Exam 4 Practice Exam

Companion to the NUR 120 Exam 4 Study Guide. Give yourself about two hours, or split it across two sittings by half.

The blueprint is 40 points: “8 questions with skeletal figures and locating heart sounds – APETM” plus 32 multiple-choice questions, with Sleep/Rest worth 6. Its headings are cardiovascular, peripheral vascular (“Refer to handouts and case summaries”) and sleep/rest (“PP slides”). HEENT is not on the blueprint, and it is not on this paper.

This paper follows that weighting. About 49% is cardiovascular, 35% peripheral vascular and 16% rest and sleep. 22 items are figure questions — original schematics of the chest drawn as you face the patient, with numbered or lettered marks, plus two of the inner ankle and one of the whole body for the pulse sites the blueprint asks you to locate — because the real paper puts a fifth of its points on a skeletal figure: name each APETM site, place it by rib and intercostal space, say where S1 and S2 are loudest and where they are equal, and find the apical pulse. Most of the chest drawings are unlabelled — no rib numbers, no guide lines, and the first rib tucked behind the clavicle as on a real skeleton, like the exam’s own picture question — so you have to find the sternal angle and count down. The drawings change from item to item on purpose, so you learn to count spaces rather than remember a picture. Blood flow through the heart has its own quiz and paper and appears here only where it explains a finding.

Starred items test content a course document marks: the cardiac deck’s red line on chest pain and its drawn arrows (the PMI; diastole as filling and systole as ejection), the PV deck’s red line on arterial occlusion, the sleep deck’s drawn arrows and red text, lines the blueprint names, the APETM activity’s “You will be tested on this”, and what the instructor stressed in the recorded lecture — including that a normal pulse documented 2+/4 “was a test question on a previous test” and that normal capillary refill is two to three seconds. Where a course document and what was said in class disagree, the rationale says so and goes with what was said.

How it works: pick an answer and the rationale appears immediately. Select-all questions need a Check click; ordering questions are answered by clicking the steps in sequence, with an Undo last if you mis-click. Fill-in questions take a word or a number; word-bank items let you click a word or type it. Nothing is saved when you close the page.

Two halves. Questions 1–78 are recall: the five listening sites both ways round, the loudness rules, the landmarks, the pulse scale and sites, and the sleep deck’s facts. Questions 79–166 are scenario and edge-case items, built on the shapes this course actually uses: ranking two abnormal findings, reading the same finding two opposite ways, deciding whether one finding really explains another, choosing a specific instruction over a vague but defensible one, classifying by mechanism rather than by feel, ordering actions where every option is correct, the distractor whose reasoning is usually right, and questions that ask two things at once. The second half is the harder practice.