Comprehensive Health Assessment
Final Exam Questions
Course Introduction
Comprehensive Health Assessment is a foundational course designed to equip students with the knowledge and skills necessary to perform thorough health evaluations across the lifespan. Emphasizing a holistic approach, the course integrates physical, psychosocial, and cultural considerations into the assessment process. Students will learn advanced techniques for collecting patient histories, conducting systematic physical examinations, and interpreting assessment findings to identify health status, risks, and needs. Through a blend of theoretical instruction and hands-on practice, this course prepares students to communicate effectively, document accurately, and support clinical decision-making in diverse healthcare settings.
Recommended Textbook
Health Assessment and Physical Examination 5th Edition by Mary Ellen Zator Estes
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Chapter 1: Critical Thinking And The Nursing Process
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Q1) A nurse working in a home care setting would most likely use which form of documentation recommended by the Center for Health Services and Policy Research?
A) PIO
B) DAR
C) MDS
D) OASIS-B1
Answer: D
Q2) Patients are most likely to be motivated and agreeable to following their plan of care when
A) their health care provider explains the plan in terms they can understand.
B) they participate in the decision-making process as the plan is developed.
C) they establish their own nursing diagnoses.
D) their physician and nurse collaborate in developing the plan.
Answer: B
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Chapter 2: Communication Techniques And The Patient
Interview
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Sample Questions
Q1) The statement "Everything will be fine," made by a nurse to parents of an infant being prepared for surgery will most likely
A) decrease the parents' anxiety.
B) reassure the parents.
C) communicate the nurse's understanding and concern.
D) relieve the nurse's anxiety.
Answer: D
Q2) In an interview with a patient who is visually impaired,it is important for the nurse to A) speak loudly and distinctly.
B) touch the patient frequently to emphasize the nurse's presence.
C) use a tone of voice, volume, and inflection appropriate to the message.
D) use simple phrases and closed questions.
Answer: C
Q3) Patients often respond to questions that begin with the word why by
A) sharing important and useful information.
B) trying to explain or defend themselves.
C) establishing a closer relationship with the nurse.
D) becoming confused.
Answer: B
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Chapter 3: The Complete Health History Including Documentation
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Sample Questions
Q1) A patient tells you that he periodically takes a prescribed medication to relieve arthritis pain.It was prescribed by his health care provider 5 years ago.What is the nurse's most appropriate response?
A) "You should discard any unused portion of a medication by the stated expiration date because some medications lose their potency and others become toxic."
B) "You need to ask your health care provider if you should continue taking this medication when you experience arthritic pain."
C) "I'll contact your health care provider about your expired medication and ask for a new prescription if she thinks it is appropriate."
D) "Have you tried any herbal products for relief of your pain?"
Answer: A
Q2) By asking Ms.K the question,"Have you done anything that makes you sneeze more?" you are determining if there are any ____________________ factors.
Answer: aggravating
Explanation:Aggravating factors are those factors that worsen the severity of the chief complaint (sneezing).
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Chapter 4: Developmental Assessment
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Sample Questions
Q1) A stressful life event commonly faced by adults in the early middle-adult years includes
A) facing an "empty nest" as children move away.
B) being diagnosed with a chronic health problem such as cancer.
C) adjusting to the possible or actual death of parents and /or life partner.
D) reviewing the experiences, relationships, and events of one's life and accepting one's life and accompanying life choices and outcomes in their entirety (a life review).
Q2) The motor skills of 3-month-old infants typically include the ability to
A) put objects in their mouth.
B) turn from back to stomach.
C) look at and play with their fingers.
D) hold the foot and put it in the mouth.
Q3) Successful completion of a life review,a key developmental task of adults in late adulthood (70 years to death),results in
A) acceptance of one's life choices, successes, and failures.
B) a sense of hopelessness.
C) fear of death.
D) signs and symptoms of depression.
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Chapter 5: Cultural Assessment
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Sample Questions
Q1) Your patient is a 72-year-old African American male.The patient is married,with three children and eight grandchildren.He is a retired lawyer from New York who is now living in Florida and has requested a health assessment.Together,the cultural influences just described make up which of the following?
A) cultural orientation
B) ethnic identity
C) multicultural identity
D) predominant cultural identity
Q2) You ask a patient from Tunisia a question and the patient responds,"yes N'sha'llah" ? The patient's response most likely implies which of the following?
A) Maybe
B) If God is willing
C) If you pray for me
D) If I live a good life
Q3) A(n)____________________ group is people who share a unique national or regional origin and social,cultural,and linguistic heritage.
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Chapter 6: Spiritual Assessment
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Sample Questions
Q1) Your patient,who is a devout Roman Catholic,is hospitalized for treatment of her chronic heart condition.You notice that the patient is wearing a crucifix and has rosary beads in her hand and religious literature in her room.You respond by A) asking if she plans on displaying other religious artifacts.
B) documenting your observations in her medical records.
C) offering to call her priest.
D) using this opportunity to ask her about her spiritual beliefs.
Q2) Which religious group discourages or prohibits cremation?
A) Buddhists
B) Christian Scientists
C) Jehovah's Witnesses
D) Jews
Q3) Which religious group discourages organ donation?
A) Islam, Judaism
B) Christian Science, Native American religions
C) Jehovah's Witness, Mormon
D) Protestants, Unitarian
Q4) An individual who is unsure that God exists is called a(n)____________________.
Q5) Solemn and ceremonial acts that reinforce faith are called ____________________.
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Chapter 7: Nutritional Assessment
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Sample Questions
Q1) Which snack is appropriate for a 2-year-old?
A) banana, crackers
B) celery, carrot sticks
C) half of a hot dog
D) peanuts, popcorn
Q2) A common eating behavior of the preschool child is
A) eating one food at a time.
B) having a larger appetite than a toddler.
C) mixing several foods together.
D) trying new foods more willingly than he did as a toddler.
Q3) A kilocalorie,also called a calorie,is the amount of heat required to raise the temperature of
A) 1 gram of water 1 degree centigrade.
B) 1 gram of water 10 degrees centigrade.
C) 1 kilogram of water 1 degree centigrade.
D) the human body 1 degree centigrade.
Q4) The three most important nutrients that provide the body with energy are
Q5) Nutrition is the process by which the body metabolizes and uses
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Chapter 8: Physical Examination Techniques
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Sample Questions
Q1) Bedridden patients who cannot sit up should be assessed in the ____________________ position.
Q2) You are using deep palpation to examine a patient's abdomen.At which depth would you palpate?
A) 1-2 cm
B) 2-3 cm
C) 4-5 cm
D) 6-8 cm
Q3) Deep palpation is more frequently performed for assessment of
A) the abdomen and male and female reproductive organs.
B) muscle guarding.
C) superficial tenderness.
D) the thorax and extremities.
Q4) The physical examination should be conducted from which of the following directions?
A) left to right
B) right to left
C) head to toe
D) toe to head
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Chapter 9: General Survey, vital Signs, and Pain
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Q1) While examining a patient admitted for acute appendicitis,the patient complains of pain in the abdominal region.You recognize that the patient is experiencing which type of pain?
A) somatic pain
B) cutaneous pain
C) chronic pain
D) visceral pain
Q2) Halitosis can be caused by which of the following? Select all that apply.
A) Tonsilitis
B) Vaginal infection
C) Pneumonia
D) Allergic rhinitis
E) Tooth decay
F) Poor oral hygiene
Q3) A weak,thready pulse can be caused by ____________________ shock.
Q4) Poor oral hygiene,allergic rhinitis,or infections such as tonsillitis,sinusitis,or pneumonia can be indicated by bad ____________________.
Q5) An apical pulse rate greater than the radial pulse rate is called
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Chapter 10: Skin, hair, and Nails
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Q1) Which diseases,reported by a patient during the family health history,are familial in nature?
A) cutaneous moniliasis and paronychia
B) pediculosis pubis and tinea capitis
C) psoriasis, brittle nails, and hair loss
D) verruca vulgaris and acne
Q2) Your patient is a 20-year-old college student who worked for the past four summers as a lifeguard at the community swimming pool.During the examination,the patient asks many questions related to the care of her skin and hair.Because your patient's work environment involved daily exposure to sunlight,the patient is at risk for which of the following?
A) contact dermatitis and eczema
B) rashes, urticaria, and angioedema
C) basal or squamous cell carcinoma and wrinkles
D) seborrheic keratosis and acne
Q3) A nodule is an example of which type of lesion?
A) nonpalpable
B) palpable
C) secondary
D) tertiary
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Chapter 11: Head, neck, and Regional Lymph Nodes
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Q1) When examining your patient's head,you note that the patient's skull has an abnormal shape.The patient also has exophthalmos and drooping eyes.You suspect that the patient has which of the following conditions?
A) craniotabes
B) acromegaly
C) hydrocephalus
D) craniosynostosis
Q2) Which of the following best describes craniotabes?
A) abnormal enlargement of the skull and bony facial structures
B) enlargement of the head without enlargement of the facial structures
C) profound state of wasting of the vital tissues that is associated with cancer, malnutrition, and severe chronic illnesses
D) softening of the skull caused by hydrocephalus or demineralization of the bone due to rickets, osteogenesis imperfecta, or syphilis
Q3) The second cervical vertebra,called the ____________________,has an odontoid process that extends into the ring of the first cervical vertebra.
Q4) A(n)_____________________ headache is an example of a vascular headache.
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Chapter 12: Eyes
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Q1) The term uveitis is used to describe inflammation of which of the following? Select all that apply.
A) Lens
B) Cornea
C) Retina
D) Optic nerve
E) Vitreous body
F) Uveal tract of the eye, including iris, ciliary body, and choroid
Q2) Which of the following are most commonly associated with diabetes mellitus?
A) Roth's spots
B) hard exudates
C) drusen
D) diffuse preretinal hemorrhage
Q3) When examining your patient,who has a thiamine deficiency related to chronic alcoholism,you are most likely to observe evidence of cranial nerve (CN)involvement resulting in the inability of his eyes to move
A) downward (CN IV).
B) medially (CN III).
C) outward (CN VI).
D) upward (CN III).
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Chapter 13: Ears, nose, mouth, and Throat
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Q1) Which portion of the ear has bony and membranous portions?
A) ossicles
B) labyrinth
C) tympanic cavity
D) tympanic membrane
Q2) Findings of a bright red pharynx with red,swollen tonsils,pillars,and uvula,as well as patches of white or yellow exudate on the tonsils are consistent with A) diphtheria.
B) infectious mononucleosis.
C) streptococcal pharyngitis and tonsillitis.
D) the presence of a foreign body.
Q3) The results of a patient's Weber test indicate a conductive hearing loss in the right ear.This is based on a report of
A) hearing the sound equally in both ears.
B) hearing the sound louder in the left ear.
C) hearing the sound louder in the right ear.
D) not hearing the sound in either ear.
Q4) You observe redness,swelling,and narrowing of the external ear,which most likely indicate acute otitis ____________________.
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Chapter 14: Breasts And Regional Nodes
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Q1) An abnormal finding related to the size and symmetry of the breasts is which of the following?
A) enlargement of the breast on the side of the dominant arm
B) nipples pointing upward and laterally
C) significant unilateral reduction of breast tissue
D) supernumerary nipples
Q2) Examination of the breasts by palpation with the patient supine includes
A) peripheral breast tissue, lactiferous ducts, areola, and nipple.
B) Cooper's ligaments, tail of Spence, and muscles and lymph nodes of the chest.
C) areola, axillary nodes, Cooper's ligaments, and compression of the nipple for discharge.
D) peripheral breast tissue, tail of Spence, areola, and compression of the nipple for discharge.
Q3) When examining a patient who has undergone a left simple mastectomy,the nurse should do which of the following?
A) examine the right breast first
B) omit palpating the lymph nodes on the left side because they were removed
C) turn her to her right side before palpation
D) omit palpating the left nipple because it was removed
Q4) The pigmented area surrounding the nipple is called the
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Chapter 15: Thorax And Lungs
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Q1) Ataxic breathing,or Biot's respirations,indicate damage to the
Q2) A normal finding when examining thoracic expansion is separation of the thumbs by
A) 2-3 cm on inspiration with return to the midline on expiration.
B) 3-5 cm on inspiration with return to the midline on expiration.
C) 3-5 cm on inspiration and 1-2 cm on expiration.
D) 5-7 cm on inspiration and 3-5 cm on expiration.
Q3) To determine the symmetry of a patient's chest wall,the nurse would do which of the following? Select all that apply.
A) Stand behind the patient.
B) Inspect the right and the left anterior thoraxes.
C) Note the shoulder height, observing any differences between the two sides of the chest wall, such as the presence of masses.
D) Move in front of the patient.
E) Inspect the right and the left posterior thoraxes, comparing right and left sides.
F) Note the position of the scapula.
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Chapter 16: Heart
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Q1) A patient reports that her only exercise is walking on Saturdays and Sundays for 15 minutes.Recommended guidelines to increase cardiovascular tone are to engage in sustained physical activity at least
A) 15 to 30 minutes daily.
B) 20 to 30 minutes, three to five times per week.
C) 30 minutes, five times per week.
D) 30 to 60 minutes daily.
Q2) The major components of the cardiovascular physical examination are the A) pericardium, periphery, and hepatic area.
B) precordium and periphery.
C) mid-precordial area, peripheral vasculature, and gastric area.
D) gastric area and periphery.
Q3) A normal pulsation palpated in the mitral area is the apical impulse,which A) has a large amplitude.
B) can be felt immediately after the first heart sound.
C) is often easier to palpate with the patient turned to the right side. D) is present in about 10% of adults.
Q4) The lower portion of the heart,called the ____________________,extends into the left thoracic cavity.
Q5) The bicuspid valve is also known as the ____________________ valve.
Page 18
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Chapter 17: Peripheral Vasculature And Lymphatic System
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Q1) A positive Homans' sign is present when the patient complains of pain in the
A) ankle upon dorsiflexion of the foot.
B) calf upon dorsiflexion of the foot.
C) calf upon flexion of the knee.
D) thigh upon elevation of the leg.
Q2) Normally,the jugular veins are most distended when the A) patient is lying flat.
B) head of the bed (HOB) is elevated at a 45° angle.
C) head of the bed is at a 90° angle.
D) patient is upright.
Q3) Which of the following is characteristic of an arterial ulceration occurring on the feet?
A) There is black and necrotic tissue, but no bleeding.
B) It commonly occurs at the sides of the ankles.
C) Pain is relieved by elevating the leg.
D) Pain is relieved by walking.
Q4) The visceral layer,a serous layer that lies against the heart,is also called the
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Chapter 18: Abdomen
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Q1) A female patient reports an increase of involuntary loss of urine with sneezing and coughing.Her past medical history reveals uterine cancer,an abdominal hysterectomy,and radiation therapy.What type of incontinence is she most likely experiencing?
A) stress incontinence
B) urge incontinence
C) overflow incontinence
D) functional incontinence
Q2) The spleen,gallbladder,stomach,liver,bile duct,small intestine,and large intestine are considered the ____________________ organs.
Q3) Which substance impairs gastric absorption and increases the risk of gastrointestinal bleeding?
A) coffee
B) tobacco
C) caffeinated beverages
D) alcohol
Q4) The most commonly used abdominal examination approach is the ____________________ technique.
Q5) ____________________ bowel sounds indicate decreased motility.
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Chapter 19: Musculoskeletal System
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Q1) A patient's inability to touch his thumb with the little finger of the same hand indicates involvement of the
A) ulnar nerve.
B) radial nerve.
C) metacarpophalangeal joints.
D) median nerve.
Q2) A patient has a decreased step height and length with increased step speed.He appears to hesitate both in initiating and in terminating ambulation.Which pathology is he most likely experiencing?
A) multiple sclerosis
B) Parkinson's disease
C) cerebellar disease
D) Alzheimer's disease
Q3) Which statement is true of a multiaxial joint?
A) It is an example of a hinge joint.
B) It provides angular movement in one axis and one plane.
C) It is the wrist between the distal radius and carpals.
D) It is also called a ball-and-socket joint.
Q4) Osteoporosis is the loss of ____________________.
Q5) Bone marrow is contained in the _________________________.
Page 21
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Chapter 20: Mental Status And Neurological Techniques
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Q1) Which finding is normal when assessing the spinal accessory nerve?
A) ability to turn the head side to side and shrug shoulders against resistance
B) ability to rapidly alternate touching finger to nose and moving finger from nose to examiner's finger in a coordinated manner
C) ability to flex arms against resistance
D) ability to elevate arms against resistance
Q2) Your patient reported each of the following facts when questioned about his family's health history.Which fact prompts you to question him further to determine if he might have a familial neurological disease?
A) His father was paralyzed at age 45 from a spinal cord tumor.
B) His older brother has a seizure disorder.
C) His grandfather died of complications related to diabetes.
D) His grandmother had hypertension and died of complications resulting from a cerebrovascular accident.
Q3) The subdural space is located below the ____________________.
Q4) Your patient has suffered a cerebrovascular accident and is presenting with erratic respirations and heart rate.The portion of the brain most likely affected is the _________________________.
Q5) Memory storage and recall are associated with the _____________________.
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Chapter 21: Female Genitalia
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Q1) Menstrual blood does not clot,because it lacks ____________________.
Q2) The nurse should monitor which of the following patients for a potential vaginal infection?
A) menstruating patient who uses sanitary napkins
B) patient who changes tampons every 3 hours during her menstrual period
C) patient given broad-spectrum antibiotics for a wound infection
D) patient who wipes from front to back to prevent contamination of the vagina with fecal material
Q3) Which activity should a patient avoid 24 to 48 hours before a scheduled physical assessment to prevent affecting the results of the Pap smear and other cultures?
A) ingesting alcohol or smoking
B) taking a tub bath, swimming, or using a hot tub
C) taking birth control pills or other hormones
D) using vaginal sprays, douching, or having coitus
Q4) The shape of your patient's cervical os is bilateral transverse,which indicates
A) normal findings.
B) cervical tears from rapid childbirth.
C) multiple deliveries.
D) nulliparity.
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Chapter 22: Male Genitalia
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Q1) Which of the following is a function of the seminal vesicles?
A) secreting an alkaline substance that protects sperm
B) secreting fluid that helps provide a source of energy for sperm metabolism
C) secreting the male hormone testosterone
D) providing lubrication at the end of the penis during sexual intercourse
Q2) To prepare your patient for acetowhitening,you apply gauze saturated with which substance to his penis and scrotum?
A) a topical stain
B) 5% acetic acid solution
C) 70% isopropyl alcohol
D) sterile normal saline
Q3) During your assessment of an uncircumcised male infant,you observe that his foreskin is retracted and the penis is swollen distal to the foreskin.This condition is known as
A) paraphimosis.
B) Peyronie's disease.
C) phimosis.
D) priapism.
Q4) Sperm production occurs at approximately age ____________________.
Q5) The testicles are suspended by the ____________________.
Page 24
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Chapter 23: Anus, rectum, and Prostate
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Q1) Your patient has requested a follow-up assessment of his pilonidal disease because of a recent onset of pruritus on his buttocks.To inspect the patient's perineum and sacrococcygeal area,you would position him
A) in the lithotomy position.
B) in the left lateral decubitus position.
C) bending over the examination table, with his legs spread apart.
D) supine, with legs spread apart.
Q2) Because of the possibility of bacteremia,a rectal examination should be avoided in patients with
A) acute bacterial prostatitis.
B) fecal incontinence.
C) irritable bowel syndrome.
D) inflammatory bowel disease.
Q3) Which lobes of the prostate gland are most accessible to examination?
A) anterior
B) posterior
C) lateral
D) median
Q4) Hemorrhoids result from ____________________ of the superior and inferior hemorrhoidal veins.
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Chapter 24: The Pregnant Patient
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Q1) Which of the following are not commonly associated with changes related to pregnancy?
A) glycosuria and proteinuria
B) elevated blood urea nitrogen (BUN) and creatinine
C) urinary frequency and nocturia
D) urinary tract infection
Q2) According to the recommendations of the American College of Obstetricians and Gynecologists,prenatal visits should be scheduled every 2 weeks from
A) 6 to 28 weeks' gestation.
B) 28 to 36 weeks' gestation.
C) 32 to 38 weeks' gestation.
D) 36 weeks' until delivery.
Q3) The incidences of small-for-gestational-age infants,preterm labor,spontaneous abortions,and lower Apgar scores are higher than normal among pregnant women who A) exercise vigorously.
B) ingest alcohol.
C) smoke.
D) drink coffee.
Q4) Melasma,or chloasma,is better known as the _____________________.
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Chapter 25: The Pediatric Patient
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Q1) To assess a male child for a hernia,you would palpate his inguinal area with
A) your little finger.
B) your index finger.
C) two fingers.
D) three fingers.
Q2) Which finding indicates the presence of a retinoblastoma?
A) absent red reflex
B) bleeding into the optic nerve sheath
C) dark reddish color of the retina
D) yellowish or white light reflex
Q3) Suspending a 3-month-old infant in a prone position while supporting the chest with your hand will normally result in extension of the head,trunk,and hips,which is referred to as which of the following reflexes?
A) Galant
B) Landau
C) Moro
D) placing
Q4) A cleft palate that involves the uvula,soft palate,hard palate,or a combination,is classified as a(n)____________________ malformation.
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Chapter 26: The Older Adult Patient
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Q1) Which of the following contribute to kidney shrinkage and a decrease in glomerular filtration rates? Select all that apply.
A) Glomerular degeneration
B) Thickening of glomerular and tubular basement membranes
C) Decreased length of proximal and distal tubes
D) Enhanced ability to dilute
E) Increased urine concentration
F) Decreased renal blood flow
Q2) When interviewing the elderly patient,all of the following techniques will be helpful,EXCEPT
A) allowing extra time for the interview.
B) scheduling more than one interview.
C) speaking loudly and slowly.
D) interviewing a family member or caregiver as well as the patient.
Q3) All of the following can normally be present in the aging adult,EXCEPT
A) decreased memory, especially short-term memory.
B) increased visual acuity.
C) diminished amounts of neurotransmitters.
D) diminished total brain weight.
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Chapter 27: The Complete Health History And Physical Examination
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Sample Questions
Q1) General guidelines for conducting a physical assessment include
A) allowing time at the conclusion of the assessment to discuss relevant findings.
B) helping patients who are older or disabled focus on identifying their limitations.
C) conducting the assessment in the same sequence each time in every situation.
D) encouraging the patient to change positions often.
Q2) A breast examination normally includes checking all of the following features of the breasts,EXCEPT
A) weight.
B) contour.
C) discharge.
D) symmetry.
Q3) Personal digital assistants (PDAs)are coming into use by nurses mainly for
A) interacting with patients.
B) data storage and retrieval.
C) formulating nursing diagnoses.
D) contacting physician specialists.
Q4) Femoral pulses are palpated and auscultated when you are assessing the
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