1. What is the “tripod” position seen in a patient with respiratory distress?
A. The patient uses neck muscles and abdominal muscles to help with breathing.
B. The patient sits or stands leaning forward and supports the upper body with their hands on the knees. ✅ (Correct)
C. The patient needs to lean forward into a table or wall for support.
D. The patient needs to stand up to breathe comfortably.
2. What is TRUE regarding the term “pulsus parvus et tardus” in relation to aortic stenosis?
A. It is caused by a floppy aortic valve making it progressively looser when it opens.
B. The pulse is weak and late relative to the contraction of the heart. ✅ (Correct)
C. Pulsus parvus et tardus is seen in both aortic and mitral valve stenosis.
D. The weak and late pulse is due to increased blood flow through the aortic valve.
E. The pulse rises quickly and rapidly.
3. When percussing the abdomen, the Nurse Practitioner notes a dullness sound. What tissue are you likely percussing?
A. Air filled sac
B. Solid organ ✅ (Correct)
C. Base of the lung
D. Fluid filled structure
4. Which of the following positive signs would indicate appendicitis?
A. Blumberg ✅ (Correct
B. Rovsing ✅ (Correct
C. McBurney ✅ (Correct – most specific)
D. Grey Turner
(Note: Blumberg and Rovsing are also associated with appendicitis, but McBurney’s is the hallmark sign.)
5. Loud, bubbly noises heard during inspiration and not cleared by a cough describe which adventitious breath sound?
A. Fine crackles
B. Coarse crackles ✅ (Correct)
C. Rhonchi
D. Pleural friction rub
6. What is Grey Turner sign?
A. Rebound tenderness
B. Ecchymosis around the flanks ✅ (Correct)
C. Abrupt cessation of inspiration on palpation of the gallbladder
D. Right lower quadrant pain intensified by left lower quadrant abdominal palpation
7. Osteoarthritis of the hip produces pain most commonly with which maneuver?
A. Palpation of the lateral hip
B. Flexion of the hip joint
C. Extension of the hip joint
D. Internal rotation of the hip joint ✅ (Correct)
E. Flexion of the spine
8. What pathological finger finding is pictured here? (Heberden nodes image)
A. Telescoping digits
B. Fusiform swelling
C. Ulnar deviation
D. Heberden Node ✅ (Correct)
9. Physical exam findings seen in heart failure include…
A. Increased jugular venous pressure, positive abdominojugular reflux test, and peripheral edema ✅ (Correct)
B. Increased jugular venous pressure, the point of maximal impulse displaced to the left, and jaundice
C. Increased jugular venous pressure, negative abdominojugular reflux test, and poor skin turgor
D. Decreased jugular venous pressure, positive abdominojugular reflux test, and crackles in the lungs
E. Decreased jugular venous pressure, negative abdominojugular reflux test, and crackles in the lungs
10. Which of the following is FALSE related to the splitting of the S2 heart sound?
A. Physiologic splitting occurs when the aortic valve closes before the pulmonic valve during inspiration
B. Paradoxical splitting occurs when the aortic valve closure follows the pulmonary closure
C. In a normal heart, S2 is usually split during expiration ✅ (Correct – this is FALSE)
D. Wide splitting can occur by a delay of the pulmonic valve closure