NR302 Quiz 3 Las Vegas 2026 V2 - Chamberlain University
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Free NR302 Quiz 3 Las Vegas 2026 V2 - Chamberlain University Questions
The nurse is preparing heart health education for a 60-year-old patient. Which should the nurse include in the teaching? Select all that apply.
- High-fat diet
- Appropriate aspirin therapy
- Low activity level
- Smoking cessation
- Cholesterol control
Explanation
Explanation:
Correct Answer: (B) Appropriate aspirin therapy, (D) Smoking cessation, and (E) Cholesterol control
Heart health education for older adults should focus on evidence-based strategies to reduce cardiovascular risk. Aspirin therapy when appropriately prescribed reduces clot formation; smoking cessation significantly lowers the risk of coronary artery disease and stroke; and cholesterol control through diet, lifestyle, and medications reduces atherosclerotic plaque formation.
Why Other Options are Incorrect:
A. High-fat diet — A high-fat diet, particularly one rich in saturated and trans fats, increases LDL cholesterol and cardiovascular risk and should be discouraged rather than recommended.
C. Low activity level — Physical inactivity is a major modifiable cardiovascular risk factor. Regular moderate exercise strengthens the heart and improves lipid profiles, blood pressure, and overall cardiovascular health.
The nurse performs a percussion of the lung fields in an adult patient. The nurse notes a low-pitched, clear, hollow sound. How should the nurse document this finding?
- Dullness
- Stridor
- Resonance
- Crepitus
Explanation
Explanation:
Correct Answer: (C) Resonance
Resonance is the normal percussion sound heard over healthy, air-filled lung tissue. It is described as a low-pitched, clear, and hollow sound. This finding indicates that the underlying lung tissue contains the expected amount of air and is free of consolidation or fluid accumulation.
Why Other Options are Incorrect:
A. Dullness — Dullness is a soft, short, high-pitched percussion sound heard over solid or fluid-filled areas such as the liver, a consolidated lung, or pleural effusion. It is not a normal lung percussion finding.
B. Stridor — Stridor is a high-pitched, harsh breathing sound caused by upper airway obstruction. It is an auscultatory finding, not a percussion finding, and represents a medical emergency.
D. Crepitus — Crepitus is a crackling sensation felt on palpation of the skin when air is trapped in the subcutaneous tissue, or a crackling sound heard in joints. It is not a percussion finding related to lung assessment.
The nurse is performing an assessment. Upon auscultation, the nurse notes a gentle, blowing, swooshing sound that can be heard on the chest wall. How should the nurse document this finding?
- Heave
- Thrill
- Murmur
- S3 sound
Explanation
Explanation:
Correct Answer: (C) Murmur
A murmur is described as a gentle, blowing, or swooshing sound heard during cardiac auscultation. It is caused by turbulent blood flow through the heart valves or great vessels. Murmurs can be innocent or pathological and are graded on a scale of I to VI based on intensity.
Why Other Options are Incorrect:
A. Heave — A heave, also called a lift, is a visible or palpable forceful movement of the chest wall caused by an enlarged or overactive ventricle. It is a palpation finding, not an auscultation finding.
B. Thrill — A thrill is a palpable vibration felt on the chest wall associated with a loud murmur. It is assessed through touch, not auscultation, and represents a tactile finding.
D. S3 sound — The S3 heart sound is an extra heart sound occurring after S2, producing a gallop rhythm. It is associated with heart failure or volume overload and is described as a dull thudding sound, not a blowing or swooshing sound.
Upon inspection, the nurse observes coughing, sputum production, barrel chest appearance, dyspnea, and weight loss. Based on these findings, what should the nurse assess next?
- Assess tactile fremitus
- Assess for any adventitious sounds
- Assess the effort of breathing
- Assess percussion notes over lung fields
Explanation
Explanation:
Correct Answer: (C) Assess the effort of breathing
Given the cluster of findings — coughing, sputum production, barrel chest, dyspnea, and weight loss — this patient is likely experiencing significant respiratory compromise, most consistent with COPD. The priority next step during inspection is to assess the effort of breathing, including the use of accessory muscles, nasal flaring, pursed-lip breathing, and intercostal retractions, as these directly reflect how hard the patient is working to maintain adequate ventilation.
Why Other Options are Incorrect:
A. Assess tactile fremitus — Tactile fremitus is a palpation technique performed after inspection. While it provides valuable information about lung consolidation or air trapping, it is not the immediate next priority during the inspection phase.
B. Assess for any adventitious sounds — Auscultation for adventitious sounds such as wheezes or crackles comes after inspection and palpation in the systematic respiratory assessment sequence and is not the next step here.
D. Assess percussion notes over lung fields — Percussion is performed after palpation in the respiratory assessment sequence. While hyperresonance would be expected in COPD, it is not the immediate next action following inspection findings.
Which respiratory assessment finding is normal?
- Absent tactile fremitus and hyperresonant percussion tones
- Increased tactile fremitus and dull percussion tones
- Adventitious sounds and limited chest expansion
- Vesicular breath sounds and symmetric tactile fremitus
Explanation
Explanation:
Correct Answer: (D) Vesicular breath sounds and symmetric tactile fremitus
Normal respiratory assessment findings include vesicular breath sounds — soft, low-pitched sounds heard over most lung fields — and symmetric tactile fremitus, meaning vibrations are felt equally on both sides of the chest during spoken words. These indicate healthy, unobstructed lung tissue.
Why Other Options are Incorrect:
A. Absent tactile fremitus and hyperresonant percussion tones — These findings suggest air trapping or pneumothorax, not a normal respiratory assessment.
B. Increased tactile fremitus and dull percussion tones — These findings are associated with consolidation such as pneumonia, where fluid or solid material replaces air in the lungs.
C. Adventitious sounds and limited chest expansion — Adventitious sounds such as crackles, wheezes, and rhonchi are abnormal breath sounds indicating underlying pathology such as asthma, pulmonary edema, or infection.
A nurse is preparing to assess a patient who is experiencing orthopnea. Which of the following would be an expected assessment finding?
- Cessation of breathing
- Difficulty breathing when lying flat
- Rapid breathing
- Shortness of breath with activity
Explanation
Explanation:
Correct Answer: (B) Difficulty breathing when lying flat
Orthopnea is defined as difficulty breathing that occurs when a person lies flat and is relieved when the person sits upright or elevates the head of the bed. It is commonly associated with heart failure and pulmonary conditions, where the supine position causes increased venous return and redistribution of fluid into the lungs, worsening dyspnea.
Why Other Options are Incorrect:
A. Cessation of breathing — This describes apnea, which is the complete absence of breathing, not orthopnea.
C. Rapid breathing — Rapid breathing is referred to as tachypnea and is a separate respiratory finding not specific to orthopnea.
D. Shortness of breath with activity — This describes exertional dyspnea, which occurs during physical activity rather than when lying down, and is a distinct finding from orthopnea.
The nurse completes an assessment and notes a respiration of 9. How should the nurse document this assessment finding?
- Eupnea
- Bradypnea
- Bradycardia
- Bradypulm
Explanation
Explanation:
Correct Answer: (B) Bradypnea
A normal adult respiratory rate ranges from 12 to 20 breaths per minute. A respiratory rate of 9 breaths per minute is significantly below this range and is documented as bradypnea. This finding may indicate CNS depression, medication effects such as opioid use, or metabolic disturbances and requires prompt nursing assessment.
Why Other Options are Incorrect:
A. Eupnea — Eupnea refers to normal, unlabored breathing at a normal rate of 12 to 20 breaths per minute. A rate of 9 does not meet this criterion.
C. Bradycardia — Bradycardia refers to a slow heart rate below 60 beats per minute, not a slow respiratory rate. These are distinct vital sign measurements.
D. Bradypulm — This is not a recognized medical or nursing term and is not a valid way to document any assessment finding.
The nurse is performing a cardiac assessment. Where would the nurse auscultate to assess the mitral valve?
- Left fifth intercostal space at the midclavicular line
- Left fifth intercostal space at the lower sternal border
- Left fourth intercostal space at the lower sternal border
- Left second intercostal space at the right sternal border
Explanation
Explanation:
Correct Answer: (A) Left fifth intercostal space at the midclavicular line
The mitral valve, also known as the apical area or the point of maximal impulse (PMI), is best auscultated at the left fifth intercostal space at the midclavicular line. This location corresponds to the apex of the heart where mitral valve sounds are transmitted most clearly.
Why Other Options are Incorrect:
B. Left fifth intercostal space at the lower sternal border — This location corresponds to the tricuspid valve auscultation area, not the mitral valve.
C. Left fourth intercostal space at the lower sternal border — This is also associated with the tricuspid area and does not represent the correct location for mitral valve assessment.
D. Left second intercostal space at the right sternal border — This is the aortic valve auscultation area, located at the base of the heart on the right side.
Upon inspection, the nurse observes coughing, sputum production, barrel chest appearance, dyspnea, and weight loss. These findings are consistent with:
- Chronic Obstructive Pulmonary Disease
- Pneumothorax
- Pleural Effusion
- Atelectasis
Explanation
Explanation:
Correct Answer: (A) Chronic Obstructive Pulmonary Disease
The combination of chronic cough with sputum production, barrel chest from long-term air trapping, dyspnea, and weight loss are hallmark clinical features of COPD. The barrel chest develops due to chronic hyperinflation of the lungs, which increases the anteroposterior diameter of the thorax over time. Weight loss in COPD occurs due to increased work of breathing and systemic inflammation.
Why Other Options are Incorrect:
B. Pneumothorax — Presents acutely with sudden onset pleuritic chest pain, absent breath sounds on the affected side, tracheal deviation, and respiratory distress. It does not present with a barrel chest or chronic sputum production.
C. Pleural Effusion — Characterized by dullness on percussion, decreased breath sounds, and decreased tactile fremitus on the affected side. It does not produce barrel chest or chronic productive cough.
D. Atelectasis — Refers to the collapse of lung tissue and presents with decreased breath sounds, dullness on percussion, and reduced chest expansion on the affected side. It does not cause the chronic progressive findings described in this scenario.
The nurse documented that the patient's thorax has a 1:1 anteroposterior-to-transverse diameter and that the ribs are horizontal. What could this assessment finding indicate?
- Pectus Excavatum
- Normal
- Barrel chest
- Scoliosis
Explanation
Explanation:
Correct Answer: (C) Barrel chest
A barrel chest is characterized by an increased anteroposterior-to-transverse diameter ratio of 1:1, giving the chest a rounded, barrel-like appearance, along with horizontal positioning of the ribs. This finding is classically associated with chronic obstructive pulmonary disease (COPD) and chronic air trapping, which causes the lungs to remain in a state of hyperinflation over time.
Why Other Options are Incorrect:
A. Pectus Excavatum — Also known as funnel chest, this is a congenital deformity where the sternum is sunken inward, creating a concave appearance of the chest. It does not involve a 1:1 AP-to-transverse diameter or horizontal ribs.
B. Normal — A normal adult thorax has an AP-to-transverse diameter ratio of approximately 1:2, meaning the chest is wider from side to side than from front to back. A 1:1 ratio is abnormal.
D. Scoliosis — Scoliosis is a lateral curvature of the spine that can cause asymmetry of the thorax. It does not produce a 1:1 AP-to-transverse diameter or horizontal rib positioning.
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