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Nursing Assessment is a foundational course that equips students with the knowledge and skills to systematically collect, organize, and analyze health data from patients across the lifespan. Emphasizing both subjective and objective assessment techniques, the course covers effective communication, interviewing, and observation skills along with physical examination methods. Students learn to identify normal and abnormal findings, document data accurately, and use evidence-based tools to support clinical decision-making. The course prepares future nurses to develop individualized care plans and contribute effectively to interdisciplinary healthcare teams by performing comprehensive and focused health assessments.
Recommended Textbook
Physical Examination and Health Assessment 5th Edition by Carolyn Jarvis
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30 Chapters
966 Verified Questions
966 Flashcards
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34 Verified Questions
34 Flashcards
Source URL: https://quizplus.com/quiz/76136
Sample Questions
Q1) Expert nurses learn to attend to a pattern of assessment data and to act without consciously labeling it.This is referred to as:
A)intuition.
B)the nursing process.
C)clinical knowledge.
D)diagnostic reasoning.
Answer: A
Q2) B = second-level priority problem
A)A patient newly diagnosed with type 2 diabetes mellitus does not know how to check his own blood glucose levels with a glucometer.
B)A teenager who was stung by a bee during a soccer match is having trouble breathing.
C)An older adult with a urinary tract infection is also showing signs of confusion and agitation.
Answer: C
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Q1) Levinson proposed a view of middle adulthood that differed from Erikson's.Which of the following statements best illustrates Levinson's views?
A)The main task of middle-aged adults is to overcome boredom with life.
B)Career reassessment in middle age is rare because of the fear of change at this age.
C)Middle age is a time when adults push to meet the goals that were set at a younger age.
D)Middle-aged adults adjust goals and emerge with a new perception of the self and the environment.
Answer: D
Q2) Normal physical changes that occur during middle adulthood (40 to 64 years)include:
A)deterioration of internal organ systems.
B)increased muscle tone and decreased muscle strength.
C)increased abdominal fat deposits from decreased activity.
D)decreased sensory function and visual changes for far vision.
Answer: C
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33 Flashcards
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Sample Questions
Q1) In the majority culture of America,coughing,sweating,and diarrhea are symptoms of an illness.For some individuals of Mexican-American origin,however,these symptoms are a normal part of living.This is probably because Mexican-Americans:
A)have less efficient immune systems and are often ill.
B)consider these symptoms a part of normal living,not symptoms of ill health.
C)come from Mexico and coughing is normal and healthy there.
D)are usually in a lower socioeconomic group and are more likely to be sick.
Answer: B
Q2) Which of the following practices reflects traditional health and illness beliefs/practices of those of African heritage?
A)Health is the reward for good behavior.
B)Balance of the body and spirit
C)The wearing of jade amulets
D)Health is harmony with nature.
Answer: D
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31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/76139
Questions
Q1) During a follow-up visit,the nurse discovers that a patient has not been taking his insulin on a regular basis.The nurse asks,"Why haven't you taken your insulin?" Which of the following is an appropriate evaluation of this question?
A)It may put the patient on the defensive.
B)It is an innocent search for information.
C)It would have been better to discuss this with his wife.
D)It is the best way to discover the reasons for his behavior.
Q2) Which of the following statements illustrate the use of open-ended questions? Select all that apply.
A)Elicits cold facts
B)Elicits feelings,opinions,and ideas
C)Builds and enhances rapport
D)Leaves interactions neutral
E)Calls for short one- to two-word answers
F)Used when narrative information is needed.
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30 Flashcards
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Sample Questions
Q1) The nurse is obtaining a health history on an 87-year-old woman.Which of the following areas of questioning would be most useful at this time?
A)Obstetric history
B)Childhood illnesses
C)General health for the past 20 years
D)Current health promotion activities
Q2) Which of the following best describes the purpose of a functional assessment?
A)It assesses how the individual is coping with life at home.
B)It determines how children are meeting developmental milestones.
C)It can identify any problems with memory the individual may be experiencing.
D)With the elderly,it helps to determine how they are managing day-to-day activities.
Q3) Which of the following is an example of a symptom?
A)Chest pain
B)Clammy skin
C)Serum potassium level 4.2 mEq/L
D)A temperature of 100S1U1P1\(\circ\)S1S1P0 F
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Sample Questions
Q1) Which of the following are manifestations of delirium? Select all that apply.
A)Develops over a short period of time
B)The person is experiencing apraxia.
C)Memory impairment or deficits
D)Occurs as a result of a medical condition,such as systemic infection
E)The person is experiencing agnosia.
Q2) A patient has been in the intensive care unit for 10 days.He has just been moved to the medical-surgical unit and the admitting nurse is planning to perform a mental status examination on him.During the tests of cognitive function the nurse would expect that he:
A)may display some disruption in thought content.
B)will state,"I am so relieved to be out of intensive care."
C)will be oriented to place and person but may not be certain of the date.
D)may show evidence of some clouding of his level of consciousness.
Q3) When examining a patient,the nurse can assess mental status by:
A)examining the patient's electroencephalogram.
B)observing the patient as he or she performs an IQ test.
C)observing the patient and inferring health or dysfunction.
D)examining the patient's response to a specific set of questions.
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Sample Questions
Q1) When documenting intimate partner violence and elder abuse,the nurse should include:
A)photographic documentation of injuries.
B)a summary of the abused patient's statements.
C)verbatim documentation of every statement made.
D)a general description of injuries in the progress notes.
Q2) As a mandatory reporter of elder abuse,which of the following must be present before a nurse notifies the authorities?
A)Statements from the victim
B)Statements from witnesses
C)Proof of abuse and/or neglect
D)Suspicion of elder abuse and/or neglect
Q3) A female patient has denied any abuse when answering the Abuse Assessment Screen,but the nurse has noticed some other conditions that are associated with intimate partner violence.Examples of such conditions include:
A)asthma.
B)confusion.
C)depression.
D)frequent colds.
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38 Flashcards
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Sample Questions
Q1) A patient has suddenly developed shortness of breath and appears to be in significant respiratory distress.Which of the following is the best action for the nurse to take?
A)Count the respirations and put a call in to the physician.
B)Percuss the thorax bilaterally,noting any differences in percussion tones.
C)Call for a chest x-ray and wait for the results before beginning an assessment.
D)Inspect the thorax for any new masses and bleeding associated with respirations.
Q2) Which technique of assessment is used to determine the presence of crepitus,swelling,and pulsations?
A)Palpation
B)Inspection
C)Percussion
D)Auscultation
Q3) The nurse is preparing to percuss to assess the underlying:
A)tissue turgor.
B)tissue texture.
C)tissue density.
D)tissue consistency.
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Sample Questions
Q1) A patient is being seen in the clinic for complaints of "fainting episodes that started last week." How should the nurse proceed with the examination?
A)Take his blood pressure in both arms and thighs.
B)Assist him to a lying position and begin taking his blood pressure.
C)Record his blood pressure in the lying,sitting,and standing positions.
D)Record his blood pressure in the lying and sitting positions and average these numbers to obtain a mean blood pressure.
Q2) A nurse is helping at a health fair at a local mall.When taking blood pressures on a variety of people,the nurse keeps in mind:
A)After menopause,blood pressure in women is usually lower than in men.
B)A black adult's blood pressure is usually higher than that of whites of the same age.
C)Blood pressure measurements in overweight people should be the same as those of normal weight.
D)A teen's blood pressure reading will be lower than that of an adult.
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Sample Questions
Q1) The nurse knows that which statement is true regarding the pain experienced by infants?
A)Pain in infants can only be assessed by physiologic changes,such as increased heart rate.
B)The Wong-Baker scale can be used to assess pain in infants.
C)A procedure that induces pain in adults will also induce pain in the infant.
D)Infants feel pain less than adults do.
Q2) A patient has had arthritic pain in her hips for several years since a hip fracture.She is able to move around in her room and has not offered any complaints so far this morning.However,when asked,she states that her pain is "bad this morning" and rates it at an 8 on a 1 to 10 scale.What does the nurse suspect?
A)She is addicted to her pain medications and cannot obtain pain relief.
B)She does not want to trouble the nursing staff with her complaints.
C)She is not in pain but rates it high to receive pain medication.
D)She has experienced chronic pain for years and has adapted to it.
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Sample Questions
Q1) The nurse is concerned about the skeletal protein reserves of a patient who has been hospitalized frequently for chronic lung disease.Which of the following measurements would be necessary to include in the assessment?
A)Body mass index
B)Weight and height
C)Mid arm muscle area
D)Ideal body weight and frame size
Q2) During a nutritional assessment,why is it important for the nurse to ask a patient what medications he or she is taking?
A)Certain drugs can affect the metabolism of nutrients.
B)The nurse needs to assess the patient for allergic reactions.
C)Medications need to be documented on the record for the physician's review.
D)Medications can affect one's memory and ability to identify food eaten in the last 24 hours.
Q3) Which of the following statements is true concerning the nutritional assessment?
A)It is only useful in patients who are overweight.
B)It identifies patients who are at risk of malnutrition.
C)This assessment can only be thoroughly done by a dietician.
D)It provides the nurse with physical findings related to all the systems.
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50 Flashcards
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Sample Questions
Q1) A patient has tingling sensations in her feet and has noticed that her tongue has become very red and painful.The nurse suspects that she has:
A)polycythemia.
B)pernicious anemia.
C)micronucleus anemia.
D)iron deficiency anemia.
Q2) Which of the following assessment findings is most consistent with clubbing of the fingernails?
A)A nail base that is firm to palpation and slightly tender
B)Curved nails with a convex profile and ridges across the nail
C)A nail base that feels spongy with an angle of the nail base of 150 degrees
D)An angle of the nail base of 180 degrees or greater with a nail base that feels spongy
Q3) A newborn infant is in the clinic for a well-baby check.The nurse observes the infant for the possibility of fluid loss because of which of the following?
A)Subcutaneous fat deposits are high in the newborn
B)Sebaceous glands are overproductive in the newborn
C)The newborn's skin is more permeable than that of the adult
D)The amount of vernix caseosa rises dramatically in the newborn
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26 Verified Questions
26 Flashcards
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Sample Questions
Q1) The nurse is performing an assessment on a 7-year-old child who has symptoms of chronic watery eyes,sneezing,and clear nasal drainage.The nurse notes the presence of a transverse line across the bridge of the nose,dark blue shadows below the eyes,and a double crease on the lower eyelids.These findings are characteristic of: A)allergies.
B)a sinus infection.
C)nasal congestion.
D)an upper respiratory infection.
Q2) A physician tells the nurse that a patient's vertebra prominens is tender and asks the nurse to re-evaluate the area in 1 hour.The area of the body the nurse will assess is the area:
A)just above the diaphragm.
B)just lateral to the knee cap.
C)at the level of the C7 vertebra.
D)at the level of the T11 vertebra.
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32 Verified Questions
32 Flashcards
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Sample Questions
Q1) A patient's vision is recorded as 20/80 in each eye.The nurse recognizes that this finding indicates that:
A)the patient has poor vision.
B)the patient has acute vision.
C)the patient has normal vision.
D)the patient is presbyopic.
Q2) A patient comes into the clinic complaining of pain in her right eye.On examination,the nurse sees a pustule at the lid margin that is painful to touch,red,and swollen.The nurse recognizes that this is
A)a chalazion.
B)a hordeolum (stye).
C)dacryocystitis.
D)blepharitis.
Q3) In assessing the sclera of a black patient,which of the following would be an expected finding?
A)Yellow fatty deposits over the cornea
B)Pallor near the outer canthus of the lower lid
C)Yellow color of the sclera that extends up to the iris
D)The presence of small brown macules on the sclera
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34 Flashcards
Source URL: https://quizplus.com/quiz/76150
Sample Questions
Q1) The mother of a 2-year-old is concerned about the upcoming placement of tympanostomy tubes in her son's ears.The nurse would include which of the following in the teaching plan?
A)The tubes are placed in the inner ear.
B)The tubes are used in children with sensorineural loss.
C)The tubes are permanently inserted during a surgical procedure.
D)The purpose of the tubes is to decrease the pressure and allow for drainage.
Q2) The nurse is assessing a 16-year-old patient with head injuries from a recent motor vehicle accident.Which of the following statements indicates the most important reason for assessing for any drainage from the canal?
A)If the drum has ruptured,there will be purulent drainage.
B)Bloody or clear watery drainage can indicate a basal skull fracture.
C)The auditory canal many be occluded from increased cerumen.
D)There may be occlusion of the canal caused by foreign bodies from the accident.
Q3) Which of the following statements concerning the eustachian tube is true?
A)It is responsible for the production of cerumen.
B)It remains open except when swallowing or yawning.
C)It allows passage of air between the middle and outer ear.
D)It helps equalize air pressure on both sides of the tympanic membrane.
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Sample Questions
Q1) A 72-year-old patient has a history of hypertension and chronic lung disease.An important question for the nurse to include in the history would be:
A)"Do you use a fluoride supplement?"
B)"Have you had tonsillitis in the last year?"
C)"At what age did you get your first tooth?"
D)"Have you noticed any dryness in your mouth?"
Q2) During an oral assessment of a 30-year-old black patient,the nurse notes bluish lips and a dark line along the gingival margin.What would the nurse do in response to this finding?
A)Check the patient's hemoglobin for anemia.
B)Assess for other signs of insufficient oxygen supply.
C)Proceed with assessment,knowing that this is a normal finding.
D)Ask if he has been exposed to an excessive amount of carbon monoxide.
Q3) During an assessment of an 80-year-old patient,the nurse would expect to find:
A)hypertrophy of the gums.
B)an increased production of saliva.
C)a decreased ability to identify odors.
D)finer and less prominent nasal hair.
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Sample Questions
Q1) A 65-year-old patient remarks that she just can't believe that her breasts sag so much.She states it must be from lack of exercise.What explanation should the nurse offer her?
A)After menopause,only women with large breasts experience sagging.
B)After menopause,sagging is usually due to decreased muscle mass within the breast.
C)After menopause,a diet that is high in protein will help maintain muscle mass,which keeps the breasts from sagging.
D)After menopause,the glandular and fat tissue atrophies,causing breast size and elasticity to diminish,resulting in breasts that sag.
Q2) A 54-year-old man comes to the clinic with a "horrible problem." He tells the nurse that he has just discovered a lump on his breast and is fearful of cancer.The nurse knows that which statement about breast cancer in males is true?
A)Breast masses in men are difficult to detect because of minimal breast tissue.
B)Breast masses in men are noticeable early because of minimal breast tissue.
C)Fewer than 1% of all breast cancer occurs in men.
D)Most breast masses in men are diagnosed as gynecomastia.
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Sample Questions
Q1) Air passing through narrowed bronchioles would produce which of the following adventitious sounds?
A)Wheezes
B)Bronchial sounds
C)Bronchophony
D)Whispered pectoriloquy
Q2) When considering the biocultural differences in the respiratory systems,the nurse knows that which statement is true?
A)The smallest chest volumes are found in Asians.
B)The largest chest volumes are found in whites.
C)Asians are most likely to contract tuberculosis.
D)Racial differences are of no significance when assessing the respiratory system.
Q3) When assessing a patient's lungs,the nurse recalls that the left lung:
A)consists of two lobes.
B)is divided by the horizontal fissure.
C)consists primarily of an upper lobe on the posterior chest.
D)is shorter than the right lung because of the underlying stomach.
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Sample Questions
Q1) When the nurse is auscultating the carotid artery for bruits,which of the following reflects correct technique?
A)While listening with the bell of the stethoscope,have the patient take a deep breath and hold it.
B)While auscultating one side with the bell of the stethoscope,palpate the carotid artery on the other side to check pulsations.
C)Lightly apply the bell of the stethoscope over the carotid artery;have the patient take a breath,exhale,and hold it briefly while the nurse listens.
D)Firmly place the bell of the stethoscope over the carotid artery,have the patient take a breath,exhale,and hold it briefly while the nurse listens.
Q2) The sac that surrounds and protects the heart is called the:
A)pericardium.
B)myocardium.
C)endocardium.
D)pleural space.
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Sample Questions
Q1) A patient has a positive Homan's sign.The nurse knows that a positive Homan's sign:
A)occurs with venous insufficiency.
B)is indicative of possible thrombophlebitis.
C)is seen in the presence of severe edema.
D)indicates problems with arterial circulation.
Q2) The nurse is attempting to assess the femoral pulse in an obese patient.Which of the following actions would be most appropriate?
A)Have the patient assume a prone position.
B)Ask the patient to bend his or her knees to the side in a froglike position.
C)Press firmly against the bone with the patient in a semi-Fowler's position.
D)Listen with a stethoscope for pulsations because it is very difficult to palpate the pulse.
Q3) To assess the dorsalis pedis artery,the nurse would palpate:
A)behind the knee.
B)over the lateral malleolus.
C)in the groove behind the medial malleolus.
D)lateral to the extensor tendon of the great toe.
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Sample Questions
Q1) When palpating the abdomen of a 20-year-old patient,the nurse notes the presence of tenderness in the left upper quadrant with deep palpation.Which of the following structures is most likely to be involved?
A)Spleen
B)Sigmoid
C)Appendix
D)Gallbladder
Q2) Which sound is normal to elicit when percussing in the seventh right intercostal space at the midclavicular line over the liver?
A)Dullness
B)Tympany
C)Resonance
D)Hyperresonance
Q3) The nurse knows that during an abdominal assessment,deep palpation is used to determine:
A)bowel motility.
B)enlarged organs.
C)superficial tenderness.
D)overall impression of skin surface and superficial musculature.
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Sample Questions
Q1) A patient tells the nurse that she is having a hard time bringing her hand to her mouth when she eats or tries to brush her teeth.The nurse knows that for her to move her hand to her mouth,she must perform the following movement: A)flexion.
B)abduction.
C)adduction.
D)extension.
Q2) A man who has had gout for several years comes to the clinic with a "problem with my toe." On examination,the nurse notes the presence of hard,painless nodules over the great toe;one had burst open with a chalky discharge.This finding is known as:
A)a callus.
B)a plantar wart.
C)tenosynovitis.
D)tophi.
Q3) The nurse knows that another term for "knock knees" is:
A)genu varum.
B)genu valgum.
C)pes planus.
D)metatarsus adductus.
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Sample Questions
Q1) In assessing a 70-year-old patient who has had a recent cerebrovascular accident,the nurse notes right-sided weakness.What might the nurse expect to find when testing his reflexes on the right side?
A)Lack of reflexes
B)Normal reflexes
C)Diminished reflexes
D)Hyperactive reflexes
Q2) A 50-year-old woman is in the clinic for "weakness in my left arm and leg for the past week." The nurse will perform which type of neurologic examination?
A)Glasgow Coma Scale
B)Neurologic recheck examination
C)Screening neurologic examination
D)Complete neurologic examination
Q3) The nurse knows that testing kinesthesia is a test of a person's:
A)fine touch.
B)position sense.
C)motor coordination.
D)perception of vibration.
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Sample Questions
Q1) An older man is concerned about his sexual performance.The nurse knows that in the absence of disease,a withdrawal from sexual activity later in life may be due to:
A)side effects of medications.
B)decreased libido with aging.
C)decreased sperm production.
D)decreased pleasure from sexual intercourse.
Q2) When the nurse is conducting sexual history from a male adolescent,which statement would be most appropriate to use at the beginning of the interview?
A)"Do you use condoms?"
B)"You don't masturbate,do you?"
C)"Have you had sex in the last 6 months?"
D)"Often boys your age have questions about sexual activity."
Q3) When performing a genitourinary assessment,the nurse notes that the urethral meatus is positioned ventrally.This finding is:
A)called hypospadius.
B)the result of phimosis.
C)probably due to a stricture.
D)often associated with aging.
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Sample Questions
Q1) Which of the following techniques is correct for palpation of the rectum?
A)Flex the finger and insert slowly toward the umbilicus.
B)Instruct the patient first that this will be a painful procedure.
C)Insert an extended index finger at a right angle to the anus.
D)Place the finger directly into the anus to overcome the tight sphincter.
Q2) While doing an assessment of the perianal area of a patient,the nurse notes the following: pigmentation of anus is darker than surrounding skin;anal opening closed;a skin sac that is shiny and blue.The patient mentioned that he has had pain with bowel movements and has noted some spots of blood occasionally.What would this assessment and history be most likely to indicate?
A)Anal fistula
B)Pilonidal cyst
C)Rectal prolapse
D)Thrombosed hemorrhoid
Q3) Which of the following statements about the anal canal is true?
A)The anal canal is about 2 cm long in the adult.
B)The anal canal slants backward toward the sacrum.
C)The anal canal contains hair and sebaceous glands.
D)The anal canal is the outlet for the gastrointestinal tract.
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Sample Questions
Q1) The nurse has just completed an inspection of a woman's external genitalia.Which of the following would be a description of a finding within normal limits?
A)Redness of the labia majora
B)Multiple nontender sebaceous cysts
C)Discharge that is sticky and yellow-green
D)Swelling of the perineum before onset of menses
Q2) The changes normally associated with menopause occur generally because the cells in the reproductive tract are:
A)aging.
B)becoming fibrous.
C)estrogen dependent.
D)able to respond to estrogen.
Q3) During the interview a patient reveals that she has some vaginal discharge.She is worried that it may be a sexually transmitted disease.The nurse's most appropriate response to this would be:
A)"Oh,don't worry.Some cyclic vaginal discharge is normal."
B)"Have you been engaging in unprotected sexual intercourse?"
C)"I'd like some information about the discharge.What color is it?"
D)"Have you had any urinary incontinence associated with the discharge?"
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Sample Questions
Q1) When the nurse performs the confrontation test,the nurse has assessed:
A)EOMs.
B)PERRLA.
C)near vision.
D)visual fields.
Q2) Which of the following statements is true regarding the recording of data from the history and physical examination?
A)Use long,descriptive sentences to document findings.
B)Record the data as soon as possible after the interview and physical examination.
C)If the information is not documented,it can be assumed that it was done as a standard of care.
D)The examiner should avoid taking any notes during the history and examination because of the possibility of decreasing rapport with the patient.
Q3) Gloves should be worn for which of the following examinations?
A)Measuring vital signs
B)Palpation of the sinuses
C)Palpation of the mouth and tongue
D)Inspection of the eye with an ophthalmoscope
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Q1) During an assessment of a hospitalized patient,the nurse pinches a fold of skin under the clavicle or on the forearm to note:
A)mobility and turgor.
B)the patient's response to pain.
C)the percentage of the patient's fat-to-muscle ratio.
D)the presence of edema.
Q2) When assessing a patient's general appearance,the nurse will include which of the following?
A)Is the patient's muscle strength equal in both arms?
B)Is ptosis or facial droop present?
C)Does the patient respond appropriately to questions?
D)Are the pupils equal in reaction and size?
Q3) During an assessment,the nurse is unable to palpate pulses in the left lower leg.The nurse should:
A)document that the pulses are not palpable.
B)reassess the pulses in 1 hour.
C)have the patient turn to the side and then palpate for the pulses again.
D)use a Doppler device to assess the pulses.
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Q1) During the assessment of a woman in her 22nd<sup> </sup>week of pregnancy,the nurse is unable to hear fetal heart tones with the Doppler device.The nurse should:
A)wait 10 minutes and try again.
B)notify the physician immediately.
C)use a fetoscope to identify fetal heart tones.
D)use ultrasound to verify cardiac activity.
Q2) During a group prenatal teaching session,the nurse teaches Kegel exercises.Which of the following statements would be appropriate for this teaching session? Select all that apply.
A)"Kegel exercises help to keep your uterus strong during the pregnancy."
B)"Kegel exercises should be performed twice a day."
C)"Kegel exercises should be performed 50 to 100 times a day."
D)"To perform Kegel exercises,squeeze slowly to a peak at the count of eight then release slowly to a count of eight."
E)"To perform Kegel exercises,perform rapidly alternating squeeze-release exercises up to the count of eight."
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Q1) The nurse is assessing an older adult's advanced activities of daily living,which would include:
A)recreational activities.
B)meal preparation.
C)balancing the checkbook.
D)self-grooming activities.
Q2) When using the various instruments to assess an older person's activities of daily living,the nurse needs to remember that a disadvantage of these instruments includes:
A)the reliability of the tools.
B)self or proxy report of functional activities.
C)lack of confidentiality during the assessment.
D)insufficient detail about the deficiencies identified.
Q3) During a morning assessment,the nurse notices that an older patient is less attentive and is unable to recall yesterday's events.The nurse administers the Mini Mental State Examination,which will screen for:
A)dementia.
B)depression.
C)delirium.
D)psychosis.
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