Assessment and Diagnostic Reasoning in Nursing Review Questions
Course Introduction
Assessment and Diagnostic Reasoning in Nursing focuses on cultivating students' abilities to systematically collect, analyze, and interpret patient data in order to make accurate clinical judgments. The course provides comprehensive instruction on the use of health assessment techniques including physical examination, patient interviews, and the analysis of laboratory and diagnostic results. Emphasis is placed on the integration of critical thinking and evidence-based practice to support differential diagnosis and prioritize patient care. Through case studies and simulation, students learn to apply diagnostic reasoning in diverse clinical scenarios, preparing them to efficiently recognize and respond to complex health needs across the lifespan.
Recommended Textbook Health Assessment for Nursing Practice 6th Edition by Wilson
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24 Chapters
634 Verified Questions
634 Flashcards
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Chapter 1: Introduction to Health Assessment
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14 Verified Questions
14 Flashcards
Source URL: https://quizplus.com/quiz/2458
Sample Questions
Q1) Which is an example of data a nurse collects during a physical examination?
A) The patient's lack of hair and shiny skin over both shins
B) The patient's stated concern about lack of money for prescriptions
C) The patient's complaints of tingling sensations in the feet
D) The patient's mother's statements that the patient is very nervous lately
Answer: A
Q2) For which person is an episodic or follow-up assessment indicated?
A) The person who had abdominal surgery yesterday
B) The person who is unaware of his high serum glucose levels
C) The person who is being admitted to a long-term care facility
D) The person who is beginning rehabilitation after a knee replacement
Answer: D
Q3) A patient comes to the emergency department and tells the triage nurse that he is "having a heart attack." What is the nurse's top priority at this time?
A) Determine the patient's personal data and insurance coverage.
B) Ask the patient to take a seat in the waiting room until his name is called.
C) Request that a nurse collect data for a comprehensive history.
D) Ask a nurse to start a focused assessment of this patient now.
Answer: D
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Page 3
Chapter 2: Obtaining a Health History
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32 Verified Questions
32 Flashcards
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Sample Questions
Q1) What does the nurse say to obtain more data about a patient's vague statement about diet such as, "My diet's okay"?
A) "Eating a variety of meats, fruits, and vegetables each day is important."
B) "Give me an example of the foods you eat in a typical day."
C) "Go on."
D) "Does your diet meet your needs or does it need improvement?"
Answer: B
Q2) Which statement by the nurse demonstrates a patient-centered interview?
A) "I need to complete this questionnaire about your medical and family history."
B) "The hospital requires me to complete this assessment as soon as possible."
C) "Tell me about the symptoms you've been having."
D) "I've had the same symptoms that you've described."
Answer: C
Q3) An example of a health promotion question included in the health history is:
A) "Do you have any allergies?"
B) "How often are you exercising?"
C) "What are you doing to relieve your leg pain?"
D) "What kind of herbs are you using?"
Answer: B
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Page 4
Chapter 3: Techniques and Equipment for Physical Assessment
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31 Verified Questions
31 Flashcards
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Sample Questions
Q1) How does the nurse detect an extra heart sound in an adult?
A) Using the bell of a stethoscope
B) With a pulse oximeter
C) Using the diaphragm of a stethoscope
D) With a Doppler ultrasound probe
Answer: A
Q2) A nurse is preparing to take a patient's blood pressure. The blood pressure cuff is 5 inches wide and the patient's upper arm circumference is 20 inches. How accurate will this patient's blood pressure be using this blood pressure cuff?
A) Accurate, the actual value
B) Higher than the actual value
C) Lower than the actual value
D) Unable to determine accuracy with available data
Answer: B
Q3) How does the nurse detect a pulse when using a Doppler?
A) The pulsation is felt.
B) The pulsation is heard.
C) The pulse wave is seen on a screen.
D) The pulse wave is printed out on special paper.
Answer: B
Page 5
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Chapter 4: General Inspection and Measurement of Vital Signs
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18 Verified Questions
18 Flashcards
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Sample Questions
Q1) Which action by the nurse results in the patient's blood pressure measurement being falsely high? (Select all that apply.)
A) Using a blood pressure cuff that is too narrow for the patient's upper arm
B) Deflating the blood pressure cuff too rapidly
C) Wrapping the blood pressure cuff too loosely
D) Reinflating the blood pressure cuff before it completely deflates
E) Positioning the patients arm above the level of the heart
Q2) Which of these respiratory rates are within normal limits?
A) 16-month-old; 42
B) 6-year-old; 20
C) 14-year-old; 26
D) 40-year-old; 10
Q3) A female patient admitted with fluid retention has been in diuretic therapy to remove fluid. She weighed 187 lb on admission. Today she weighs 179 lb. Since admission, this patient has lost _____ L from fluid loss.
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Chapter 5: Cultural Assessment
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Sample Questions
Q1) Which question is most effective in assessing a patient's personal beliefs about health and illness?
A) "What or who do you believe controls your health?"
B) "Do you see your health care provider annually?"
C) "Do you have specific beliefs about health and illness?"
D) "Who makes the health decisions in your family?"
Q2) Which question is the most appropriate to learn about a patient's religious practices?
A) "How often do you go to church?"
B) "Where is your church located?"
C) "Do you mind telling me about your religion?"
D) "Do you have any specific religious or spiritual practices or beliefs?"
Q3) A Hispanic patient tells an African-American nurse, "You are African-American and can't possibly understand how a person like me feels." What is an appropriate response by the nurse at this time?
A) Find a nurse who is not African-American to interview the patient.
B) Ask the patient, "Why do you think that, since we just met?"
C) Note that the patient is very defensive about being racially different.
D) Encourage the patient to describe what he means by his statement.
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Page 7
Chapter 6: Pain Assessment
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) A patient who had an amputation of his lower leg comes to the clinic with a complaint of pain. He asks, "How I can be feeling pain in my foot-my foot is gone?" What is the appropriate response from the nurse?
A) "After your amputation, pain perception increases."
B) "Amputating your leg caused abnormal processing of sensory input by the peripheral nervous system."
C) "Stimulation of nerves from your leg sends impulses to the brain so that you feel pain even though your leg is no longer there."
D) "When sensory nerves enter the spinal cord, they stimulate nerves from unaffected organs in the same spinal cord segment as those neurons in areas where injury or disease is located."
Q2) A patient with gout is complaining of severe, throbbing pain in the great toe. What type of pain is this patient experiencing?
A) Neuropathic pain
B) Somatic pain
C) Referred pain
D) Visceral pain
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Chapter 7: Mental Health Assessment
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17 Verified Questions
17 Flashcards
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Sample Questions
Q1) A patient in the waiting room appears anxious and moves around the room cleaning surfaces with a disinfectant cloth. This behavior is consistent with which disorder?
A) Bipolar disorder
B) Delirium
C) Schizophrenia
D) Obsessive-compulsive disorder
Q2) During conversation, the nurse observes that the patient is talking continuously and excitedly, and is switching rapidly from one topic to another with seemingly no relationship between topics. This behavior is often associated with which disorder?
A) Depression
B) Obsessive-compulsive disorder
C) Schizophrenia
D) Bipolar disorder
Q3) What function do neurotransmitters have in mental health disorders?
A) Dopamine levels are increased in schizophrenia.
B) Increased levels of gamma aminobutyric acid (GABA) contribute to anxiety.
C) Serotonin is decreased in a state of anxiety.
D) Norepinephrine is increased in depression.
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Chapter 8: Nutritional Assessment
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22 Verified Questions
22 Flashcards
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Sample Questions
Q1) A patient is put on an 1800-calorie a day diet plan. During discharge teaching, the nurse explains to this patient how to use nutrition labels to determine the amount of carbohydrates in the product. The nurse explains, however, that the label is based on 2000 calories. Which is the appropriate formula to teach this patient of the maximum grams of carbohydrates she can eat on her prescribed diet?
A) 1800 calories × 0.45 = 810/4 calories/gram = 202.5 g
B) 1800 calories × 0.60 = 1080/4 calories/gram = 270 g
C) 1800 calories × 0.55 = 990/9 calories/gram = 110 g
D) 1800 calories × 0.50 = 900/9 calories/gram = 100 g
Q2) A woman's waist circumference is 32 inches and her hip circumference is 29 inches. Her waist-to-hip ratio is _____.
Q3) A man who is 6 feet 9 inches tall is told by his provider to lose weight so that he is closer to his desired body weight. He asks the nurse, How can I find out what my desired body weight should be? The nurse responds, Let me show you how to calculate it. Your desired body weight (DBW) should be ______ lb.
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Chapter 9: Skin, Hair, and Nails
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) A nurse notices multiple lesions on a patient's left hand that are 0.5 cm in width, elevated, circumscribed, and filled with serous fluid. What kind of primary lesions are these?
A) Macules
B) Patches
C) Vesicles
D) Bullae
Q2) When performing a skin assessment of an adult patient, the nurse expects what finding?
A) Reddened area does not blanch when gentle pressure is applied.
B) Indentation of the finger remains in the skin after palpation.
C) Flaking or scaling of the skin
D) Return of skin to its original position when pinched up slightly
Q3) When the patient's chart includes a notation that petechiae are present, what finding does a nurse expect during inspection?
A) Purplish-red pinpoint lesions
B) Deep purplish or red patches of skin
C) Small raised fluid-filled pinkish nodules
D) Generalized reddish discoloration of an area of skin
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Page 11
Chapter 10: Head, Eyes, Ears, Nose, and Throat
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75 Verified Questions
75 Flashcards
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Sample Questions
Q1) Nurses inquire about lifestyle behaviors in those patients with specific risk factors for cataracts. Which characteristics are associated with risk factors for cataracts? (Select all that apply.)
A) Smoking more than 20 cigarettes a day
B) Having parents with cataracts
C) Chronic consumption of alcohol
D) Having a chronic disease, such as diabetes mellitus
E) Being Asian
F) Being a man
Q2) A patient reports a history of snorting cocaine and is concerned about his bloody nasal drainage. What does the nurse expect to see on inspection of his nose?
A) Deviated septum
B) Pale turbinates
C) Perforated nasal septum
D) Localized erythema and edema
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Chapter 11: Lungs and Respiratory System
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32 Verified Questions
32 Flashcards
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Sample Questions
Q1) In reviewing the patient's record, the nurse notes that the patient has air in the subcutaneous tissue. The nurse validates that this patient has crepitus with which finding?
A) Asymmetric expansion of the chest wall on inhalation
B) Increased transmission of vocal vibrations on auscultation
C) Crackling sensation under the skin of the chest on palpation
D) Coarse grating sounds heard over the mediastinum on inspiration
Q2) A nurse is auscultating the lungs of a healthy male patient and hears crackles on inspiration. What action can the nurse take to ensure this is an accurate finding?
A) Make sure the bell of the stethoscope is used, rather than the diaphragm.
B) Hold stethoscope firmly to prevent movement when placed over chest hair.
C) Ask the patient not to talk while the nurse is listening to the lungs.
D) Change the patient's position to ensure accurate sounds.
Q3) A patient tells the nurse that she has smoked 2 packs of cigarettes a day for 20 years. The nurse records this as how many pack-years?
A) 10
B) 20
C) 40
D) 60
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Page 13
Chapter 12: Heart and Peripheral Vascular System
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32 Verified Questions
32 Flashcards
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Sample Questions
Q1) A nurse informs a patient that her blood pressure is 128/78. The patient asks what the number 128 means. What is the nurse's appropriate response? The 128 represents the pressure in your blood vessels when:
A) "The ventricles relax and the aortic and pulmonic valves open."
B) "The ventricles contract and the mitral and tricuspid valves close."
C) "The ventricles contract and the mitral and tricuspid valves open."
D) "The ventricles relax and the aortic and pulmonic valves close."
Q2) While taking a history, a nurse learns that this patient experiences shortness of breath (dyspnea). If the cause of the dyspnea is a cardiovascular problem, the nurse expects which abnormal finding on examination?
A) Flat jugular neck veins
B) Red, shiny skin on the legs
C) Weak, thready peripheral pulses
D) Edema of the feet and ankles
Q3) What does the S2 heart sound represent?
A) The beginning of systole
B) The closure of the aortic and pulmonic valves
C) The closure of the tricuspid and mitral valves
D) A split heart sound on exhalation
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Page 14
Chapter 13: Abdomen and Gastrointestinal System
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38 Verified Questions
38 Flashcards
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Sample Questions
Q1) What technique does a nurse use when performing deep palpation of a patient's abdomen?
A) Places the left hand under the ribs to lift them up
B) Asks the patient to breathe slowly through the mouth
C) Positions the patient on the right side with knees flexed
D) Uses the heel of the hand to depress the abdomen
Q2) When assessing an adult's liver, the nurse percusses the lower border and finds it to be 5 cm below the costal margin. What is the nurse's appropriate action at this time?
A) Document this as an expected finding for this adult.
B) Palpate the gallbladder for tenderness.
C) Percuss downward beginning in the right midclavicular line.
D) Use the hooking technique to palpate the lower border of the liver.
Q3) The nurse recognizes which clinical finding as expected on palpation of the abdomen?
A) Inability to palpate the spleen
B) Left kidney rounded at 2 cm below the costal margin
C) Slight tenderness of the gallbladder on light palpation
D) Bounding pulsation of the aorta over the umbilicus
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15
Chapter 14: Musculoskeletal System
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27 Verified Questions
27 Flashcards
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Sample Questions
Q1) The nurse notes that there is an audible clicking sound when the patient opens and closes the mouth. What is the appropriate response of the nurse at this time?
A) Recording this as an abnormal finding, requiring additional assessment
B) Measuring the distance between each side of the mandible and the eyes
C) Applying resistance to the maxilla and asking the patient to repeat the motion
D) Documenting this finding as expected if no other signs or symptoms are found
Q2) While giving a history, the patient reports having carpal tunnel syndrome. Based on this information, what technique does the nurse include in a focused assessment?
A) Ask the patient to press the pads of the right and left fingers against each other and hold for 1 minute.
B) Ask the patient to push the hand against the nurse's forearm while attempting to flex the wrist.
C) Ask the patient to flex both wrists and press the dorsal aspects of the hands together for 1 minute.
D) Hold pressure to the radial and ulnar pulses and watch for blanching.
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16
Chapter 15: Neurologic System
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34 Verified Questions
34 Flashcards
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Sample Questions
Q1) A nurse correlates a patient's altered stereognosis with a neurologic dysfunction in which part of the nervous system?
A) Midbrain or pons
B) Temporal lobe or ascending nerve tracts
C) Frontal lobe or motor nerve tracts
D) Parietal lobe or sensory nerve tracts
Q2) A nurse holds the patient's relaxed arm with the elbow flexed at a 90-degree angle, places a thumb over the appropriate tendon in the antecubital fossa, and strikes the thumb with the pointed end of the reflex hammer. What is the expected response for this deep tendon reflex?
A) Extension of the left elbow
B) Pronation of the left forearm
C) Supination of the left arm
D) Flexion of the left elbow
Q3) The nurse assesses the glossopharyngeal nerve (CN IX) by testing which reflex?
A) Corneal reflex
B) Gag reflex
C) Blink reflex
D) Cough reflex
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Page 17
Chapter 16: Breasts and Axillae
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24 Verified Questions
24 Flashcards
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Sample Questions
Q1) During a breast examination of a healthy female, the nurse recognizes which finding as normal?
A) Asymmetrical venous pattern
B) Unequal nipple size
C) Supernumerary nipples along the milk line
D) Pink discharge from one nipple when manipulated
Q2) Based on the history, a nurse determines that the patient with which finding requires further assessment?
A) Occasional discharge from nipples
B) Supernumerary nipples along the milk line
C) Rash in the axillae associated with change in deodorant
D) Mild breast swelling that fluctuates with the menstrual cycle
Q3) What is the purpose of asking a female to lean forward during the breast examination?
A) To accentuate the Montgomery glands
B) To observe for symmetry of the suspensory ligaments
C) To compare nipple symmetry
D) To identify any breast masses in the subcutaneous tissues
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Chapter 17: Reproductive System and the Perineum
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40 Verified Questions
40 Flashcards
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Sample Questions
Q1) When palpating the epididymis, the nurse considers which finding to be abnormal?
A) The epididymis is located on the posterolateral surface of each testis.
B) The epididymis feels like a tubular, comma-shaped structure.
C) The epididymis collapses on palpation.
D) The epididymis has an irregular, nodular surface.
Q2) The pregnant patient tells the nurse that she has had three pregnancies and two live births to date. How does the nurse record this in the patient's history?
A) Gravida 3, para 3
B) Gravida 3, para 2
C) Gravida 2, para 3
D) Gravida 2, para 2
Q3) The nurse recognizes which patient has the highest risk of endometrial cancer?
A) A 24-year-old woman with menarche at age 9
B) A 30-year-old woman who started menstruating at age 19
C) A 42-year-old woman who reached menopause at age 40
D) A 64-year-old woman who had irregular, heavy menstrual cycles
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Chapter 18: Developmental Assessment Throughout the Life Span
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) A parent tells the nurse about having difficulty disciplining a 5-year-old child. What characteristic does the nurse teach this parent to improve the discipline of this child?
A) Children at this age are incapable of delaying gratification.
B) At age 5 years, children are not interested in attaining rights and privileges of individuality.
C) Five-year-olds should demonstrate basic social skills and respond to others' expectations.
D) At age 5 years, children use highly inappropriate methods of expressing frustration.
Q2) During a counseling session, which statement by an adolescent indicates he is adjusting to expected developmental tasks?
A) "I wish my parents would just leave me alone."
B) "I'm hoping to go to college."
C) "I don't have any friends."
D) "It's terrible being taller than all my friends."
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Chapter 19: Assessment of the Infant, Child, and Adolescent
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45 Verified Questions
45 Flashcards
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Sample Questions
Q1) In performing a respiratory assessment of a 1-month-old infant, the nurse recognizes which finding as abnormal?
A) Sneezing
B) Coughing
C) Abdominal breathing
D) Predominantly nose breathing
Q2) How does a nurse collect baseline measurements of a 6-month-old infant?
A) Measure the chest circumference around the lower ribs.
B) Ask the parent how much the infant's weight has changed since birth.
C) Measure the head just above the ears and eyebrows.
D) Ask the parent to hold the infant while the nurse measures the length.
Q3) Which tool is most appropriate for testing the vision of a 5-year-old child?
A) Denver II test
B) Snellen E chart
C) Allen picture cards
D) Snellen standard chart
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21
Chapter 20: Assessment of the Pregnant Patient
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) In measuring fundal height, the nurse documents which finding as abnormal?
A) 29 cm at week 30
B) 28 cm at week 26
C) 34 cm at week 38
D) 26 cm at week 24
Q2) A nurse instructs the patient about which expected skin changes during pregnancy?
A) Nipples becoming thicker
B) Hands and feet becoming pale and cool
C) Blotchy, brown pigmentation of the abdomen
D) Stretch marks on the expanding abdomen
Q3) In reviewing the results of physical examination of a 25-year-old pregnant patient, a nurse recognizes which finding as expected?
A) Small, round, oval cervix
B) Pale, symmetrical cervix
C) Smooth, bluish-colored cervix
D) Slit-shaped, pink cervix
Q4) If a patient's last menstrual period was May 13, her estimated date of birth is
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Chapter 21: Assessment of the Older Adult
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Sample Questions
Q1) Which finding on cardiovascular assessment of an older adult patient warrants further evaluation?
A) Occasional ectopic beats heard on auscultation of the heart
B) Murmur heard over the mitral valve
C) Systolic pressure of 156 in the right arm and 188 in the left arm
D) Persistent S4 sound in a patient with a history of decreased ventricular function
Q2) A nurse asks an older adult patient to rise from an arm chair without using the arms, stand with eyes closed, and turn around in a circle. What is the nurse assessing in this patient?
A) Ability to follow instructions
B) Muscle strength
C) Balance
D) Hearing
Q3) What is the best color for nurses to select when designing educational materials for older adults?
A) Blue
B) Yellow
C) Violet
D) Green
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Page 23
Chapter 22: Conducting a Head-to-Toe Examination
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Sample Questions
Q1) Which techniques does a nurse use routinely to collect data when assessing a patient's anterior thorax? (Select all that apply.)
A) Palpation of the thorax for fremitus
B) Inspection of the skin for color, intactness, lesions, and scars
C) Auscultation of breath sounds bilaterally
D) Auscultation of heart sounds for rate, rhythm, frequency, and S1 and S2
E) Palpation of the anterior chest wall for thoracic expansion
F) Inspection of respiratory movement for symmetry and ease of respiration
Q2) Which techniques does a nurse use routinely to collect data when assessing a patient's posterior thorax? (Select all that apply.)
A) Inspection of the thorax for symmetry of shoulders
B) Percussion of the costovertebral angle bilaterally
C) Inspection of respiratory movement for symmetry, depth, and rhythm of respiration
D) Percussion of the posterior and lateral thorax for resonance
E) Palpation of vertebrae for alignment and tenderness
F) Inspection of thorax for muscular development and scapular alignment
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Chapter 23: Documenting the Comprehensive Health Assessment
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Sample Questions
Q1) A patient reports she has shortness of breath and peripheral edema. Under which category does the nurse document these data?
A) Review of systems
B) Present health status
C) Past health history
D) Functional ability
Q2) Which data do nurses document under the category of personal and psychosocial health history? (Select all that apply.)
A) Allergies to medications or food
B) Diet and foods eaten on a regular basis
C) Type of employment
D) Address and date of birth
E) Activities that promote health
F) Use of tobacco and alcohol
Q3) The nurse documents which data under the category of present health status?
A) Counts on her friends in stressful times
B) "I only sleep for 2 to 3 hours a night and use diphenhydramine for sleep."
C) Has a physical examination and flu vaccination annually
D) "I feel good about myself most of the time."
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Chapter 24: Adapting Health Assessment to the Hospitalized Patient
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Sample Questions
Q1) For which patient does the nurse make assessment of the oral mucous membrane a priority?
A) The patient who has an arteriovenous (AV) fistula
B) The patient who has a gastrostomy tube
C) The patient who uses a Ventimask
D) The patient who has a colostomy
Q2) How does a nurse assess perfusion to the foot when a patient has a cast from the left middle calf to the toes?
A) Palpate the popliteal pulse of the left leg.
B) Palpate the posterior tibial pulse of the left leg.
C) Assess movement and sensation of the left toes.
D) Assess the capillary refill of the left toes.
Q3) Development of which complication is considered a never event?
A) Fever
B) Atelectasis
C) Pressure ulcer
D) Thrombophlebitis
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