NUR612 Exam Practice Guide Questions and
Correct Answers| Latest 2025
Differential diagnoses for cough? - ✔✔bronchitis, pleural effusion, URI, influenza,
pneumonia, croup, bronchiectasis, emphysema, GERD
Normal vs abnormal findings of chest and skin including inspection, auscultation,
palpation? - ✔✔Chest--> Inspection: note shape and symmetry of chest
anterior/posterior; Normal: chest symmetrical; AP diameter less than half transverse
diameter ratio 1:2; Barrel chest and pidgeon chest abnormal findings; observe
respiration-rate should be 12-20 respirations a minute (ratio of respirations to heartbeat
1:4);
look for retractions and audible adventitious sounds. Palpation--> palpate for crepitus,
thoracic expansion, and tactile fremitus-decreased or absent fremitus may be caused by
excess air in lungs seen in emphysema, pleural thickening, effusion, or bronchial
obstruction; Percussion- resonance should be heard over all areas of lungs;
hyperresonance is from hyperinflation and may indicate emphysema, pneumo, or
asthma. Dullness may indicate pneumonia or pleural effusion; Auscultation--> normal bs
vesicular (heard over most lung fields), bronchovesicular (heard over bronchus area and
right upper lung field), and bronchial (heard only over trachea); Adventitious are
wheezes, crackles, pleural friction rub, and rhochi.
Skin---> Inspection: note color (abnormal jaundice); look for skin thickness, rashes,
ecchymosis, moles; Palpation--> moisture, temperature, texture, and mobility. Minimal
perspiration should be present; skin should be cool to warm; texture should be
smooth/even. Assess turgor and for skin lesions;
Bronchial breath sounds - ✔✔heard over trachea; high pitch; loud and long
expirations; sometimes a bit longer than inspiration
,Vesicular breath sounds - ✔✔low-pitched, low-intensity sounds heard over healthy
tissue
Bronchovesicular breath sounds - ✔✔typically moderate in intensity; heard over the
major bronchi
Where is the diaphragmatic excursion? - ✔✔Percuss along scapular line until you
locate the lower border, the point marked by a change in note from resonance to
dullness. Mark the point at the scapular line with a pen. Allow pt. to breathe, and then
repeat on other side.Excursion distance usually 3-5 cm
Pectus carninatum - ✔✔Pigeon chest
Clubbed fingers - ✔✔enlargement of terminal phalanges of the fingers/toes
associated with emphysema, lung ca, the cyanosis of congenital heart disease, and cystic
fibrosis.
Barrel chest - ✔✔When the AP diameter approaches or equals the lateral diameter (a
ratio of 1.0 or even greater). Results from compromised respiration as in chronic
asthma, cystic fibrosis, or emphysema.
Retractions - ✔✔Seen when the chest wall caves in at the sternum, between the ribs,
at the suprasternal notch, above the clavicles, and at the lowest point in the respiratory
tract. Suggestive of obstruction to inspiration at any point in the respiratory tract.
Why are lesions transluminated? - ✔✔Used to determine the presence of fluid in
cysts and masses.
, ABCDE of melanoma - ✔✔Asymmetry-one-half of a mole or birthmark does not
match the other.
Borders-edges are irregular, ragged, notched, or blurred.
Color-color is not the same all over
Diameter- is >6mm or is growing larger
Evolution- changes in existing pigmented lesions, particularly in nonuniform,
asymmetric manner.
What types of rashes have genetic transfer? - ✔✔Eczema, psoriasis
Squamous cell carcinoma - ✔✔Also due to sun. Rapid growing and invasive. Lesion is
tender. Warty appearance, pink color.
Malignant carcinoma - ✔✔Irregular borders. Most deadly skin cancer. Can arrive
from prior moles that change shape/size. Genetic predisposition. Asymmetrical.
Basal cell carcinoma - ✔✔Border raised above the center or center is depressed
compared to lesion. Slow growing. Starts as non-healing sore often from sun exposure.
Waxy/pearly appearance. Crusts over in time.
Seborrehesis keratosis - ✔✔are pigmented, raised, warty lesions, usually appearing
on face or trunk.
Macule - ✔✔Flat, circumscribed with change in color less than one centimeter such
as a freckle or flat mole.
Papule - ✔✔Solid circumscribed less than one centimeter such as a wart.
Correct Answers| Latest 2025
Differential diagnoses for cough? - ✔✔bronchitis, pleural effusion, URI, influenza,
pneumonia, croup, bronchiectasis, emphysema, GERD
Normal vs abnormal findings of chest and skin including inspection, auscultation,
palpation? - ✔✔Chest--> Inspection: note shape and symmetry of chest
anterior/posterior; Normal: chest symmetrical; AP diameter less than half transverse
diameter ratio 1:2; Barrel chest and pidgeon chest abnormal findings; observe
respiration-rate should be 12-20 respirations a minute (ratio of respirations to heartbeat
1:4);
look for retractions and audible adventitious sounds. Palpation--> palpate for crepitus,
thoracic expansion, and tactile fremitus-decreased or absent fremitus may be caused by
excess air in lungs seen in emphysema, pleural thickening, effusion, or bronchial
obstruction; Percussion- resonance should be heard over all areas of lungs;
hyperresonance is from hyperinflation and may indicate emphysema, pneumo, or
asthma. Dullness may indicate pneumonia or pleural effusion; Auscultation--> normal bs
vesicular (heard over most lung fields), bronchovesicular (heard over bronchus area and
right upper lung field), and bronchial (heard only over trachea); Adventitious are
wheezes, crackles, pleural friction rub, and rhochi.
Skin---> Inspection: note color (abnormal jaundice); look for skin thickness, rashes,
ecchymosis, moles; Palpation--> moisture, temperature, texture, and mobility. Minimal
perspiration should be present; skin should be cool to warm; texture should be
smooth/even. Assess turgor and for skin lesions;
Bronchial breath sounds - ✔✔heard over trachea; high pitch; loud and long
expirations; sometimes a bit longer than inspiration
,Vesicular breath sounds - ✔✔low-pitched, low-intensity sounds heard over healthy
tissue
Bronchovesicular breath sounds - ✔✔typically moderate in intensity; heard over the
major bronchi
Where is the diaphragmatic excursion? - ✔✔Percuss along scapular line until you
locate the lower border, the point marked by a change in note from resonance to
dullness. Mark the point at the scapular line with a pen. Allow pt. to breathe, and then
repeat on other side.Excursion distance usually 3-5 cm
Pectus carninatum - ✔✔Pigeon chest
Clubbed fingers - ✔✔enlargement of terminal phalanges of the fingers/toes
associated with emphysema, lung ca, the cyanosis of congenital heart disease, and cystic
fibrosis.
Barrel chest - ✔✔When the AP diameter approaches or equals the lateral diameter (a
ratio of 1.0 or even greater). Results from compromised respiration as in chronic
asthma, cystic fibrosis, or emphysema.
Retractions - ✔✔Seen when the chest wall caves in at the sternum, between the ribs,
at the suprasternal notch, above the clavicles, and at the lowest point in the respiratory
tract. Suggestive of obstruction to inspiration at any point in the respiratory tract.
Why are lesions transluminated? - ✔✔Used to determine the presence of fluid in
cysts and masses.
, ABCDE of melanoma - ✔✔Asymmetry-one-half of a mole or birthmark does not
match the other.
Borders-edges are irregular, ragged, notched, or blurred.
Color-color is not the same all over
Diameter- is >6mm or is growing larger
Evolution- changes in existing pigmented lesions, particularly in nonuniform,
asymmetric manner.
What types of rashes have genetic transfer? - ✔✔Eczema, psoriasis
Squamous cell carcinoma - ✔✔Also due to sun. Rapid growing and invasive. Lesion is
tender. Warty appearance, pink color.
Malignant carcinoma - ✔✔Irregular borders. Most deadly skin cancer. Can arrive
from prior moles that change shape/size. Genetic predisposition. Asymmetrical.
Basal cell carcinoma - ✔✔Border raised above the center or center is depressed
compared to lesion. Slow growing. Starts as non-healing sore often from sun exposure.
Waxy/pearly appearance. Crusts over in time.
Seborrehesis keratosis - ✔✔are pigmented, raised, warty lesions, usually appearing
on face or trunk.
Macule - ✔✔Flat, circumscribed with change in color less than one centimeter such
as a freckle or flat mole.
Papule - ✔✔Solid circumscribed less than one centimeter such as a wart.
