Advanced Health Assessment TEST BANK
NUR-631 Advanced Health Assessment TEST
BANK Exam LATEST 2024/2025 D'Youville
University GRADED A + GUARANTEED PASS
(QUESTIONS AND ANSWERS WITH
RATIONALES) ACE YOUR EXAM from BATES
Instructions – READ THE QUESTIONS CAREFULLY ,
ANSWER ALL QUESTIONS
The primary muscles of respiration include the :
A) trapezius and rectus abdominis.
B) sternomastoids and scaleni.
C) diaphragm and intercostals.
D) external obliques and pectoralis major. - ANS :C) diaphragm and intercostals.
The major muscle of respiration is the diaphragm. The intercostal muscles life the sternum and elevate the ribs
during inspiration, increasing the anteroposterior diameter. Expiration is primarily passive. Forced inspiration involves
the use of other muscles, such as the accessory neck muscles (sternomastoids, scalene, trapazii). Forced expiration
involves the abdominal muscles (Bates, p309).
When auscultating the lungs of an adult patient, the nurse practitioner notes that over the posterior lower lobes
low-pitched, soft breath sounds are heard, with inspiration being longer than expiration. The nurse interprets that
these are:
A) bronchial breath sounds and are normal in that location
B) sounds normally auscultated over the trachea
C) vesicular breath sounds and are normal in that location
D) bronchovesicular breath sounds and are normal in that location - ANS :C) vesicular breath sounds and are normal
in that location
, Advanced Health Assessment TEST BANK
Vesicular breath sounds are low-pitched, soft sounds with inspiration being longer than expiration. These breath
sounds are expected over peripheral lung fields where air flows through smaller bronchioles and alveoli (Bates,
p324)
The nurse practitioner is auscultating the chest in an adult. Which technique is correct?
A) Instruct the patient to breathe in and out only through his or her nose.
B) Use the diaphragm of the stethoscope held firmly against the chest.
C) Instruct the patient to take deep, rapid breaths.
D) Use the bell of the stethoscope held lightly against the chest to avoid friction. - ANS :B) Use the diaphragm of the
stethoscope held firmly against the chest.
The diaphragm of the stethoscope held firmly against the chest is the correct way to auscultate breath sounds. The
patient should be instructed to breathe through his or her mouth, a little deeper than usual, but not to
hyperventilate. (Bates, p323)
You can tell that you hear bronchovesicular sounds by the:
A) soft, low pitch sound you hear over most of both lung. The inspiratory sounds last longer than the expiratory
sounds.
B) very loud and relatively high pitch of the sounds heard over the trachea in the neck
C) inspiratory and expiratory sounds are equal in duration and pitch is intermediate. Sounds are heard in the 1st and
2nd interspaces anteriorly and between the scapulae
D) crepitus palpated at the costochrondral junctions - ANS :C) inspiratory and expiratory sounds are equal in duration
and pitch is intermediate. Sounds are heard in the 1st and 2nd interspaces anteriorly and between the scapulae
Bronchovesicular breath sounds are heard in the 1st and 2nd interspaces anteriorly and between the scapulae. They
are intermediate in intensity. Inspiration to expiration periods are equal. Inspiration and expiration are equal. (Bates,
p324)
The NP knows that normal newborn lung sounds:
A) are harsh and loud in the upper airway of the infant because the stethoscope is closer to the origin of the sounds
B) are vesicular
C) are easily auscultated without the stethoscope
D) are quiet in the infant compared to the adult ANS :A) are harsh and loud in the upper airway of the infant because
the stethoscope is closer to the origin of the sounds -
, Advanced Health Assessment TEST BANK
Fine crackles are commonly heard in the immediate newborn period as a result of the opening of the airways and
learning of fluid. Persistent fine crackles would be noticed with pneumonia, bronchiolitis, or atelectasis. (Bates, p
831)
During an assessment of an adult, the nurse practitioner has noted abnormally located bronchovesicular breath
sounds and asks the patient to say "ee" which sounds like "a." Which of the following is true?
A) The NP suspects the patient has had a pneumothorax.
B) The NP suspects the patient is in the early phases of COPD.
C) The NP documents that there is positive egophony and he/she becomes highly suspicious of pneumonia.
D) The NP concludes that there is only a low likelihood that the patient has pneumonia. - ANS :C) The NP documents
that there is positive egophony and he/she becomes highly suspicious of pneumonia.
If "ee" sounds like "a" then egophony is present and it could be a sign of pneumonia. (Bates, p327).
A teenage patient comes to the emergency room with complaints of an "inability to breathe and a sharp pain in my
left chest." Your assessment findings include the following: Cyanosis, tachypnea, tracheal deviation to the right,
decreased tactile fremitus on the left, hyperresonance on the left, and decreased breath sounds on the left. This
description is consistent with:
A) acute pneumonia
B) an asthmatic attack
C) a pneumothorax
D) bronchitis - ANS :C) a pneumothorax
With a pneumothorax, free air in the pleural space causes partial or complete lung collapse. If the pneumothorax is
large then tachypnea and cyanosis are seen. Unequal chest expansion, decreased or absent tactile fremitus, tracheal
deviation to the unaffected side, decreased chest expansion, hyperresonnant percussion tones, and decreased or
absent breath sounds are found with the presence of a pneumothorax. (Bates, p 340)
The diameter of the PMI is approximately:
A) 1-2.5 cm in diameter and any larger is evidence of mitral valve prolapse
B) 1-2.5 cm in diameter and any larger is evidence of left ventricular hypertrophy
C) .5-1 cm in diameter and any larger is evidence supporting left ventricular hypertrophy
, Advanced Health Assessment TEST BANK
D) .5-1 cm in diameter and any larger is evidence of mitral valve prolapse - ANS :B) 1-2.5 cm in diameter and any
larger is evidence of left ventricular hypertrophy
(Bates p 344)
The direction of blood flow through the heart is best described by which of the following?
A) Aorta - R atrium - R ventricle - lungs - pulmonary vein - L atrium - L ventricle - vena cava
B) R atrium - R ventricle - pulmonary vein - lungs - pulmonary artery - L atrium - L ventricle
C) R atrium - R ventricle - pulmonary artery - lungs - pulmonary vein - L atrium - L ventricle
D) Vena cava - R atrium - R ventricle - lungs - pulmonary artery- L atrium - L ventricle - ANS :C) R atrium - R ventricle -
pulmonary artery - lungs - pulmonary vein - L atrium - L ventricle
Returning blood from the body empties into the R atrium and flows into the R ventricle, then goes to the lungs
through the pulmonary artery. The lungs oxygenate the blood and it is then returned to the L atrium by the
pulmonary vein. It goes from there to the L ventricle and then out to the body through the aorta (Bates, pg 345)
When listening to heart sounds, the nurse knows that the valve closures that can be heard for S2 is:
A) pulmonic
B) aortic
C) tricuspid
D) mitral - ANS :B) aortic
The second heart sound (S2) occurs with the closure of the aortic valve and signals the end of systole. Although it is
heard over all the precordium, S2 is loudest at the base of the heart. (Bates, p347)
A 45-year-old man is in the clinic for a routine physical. During history the patient states he has been having difficulty
sleeping. "I'll be sleeping great and then I wake up and feel like I can't catch my breath." His symptoms indicates
sleep related symptoms of a certain type of disease, so which question would the NP want to ask?
A) Have you had a recent sinus infection or URI?
B) Do you have any history of problems with your heart?
C) Do you think it is because it's been so hot at night?
D) When was your last electroencephalogram? - ANS :B) Do you have any history of problems with your heart?
NUR-631 Advanced Health Assessment TEST
BANK Exam LATEST 2024/2025 D'Youville
University GRADED A + GUARANTEED PASS
(QUESTIONS AND ANSWERS WITH
RATIONALES) ACE YOUR EXAM from BATES
Instructions – READ THE QUESTIONS CAREFULLY ,
ANSWER ALL QUESTIONS
The primary muscles of respiration include the :
A) trapezius and rectus abdominis.
B) sternomastoids and scaleni.
C) diaphragm and intercostals.
D) external obliques and pectoralis major. - ANS :C) diaphragm and intercostals.
The major muscle of respiration is the diaphragm. The intercostal muscles life the sternum and elevate the ribs
during inspiration, increasing the anteroposterior diameter. Expiration is primarily passive. Forced inspiration involves
the use of other muscles, such as the accessory neck muscles (sternomastoids, scalene, trapazii). Forced expiration
involves the abdominal muscles (Bates, p309).
When auscultating the lungs of an adult patient, the nurse practitioner notes that over the posterior lower lobes
low-pitched, soft breath sounds are heard, with inspiration being longer than expiration. The nurse interprets that
these are:
A) bronchial breath sounds and are normal in that location
B) sounds normally auscultated over the trachea
C) vesicular breath sounds and are normal in that location
D) bronchovesicular breath sounds and are normal in that location - ANS :C) vesicular breath sounds and are normal
in that location
, Advanced Health Assessment TEST BANK
Vesicular breath sounds are low-pitched, soft sounds with inspiration being longer than expiration. These breath
sounds are expected over peripheral lung fields where air flows through smaller bronchioles and alveoli (Bates,
p324)
The nurse practitioner is auscultating the chest in an adult. Which technique is correct?
A) Instruct the patient to breathe in and out only through his or her nose.
B) Use the diaphragm of the stethoscope held firmly against the chest.
C) Instruct the patient to take deep, rapid breaths.
D) Use the bell of the stethoscope held lightly against the chest to avoid friction. - ANS :B) Use the diaphragm of the
stethoscope held firmly against the chest.
The diaphragm of the stethoscope held firmly against the chest is the correct way to auscultate breath sounds. The
patient should be instructed to breathe through his or her mouth, a little deeper than usual, but not to
hyperventilate. (Bates, p323)
You can tell that you hear bronchovesicular sounds by the:
A) soft, low pitch sound you hear over most of both lung. The inspiratory sounds last longer than the expiratory
sounds.
B) very loud and relatively high pitch of the sounds heard over the trachea in the neck
C) inspiratory and expiratory sounds are equal in duration and pitch is intermediate. Sounds are heard in the 1st and
2nd interspaces anteriorly and between the scapulae
D) crepitus palpated at the costochrondral junctions - ANS :C) inspiratory and expiratory sounds are equal in duration
and pitch is intermediate. Sounds are heard in the 1st and 2nd interspaces anteriorly and between the scapulae
Bronchovesicular breath sounds are heard in the 1st and 2nd interspaces anteriorly and between the scapulae. They
are intermediate in intensity. Inspiration to expiration periods are equal. Inspiration and expiration are equal. (Bates,
p324)
The NP knows that normal newborn lung sounds:
A) are harsh and loud in the upper airway of the infant because the stethoscope is closer to the origin of the sounds
B) are vesicular
C) are easily auscultated without the stethoscope
D) are quiet in the infant compared to the adult ANS :A) are harsh and loud in the upper airway of the infant because
the stethoscope is closer to the origin of the sounds -
, Advanced Health Assessment TEST BANK
Fine crackles are commonly heard in the immediate newborn period as a result of the opening of the airways and
learning of fluid. Persistent fine crackles would be noticed with pneumonia, bronchiolitis, or atelectasis. (Bates, p
831)
During an assessment of an adult, the nurse practitioner has noted abnormally located bronchovesicular breath
sounds and asks the patient to say "ee" which sounds like "a." Which of the following is true?
A) The NP suspects the patient has had a pneumothorax.
B) The NP suspects the patient is in the early phases of COPD.
C) The NP documents that there is positive egophony and he/she becomes highly suspicious of pneumonia.
D) The NP concludes that there is only a low likelihood that the patient has pneumonia. - ANS :C) The NP documents
that there is positive egophony and he/she becomes highly suspicious of pneumonia.
If "ee" sounds like "a" then egophony is present and it could be a sign of pneumonia. (Bates, p327).
A teenage patient comes to the emergency room with complaints of an "inability to breathe and a sharp pain in my
left chest." Your assessment findings include the following: Cyanosis, tachypnea, tracheal deviation to the right,
decreased tactile fremitus on the left, hyperresonance on the left, and decreased breath sounds on the left. This
description is consistent with:
A) acute pneumonia
B) an asthmatic attack
C) a pneumothorax
D) bronchitis - ANS :C) a pneumothorax
With a pneumothorax, free air in the pleural space causes partial or complete lung collapse. If the pneumothorax is
large then tachypnea and cyanosis are seen. Unequal chest expansion, decreased or absent tactile fremitus, tracheal
deviation to the unaffected side, decreased chest expansion, hyperresonnant percussion tones, and decreased or
absent breath sounds are found with the presence of a pneumothorax. (Bates, p 340)
The diameter of the PMI is approximately:
A) 1-2.5 cm in diameter and any larger is evidence of mitral valve prolapse
B) 1-2.5 cm in diameter and any larger is evidence of left ventricular hypertrophy
C) .5-1 cm in diameter and any larger is evidence supporting left ventricular hypertrophy
, Advanced Health Assessment TEST BANK
D) .5-1 cm in diameter and any larger is evidence of mitral valve prolapse - ANS :B) 1-2.5 cm in diameter and any
larger is evidence of left ventricular hypertrophy
(Bates p 344)
The direction of blood flow through the heart is best described by which of the following?
A) Aorta - R atrium - R ventricle - lungs - pulmonary vein - L atrium - L ventricle - vena cava
B) R atrium - R ventricle - pulmonary vein - lungs - pulmonary artery - L atrium - L ventricle
C) R atrium - R ventricle - pulmonary artery - lungs - pulmonary vein - L atrium - L ventricle
D) Vena cava - R atrium - R ventricle - lungs - pulmonary artery- L atrium - L ventricle - ANS :C) R atrium - R ventricle -
pulmonary artery - lungs - pulmonary vein - L atrium - L ventricle
Returning blood from the body empties into the R atrium and flows into the R ventricle, then goes to the lungs
through the pulmonary artery. The lungs oxygenate the blood and it is then returned to the L atrium by the
pulmonary vein. It goes from there to the L ventricle and then out to the body through the aorta (Bates, pg 345)
When listening to heart sounds, the nurse knows that the valve closures that can be heard for S2 is:
A) pulmonic
B) aortic
C) tricuspid
D) mitral - ANS :B) aortic
The second heart sound (S2) occurs with the closure of the aortic valve and signals the end of systole. Although it is
heard over all the precordium, S2 is loudest at the base of the heart. (Bates, p347)
A 45-year-old man is in the clinic for a routine physical. During history the patient states he has been having difficulty
sleeping. "I'll be sleeping great and then I wake up and feel like I can't catch my breath." His symptoms indicates
sleep related symptoms of a certain type of disease, so which question would the NP want to ask?
A) Have you had a recent sinus infection or URI?
B) Do you have any history of problems with your heart?
C) Do you think it is because it's been so hot at night?
D) When was your last electroencephalogram? - ANS :B) Do you have any history of problems with your heart?
