Advanced Health Assessment
Textbook Exam Questions
Course Introduction
Advanced Health Assessment is a graduate-level course designed to equip healthcare professionals with the knowledge and skills required for comprehensive and systematic patient evaluations. The course emphasizes advanced techniques in history-taking, physical examination, and diagnostic reasoning across the lifespan, integrating evidence-based assessment tools and emerging health technologies. Students will develop proficiency in collecting, analyzing, and synthesizing health data to inform clinical decisions, recognize normal and abnormal findings, and formulate differential diagnoses. The course prepares students to assume leadership roles in advanced practice nursing and other health professions, fostering critical thinking and cultural competence in diverse clinical settings.
Recommended Textbook
Seidels Guide to Physical Examination 9th Edition by Jane
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Page 2
W. Ball
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) After you ask a patient about her family history, she says, "Tell me about your family now." Which response is generally most appropriate?
A) Ignore the patient's comment and continue with the interview.
B) Give a brief, undetailed answer.
C) Ask the patient why she needs to know.
D) Tell the patient that you do not discuss your family with patients.
Answer: B
Q3) Periods of silence during the interview can serve important purposes, such as:
A) allowing the clinician to catch up on documentation.
B) promoting calm.
C) providing time for reflection.
D) increasing the length of the visit.
Answer: C
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Chapter 2: Cultural Competency
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Sample Questions
Q1) Which statement is true regarding the relationship of physical characteristics and culture?
A) Physical characteristics should be used to identify members of cultural groups.
B) There is a difference between distinguishing cultural characteristics and distinguishing physical characteristics.
C) To be a member of a specific culture, an individual must have certain identifiable physical characteristics.
D) Gender and race are the two essential physical characteristics used to identify cultural groups.
Answer: B
Q2) Which variables can intrude on successful communication? (Select all that apply.)
A) Social class
B) Gender
C) Stereotype
D) Phenotype
E) Age
Answer: A, B, E
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Chapter 3: Examination Techniques and Equipment
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Sample Questions
Q1) The infant should be placed in which position to have his or her height or length measured?
A) Vertically, with the examiner's hands under the infant's axillae
B) Supine on a measuring board
C) Prone on a measuring board
D) In the lateral position, with the toes against a measuring board
Answer: B
Q2) 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
Q3) To perform a deep tendon reflex measurement, you should:
A) briskly tap the tendon with the rubber end of the hammer.
B) place the hammer firmly on the tendon for 3 to 5 seconds.
C) tap the silver end of the hammer on the tendon.
D) use the needle implement to determine sensory perception.
Answer: A
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Chapter 4: Clinical Reasoning
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Sample Questions
Q1) A valid history and physical examination can serve to:
A) create higher healthcare costs.
B) limit the indiscriminate use of diagnostics.
C) threaten patient satisfaction.
D) increase the risk of liability.
Q2) Mr. Johnson actually has streptococcal pharyngitis; however, the throat culture is initially read as negative. This situation describes a test with a:
A) low sensitivity.
B) high sensitivity.
C) high specificity.
D) low specificity.
Q3) Which is an accepted method of making a diagnosis?
A) Relying on intuition
B) Making maximal use of laboratory tests
C) Using first assumptions
D) Using algorithms
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6
Chapter 5: Documentation
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Sample Questions
Q1) A SOAP note is used in which type of recording system?
A) Preventive care
B) Problem oriented
C) Systems review
D) Traditional treatment
Q2) Which format would be used for visits that address problems not yet identified in the problem-oriented medical record (POMR)?
A) Brief SOAP note
B) Comprehensive health history
C) Progress note
D) Referral note
Q3) Drawing of stick figures is most useful to:
A) compare findings in extremities.
B) demonstrate radiation of pain.
C) indicate consistency of lymph nodes.
D) indicate mobility of masses.
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Chapter 6: Vital Signs and Pain Assessment
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Sample Questions
Q1) The fifth vital sign is:
A) pain.
B) orientation.
C) waist-to-hip ratio.
D) body mass index (BMI).
Q2) During expiration, the internal intercostals:
A) increase the force of muscular contraction.
B) decrease the lateral diameter during expiration.
C) decrease the intrathoracic space.
D) increase elastic recoil during expiration.
Q3) The perception of pain:
A) is the same across cultures.
B) can be easily assessed in neonates.
C) is predictable with the same circumstances.
D) is affected by emotions and quality of sleep.
Q4) 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.
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Chapter 7: Mental Status
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Sample Questions
Q1) When you ask the patient to tell you the meaning of a proverb or metaphor, you are assessing which of the following?
A) Level of consciousness
B) Abstract reasoning
C) Emotional stability
D) Memory
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) Appropriateness of logic, sequence, cohesion, and relevance to topics are markers for the assessment of:
A) mood and feelings.
B) attention span.
C) thought process and content.
D) abstract reasoning.
Q4) The examiner should be concerned about neurologic competence if a social smile cannot be elicited by the time a child is _________ old.
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Chapter 8: Growth, Measurement, and Nutrition
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Sample Questions
Q1) Optimal infant birth weight is difficult for pregnant adolescents to obtain because:
A) they have not completed their own growth spurt.
B) there are insufficient uterine supporting structures.
C) the amniotic fluid is variable in pregnant adolescents.
D) blood volume has not reached adult proportions.
Q2) Which of the following is the most accurate reflection of an individual's food intake?
A) 24-hour diet recall
B) Food diary
C) Computerized nutrient analysis
D) Serum protein assay
Q3) The upper-to-lower segment ratio should be calculated:
A) bimonthly for the first year of life.
B) annually for the first 5 years.
C) only when a child is suspected of having a growth problem or unusual body proportions.
D) in children of first-generation immigrants.
Q4) Infants normally increase their birth length by ____% during the first year of life.
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Chapter 9: Skin, Hair, and Nails
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Sample Questions
Q1) The most common cutaneous neoplasm is:
A) basal cell carcinoma.
B) compound nevus.
C) seborrheic keratosis.
D) senile actinic keratosis.
Q2) Fluorescing lesions are best distinguished using a(n):
A) incandescent lamp.
B) magnifying glass.
C) transilluminator.
D) Wood's lamp.
Q3) A flat, nonpalpable lesion is described as a macule if the diameter is:
A) larger than 1 cm.
B) smaller than 1 cm.
C) 3 cm exactly.
D) too irregular to measure.
Q4) The skin repairs surface wounds by:
A) exaggerating cell replacement.
B) excreting lactic acid.
C) producing vitamins.
D) providing a mechanical barrier.
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Chapter 10: Lymphatic System
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Sample Questions
Q1) When examining lymph nodes near a joint in the arm or leg, which of the following maneuvers is likely to facilitate the examination?
A) Extension of the extremity
B) Circumduction of the extremity
C) Flexion of the extremity
D) Rotation of the extremity
Q2) An organ that is essential to the development of protective immune function in the infant but has little or no demonstrated function in the adult is the:
A) spleen.
B) liver.
C) thymus.
D) pancreas.
Q3) A red streak that follows the course of the lymphatic collecting duct is a finding associated with:
A) Hodgkin disease.
B) lymphangitis.
C) lymphedema.
D) lymphoma.
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Chapter 11: Head and Neck
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Sample Questions
Q1) Mr. Donaldson is a 64-year-old patient with complaints of headaches. As the examiner, you are palpating his head during your physical examination. Which of the following would be your first step?
A) Palpate the patient's hair, noting texture, color, and distribution.
B) Palpate the temporomandibular joint.
C) Palpate the skull from front to back.
D) Palpate the temporal artery.
Q2) You are palpating a patient's thyroid and find that its broadest dimension measures 4 cm. The right lobe is 25% larger than the left. These data would indicate:
A) a congenital anomaly.
B) a multinodular goiter.
C) a normal thyroid gland.
D) thyroiditis.
Q3) During a head and neck assessment of a neonate, it is important to screen for:
A) the presence of torticollis.
B) signs and symptoms of cerebral palsy.
C) uneven movement of the eyes.
D) unilateral movement of the tongue.
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Chapter 12: Eyes
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Sample Questions
Q1) To differentiate between infants who have strabismus and those who have pseudostrabismus, use the:
A) confrontation test.
B) corneal light reflex.
C) E chart.
D) Amsler grid.
Q2) Cotton wool spots are most closely associated with:
A) glaucoma.
B) normal aging processes.
C) hypertension.
D) eye trauma.
Q3) Changes seen in proliferative diabetic retinopathy are the result of:
A) anoxic stimulation.
B) macular damage.
C) papilledema.
D) minute hemorrhages.
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Chapter 13: Ears, Nose, and Throat
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Sample Questions
Q1) Bulging of an amber tympanic membrane without mobility is usually associated with:
A) middle ear effusion.
B) healed tympanic membrane perforation.
C) impacted cerumen in the canal.
D) repeated and prolonged crying cycles.
Q2) When conducting an adult otoscopic examination, you should:
A) position the patient's head leaning toward you.
B) grasp the handle of the otoscope as you would a baseball bat.
C) select the largest speculum that will fit in the canal.
D) ask the patient to keep his or her eyes closed.
Q3) Mrs. Donaldson is a 31-year-old patient who is pregnant. In providing Mrs. Donaldson with healthcare information, you will explain that she can expect to experience:
A) more nasal stuffiness.
B) a sensitive sense of smell.
C) drooling.
D) enhanced hearing.
Q4) 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) When auscultating the apex of the lung, you should listen at a point:
A) even with the second rib.
B) 4 cm above the first rib.
C) higher on the right side.
D) on the convex diaphragm surface.
Q2) Which site of chest wall retractions indicates a more severe obstruction in the asthmatic patient?
A) Lower chest
B) Along the anterior axillary line
C) Above the clavicles
D) At the nipple line
Q3) As you take vital signs on Mr. Barrow, age 78 years, you note that his respirations are 40 breaths/min. He has been resting, and his mucosa is pink. In regard to Mr. Barrow's respirations, you would:
A) document his rate as normal.
B) do nothing because his color is pink.
C) note that his rate is below normal.
D) report that he has an above-average rate.
Q4) An Apgar score of __________ is given to the infant who demonstrates irregular respiratory effort.
Page 16
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Chapter 15: Heart
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Sample Questions
Q1) 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.
Q2) If the apical impulse is more vigorous than expected, it is called a:
A) lift.
B) thrill.
C) bruit.
D) murmur.
Q3) An apical PMI palpated beyond the fifth intercostal space may indicate:
A) decreased cardiac output.
B) obesity.
C) left ventricular hypertrophy.
D) hyperventilation.
Q4) The most helpful finding in determining left-sided heart failure is: A) dyspnea.
B) orthopnea.
C) jugular vein distention.
D) an S<sub>3</sub> heart sound.
Page 17
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Chapter 16: Blood Vessels
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Sample Questions
Q1) You are examining Mr. S, a 79-year-old diabetic man complaining of claudication. Which of the following physical findings is consistent with the diagnosis of peripheral arterial disease?
A) Thick, calloused skin
B) Ruddy, thin skin
C) Warmer temperature of extremity in contrast to other body parts
D) Loss of hair over the extremities
Q2) A characteristic distinguishing primary Raynaud phenomenon from secondary Raynaud phenomenon includes which of the following?
A) Vasospasm
B) Digital ischemia with pain
C) Triphasic demarcated skin
D) Cold and achy improving with warming
Q3) Induration, edema, and hyperpigmentation are common associated findings with which of the following?
A) Peripheral arterial disease
B) Venous ulcer
C) Arterial embolic disease
D) Venous thrombus
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Chapter 17: Breasts and Axillae
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Sample Questions
Q1) A 50-year-old woman presents as a new patient. Which finding in her personal and social history would increase her risk profile for developing breast cancer?
A) Drinking three glasses of wine per week
B) Early menopause
C) Nulliparity
D) Late menarche
Q2) A firm, transverse ridge of compressed tissue is felt bilaterally along the lower edge of a 40-year-old patient's breast. You should:
A) ask the patient if she has a history of breast cancer.
B) refer the patient to a surgeon.
C) ask the patient to have a mammogram as soon as possible.
D) record the finding in the patient's record.
Q3) When examining axillary lymph nodes, the patient's arm is:
A) raised fully above the head.
B) extended at the side.
C) flexed at the elbow.
D) crossed over the chest.
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19
Chapter 18: Abdomen
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Sample Questions
Q1) To assess for liver enlargement in the obese person, you should:
A) use the hook method.
B) have the patient lean over at the waist.
C) auscultate using the scratch technique.
D) attempt palpation during deep exhalation.
Q2) Flatulence, diarrhea, dysuria, and tenderness with abdominal palpation are findings usually associated with:
A) diverticulitis.
B) pancreatitis.
C) ruptured ovarian cyst.
D) splenic rupture.
Q3) When assessing abdominal pain in a college-age woman, one must include:
A) history of interstate travel.
B) food likes and dislikes.
C) age at completion of toilet training.
D) the first day of the last menstrual period.
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Chapter 19: Female Genitalia
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Sample Questions
Q1) Itchy, painful, small red vesicles are typical of:
A) condyloma acuminatum.
B) condyloma latum.
C) herpes simplex lesions.
D) syphilitic chancre.
Q2) The pelvic joint that separates most appreciably during late pregnancy is the:
A) sacroiliac.
B) symphysis.
C) sacrococcygeal.
D) iliofemoral.
Q3) 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.
Q4) The risk of ovarian cancer is increased by:
A) the use of oral contraceptives.
B) cigarette smoking.
C) age between 35 and 50 years.
D) early age at first intercourse.
21
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Chapter 20: Male Genitalia
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Sample Questions
Q1) An enlarged painless testicle in an adolescent or adult male may indicate:
A) epididymitis.
B) testicular torsion.
C) a tumor.
D) an undescended testicle.
Q2) Difficulty replacing the retracted foreskin of the penis to its normal position is called:
A) paraphimosis.
B) Peyronie disease.
C) phimosis.
D) priapism.
Q3) Which condition is a complication of mumps in the adolescent or adult?
A) Cystitis
B) Epididymitis
C) Orchitis
D) Paraphimosis
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Chapter 21: Anus, Rectum, and Prostate
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Sample Questions
Q1) Nodules found in the peritoneum through the anterior rectal wall:
A) are found with bidigital palpation.
B) are called shelf lesions.
C) are chronic fibrosis.
D) are found by having the patient bear down.
Q2) Thrombosed hemorrhoids are:
A) flabby skin sacs.
B) red, inflamed, and painful.
C) fluctuant soft papules.
D) blue, shiny, painful masses.
Q3) Which finding in an infant may indicate lower spinal deformities?
A) Perirectal redness
B) Shrunken buttocks
C) Rectal prolapse
D) Dimpling in the pilonidal area
Q4) The caliber of the urinary stream is routine information in the history of:
A) adolescents.
B) infants.
C) older adults.
D) sexually active young men.
23
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Chapter 22: Musculoskeletal System
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Sample Questions
Q1) A finding that is indicative of osteoarthritis is (are):
A) swan neck deformities.
B) Bouchard nodes.
C) ganglions.
D) Heberden nodes.
Q2) A wheelchair-dependent older woman would most likely develop skin breakdown at: A) C7.
B) the iliac crests.
C) L4.
D) the gibbus.
Q3) The articulation of the radius and carpal bones is the: A) wrist.
B) elbow.
C) shoulder.
D) clavicle.
Q4) Risk factors for sports-related injuries include: A) competing in colder climates.
B) previous fracture.
C) history of recent weight loss.
D) failure to warm up before activity.
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Chapter 23: Neurologic System
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Sample Questions
Q1) Persons with Parkinson disease have an altered gait characterized by:
A) short shuffling steps.
B) the trunk in a backward position.
C) exaggerated swinging of the arms.
D) lifting the legs in a high-stepping fashion.
Q2) Which is a concern, rather than an expected finding, in older adults?
A) Reduced ability to differentiate colors
B) Bilateral pillrolling of the fingers
C) Absent plantar reflex
D) Reduction in upward gaze
Q3) When you ask a patient to close his or her eyes and identify an object placed in the hand, you are evaluating:
A) stereognosis.
B) graphesthesia.
C) vibratory sensation.
D) extinction phenomenon.
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Chapter 24: Sports Participation Evaluation
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Sample Questions
Q1) Which medical condition would exclude a person from sports participation?
A) Asthma
B) Fever
C) Controlled seizures
D) HIV-positive status
Q2) One of the most important aspects to consider in the orthopedic screening examination is:
A) muscle contraction.
B) flexibility.
C) symmetry.
D) balance.
Q3) Your 15-year-old patient is athletic and thin. Radiography of an ankle injury reveals a stress fracture. You should question this patient about her:
A) sleep patterns.
B) salt intake.
C) aerobic workouts.
D) menstrual cycles.
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26
Chapter 25: Putting it All Together
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Q1) Observation of the child playing in the playroom provides information about which two systems?
A) Dermatologic and cardiovascular
B) Neurologic and musculoskeletal
C) Respiratory and ear, nose, and throat
D) Gastrointestinal and genitourinary
Q2) Mrs. Kia has brought her newborn infant in for a 2-week examination. The examination of the newborn should begin with:
A) inspection.
B) palpation.
C) vital signs.
D) auscultation.
Q3) Which cannot be assessed in the crying infant?
A) Tactile fremitus
B) Respiratory rate
C) Lung excursion
D) Facial symmetry
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Chapter 26: Emergency or Life-Threatening Situations
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Sample Questions
Q1) On palpating the chest wall of a trauma patient, you feel subcutaneous crepitus (emphysema), which is a sign that:
A) air has leaked into soft tissue.
B) a fracture underlies the injury.
C) a foreign body is present.
D) there is vascular obstruction.
Q2) Respiratory distress may be evidenced by:
A) retractions of accessory muscles.
B) bradycardia.
C) flushed skin.
D) decreased capillary refill time.
Q3) In life-threatening emergencies, consent for treatment:
A) is obtained before treatment to protect the facility from liability.
B) is not necessary.
C) occurs after treatment is administered.
D) is not valid because the patient is not competent.
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