Advanced Health Assessment
Mock Exam
Course Introduction
Advanced Health Assessment is a graduate-level course designed to enhance the clinical skills of healthcare professionals by building on foundational knowledge of health evaluation across the lifespan. The course emphasizes comprehensive history-taking, advanced physical examination techniques, and the integration of diagnostic reasoning to identify normal and abnormal findings. Through lectures, case studies, and hands-on practice, students develop proficiency in collecting and analyzing complex patient data, differentiating subtle clinical presentations, and documenting assessment findings. The course prepares students for advanced practice roles by fostering critical thinking, cultural competence, and effective communication in assessing individuals from diverse populations.
Recommended Textbook Health Assessment for Nursing Practice 6th Edition by Wilson
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634 Verified Questions
634 Flashcards
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Page 2
Chapter 1: Introduction to Health Assessment
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Sample Questions
Q1) Which patient information does the nurse document in the patient's physical assessment?
A) Slurred speech
B) Immunizations
C) Smoking habit
D) Allergies
Answer: A
Q2) For which person is a comprehensive assessment indicated?
A) The person who had abdominal surgery yesterday
B) The person who is unaware of his high serum glucose levels
C) The person who is being admitted to a long-term care facility
D) The person who is beginning rehabilitation after a knee replacement
Answer: C
Q3) Which activity illustrates the concept of secondary prevention?
A) Annual mammogram
B) Nutrition classes on low-fat cooking
C) Education on living with diabetes mellitus
D) Cardiac rehabilitation after coronary artery bypass surgery
Answer: A
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Page 3
Chapter 2: Obtaining a Health History
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Sample Questions
Q1) For which patient is a focused health history most appropriate?
A) A new patient at the health clinic for an annual examination
B) A patient admitted to the hospital with vomiting and abdominal pain
C) A patient at the health care provider's office for a sport physical
D) A patient discharged 11 months ago who is being readmitted today
Answer: B
Q2) Which questions are pertinent to ask when obtaining a symptom analysis from a patient who reports a headache? (Select all that apply.)
A) Describe what the headache feels like.
B) When was your last eye examination?
C) What makes the headaches worse?
D) How do you rate the headaches on a scale of 0 (meaning no pain) to 10 (meaning the worse pain ever)?
E) Do you have any symptoms with the headaches, such as nausea?
F) When did you first notice the headaches?
Answer: A, C, D, E, F
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4
Chapter 3: Techniques and Equipment for Physical Assessment
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Sample Questions
Q1) A patient is complaining of pain over the maxillary sinuses. Which device does the nurse use to determine if there is air or fluid in the patient's sinuses?
A) Magnification device
B) Transilluminator
C) Monofilament
D) Wood lamp
Answer: B
Q2) How does the nurse detect a pulse when using a Doppler?
A) The pulsation is felt.
B) The pulsation is heard.
C) The pulse wave is seen on a screen.
D) The pulse wave is printed out on special paper.
Answer: B
Q3) What tool does the nurse use to assess the patient's near vision?
A) A Snellen eye chart placed about 12 inches from the patient's face
B) An ophthalmoscope with the diopter set at 0 (zero)
C) A Jaeger or Rosenbaum chart placed about 2 feet from the patient's face
D) A newspaper held about 14 inches from the patient's face
Answer: D
Page 5
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Chapter 4: General Inspection and Measurement of Vital Signs
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Sample Questions
Q1) Which method of temperature measurement indirectly reflects inner core temperature? (Select all that apply.)
A) Axillary temperature
B) Oral temperature
C) Tympanic temperature
D) Rectal temperature
E) Temporal artery temperature
Q2) Which action by the nurse results in the patient's blood pressure measurement being falsely high? (Select all that apply.)
A) Using a blood pressure cuff that is too narrow for the patient's upper arm
B) Deflating the blood pressure cuff too rapidly
C) Wrapping the blood pressure cuff too loosely
D) Reinflating the blood pressure cuff before it completely deflates
E) Positioning the patients arm above the level of the heart
Q3) A female patient admitted with fluid retention has been in diuretic therapy to remove fluid. She weighed 187 lb on admission. Today she weighs 179 lb. Since admission, this patient has lost _____ L from fluid loss.
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Page 6
Chapter 5: Cultural Assessment
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Sample Questions
Q1) A nurse can improve cultural awareness with which behavior?
A) Being sensitive to differences between the cultures of the nurse and patient
B) Making generalizations about various ethnic and cultural groups
C) Learning everything about the various cultural groups in the nurse's city
D) Taking a foreign language class
Q2) A male nurse is assigned to the care of a gay male with alcoholism. This sexual orientation is inconsistent with the beliefs of the nurse. What actions, if any, can the nurse take to provide patient-centered care to this patient?
A) No action is necessary at this time.
B) Examine his own feelings about alcoholism and homosexuality.
C) Determine the patient's degree of risk for contracting the human immunodeficiency virus.
D) Discuss homosexuality and alcoholism with the patient.
Q3) What are the characteristics of one's culture?
A) Color of skin and hair
B) System of beliefs and practices
C) Food preferences
D) Language and religion
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Chapter 6: Pain Assessment
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Sample Questions
Q1) A patient who had extensive surgery asks the nurse for pain medication for a pain of 9 on a scale of 0 to 10. The nurse completes an assessment of this patient's pain and agrees to give pain medication. When the nurse returns to the patient with the ordered intravenous pain medication, she notices the patient's eyes are closed and he appears to be sleeping. What is the nurse's appropriate action at this time?
A) Lock up the medication in a safe location until the patient awakens.
B) Arouse the patient to confirm he still wants the medication.
C) Give the medication as ordered and agreed to.
D) Consult a colleague about what action to take.
Q2) A patient with a partial small bowel obstruction describes the pain as "cramping, off-and-on pain that spreads over my stomach." What type of pain is this patient experiencing?
A) Referred pain
B) Phantom pain
C) Somatic pain
D) Visceral pain
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Chapter 7: Mental Health Assessment
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Sample Questions
Q1) An elderly patient was admitted with pneumonia and a fever of 104.5° F. At the time of admission he was confused, disoriented, restless, and tried to slap the nurse who started an intravenous line. His daughter stated, "Just yesterday he was perfectly fine, except for a cold. I can't believe he is acting this way now." Within a few days, his erratic behavior subsided and his daughter was relieved that he was "back to normal." The nurse recognizes that this patient was exhibiting signs of which disorder?
A) Dementia
B) Delirium
C) Panic attack
D) Alcohol withdrawal
Q2) During a sports physical for a 16-year-old girl, the nurse asks which question to collect data about drug use?
A) "Many teenagers have tried street drugs. Have you tried these drugs?"
B) "Tell me which street drugs your friends have offered to you?"
C) "Do most of your friends drink alcohol or do street drugs?"
D) "Your high school has a reputation for drug use. Do you use drugs?"
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Chapter 8: Nutritional Assessment
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Sample Questions
Q1) A patient is put on an 1800-calorie a day diet plan. During discharge teaching, the nurse explains to this patient how to use nutrition labels to determine the amount of carbohydrates in the product. The nurse explains, however, that the label is based on 2000 calories. Which is the appropriate formula to teach this patient of the maximum grams of carbohydrates she can eat on her prescribed diet?
A) 1800 calories × 0.45 = 810/4 calories/gram = 202.5 g
B) 1800 calories × 0.60 = 1080/4 calories/gram = 270 g
C) 1800 calories × 0.55 = 990/9 calories/gram = 110 g
D) 1800 calories × 0.50 = 900/9 calories/gram = 100 g
Q2) A patient with mild renal disease has been put on a 2200-calorie per day diet plan with the lowest recommended amount of protein. During discharge teaching, the nurse explains to this patient how to use nutrition labels to determine the amount of protein in the product. The nurse explains, however, that the label is based on 2000 calories. Which is the appropriate formula to teach this patient the least amount of protein he can eat on his prescribed diet?
A) 2200 calories × 0.15 = 330/9 calories/gram = 36.6 g
B) 2200 calories × 0.10 = 220/4 calories/gram = 55 g
C) 2200 calories × 0.20 = 440/9 calories/gram = 48.8 g
D) 2200 calories × 0.12 = 264/4 calories/gram = 66 g
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Chapter 9: Skin, Hair, and Nails
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Sample Questions
Q1) A patient asks the nurse if it is possible to grow new skin. What is the nurse's most appropriate response?
A) "Even if new skin growth is required, the melanocytes do not regenerate."
B) "The avascular epidermis sheds slowly and is replaced completely every 4 weeks."
C) "The outer layer of skin remains the same over the lifetime except for repairing injuries."
D) "Epidermal regeneration is impossible because it is avascular."
Q2) A patient has come to the clinic complaining of a "bump" behind his right ear. Upon inspection, the nurse notes a lesion that is elevated, solid, and 4 cm in diameter. What does the nurse call this lesion when she reports her findings to the health care provider?
A) Tumor
B) Nodule
C) Keloid
D) Papule
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11
Chapter 10: Head, Eyes, Ears, Nose, and Throat
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Sample Questions
Q1) Nurses inquire about lifestyle behaviors in those patients with specific risk factors for cataracts. Which characteristics are associated with risk factors for cataracts? (Select all that apply.)
A) Smoking more than 20 cigarettes a day
B) Having parents with cataracts
C) Chronic consumption of alcohol
D) Having a chronic disease, such as diabetes mellitus
E) Being Asian
F) Being a man
Q2) Which findings does the nurse expect when assessing the mouth of a healthy adult? (Select all that apply.)
A) Lips appear pink, smooth, moist, and symmetric.
B) Teeth are white, yellow, or gray, with smooth edges.
C) Exposed tooth neck and brown spots between teeth
D) Slight roughness on the dorsum of the tongue
E) Hard palate appears smooth, pale, and immovable.
F) Mucous membranes are dry and intact.
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Page 12
Chapter 11: Lungs and Respiratory System
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Sample Questions
Q1) A patient reports a productive cough with yellow sputum, fever, and a sharp pain when taking a deep breath to cough. Based on these data, what abnormal finding will the nurse anticipate on examination?
A) Decreased breath sounds on auscultation
B) Increased tactile fremitus and dull percussion tones
C) Inspiratory wheezing found on auscultation
D) Muffled sounds heard when the patient says "e-e-e"
Q2) A nurse is auscultating the lungs of a healthy male patient and hears crackles on inspiration. What action can the nurse take to ensure this is an accurate finding?
A) Make sure the bell of the stethoscope is used, rather than the diaphragm.
B) Hold stethoscope firmly to prevent movement when placed over chest hair.
C) Ask the patient not to talk while the nurse is listening to the lungs.
D) Change the patient's position to ensure accurate sounds.
Q3) After taking a brief health history, a nurse needs to complete a focused assessment on which patient?
A) A male who works as a painter
B) A male who plays basketball and hockey
C) A female who recently moved into a college dormitory
D) A female who has a history of gout
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Page 13
Chapter 12: Heart and Peripheral Vascular System
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Sample Questions
Q1) During a health fair, the nurse is alert for which risk factors for hypertension? (Select all that apply.)
A) Excessive protein intake
B) Having parents with hypertension
C) Excessive alcohol intake
D) Being Asian
E) Experiencing persistent stress
F) Elevated serum lipids
Q2) A nurse is assessing a patient's peripheral circulation. Which finding indicates venous insufficiency of this patient's legs?
A) Paresthesias and weak, thin peripheral pulses
B) Leg pain that can be relieved by walking
C) Edema that is worse at the end of the day
D) Leg pain that increases when the legs are lowered
Q3) Which pulse may be a challenge for a nurse to palpate?
A) Temporal
B) Femoral
C) Popliteal
D) Dorsalis pedis
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Page 14
Chapter 13: Abdomen and Gastrointestinal System
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Sample Questions
Q1) When assessing the abdomen of a patient who has fluid in the peritoneal cavity, the nurse expects what change to occur when the patient turns from supine to the left side?
A) Movement of the tympanic tones from lateral in the supine position to closer to midline when lying on the left side
B) Movement of the dull tones from lateral in the supine position to closer to midline when lying on the left side
C) Change in bowel sounds from hypoactive in the supine position to hyperactive when lying on the left side
D) Change in bowel sounds from hyperactive in the supine position to hypoactive when lying on the left side
Q2) During an assessment for abdominal pain, a patient reports a colicky abdominal pain and pain in the right shoulder that gets worse after eating fried foods. What question does the nurse ask to confirm the suspicion of cholelithiasis?
A) "Have you noticed any swelling in your ankles or feet at the end of the day?"
B) "Have you noticed a change in the color of your urine or stools?"
C) "Have you vomited up any blood in the last 24 hours?"
D) "Have you experienced fever, chills, or sweating?"
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Chapter 14: Musculoskeletal System
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Sample Questions
Q1) When assessing the neck of a healthy adult, a nurse expects which findings?
A) A convex contour of the posterior cervical spine
B) Bending of the head to the right and left (ear to shoulder) 15 degrees
C) Turning the chin to the right shoulder and then the left shoulder
D) Hyperextension of the head 30 degrees from midline
Q2) The nurse asks the patient to rest the left arm on a table and to move the lower arm so that the palm of the hand is up and then down. What motion is the nurse testing?
A) Adduction and abduction of the wrist
B) Supination and pronation of the wrist
C) Adduction and abduction of the elbow
D) Supination and pronation of the elbow
Q3) When a nurse asks a patient to place the right arm behind the back, so that the back of the hand is touching the lower spine, the nurse is testing for which range of motion?
A) Pronation of the elbow
B) Hyperextension of the elbow
C) Internal rotation and adduction of the shoulder
D) External rotation and abduction of the shoulder
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Chapter 15: Neurologic System
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Sample Questions
Q1) In assessing a patient with a tumor in the pons, the nurse expects to find which abnormalities due to pressure on cranial nerves?
A) Dilated pupils and ptosis
B) Facial asymmetry and impaired hearing
C) Difficulty swallowing
D) Impaired gag reflex
Q2) The nurse hears in a report that a patient has receptive or fluent aphasia. What communication abilities does the nurse anticipate from this patient?
A) The patient understands speech but is unable to translate ideas into meaningful speech.
B) The patient is able to understand speech but has difficulty forming words creating muffled speech.
C) The patient is unable to comprehend speech and thus does not respond verbally.
D) The patient is emotionally liable and cries easily, which interferes with the ability to communicate.
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Chapter 16: Breasts and Axillae
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Sample Questions
Q1) While giving a presentation about breast health, a nurse informs patients about which recommendation?
A) Women in their 30s should have annual clinical breast examinations.
B) Women at high risk of breast cancer should have semiannual mammograms.
C) Women who are postmenopausal require clinical breast examination every 5 years.
D) A screening mammogram is recommended for all women beginning at age 50 years.
Q2) Which statement by a 40-year-old man would be most indicative of possible breast cancer?
A) "I had embarrassing breast enlargement when I was a teenager."
B) "I think I felt a hard spot in my left breast, but it does not hurt."
C) "My right breast has always been a little smaller than the left."
D) "My father's breasts got larger after he was older."
Q3) What is the purpose of asking a female to lean forward during the breast examination?
A) To accentuate the Montgomery glands
B) To observe for symmetry of the suspensory ligaments
C) To compare nipple symmetry
D) To identify any breast masses in the subcutaneous tissues
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Chapter 17: Reproductive System and the Perineum
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Sample Questions
Q1) The nurse recognizes which patient has the highest risk of endometrial cancer?
A) A 24-year-old woman with menarche at age 9
B) A 30-year-old woman who started menstruating at age 19
C) A 42-year-old woman who reached menopause at age 40
D) A 64-year-old woman who had irregular, heavy menstrual cycles
Q2) On inspection of the internal structure of the vagina, the nurse notes a rounded protrusion on the posterior wall of the vagina. How does the nurse document this finding?
A) Rectocele
B) Cystocele
C) Bartholin cyst
D) Nabothian cyst
Q3) A nurse examines a patient and finds a single, firm, painless open sore with indurated borders on the vulva. The nurse correlates this finding with which disorder?
A) Human papillomavirus (HPV) infection
B) Herpes infection
C) Gonorrhea
D) Syphilis
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19
Chapter 18: Developmental Assessment Throughout the Life Span
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Sample Questions
Q1) The parents of a 14-year-old boy express concern that their son's behavior ranges from clean-cut and personable to "grungy" and sullen. They have tried talking with him about this and have tried disciplining him, but he continues to show different sides, and they are confused. What is the nurse's assessment for the behavior of this teenager?
A) The teenager is dangerously labile.
B) This behavior is normal experimentation.
C) This boy is being rebelliously hostile.
D) This behavior may require hospitalization.
Q2) A parent tells the nurse about having difficulty disciplining a 5-year-old child. What characteristic does the nurse teach this parent to improve the discipline of this child?
A) Children at this age are incapable of delaying gratification.
B) At age 5 years, children are not interested in attaining rights and privileges of individuality.
C) Five-year-olds should demonstrate basic social skills and respond to others' expectations.
D) At age 5 years, children use highly inappropriate methods of expressing frustration.
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Chapter 19: Assessment of the Infant, Child, and Adolescent
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Sample Questions
Q1) On assessment of an infant's abdomen, the nurse notes which finding as normal?
A) Easily palpable spleen
B) Flat to slightly concave abdominal contour
C) Lower liver border 2 inches below the costal margin
D) Small protrusion between the rectus muscles when crying
Q2) How does a nurse respond to parents of a 5-year-old who are worried that their child has a protruding abdomen?
A) Assesses the child to differentiate a normal "potbelly" from a hernia
B) Suggests that the parents administer an appropriate dose of a laxative at bedtime
C) Refers the parents to a nutritionist to develop an appropriate weight-loss diet for the child
D) Informs the parents that a protruding abdomen is always an abnormal finding in this age group
Q3) Which finding rules out defects in the cornea, lens, and vitreous chamber of an infant?
A) Bilateral red reflex
B) Symmetric corneal light reflex
C) Bilateral blink reflex
D) Symmetric eye movements
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Page 21
Chapter 20: Assessment of the Pregnant Patient
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Sample Questions
Q1) To perform Leopold maneuvers, the nurse uses which assessment technique?
A) Percussing over the symphysis pubis
B) Auscultating all four abdominal quadrants
C) Palpating the fundus
D) Measuring from symphysis pubis to the umbilicus
Q2) A nurse refers which pregnant patient for additional assessment?
A) A woman at 36 weeks of gestation who has 30% effacement of the cervix
B) A woman at 19 weeks of gestation who has noticed fetal movement every day this week
C) A woman at 20 weeks of gestation who has gained 4 lb in the last 2 weeks
D) A woman at 28 weeks of gestation who has a systolic blood pressure of 40 mg Hg over baseline
Q3) A pregnant woman who drinks alcoholic beverages while pregnant increases the risk for which disorder?
A) Low infant birth weight
B) Birth defects
C) Abruptio placentae
D) Gestational diabetes mellitus
Q4) If a patient's last menstrual period was May 13, her estimated date of birth is
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Chapter 21: Assessment of the Older Adult
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Sample Questions
Q1) Which finding on cardiovascular assessment of an older adult patient warrants further evaluation?
A) Occasional ectopic beats heard on auscultation of the heart
B) Murmur heard over the mitral valve
C) Systolic pressure of 156 in the right arm and 188 in the left arm
D) Persistent S4 sound in a patient with a history of decreased ventricular function
Q2) When assessing the pain level of an older adult, a nurse considers which factor?
A) Neural transmission of pain is increased as a part of the aging process.
B) Older adult patients are not reliable in their descriptions of pain and how it affects them.
C) Physiologic indicators of pain that are unique to older adults are tachycardia and hypotension.
D) The older adult may believe that pain is a factor of aging and not worth mentioning.
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Chapter 22: Conducting a Head-to-Toe Examination
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Q1) Which data does a nurse collect during the general survey when meeting a patient for the first time? (Select all that apply.)
A) Gait
B) Muscle strength
C) Heart sounds
D) Hearing and speech abilities
E) Mood or affect
F) Position of the trachea
Q2) Which techniques does a nurse use routinely to collect data when assessing a patient's anterior thorax? (Select all that apply.)
A) Palpation of the thorax for fremitus
B) Inspection of the skin for color, intactness, lesions, and scars
C) Auscultation of breath sounds bilaterally
D) Auscultation of heart sounds for rate, rhythm, frequency, and S1 and S2
E) Palpation of the anterior chest wall for thoracic expansion
F) Inspection of respiratory movement for symmetry and ease of respiration
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Chapter 23: Documenting the Comprehensive Health Assessment
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Sample Questions
Q1) A patient reports she has shortness of breath and peripheral edema. Under which category does the nurse document these data?
A) Review of systems
B) Present health status
C) Past health history
D) Functional ability
Q2) What data do nurses document under the category general survey?
A) Mental health
B) Functional ability
C) Diet and nutrition
D) Orientation
Q3) Which data do nurses document under the category of personal and psychosocial health history? (Select all that apply.)
A) Allergies to medications or food
B) Diet and foods eaten on a regular basis
C) Type of employment
D) Address and date of birth
E) Activities that promote health
F) Use of tobacco and alcohol
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Chapter 24: Adapting Health Assessment to the Hospitalized Patient
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Sample Questions
Q1) How does a nurse assess perfusion to the foot when a patient has a cast from the left middle calf to the toes?
A) Palpate the popliteal pulse of the left leg.
B) Palpate the posterior tibial pulse of the left leg.
C) Assess movement and sensation of the left toes.
D) Assess the capillary refill of the left toes.
Q2) What data do nurses collect when assessing a patient's wound? (Select all that apply.)
A) Skin turgor
B) Width, length, and depth
C) Presence of pulsations
D) Wound color
E) Presence of edema
F) Drainage color
Q3) Development of which complication is considered a never event?
A) Fever
B) Atelectasis
C) Pressure ulcer
D) Thrombophlebitis
26
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