease. Priority
medical decisions include initiating beta-blocker therapy (metoprolol) to reduce
myocardial oxygen demand, starting aspirin for its antiplatelet effects, and referring to
cardiology for possible angiography. Checking for thyroid dysfunction is important but is
not a priority in the acute management of ischemic heart disease.
3. While examining a 53-year-old female patient, you auscultate abnormal breath
sounds over all fields, and now assess transmission of voice sounds by having the
patient say "ee" while auscultating the chest with the diaphragm of your
stethoscope. Normally, you should auscultate a muffled "e" sound, however, you
hear a nasally "a" sound. Which one of the following will you document is present?
a. Positive stereognosis
b. Positive for egophony
c. Negative for bronchophony
d. Negative for egophony
Correct Answer: b. Positive for egophony
Expert Rationale: Egophony is present when the patient says "ee" and the examiner
hears "a" (nasally sound). This indicates increased transmission of voice sounds due to
consolidation of lung tissue, as seen in pneumonia or other conditions that increase lung
density. Bronchophony is assessed by having the patient say "99" and hearing it more
clearly and loudly than normal.
4. During a post-hospital discharge visit, you notice your 71-year-old female patient
,has been diagnosed with a "new murmur" found by the hospitalist during their
recent hospitalization for CHF exacerbation. In evaluating the patient, during which
phase of the cardiac cycle would you anticipate auscultation of a S3 or S4 heart
sound?
a. Diastole
b. S3 in systole while S4 in diastole
c. Systole
d. S4 in diastole while S3 in systole
Correct Answer: a. Diastole
Expert Rationale: Both S3 and S4 heart sounds are diastolic sounds. S3 (ventricular
gallop) occurs during early diastole when blood rapidly fills a dilated ventricle,
commonly heard in heart failure. S4 (atrial gallop) occurs during late diastole when the
atria contract against a stiff ventricle, commonly heard in hypertension and ventricular
hypertrophy.
5. The point of maximum impulse (PMI) is MOST often palpable in healthy adults
when positioned in the supine or left lateral decubitus position. Which one of the
following locations is most commonly described as the PMI in a healthy adult?
a. Left 2nd intercostal space, midaxillary line
b. Left 5th intercostal space, midclavicular line
c. Right 4th intercostal space, midaxillary line
d. Right 2nd intercostal space, midclavicular line
Correct Answer: b. Left 5th intercostal space, midclavicular line
Expert Rationale: The PMI, also known as the apical impulse, is most commonly
located at the left 5th intercostal space at the midclavicular line in healthy adults. This is
where the apex of the heart is closest to the chest wall. Displacement of the PMI can
indicate cardiac enlargement or other pathology.
, 6. While assessing the 19-year-old patient for a new onset cough, the nurse
practitioner may inspect, auscultate, palpate, and/or percuss. How does performing
percussion of the thorax assist the provider during the physical examination?
a. To assist with the confirmation of cardiac origin of angina
b. To assess for deep-seated lesion and tumors
c. To assess for any pain or discomfort prior to palpation of the chest wall
d. To identify if underlying tissue are air-filled, fluid-filled or consolidated
Correct Answer: d. To identify if underlying tissue are air-filled, fluid-filled or
consolidated
Expert Rationale: Percussion of the thorax helps identify whether underlying tissues are
air-filled (tympanic/resonant), fluid-filled (dull), or consolidated (dull). This assists in
diagnosing conditions such as pneumonia, pleural effusion, or pneumothorax.
7. Your 42-year-old male patient has been referred to your clinic for establishing
care and on his intake survey, you note he has documented diagnosis of interstitial
lung disease. You have decided to perform a diaphragmatic excursion test on the
patient. Which one of the following results would you expect to see in this patient?
a. Approximately equal level of change in the descent of the diaphragm bilaterally during
maximal inspiration and expiration, with a decreased overall inspiratory capacity
b. Ascension of 8-12 inches of the diaphragm noted bilaterally on expiration, though
often much less on the right side due to the location of the heart and great vessels
c. Much greater descent of the diaphragm on the right side due to the liver present (two-
three times larger)
d. Absent or no change in movement of the diaphragm noted between full inspiration and
full expiration measurement
Correct Answer: a. Approximately equal level of change in the descent of the
Accurate Questions & Correct Answers (Verified Answers) and Full Deep
Expert Rationales | Latest (2026/2027) Updated Version {JUST RELEASED}
- Chamberlian College Of Nursing
1. The nurse practitioner assessing the patient with a rapid cardiac rhythm may
assess for a pulse deficit by auscultating the patient's heart while watching the EKG
rhythm. Where would the S1 heart sounds correlate with the electrocardiographic
waves?
a. At the end of the T wave
b. At the start of the T wave
c. Peak of the R wave
d. At the start of the P wave
Correct Answer: c. Peak of the R wave
Expert Rationale: The S1 heart sound corresponds to the closure of the mitral and
tricuspid valves, which occurs at the beginning of ventricular systole. On the ECG, this
correlates with the peak of the R wave, which represents the onset of ventricular
depolarization and the beginning of systole. Understanding this correlation helps the
practitioner assess for pulse deficits and other cardiac abnormalities.
2. Michael, a 72-year-old male patient who previously presented with stable cardiac-
type chest pain has underwent a stress test. He presents today to review the stress
test results, which show EKG findings of ST segment depression during the exam in
leads V3 and V4 as well as some concurrent chest discomfort. Based on these
findings, which of the following are NOT priority medical decisions?
a. Prescribe metoprolol (Lopressor) 12.5mg PO BID
b. Prescribe aspirin 81mg PO daily
c. Refer to cardiology for angiography
,d. Check for thyroid dysfunction
Correct Answer: d. Check for thyroid dysfunction
Expert Rationale: The stress test findings of ST segment depression with concurrent
chest discomfort indicate myocardial ischemia, likely coronary artery disease. Priority
medical decisions include initiating beta-blocker therapy (metoprolol) to reduce
myocardial oxygen demand, starting aspirin for its antiplatelet effects, and referring to
cardiology for possible angiography. Checking for thyroid dysfunction is important but is
not a priority in the acute management of ischemic heart disease.
3. While examining a 53-year-old female patient, you auscultate abnormal breath
sounds over all fields, and now assess transmission of voice sounds by having the
patient say "ee" while auscultating the chest with the diaphragm of your
stethoscope. Normally, you should auscultate a muffled "e" sound, however, you
hear a nasally "a" sound. Which one of the following will you document is present?
a. Positive stereognosis
b. Positive for egophony
c. Negative for bronchophony
d. Negative for egophony
Correct Answer: b. Positive for egophony
Expert Rationale: Egophony is present when the patient says "ee" and the examiner
hears "a" (nasally sound). This indicates increased transmission of voice sounds due to
consolidation of lung tissue, as seen in pneumonia or other conditions that increase lung
density. Bronchophony is assessed by having the patient say "99" and hearing it more
clearly and loudly than normal.
4. During a post-hospital discharge visit, you notice your 71-year-old female patient
,has been diagnosed with a "new murmur" found by the hospitalist during their
recent hospitalization for CHF exacerbation. In evaluating the patient, during which
phase of the cardiac cycle would you anticipate auscultation of a S3 or S4 heart
sound?
a. Diastole
b. S3 in systole while S4 in diastole
c. Systole
d. S4 in diastole while S3 in systole
Correct Answer: a. Diastole
Expert Rationale: Both S3 and S4 heart sounds are diastolic sounds. S3 (ventricular
gallop) occurs during early diastole when blood rapidly fills a dilated ventricle,
commonly heard in heart failure. S4 (atrial gallop) occurs during late diastole when the
atria contract against a stiff ventricle, commonly heard in hypertension and ventricular
hypertrophy.
5. The point of maximum impulse (PMI) is MOST often palpable in healthy adults
when positioned in the supine or left lateral decubitus position. Which one of the
following locations is most commonly described as the PMI in a healthy adult?
a. Left 2nd intercostal space, midaxillary line
b. Left 5th intercostal space, midclavicular line
c. Right 4th intercostal space, midaxillary line
d. Right 2nd intercostal space, midclavicular line
Correct Answer: b. Left 5th intercostal space, midclavicular line
Expert Rationale: The PMI, also known as the apical impulse, is most commonly
located at the left 5th intercostal space at the midclavicular line in healthy adults. This is
where the apex of the heart is closest to the chest wall. Displacement of the PMI can
indicate cardiac enlargement or other pathology.
, 6. While assessing the 19-year-old patient for a new onset cough, the nurse
practitioner may inspect, auscultate, palpate, and/or percuss. How does performing
percussion of the thorax assist the provider during the physical examination?
a. To assist with the confirmation of cardiac origin of angina
b. To assess for deep-seated lesion and tumors
c. To assess for any pain or discomfort prior to palpation of the chest wall
d. To identify if underlying tissue are air-filled, fluid-filled or consolidated
Correct Answer: d. To identify if underlying tissue are air-filled, fluid-filled or
consolidated
Expert Rationale: Percussion of the thorax helps identify whether underlying tissues are
air-filled (tympanic/resonant), fluid-filled (dull), or consolidated (dull). This assists in
diagnosing conditions such as pneumonia, pleural effusion, or pneumothorax.
7. Your 42-year-old male patient has been referred to your clinic for establishing
care and on his intake survey, you note he has documented diagnosis of interstitial
lung disease. You have decided to perform a diaphragmatic excursion test on the
patient. Which one of the following results would you expect to see in this patient?
a. Approximately equal level of change in the descent of the diaphragm bilaterally during
maximal inspiration and expiration, with a decreased overall inspiratory capacity
b. Ascension of 8-12 inches of the diaphragm noted bilaterally on expiration, though
often much less on the right side due to the location of the heart and great vessels
c. Much greater descent of the diaphragm on the right side due to the liver present (two-
three times larger)
d. Absent or no change in movement of the diaphragm noted between full inspiration and
full expiration measurement
Correct Answer: a. Approximately equal level of change in the descent of the
