Clinical Skills for Nurses
Textbook Exam Questions
Course Introduction
Clinical Skills for Nurses is a comprehensive course designed to equip nursing students with the essential practical abilities required for effective patient care in various healthcare settings. Through a combination of theoretical instruction and hands-on practice, students will learn fundamental clinical skills such as patient assessment, vital sign measurement, wound care, medication administration, infection control, and basic life support. The course emphasizes the importance of safety, communication, ethical considerations, and adherence to professional standards while performing clinical procedures. By the end of the course, students will have developed the confidence and competence needed to deliver high-quality, evidence-based nursing care.
Recommended Textbook
Seidels Guide to Physical Examination 9th Edition by Jane W. Ball
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Chapter 1: The History and Interviewing Process
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Sample Questions
Q1) When interviewing older adults, the examiner should:
A) speak extremely loudly, because most older adults have significant hearing impairment.
B) provide a written questionnaire in place of an interview.
C) position himself or herself facing the patient.
D) dim the lights to decrease anxiety.
Answer: C
Q2) Ms. A states, "My life is just too painful. It isn't worth it." She appears depressed. Which one of the following statements is the most appropriate caregiver response?
A) "Try to think about the good things in life."
B) "What in life is causing you such pain?"
C) "You can't mean what you're saying."
D) "If you think about it, nothing is worth getting this upset about."
Answer: B
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Chapter 2: Cultural Competency
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Sample Questions
Q1) The definition of ill or sick is based on a:
A) stereotype.
B) cultural behavior.
C) belief system.
D) cultural attitude.
Answer: C
Q2) A 22-year-old female nurse is interviewing an 86-year-old male patient. The patient avoids eye contact and answers questions only by saying, "Yeah," "No," or "I guess so." Which of the following is appropriate for the interviewer to say or ask?
A) "We will be able to communicate better if you look at me."
B) "It's hard for me to gather useful information because your answers are so short."
C) "Are you uncomfortable talking with me?"
D) "Does your religion make it hard for you to answer my questions?"
Answer: C
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Chapter 3: Examination Techniques and Equipment
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Sample Questions
Q1) Expected normal percussion tones include:
A) dullness over the lungs.
B) hyperresonance over the lungs.
C) tympany over an empty stomach.
D) flatness over an empty stomach.
Answer: C
Q2) Which technique is used during both the history taking and the physical examination process?
A) Auscultation
B) Inspection
C) Palpation
D) Percussion
Answer: B
Q3) Tuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure:
A) buzzing or tingling sensations.
B) buzzing from bone conduction.
C) hearing range of normal speech.
D) noise above the threshold level.
Answer: C
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Chapter 4: Clinical Reasoning
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Sample Questions
Q1) Medical decision making requires a balance between:
A) trust and suspicion.
B) ethical and unethical behavior.
C) remembering and superstition.
D) mechanism and probabilism.
Q2) New findings of unknown causes are:
A) problems to be noted on the problem list.
B) deferred for subsequent visits.
C) diagnosed before physical examination.
D) reserved for specialists.
Q3) Positive outcomes depend on the:
A) number of laboratory tests ordered.
B) quality of decisions made.
C) use of pharmacologic modalities.
D) time saved by the use of ancillary personnel.
Q4) Utilitarianism can be described as:
A) balancing interests.
B) preventing harm.
C) choosing wisely.
D) doing good.
Page 6
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Chapter 5: Documentation
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Q1) Which part of the information contained in the patient's record may be used in court?
A) Subjective information only
B) Objective information only
C) Diagnostic information only
D) All information
Q2) Allergies to drugs and foods are generally listed in which section of the medical record?
A) History of present illness
B) Past medical history
C) Social history
D) Problem list
Q3) A detailed description of the symptoms related to the chief complaint is presented in the:
A) history of present illness.
B) differential diagnosis.
C) assessment.
D) general patient information section.
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Chapter 6: Vital Signs and Pain Assessment
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Q1) Infants delivered by Cesarean section demonstrate which respiratory characteristic in comparison to infants delivered vaginally?
A) Slower respiratory rate
B) Faster respiratory rate
C) Shallower respirations
D) Deeper respirations
Q2) Underestimation of blood pressure will occur if the cuff's width covers:
A) less than half of the upper arm.
B) less than 5 inches of the lower arm.
C) more than two-thirds of the upper arm.
D) more than 4 inches of the lower arm.
Q3) Which pulse characteristic in the neonate may indicate infection?
A) Bounding pulse rate
B) Regular pulse rate
C) Sustained high pulse rate
D) Intermittent slow pulse rate
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Chapter 7: Mental Status
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Sample Questions
Q1) The Mini-Mental State Examination (MMSE) may be used to:
A) estimate cognitive changes quantitatively.
B) estimate personality disorders qualitatively.
C) diagnose neurologic disorders.
D) determine the cause of memory loss.
Q2) Assessing orientation to person, place, and time helps determine:
A) ability to understand analogies.
B) abstract reasoning.
C) attention span.
D) state of consciousness.
Q3) The ability for abstract thinking normally develops during: A) infancy.
B) early childhood.
C) adolescence.
D) adulthood.
Q4) Peripheral neuropathy is most likely to be manifested by: A) impaired memory.
B) impaired abstract reasoning.
C) impaired writing ability.
D) hallucinations.
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Chapter 8: Growth, Measurement, and Nutrition
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Sample Questions
Q1) The gonads begin to secrete estrogen and testosterone during:
A) infancy.
B) puberty.
C) pregnancy.
D) early adulthood.
Q2) Between 5 and 24 months of life, the infant's chest circumference is normally:
A) about equal to the head circumference.
B) greater than head circumference by 2 inches.
C) smaller than head circumference by about 4 inches.
D) at least 2 inches smaller than head circumference.
Q3) The rate of weight gain during pregnancy is expected to be:
A) greatest in the first trimester.
B) greatest in the second trimester.
C) greatest in the third trimester.
D) about the same in each trimester.
Q4) During adolescence, the head size normally increases as a result of:
A) sinus development.
B) brain mass increase.
C) evolution of lymphatic tissue.
D) hypertrophy of myelin.
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Chapter 9: Skin, Hair, and Nails
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Sample Questions
Q1) A single transverse line seen in the palm of a small child may imply:
A) Down syndrome.
B) Turner syndrome.
C) systemic sclerosis.
D) profound dehydration.
Q2) Mrs. Franklin is a 68-year-old patient who presents to the office with a complaint that her nails do not seem to be growing. As the healthcare provider, you explain to her that the nails of older adults grow slowly because of:
A) decreased circulation.
B) dietary deficiencies.
C) fungal infections.
D) low hormone levels.
Q3) A 17-year-old student complains of a "rash for 3 days." You note pale, erythematous oval plaques over the trunk. They have fine scales and are arranged in a fernlike pattern, with parallel alignment. What is the nurse's next action?
A) Teach infectious control measures.
B) Inquire about another recent skin lesion.
C) Inspect the palms and the soles.
D) Inform the patient that this will resolve within a week.
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Page 11
Chapter 10: Lymphatic System
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Sample Questions
Q1) Mrs. Farrel brings in her 6-year-old son with complaints of a sore throat and fever. As the healthcare provider, you are concerned about his tonsils and adenoids. Enlarged tonsils and adenoids may obstruct the:
A) thoracic duct.
B) esophagus.
C) nasopharyngeal passageway.
D) external auditory meatus.
Q2) Which disorder is characterized by a single node that is chronically enlarged and nontender in a patient with no other symptoms?
A) Retropharyngeal abscess
B) Streptococcal pharyngitis
C) Mononucleosis
D) Toxoplasmosis
Q3) Which finding indicates that the examiner is assessing a blood vessel rather than a lymph node?
A) A bruit
B) Inflammation
C) Tenderness
D) Redness
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Page 12
Chapter 11: Head and Neck
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Sample Questions
Q1) The thyroid gland should:
A) be slightly left of midline.
B) have a clear vascular sound.
C) move when the patient swallows.
D) tug with each heartbeat.
Q2) Mrs. Britton brings her 16-year-old son in with a complaint that he is not developing correctly into adolescence. Which structures disproportionately enlarge in the male during adolescence?
A) Coronal sutures
B) Hyoid and cricoid cartilages
C) Mandible and maxilla bones
D) Nose and thyroid cartilages
Q3) Nuchal rigidity is most commonly associated with:
A) thyroiditis.
B) meningeal irritation.
C) Down syndrome.
D) cranial nerve V damage.
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Chapter 12: Eyes
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Sample Questions
Q1) Which finding, when seen in the infant, is ominous?
A) Difficulty tracking objects with the eyes
B) Appearing to have better peripheral than central vision
C) Blinking when bright light is directed at the face
D) White pupils on photographs
Q2) Dot hemorrhages, or microaneurysms, in the retina and the presence of hard and soft exudates are most commonly seen in those with:
A) Down syndrome.
B) diabetic retinopathy.
C) systemic lupus.
D) glaucoma.
Q3) When testing corneal sensitivity controlled by cranial nerve V, you should expect the patient to respond with:
A) brisk blinking.
B) copious tearing.
C) pupil dilation.
D) reflex smiling.
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Chapter 13: Ears, Nose, and Throat
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Sample Questions
Q1) Mr. Akins is a 78-year-old patient who presents to the clinic with complaints of hearing loss. Which are changes in hearing that occur in older adults? (Select all that apply.)
A) Results from cranial nerve VII
B) Slow progression
C) Loss of high frequency
D) Bone conduction heard longer than air conduction
E) Sounds may be garbled, difficult to localize
F) Unable to hear in a crowded room
Q2) Mr. Sprat is a 21-year-old patient who complains of nasal congestion. He admits to using recreational drugs. On examination, you have noted a septal perforation. Which of the following recreational drugs is commonly associated with nasal septum perforation?
A) Heroin
B) Cocaine
C) PCP
D) Ecstasy
Q3) When you ask the patient to identify smells, you are assessing cranial nerve __.
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Chapter 14: Chest and Lungs
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Sample Questions
Q1) A 44-year-old male patient who complains of a cough has presented to the emergency department. He admits to smoking one pack per day. During your inspection of his chest, the most appropriate lighting source to highlight chest movement is:
A) bright tangential lighting.
B) daylight from a window.
C) flashlight in a dark room.
D) fluorescent ceiling lights.
Q2) In which patient situation would you expect to assess tachypnea?
A) Patient who is depressed
B) Patient who abuses narcotics
C) Patient with metabolic acidosis
D) Patient with myasthenia gravis
Q3) Which finding suggests a minor structural variation?
A) Barrel chest
B) Clubbed fingers
C) Pectus carinatum
D) Chest wall retractions
Q4) An Apgar score of __________ is given to the infant who demonstrates irregular respiratory effort.
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Chapter 15: Heart
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Sample Questions
Q1) Which one of the following is a common symptom of cardiovascular disorders in the older adult?
A) Fatigue
B) Joint pain
C) Poor night vision
D) Weight gain
Q2) In the adult, the apical impulse should be most visible when the patient is in what position?
A) Supine
B) Upright
C) Lithotomy
D) Right lateral recumbent
Q3) Chest pain with an organic cause in a child is most likely the result of:
A) cardiac disease.
B) asthma.
C) esophageal reflux.
D) arthritis.
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Page 17
Chapter 16: Blood Vessels
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Sample Questions
Q1) The most prominent component of the jugular venous pulse is the:
A) a wave.
B) c wave.
C) v wave.
D) x slope.
Q2) You are performing a physical examination on a 46-year-old male patient. His examination findings include the following: positive peripheral edema, holosystolic murmur in the tricuspid region, and a pulsatile liver. His diagnosis is:
A) an aortic aneurysm.
B) an arteriovenous fistula.
C) tricuspid stenosis.
D) tricuspid regurgitation.
Q3) Observation of hand veins can facilitate the assessment of:
A) mitral valve competency.
B) a heart murmur.
C) right heart pressure.
D) left heart pressure.
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Chapter 17: Breasts and Axillae
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Sample Questions
Q1) Your patient is a nursing mother who asks you to look at a mole she has under her left breast at the inframammary fold. The mole is nontender and soft and has grown in size since she started nursing. There are no other changes to the mole. This mole probably represents an undiagnosed:
A) Montgomery tubercle.
B) case of Paget disease.
C) supernumerary nipple.
D) fat necrosis.
Q2) A nursing mother complains that her breasts are tender. You assess hard, shiny, and erythemic breasts bilaterally. You should advise the patient to:
A) massage gently and continue nursing.
B) apply warm compresses and stop nursing.
C) monitor her temperature and restrict fluids.
D) sleep wearing a bra and wash her breasts with antibacterial soap.
Q3) Montgomery tubercles are most prominent in the breasts of:
A) adult males.
B) patients with lung disease.
C) pregnant women.
D) pubertal females.
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Page 19
Chapter 18: Abdomen
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Sample Questions
Q1) When using the bimanual technique for palpating the abdomen, you should:
A) push down with the bottom hand and the other hand on top.
B) push down with the top hand and concentrate on sensation with the bottom hand.
C) place the hands side by side and push equally.
D) place one hand anteriorly and the other hand posteriorly, squeezing the hands together.
Q2) An umbilical assessment in the newborn that is of concern is:
A) a thick cord.
B) umbilical hernia.
C) one umbilical artery and two veins.
D) pulsations superior to the umbilicus.
Q3) A 51-year-old woman calls with complaints of weight loss and constipation. She reports enlarged hemorrhoids and rectal bleeding. You advise her to:
A) use a topical, over-the-counter hemorrhoid treatment for 1 week.
B) exercise and eat more fiber.
C) come to the laboratory for a stool guaiac test.
D) eat six small meals a day.
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Page 20
Chapter 19: Female Genitalia
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Sample Questions
Q1) The vaginal mucosa of a woman of childbearing years should appear:
A) smooth and pink.
B) moist and excoriated.
C) dry and papular.
D) transversely rugated.
Q2) The assessment of which structure is not part of the bimanual examination?
A) Cervix
B) Bladder
C) Uterus
D) Ovaries
Q3) Which structure is located posteriorly on each side of the vaginal orifice?
A) Skene glands
B) Clitoris
C) Perineum
D) Bartholin glands
Q4) The adnexa of the uterus are composed of the:
A) corpus and cervix.
B) fallopian tubes and ovaries.
C) uterosacral and broad ligaments.
D) vagina and fundus.
Page 21
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Chapter 20: Male Genitalia
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Sample Questions
Q1) While examining an 18-year-old man, you note that his penis and testicles are more darkly pigmented than the body skin. You should consider this finding to be:
A) within normal limits.
B) suggestive of a skin fungus.
C) suggestive of psoriasis.
D) caused by excessive progesterone.
Q2) The most common type of hernia occurring in young males is:
A) hiatal.
B) incarcerated femoral.
C) indirect inguinal.
D) umbilical.
Q3) You palpate a soft, slightly tender mass in the right scrotum of an adult male. You attempt to reduce the size of the mass, and there is no change in the mass size. Your next assessment maneuver is to:
A) use two fingers to attempt to reduce the mass.
B) palpate the left scrotum simultaneously.
C) lift the right testicle and then compare pain level.
D) transilluminate the mass.
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Chapter 21: Anus, Rectum, and Prostate
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Sample Questions
Q1) Prostate-specific antigen (PSA) screening is controversial because:
A) there are many false-negative results.
B) PSA is produced by many other tissues.
C) it is less sensitive than digital rectal examination.
D) no data have proved that it decreases mortality.
Q2) Mr. Sweeney is a 58-year-old man who has presented for a routine annual prostate examination. On examination, you note a normal prostate gland. Which of the following characteristics should describe the normal prostate? (Select all that apply.)
A) Rubbery consistency
B) About 4 cm in diameter
C) Fluctuant softness
D) Gland protruding 1 cm into the rectum
E) Firm, smooth, and slightly movable
Q3) The posterior surface of the prostate can be located by palpation of the:
A) anal canal and perineum.
B) anterior wall of the rectum.
C) lateral wall of the anus.
D) lower abdomen and perineum.
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Chapter 22: Musculoskeletal System
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Sample Questions
Q1) The temporomandibular joint is palpated:
A) under the mandible, anterior to the sternocleidomastoid muscle.
B) above the mandible at midline.
C) anterior to the tragus.
D) at the mastoid process.
Q2) Light skin and thin body habitus are risk factors for:
A) rheumatoid arthritis.
B) osteoarthritis.
C) congenital bony defects.
D) osteoporosis.
Q3) Skeletal changes in older adults are the result of:
A) increased bone deposition.
B) increased bone resorption.
C) decreased bone deposition.
D) decreased bone resorption.
Q4) Expected normal findings during the inspection of spinal alignment include:
A) asymmetric skin folds at the neck.
B) slight right-sided scapular elevation.
C) concave lumbar curve.
D) the head positioned superiorly to the gluteal cleft.
Page 24
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Chapter 23: Neurologic System
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Q1) It is especially important to test for ankle clonus if:
A) deep tendon reflexes are hyperactive.
B) deep tendon reflexes are hypoactive.
C) the Romberg sign is positive.
D) the patient has peripheral neuropathy.
Q2) The area of body surface innervated by a particular spinal nerve is called a:
A) dermatome.
B) nerve pathway.
C) spinal accessory area.
D) cutaneous zone.
Q3) An acute polyneuropathy that commonly follows a nonspecific infection occurring 10 to 14 days earlier and that primarily affects the motor and autonomic peripheral nerves in an ascending pattern is:
A) cerebral palsy.
B) HIV encephalopathy.
C) Guillain-Barré syndrome.
D) Rett syndrome.
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Chapter 24: Sports Participation Evaluation
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Sample Questions
Q1) One of the most important aspects to consider in the orthopedic screening examination is:
A) muscle contraction.
B) flexibility.
C) symmetry.
D) balance.
Q2) You are conducting a preparticipation physical examination for a 10-year-old girl with Down syndrome who will be playing basketball. She has slight torticollis and mild ankle clonus. Which additional diagnostic test would be required for her?
A) Cervical spine radiography
B) Visual acuity
C) Mini-Mental State Examination
D) Nerve conduction studies
Q3) Why should the preparticipation sports examination take place well in advance of the planned sports activity? (Select all that apply.)
A) To allow completion of therapy for identified problems
B) Because routine health maintenance needs to be addressed
C) Because it should be 6 weeks prior to the planned sports event
D) To allow completion of follow-up testing
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Page 26
Chapter 25: Putting it All Together
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Q1) When you attempt to move a 10-month-old child from his mother's lap to the examination table, he screams loudly. Your best action is to:
A) move the child to the examination table and proceed matter of factly with the examination.
B) ask the mother to try to get the child to stop crying.
C) perform the examination while the child is in the mother's lap.
D) defer the examination until another day.
Q2) Which patient position facilitates inspection of the chest and shoulders?
A) Sitting
B) Supine
C) Trendelenburg
D) Prone
Q3) In crying infants, it is often difficult to:
A) perform tactile fremitus assessments.
B) determine lung expansion.
C) auscultate heart sounds.
D) visualize the pharynx.
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Chapter 26: Emergency or Life-Threatening Situations
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Q1) During injury assessment, one of the most crucial historical components is:
A) number of siblings.
B) history of prior fractures.
C) mechanism of injury.
D) past and current occupational exposure.
Q2) You would complete a Glasgow Coma Scale rating during the:
A) health history.
B) physical examination.
C) primary survey.
D) secondary survey.
Q3) The approximate expected systolic blood pressure for a child older than 1 year is:
A) 120 + child's age in years.
B) 80 + child's age in years.
C) 120 ?- child's age in years.
D) 80 + (the child's age in years).
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