21 Sep In order to successfully complete this online course, NU304, what must you do?
NU304 Health Assessment in Nursing
Week 1 Quiz
Question 1In order to successfully complete this online course, NU304, what must you do?
a.Successfully pass all laboratory video demonstrations with 80% or above.
b.Successfully complete all work with a grade of 75%.
c.Achieve a grade of at least 70%.
Question 2The required text for this course is:
a.Hogan-Quigley, B., Palm, M. & Bickley, L. (2017) Bates nursing guide to physical examination and history taking. PA: Lippincott Williams & Wilkins.
b.Bickley, L. (2017). Bates’ guide to physical examination and health assessment (12th ed.). New York: Lippincott, Williams & Wilkins.
c.Dains, J.E., Baumann, L.C., & Scheibel, P. (2016) Advanced health assessment and clinical diagnosis in primary care (5th ed.). Boston: Elsevier.
Question 3The discussion board assignments are not mandatory and are not included in the overall grade requirements.
Any concerns about the course should be addressed immediately to whom?
a.Dean of Students
b.Professor teaching the course – Dr. Dianna Jones
Question 5If you have any technical issues or need technical assistance at any time during the course, what should you do?
a.Contact Regis Information Technology HelpDesk at 781-768-7177 or email email@example.com.
b.Try to figure it out on your own.
c.Contact someone in your area that specializes in information technology.
NU304 Health Assessment in Nursing
Week 3 Quiz
Question 1While taking the history of a patient, you develop a genogram. Why do you do this?
a.To identify genetic and family health problems
b.To identify non-genetic conditions
c.To identify her chief complaint
d.To identify potential acute conditions
Question 2A patient had a normal corneal light reflex. What does this mean?
a.The eye focuses the image in the center of the pupil
b.Constriction of both pupils occurs in response to bright light
c.Light is reflected at the same spot in both eyes
d.The eyes converge to focus on light
When taking the family history, it is especially important to include:
Which of the following statements best describes the purpose of a health history?
a.To provide an opportunity for interaction between patient and nurse
b.To document the normal and abnormal findings of a full physician assessment
c.To provide a forum for obtaining the patient’s biographical information
d.To provide a database of subjective information about the patient’s past and present health
Question 5In performing the whisper test to assess for hearing, which of the following would the nurse do?
a.Whisper two syllable words and ask the patient to repeat them
b.Stand 4 feet away to ensure that the patient can hear at this distance
c.Cover your mouth so that the sound is muffled
d.Ask the patient to cover the ear you are assessing to occlude outside noise
Question 6You notice a solid, elevated, circumscribed lesion less than 1 cm on your patient’s arm. How would you describe this in your note?
Question 7When checking a patient for a visual acuity, which of the following assessment tools would you use?
a.Pupillary light reflex
c.Corneal light reflex
Question 8You are doing a fundoscopic exam on a patient. When you first place the ophthalmoscope to the eye, you see a red circle. What does this mean?
a.The light source is functioning appropriately
b.She has begun to show some signs of retinal degneration
c.This is a reflection of the retina
d.She has an opacity, which is causing the light to reflect back
Question 9When examining the nasal cavity, which finding would you consider abnormal?
a.Pink, moist mucosa
b.Large amounts of cilia
c.Boggy, pale turbinates
Conductive type hearing loss involves:
a.Inflammation of the labyrinth
b.Pathology of the inner ear or CNVIII
c.A gradual nerve degeneration
d.A mechanical dysfunction of the external or middle ear
Question 11When examining the inner ears of a patient, which of the following would be an abnormal finding?
a.Sticky, honey colored cerumen in the canal
b.Presence of a cone of light bilaterally
c.Gray tympanic membrane slightly concave
d.A pink, tympanic membrane with injections and slight bulging
Question 12Which superficial group of nodes is palpated during the assessment of HEENT?
Question 13The confrontation test is a gross measure of:
b.Extra ocular movements
c.Eye strength and muscle movement
Question 14You are in the process of assessing your patient’s thyroid gland. It is located:
a.Anterior to the uvula
b.Above the hyoid bone
c.Between occipital nodes
d.Below the cricoid cartilage
Question 15A thorough skin assessment is very important because the skin holds information about:
Question 16The temporomandibular joint is just below the temporal artery and anterior to the:
Question 17You are assessing the ears of a two year old patient. The proper technique for using the otoscope is:
a.Pull the pinna down and back
b.Pull the pinna up and back
c.Insert speculum without manipulation of the pinna
d.Pull the tragus forward
Question 18A normal response when assessing for extraocular movements (EOMs) is:
a.Asymmetry of the light reflex
c.Parallel tracking of an object with both eyes
d.Unequal pupillary response
Question 19During the neck exam, the nurse completed a lymph node assessment on a healthy 30 year old female patient. The nurse understands that most lymph nodes in healthy adults are:
a.Irregular shaped and mobile
b.Not palpable or slightly palpable and mobile
c.Large, firm and fixed
d.Palpable and very tender
Question 20Which of the following statements best describes the purpose of history of present illness?
a.To provide a database of subjective information about the patient’s symptoms and chief complaint
b.To document the normal and abnormal findings of a physical assessment
c.To provide a forum for obtaining the patient’s biographical information
d.To provide an opportunity for the interaction between patient and nurse
NU304 Health Assessment in Nursing
Week 5 Quiz
Question 1While auscultating a patient’s lung sounds, what sound would you expect to hear in the peripheral lung?
Question 2You are assessing the carotid arteries for the presence of a bruit. A bruit is a:
a.Loud, whooshing, blowing sound best heard with the bell of the stethoscope
b.Soft, rattling sound best heard with the diaphragm of the stethoscope
c.High-pitched tinkling sound best heard with the diaphragm of the stethoscope
d.Low gurgling sound best heard with the diaphragm of the stethoscope
Question 3 The expected normal assessment findings in your patient’s lungs include the presence of:
a.Clear lung fields with limited chest expansion
b.Symmetrical expansion and tactile fremitus
c.Absent voice sounds and hyperresonant percussion tones
d.Increased tactile fremitus and dull percussion tones
Question 4Which of the following is true about the left lung?
a.It is divided by horizontal fissure
b.It is shorter than the right lung because of the underlying stomach
c.It consists primarily of an upper lobe on the posterior chest
d.It consists of two lobes
Question 5Functions of the respiratory system include:
a.Supplying oxygen to the body for energy production
b.All of the above
c.Removing carbon dioxide as a waste product of energy reactions
d.Maintaining homeostasis (acid-base balance)
Question 6Which of the following is the sequence for auscultating heart sounds?
a.Aortic area, pulmonic area, mitra area, Erb’s point, tricuspid area
b.Pulmonic area, aortic area, Erb’s point, tricuspid area, mitral area
c.Pulmonic area, mitral area, aortic area, Erb’s point, tricuspid area
d.Aortic area, pulmonic area, Erb’s point, tricuspid area, mitral area
Question 7In your assessment of a normal adult, where would you expect to palpate the apical impulse?
a.Fifth right intercostal space at the midclavicular line
b.Fifth left intercostal space at the midclavicular line
c.Fourth left intercostal space at the sternal border
d.Third left intercostal space at the sternal border
Question 8The normal sound elicited when percussing the lungs is:
a.A high-pitched tinkling sound
Question 9When percussing the abdomen, tympany is present:
a.Over fluid or a mass
b.Over adipose tissue
c.When there is a gastric distension
d.Over a small amount of air/gas
Question 10A patient is complaining of tenderness along the costovertebral angle. This is most often indicative of:
Question 11 The arteries in the arm include the:
a.Brachial, ulnar and radial
b.Superficial, radial and ulnar
c.Superficial, ulnar and saphenous
d.Brachial, ulnar and posterial tibial
Question 12The deep veins run alongside the deep arteries and conduct most of the venous return from the leg. The deep veins include the:
a.Great saphenous and small saphenous
b.Thoracic duct and saphenous
c.Femoral and popliteal
d.Jugular veins and thoracic duct
Question 13Which of the following describes the superficial group of nodes that are accessible to inspection and palpation and give clues to the status of the lymphatic system?
a.Cervical, thoracic, axillary and inguinal
b.Cervical, axillary, epitrochlear and inguinal
c.Axillary, epitrochlear, saphenous and inguinal
d.Cervical, superficial, axillary and inguinal
Question 14The two atrioventricular valves that separate the atria and ventricles are called:
a.Tricuspid and mitral
b.Tricuspid and aortic
c.Aortic and mitral
d.Pulmonic and aortic
Question 15Systole is the part of the heart cycle in which:
a.The heart is in contraction
b.The extra heart sounds 53 and 54 may be heard
c.The pressure in the atria is higher than that in the ventricles
d.The heart is at rest
Question 16Right upper quadrant tenderness may indicate pathology in the:
a.Pancreas and descending colon
b.Stomach and spleen
c.Liver and gall bladder
d.Appendix and ileocecal valve
Question 17To check for liver tenderness/enlargement, the provider places his/her fingers or hand under the right rib cage and asks the patient to take a deep breath. A normal response is:
a.Pain in the right upper quad
b.To complete the deep breath with pain that radiates to the right shoulder
c.Pain that radiates to the left upper quad
d.To complete the deep breath without pain
Question 18The proper order of assessing the abdomen is:
a.Inspection, palpation, auscultation, percussion
b.Palpation, percussion, auscultation, inspection
c.Inspection, auscultation, percussion, palpation
d.Percussion, auscultation, inspection, palpation
Question 19The main reason auscultation precedes percussion and palpation of the abdomen is:
a.To prevent distortion of bowel sounds that might occur after percussion and palpation
b.To determine areas of tenderness before employing percussion and palpation
c.To prevent distortion of vascular sounds such as bruits and hums that might occur after percussion and palpation
d.To allow the patient more time to relax and become comfortable with the physical exam
Question 20The pulmonary artery delivers un-oxygenated blood to the lungs.
NU304 Health Assessment in Nursing
Week 7 Quiz
When the patient moves her right shoulder, a grating, cracking sound is heard in the joint. It can also be felt upon palpation. This is known as:
Question 2To assess range of motion in the neck, the patient is asked to perform:
a.Flexion, expansion, rotation and lateral movements
b.Flexation, extension, rotation and lateral movements
c.Flexion, extension, rotation and lateral movements
d.Flexion, extension, rotation and medial movements
Question 3 The patient is asked to point her toe downward towards the ground. The movement she is performing is described as:
Question 4When a patient is asked to move a body part such as a leg towards the midline of the body, they would be:
a.Circumducting the leg
b.Abducting the leg
c.Adducting the leg
d.Retroducting the leg
Question 5Which of the following cranial nerve is responsible for sense of smell?
a.Acoustic CN VIII
b.Olfactory CN I
c.Facial CN VIII
d.Hypoglossal CN XII
Question 6When assessing triceps reflex, what is the expected response?
a.Pronation of the hand
b.Flexion and supination of the forearm
c.Flexion of the hand
d.Extension at the elbow
Question 7Which cranial nerve is used to assess tongue movement?
Question 8During the neurological exam, you are assessing a patient standing with his feet together, arms by his side and eyes closed. He begins to sway and move his feet father apart. You would document this as:
a.Negative Homan’s sign
b.Positive Romberg’s sign
d.Lack of coordination
Question 9Which of the following cranial nerves would be used to assess the gag reflex, swallowing and the “ahh” reflex?
a.Glossopharyngeal CNIX and Vagus CNX
b.Vagus CNX and Hypoglossal CNXII
c.Spinal accessory CNXI and Vagus CNX
d.Hypoglossal CN XII and Spinal accessory CN XI
Question 10When a patient is asked to move a body part such as bending forward at the waist, they would be producing the movement flexion. Which of the following is responsible for that type of movement?
Question 11When assessing the range of motion of the wrist, the nurse asks the patient to move his/her forearms so the palms of the hands are facing up. This movement would create a position known as:
Question 12 Mrs. T. is 8 months pregnant and she is complaining of a change in posture and lower back pain. You tell her that during pregnancy, women have a posture shift to compensate for the enlarging fetus. This shift in posture is called:
Question 13Which of the following cranial nerves is not responsible for eye movement?
a.Trochlear (CN IV)
b.Abducens (CN VI)
c.Oculomotor (CN III)
d.Trigeminal (CN V)
Question 14You are testing the function of the cranial nerve XI. Which of the following best describes the response you would expect if the nerve is intact?
a.Sticks tongue out midline without tremors or deviation
b.Demonstrates full range of motion of the wrist
c.Follows an object with eyes without nystagmus
d.Should shrug against resistance
Question 15When assessing reflexes on a patient, you document them all to be 1+. This would be considered:
Question 16To assess your patient’s range of motion in her upper extremities, you ask her to raise her arms outward up over her head. The movement she is performing is called:
Question 17The patient is asked to point her toe upwards towards her nose. The movement she is performing is described as:
Question 18When assessing reflexes on a patient, you document them all to be 3+. This would be considered:
Question 19Joints are divided into two categories: nonsynovial and synovial. The following is an example of a nonsynovial joint:
Question 20Which of the following cranial nerves would be used to assess the tuning fork tests, Weber and Rinne, and the whisper test?
NU304 Health Assessment in Nursing
Week 8 Quiz
Question 1A 50-year old patient is seen in the clinic for annual physical examination and screening. The patient has no known health problems. This type of care is referred to as:
Question 2A 62 year-old man states that his doctor told him that he has an “inguinal hernia”. He asks the nurse to explain what a hernia is. The nurse should:
a.Refer him to his physician for additional consultation because the physician made the initial diagnosis.
b.Explain that a hernia is often the result of prenatal growth and abnormalities
c.Explain that a hernia is a loop of bowel coming through a weak spot in the abdominal muscles
d.Tell him not to worry and that most men his age develop hernias
Question 3A Nodule is:
a.Solid, elevated hard or soft mass, larger than 1 cm
b.Elevated cavity containing more than 1 cm of free fluid
c.A hypertrophic scar
d.A solid, elevated mass smaller than 1 cm
Question 4A normal pupillary light reflex indicates:
a.Light is reflected at the same spot in both eyes
b.The eyes converge to focus on the light
c.The eye focuses the image in the center of the pupil
d.Constriction of both pupils occurs in response to bright light
Question 5A nurse is assessing her patient with a diagnosis of dehydration. How would the nurse assess the patient’s skin turgor?
a.Pinch a fold of skin on the patient’s abdomen
b.Pinch a fold of skin on the patient’s cheek
c.Pinch a fold of skin on the patient’s upper thigh
d.Pinch a fold of skin on the patient’s forearm or dorsal surface of hand
Question 6A patient is anxious, dyspneic, pale and using accessory muscles to breathe. The nurse should initially perform which type of assessment?
Question 7A patient is unable to shrug her shoulders against the nurse’s resistant hands. What cranial nerve is involved with successful shoulder shrugging?
Question 8A patient presents with complaint of a popping sensation in front of his ears when he ‘s opening and closing his mouth. To further examine this, the nurse would:
a.Place the stethoscope over the temporomandibular joint and listen for bruits.
b.Place the hands over his ears and ask him to open his mouth “really wide”.
c.Place one hand on his forehead and the other on his jaw and ask him to try to open his mouth.
d.Place first and second fingers just anterior to the tragus of the patient’s ear and ask him to open and close his mouth.
Question 9A patient’s annual physical examination reveals a lateral curvature of the thoracic and lumbar segments of his spine standing and when forward bending. This curvature indicates:
d.Herniated nucleus pulposus
Question 10A thorough skin assessment is very important because the skin holds information about:
Question 11Adventitious breath sounds are heard when auscultating a patient’s lungs. Which of the following would be an important part of the subjective assessment of this patient?
a.Send the patient for a chest x-ray because this is indicative of a potentially serious condition
b.Question the patient about his/her lifestyle regarding smoking habits
c.No more information is needed because adventitious breath sounds in the lower lobes are normal
d.Assess the thoracic area both anterior and posterior again and have the patient cough prior to auscultation
Question 12After teaching a group of students about age-related changes in the lungs, the instructor determines that the teaching was successful when the students identify which of the following:
a.Increased functional capillaries
c.Loss of subcutaneous fat
d.Loss of elasticity
An elderly man has come in for a physical examination, he tells you that he has been ill with a productive cough for the past week. This information would be written under the section that covers:
a.Mood and affect
d.History of present illness
Question 14 An important technique used when auscultating the thorax is moving the stethoscope back and forth from one side to the other. This is done for:
a.Side to side comparison
b.Interspace by interspace comparison
c.Posterior to anterior comparison
d.Top to bottom comparison
Question 15Cyanosis or pallor occurs with:
a.Low cardiac output states as a result of decreased tissue perfusion
b. Increased heart rate in the person who is ambulatory during the day
c.Elevation of the legs
d.Increased fatigue from standing all day
Question 16During an assessment of a healthy adult, where would the nurse expect to palpate the point of maximal impulse (PMI)?
a.Fourth left intercostal space at the anterior axillary line
b.Fourth left intercostal space at the sternal border
c.Fifth left intercostal space at the midclavicular line
d.Third left intercostal space at the midclavicular line
Question 17During an examination, the nurse notices that a patient is unable to stick out his tongue. Which cranial nerve is involved with successful performance of this action?
Question 18During the abdominal assessment, your patient is complains of tenderness along the costovertebral angle. This is most often indicative of:
Question 19During the examination of a patient, the nurse notes that the patient has several small, <1cm raised, solid lesions on her posterior thorax. What is another name for this type of lesion?
Question 20For the abdominal assessment, what are the last two assessment techniques?
a.Palpation – light and deep and percussion
b.Percussion and assessing for CVA tenderness
c.Auscultation and palpation – light and deep
d.Percussion and palpation – light and deep
Question 21For the abdominal assessment, what is the second assessment technique?
b.Palpation, light and deep
Question 22For the abdominal assessment, what is the third assessment technique?
b.Palpation – deep first and then light
c.Palpation – light first and then deep
Question 23For the abdominal
assessment, what is the first step to the assessment?
Question 24In assessing the carotid arteries of an older patient with cardiovascular disease, the nurse would:
a.Instruct patient to take slow, deep breaths during auscultation
b.Auscultate with the bell of the stethoscope to assess for bruits
c.Inspect while you instruct the patient to swallow a sip of water
d.Palpate both arteries simultaneously to compare amplitude
Question 25In assessing the tonsils of a 24-year old patient, the nurse notes that the tonsils are erythematous with exudates bilaterally, and they are touching each other. How would you grade the tonsils?
Question 26In performing a breast examination, the nurse knows that it is especially important for the healthcare provider to examine the upper, outer quadrant of the breast (Tail of Spence). The reason for this is that the upper, outer quadrant is:
a.More prone to injury and calcifications than other locations in the breast
b.The largest quadrant of the breast
c.The location of most breast tumors
d.Where most of the suspensory ligaments attach
Question 27In performing an examination of a 2-year old with a suspected ear infection, the nurse would:
a.Pull the pinna down and back before inserting the speculum
b.Omit the otoscopic exam if the child has a fever
c.Ask the mother to leave the room while examining the child
d.Pull the ear up and back before inserting the speculum
Question 28In performing auscultation of heart sounds, which sequence would the nurse use?
a.Aortic area – pulmonic area – Erb’s point – tricuspid area – mitral area
b.Aortic area – tricuspid area – Erb’s point – mitral area – pulmonic area
c.Pulmonic area – aortic area – Erb’s point – tricuspid area – mitral area
d.Pulmonic area – Erb’s point – tricuspid area – pulmonic area – mitral area
Question 29Select the best description of “review of systems” as part of the health history.
a.The recording of the objective findings of the practitioner
b.A documentation of the problem as described by the patient
c.A statement that describes the overall health state of the patient
d.The evaluation of the past and present health state of each body system
Question 30The confrontation test is a gross measure of:
a.Eye strength and muscle movement
Question 31The main reason auscultation precedes percussion and palpation of the abdomen it to:
a.Determine areas of tenderness before using percussion and palpation
b.Prevent distortion of vascular sounds such as bruits and hums that might occur after percussion and palpation
c.Allow the patient more time to relax and therefore be more comfortable with the physical examination
d.Prevent distortion of bowel sounds that might occur after percussion and palpation
Question 32The nurse assesses a patient presenting with nausea, vomiting and diarrhea. What initial assessment is most appropriate for this patient?
a.Palpate abdomen, percuss abdomen, auscultate heart
b.Blood draw, auscultate lungs and auscultate heart
c.Auscultate abdomen, palpate abdomen and check cranial nerves
d.Vital signs and assessing for dehydration
Question 33The nurse is assessing a patient with left ear conductive hearing loss. During the assessment the nurse performs the Weber test. The nurse knows that:
a.Sound will be louder in the affected ear
b.Sound will be diminished in both ears
c.Sound will be louder in the good ear
d.Sound will lateralize equally in both ears
Question 34The nurse is caring for a patient with a nursing diagnosis of impaired skin integrity related to a stage III decubitus ulcer. What would be the most important assessment tool for the nurse to use in caring for this patient?
a.The Braden Scale
b.The Visual analog Scale
c.Brief Pain Inventory
d.McGill Pain Questionnaire
Question 35The nurse is caring for an 88 year-old man hospitalized with a fractured hip. Assessment findings indicate that the patient is malnourished. In conducting a comprehensive dietary assessment during the history, what would be the method of choice for determining this patient’s dietary intake?
Question 36The nurse is palpating the lymph nodes of a 25-year old man and notes an enlarged node on the back of his neck near the hairline. The nurse recognizes this lymph node as the:
Question 37The nurse knows that bronchovesicular breath sounds are:
a.Expected near the major airways
b.Similar to bronchial sounds except that they are shorter in duration
d.Musical in quality
Question 38The sinuses that are not accessible to palpation include:
a.Occipital and mental
b.Frontal and maxillary
c.Ethmoid and sphenoid
d.Parotid and jugulodigastric
Question 39When assessing for CVA tenderness, you would tap on:
a.Area of the back overlying the kidneys
b. Scapula area of posterior thorax
c.Left lower quadrant
d.Right upper quadrant
Question 40When assessing the lower extremities, it is critical for the examiner to:
a.Evaluate the venous system and then the arterial system
b.Start at the femoral area
c.Start at the head and work his/her way down
d.Compare side to side
Question 41When assessing the range of motion of the wrist, the nurse asks the patient to move their forearms so that the hands are facing up. This movement would create a position known as:
Question 42When listening to heart sounds, the nurse knows that which of the following statements concerning S1 is true?
a.S1 is caused by closure of the pyloric valve
b.S1 is louder than S2 at the base
c.S1 results from the closure of mitral and tricuspid valves
d.S1 indicates the beginning of diastole
Question 43When one is testing the triceps reflex, what is the expected response?
a.Extension of the forearm
b.Pronation of the hand
c.Flexion and rotation of the forearm
d.Flexion of the hand and wrist
Question 44When 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?
Question 45When performing the corneal light reflex assessment, the nurse notes that the light is reflected in the same spot in each eye. The nurse would:
a.Document this as an asymmetric light reflex
b.Refer the individual for further evaluation
c.Consider this a normal finding
d.Perform the confrontation test to validate the findings
Question 46When the nurse asks a 68-year old patient to stand with feet together and arms at his side with his eyes
closed, he starts to sway and moves his feet further apart. The nurse would document this finding as:
a.Positive Romberg’s sign
b.Negative Homan’s sign
c.Lack of coordination
d.Positive Pronator drift
Question 47Which of the following are appropriate locations for eliciting reflexes?
a.Femoral and Popliteal
b.Abdominal and Thoracic area
c.Scapular and Femoral
d.Patellar and Achilles
Question 48Which of the following cranial nerves are used to assess swallowing, voice, gag reflex and tongue movement?
a.CN IX, X XI
b.CN VII, X, IX
c.CN IX, X, XII
d.CN VII, X, XI
Question 49Which of the following statements would be considered subjective data?
b.Rash after a bee sting
c.Denies edema or difficulty breathing after bee sting
d.Suggest allergy work-up for bee sting allergy
Question 50You are describing how to perform a testicular self examination to a patient. Which of the following statements is most appropriate?
a.A good time to examine your testicles is just before you take a shower
b.If you notice enlarged testicles or a painless mass, call your healthcare provider
c.The testicle is egg shaped and movable. It feels firm and has a lumpy consistency
d.Perform testicular exam at least once a week to detect early stages of testicular cancer
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