Comprehensive Assessment in Nursing Practice
Final Exam Questions
Course Introduction
Comprehensive Assessment in Nursing Practice equips students with the knowledge and skills necessary to conduct thorough health assessments across the lifespan. This course focuses on the systematic collection and analysis of data to evaluate the physical, psychological, sociocultural, and environmental factors affecting patient health. Students will develop competence in interviewing, physical examination techniques, and the use of diagnostic tools, emphasizing holistic patient care and critical thinking. Through case studies, simulated experiences, and practical sessions, learners will integrate assessment findings to support clinical decision-making and create individualized care plans, ensuring safe and effective nursing interventions in diverse healthcare settings.
Recommended Textbook Health Assessment for Nursing Practice 6th Edition by Wilson
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Page 2
Chapter 1: Introduction to Health Assessment
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Q1) Which activity illustrates the concept of secondary prevention?
A) Annual mammogram
B) Nutrition classes on low-fat cooking
C) Education on living with diabetes mellitus
D) Cardiac rehabilitation after coronary artery bypass surgery
Answer: A
Q2) For which person is a comprehensive 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: C
Q3) After collecting the data, the nurse begins data analysis with which action?
A) Clustering data
B) Documenting subjective data
C) Reporting information to other health team members
D) Documenting objective information
Answer: A
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3
Chapter 2: Obtaining a Health History
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Q1) During the history, the patient states that she does not use many drugs. What is the nurse's appropriate response to this statement?
A) "Tell me about the drugs you are using currently."
B) "To some people six or seven is not many."
C) "Do you mean prescription drugs or illicit drugs?"
D) "How often are you using these drugs?"
Answer: A
Q2) A patient comes to the ambulatory surgery center for an elective procedure this morning. While giving the admission history, the patient states she is allergic to latex.
What is the most appropriate response by the nurse at this time?
A) Removing all latex products from the patient's room
B) Using powdered gloves when providing care to this patient
C) Informing the surgeon that the patient has type I hypersensitivity to latex
D) Questioning the patient about symptoms experienced in the past with latex
Answer: D
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Chapter 3: Techniques and Equipment for Physical Assessment
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Q1) What assessment data do nurses obtain through striking a hand directly against the flank or costovertebral angle of a patient's body?
A) Fluid in the lungs
B) Tenderness over the kidneys
C) Air in the abdomen
D) Tenderness over the liver
Answer: B
Q2) 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
Q3) Which explanation is most appropriate for a nurse preparing to palpate a patient's neck?
A) "I need to feel for tumors in your neck."
B) "I'm going to feel your neck for any abnormalities."
C) "I need to press deeply on your neck so please hold still."
D) "Is there any tenderness in your neck?"
Answer: B
Page 5
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Chapter 4: General Inspection and Measurement of Vital Signs
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Q1) According to research findings, which site is preferred for measuring blood pressure when the nurse is unable to use the patient's upper arms?
A) Ankle
B) Thigh
C) Calf
D) Wrist
Q2) Which method of temperature measurement does a nurse choose when assessing school-aged children in a wellness clinic? (Select all that apply.)
A) Axillary temperature
B) Rectal temperature
C) Temporal artery temperature
D) Oral temperature
E) Tympanic membrane temperature
Q3) A temperature of 99.8° F taken in the axilla is equivalent to which temperature value taken orally?
A) 100.8° F
B) 99.8° F
C) 98.8° F
D) 97.8° F
Page 6
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Chapter 5: Cultural Assessment
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Q1) During the first prenatal visit for a 20-year-old Hispanic woman, the nurse assesses the patient's health beliefs and practices. Which questions are appropriate as part of this assessment? (Select all that apply.)
A) You are Hispanic, do you need me to find an interpreter?
B) What is the language that is usually spoken in your home?
C) How do you define health and illness?
D) Which Catholic church do you attend?
E) Do you have specific beliefs or preferences concerning food or food preparation?
F) Do you or the members of your family have certain beliefs and practices surrounding pregnancy and childbirth?
Q2) An Asian woman comes to the clinic with a complaint of back pain. During the history, she tells the nurse that she usually uses acupuncture for her pain. What is the nurse's best response?
A) "When have you used acupuncture, and what effects did it have?"
B) "Acupuncture is good for some problems, but for major illnesses it's best to use medications."
C) "Why did you use acupuncture?"
D) "I have heard that many Asian people use acupuncture."
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Page 7
Chapter 6: Pain Assessment
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Q1) Which patient has pain caused by abnormal processing of sensory input from the peripheral nervous system?
A) The patient who has aching pain from muscle strain
B) The patient who has burning pain along the sciatic nerve
C) The patient who has cramping pain from a tumor in the colon
D) The patient who has throbbing pain from arthritis
Q2) Which patient would be expected to experience acute pain?
A) A patient who had abdominal surgery 8 hours ago
B) A patient who has cancer and has been receiving treatment for 4 months
C) A patient who states that he or she has lived with severe pain for many years
D) A patient who has been treated unsuccessfully over the past year for back pain
Q3) 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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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) Which patient may be experiencing severe anxiety?
A) A woman who tells the nurse she is terrified of cats
B) A man who tells the nurse he feels worthless and is always tired
C) A woman who reports that she is sleeping very lightly each night because her child has an ear infection
D) A man who phones the nurse five times asking for instructions about how to take his new medication
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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9
Chapter 8: Nutritional Assessment
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Q1) Nurses use which measurement as the most highly correlated with risk of morbidity and mortality?
A) Waist-to-hip ratio
B) Triceps skinfold measure
C) Desirable body weight
D) Body mass index (BMI)
Q2) A nurse calculates a patient's body mass index (BMI) as 33. This measurement indicates which class of weight?
A) Overweight
B) Obesity class I
C) Obesity class II
D) Obesity class III
Q3) A nurse is asking questions about the present health status of a young woman who has lost weight recently. Which question is most appropriate when inquiring about present health status?
A) "What concerns have you had in the past regarding your weight?"
B) "Do you have anorexia?"
C) "Describe the recent changes in your weight."
D) "Do you have a family history of eating disorders?"
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Page 10
Chapter 9: Skin, Hair, and Nails
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Q1) A patient reports the mole on the scalp has started itching and it bleeds when scratching it. What other finding is a danger sign for pigmented skin lesions?
A) Symmetry of the lesion
B) Rounded border
C) Color variation
D) Size less than 6 mm wide
Q2) A nurse is inspecting the skin of a patient who has had skin problems after multiple piercings. How will the nurse recognize the characteristics of keloids?
A) Roughened and thickened scales involving flexor surfaces
B) Hypertrophic scarring extending beyond the original wound edges
C) Thin, fibrous tissue replacing normal skin following injury
D) Loss of the epidermal layer, creating a hollowed-out or crusted area
Q3) What findings does a nurse expect when inspecting and palpating a patient's nails?
A) A nail base angle of not more than 90 degrees.
B) Whitish to clear nails in darker-skinned patients.
C) Nail surface is smooth and rounded.
D) Transverse depression running across the nails.
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Chapter 10: Head, Eyes, Ears, Nose, and Throat
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Sample Questions
Q1) During symptom analysis, the nurse helps the patient distinguish between dizziness and vertigo. Which description by the patient indicates vertigo?
A) "I felt faint, like I was going to pass out."
B) "I just could not keep my balance when I sat up."
C) "It seemed that the room was spinning around."
D) "I was afraid that I was going to lose consciousness."
Q2) The nurse is taking a health history on a patient who reports frequent headaches with pain in the front of the head, but sometimes felt in the back of the head. Which statement by the patient is most indicative of tension headaches?
A) "I usually have nausea and vomiting with my headaches."
B) "My whole head is constantly throbbing."
C) "It feels like my head is in a vice."
D) "The pain is on the left side over my eye, forehead, and cheek."
Q3) What instructions does the nurse give the patient before using the Snellen visual acuity chart?
A) "Remove your eyeglasses before attempting to read the lowest line."
B) "Stand 10 feet from the chart and read the first line aloud."
C) "Hold a white card over one eye and read the smallest possible line."
D) "Squint if necessary to improve the ability to read the largest letters."
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Page 12
Chapter 11: Lungs and Respiratory System
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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) During the problem-based history, a patient reports coughing up sputum when lying on the right side, but not when lying on the back or left side. The nurse suspects this patient may have a lung abscess. What additional question does the nurse ask to gather more data?
A) "Does the sputum have an odor?"
B) "Do you have chest pain when you take a deep breath?"
C) "Have you also experienced tightness in your chest?"
D) "Have you coughed up any blood?"
Q3) A patient tells the nurse that he has smoked 1 \(\frac{1}{2}\) packs of cigarettes a day for 14 years. The number of packs the nurse should record in the medical record is ___ pack-years.
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Chapter 12: Heart and Peripheral Vascular System
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Q1) While assessing edema on a male patient's lower leg, the nurse notices that there is a slight imprint of his fingers where he palpated the patient's leg. How does the nurse document this finding?
A) No edema
B) 1+ edema
C) 2+ edema
D) 3+ edema
Q2) To document the palpation of a pulse, the nurse is correct in making which notation about the rhythm?
A) "Rhythm 100 beats/min"
B) "Irregular rhythm"
C) "Rhythm noted at +2"
D) "Bounding rhythm"
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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Chapter 13: Abdomen and Gastrointestinal System
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Q1) A patient reports having frequent heartburn. Which question does the nurse ask in response to this information?
A) "Has your abdomen been distended when you feel the heartburn?"
B) "What have you eaten in the last 24 hours?"
C) "Is there a history of heart disease in your family?"
D) "How long after eating do you have heartburn?"
Q2) When assessing the abdomen of a patient who has fluid in the peritoneal cavity, the nurse expects what change to occur when the patient turns from supine to the left side?
A) Movement of the tympanic tones from lateral in the supine position to closer to midline when lying on the left side
B) Movement of the dull tones from lateral in the supine position to closer to midline when lying on the left side
C) Change in bowel sounds from hypoactive in the supine position to hyperactive when lying on the left side
D) Change in bowel sounds from hyperactive in the supine position to hypoactive when lying on the left side
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15
Chapter 14: Musculoskeletal System
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Q1) When a nurse asks a patient to place the right arm behind the back, so that the back of the hand is touching the lower spine, the nurse is testing for which range of motion?
A) Pronation of the elbow
B) Hyperextension of the elbow
C) Internal rotation and adduction of the shoulder
D) External rotation and abduction of the shoulder
Q2) A patient reports joint pain interfering with sleep and morning joint stiffness for the first hour after getting out of bed. Considering this report, what abnormal findings does the nurse anticipate during the examination?
A) Abrupt onset of local tenderness, edema, and decreased range of motion of the shoulder and hip bilaterally
B) Decreased range of motion of one hip and knee with pain on flexion and crepitus during movement of these joints
C) Erythema in one great toe, ankle, and lower leg that is painful to the touch
D) Hot, painful, deformed, and edematous wrists and peripheral interphalangeal joints bilaterally
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16
Chapter 15: Neurologic System
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Q1) A patient reports having difficulty swallowing. Based on this information, how does the nurse assess the appropriate cranial nerve?
A) Ask the patient to stick out the tongue and move it in all directions.
B) Ask the patient to move the head to the right and left.
C) Observe the symmetry of the face when the patient talks.
D) Assess for taste on the anterior part of the tongue.
Q2) 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
Q3) What is the patient's expected response when the nurse is assessing graphesthesia?
A) Lies supine and runs one heel along the opposite shin
B) Identifies a familiar object placed in the hands
C) Describes where a sensation of a vibrating tuning fork is felt
D) Identifies a letter or number drawn in the hand
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Chapter 16: Breasts and Axillae
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Q1) The nurse notices dimpling of the skin surrounding a palpable mass in the right breast of a female patient. What is the most appropriate action for the nurse to take next?
A) Record this as an expected finding.
B) Palpate the area of dimpling for pain.
C) Palpate the borders of the area of dimpling for irregularity.
D) Tell the patient that dimpling indicates the mass is benign.
Q2) When examining the lymph nodes of an adult female patient, the nurse recognizes which finding as normal?
A) Visible superficial nodes
B) Palpable supraclavicular nodes
C) Nonpalpable lymph nodes in the axilla
D) Enlarged, fixed nodes in the neck
Q3) While giving a presentation about breast health, a nurse informs patients about which recommendation?
A) Women in their 30s should have annual clinical breast examinations.
B) Women at high risk of breast cancer should have semiannual mammograms.
C) Women who are postmenopausal require clinical breast examination every 5 years.
D) A screening mammogram is recommended for all women beginning at age 50 years.
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Page 18
Chapter 17: Reproductive System and the Perineum
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Q1) The patient is unable to tolerate a bimanual pelvic examination due to pain in ovaries and fallopian tubes. Which disorder does the nurse suspect?
A) Tertiary syphilis
B) Genital herpes
C) Human papillomavirus (HPV) infection
D) Pelvic inflammatory disease
Q2) How does a nurse recognize when a patient has a testicular torsion?
A) The nurse sees a light red glow on transillumination of the scrotum.
B) The nurse palpates testicular edema that is painless.
C) The patient reports a pulling sensation and dull ache of the scrotum.
D) The patient complains of sudden onset of severe pain with edema of the scrotum.
Q3) The nurse documents which finding as expected on inspection of the anus?
A) Skin tone darker and coarser than that of the surrounding skin
B) Sphincter lightly closed when the patient is relaxed
C) Large amount of stiff, curling hair surrounding the anus
D) Slight protrusion under the skin when the patient strains or bears down
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Chapter 18: Developmental Assessment Throughout the Life Span
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Q1) The parents of a toddler express concern that the child is not progressing the same way as their other children did at that age. What is the most appropriate suggestion the nurse can give the parents about monitoring the progress of the toddler?
A) Advising the parents to take the toddler to the clinic every 2 months for reevaluation
B) Teaching the parents how to use the Denver II test to assess for gross motor movement, language, fine motor movement, and personal-social skills
C) Suggesting that the child needs more time to reach the milestones and that additional monitoring is not necessary
D) Informing the parents about the ages and stages questionnaire (ASQ), which identifies developmental delays in children from 4 to 60 months
Q2) Which statement reflects a 21-year-old woman's achievement of an expected developmental task?
A) "I am planning to get married next year."
B) "I don't plan anything without asking my boyfriend first."
C) "I don't know which direction I'll take after college."
D) "I am living with my parents and may stay for a while."
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Page 20
Chapter 19: Assessment of the Infant, Child, and Adolescent
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Q1) During the assessment of a newborn within hours after birth, a nurse determines which finding as abnormal?
A) Capillary refill time of less than 1 second
B) Apical pulse felt at the second intercostal space
C) Splitting of heart sounds
D) Cyanosis of the hands and feet
Q2) Which behavior would be most indicative of hearing impairment in a 1-year-old child?
A) Failure to respond to mother's voice
B) Crying when a loud noise occurs unexpectedly
C) Saying only single-syllable words
D) Disinterest in playing with musical toys
Q3) What finding does a nurse expect when assessing a 1-month-old's eyes and vision?
A) The newborn distinguishes most colors
B) Tears when the newborn cries
C) The newborn following a bright toy or light
D) The newborn's blink reflex is present
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Chapter 20: Assessment of the Pregnant Patient
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Q1) If a patient's last menstrual period was May 13, her estimated date of birth is
Q2) A pregnant woman who drinks alcoholic beverages while pregnant increases the risk for which disorder?
A) Low infant birth weight
B) Birth defects
C) Abruptio placentae
D) Gestational diabetes mellitus
Q3) The nurse documents which clinical finding as an expected change associated with advancing pregnancy?
A) Slight persistent ankle edema
B) Hypoplasia of the thyroid gland
C) Increased diaphragmatic excursion
D) Heart murmur after 20 weeks of gestation
Q4) A pregnant patient's weight before pregnancy was 163 lb. The nurse expects the patient to weigh ______ to ______ lb during the second trimester.
Q5) A pregnant patient's weight before pregnancy was 148 lb. Her expected weight during the first trimester is ______ to ______ lb.
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Chapter 21: Assessment of the Older Adult
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Q1) When assessing the skin of an older adult, a nurse notices pigmented, raised warty-appearing lesions on the trunk. How does a nurse document this finding?
A) Solar lentigo
B) Basal cell skin cancer
C) Seborrheic keratosis
D) Sebaceous hyperplasia
Q2) The nurse examining the breasts of an older adult woman recognizes which finding as normal?
A) Firm and rounded breasts of equal size and shape
B) Relatively large size and number of mammary ducts
C) Loose elasticity and puckering of the suspensory ligaments
D) Flattened breasts with a slightly granular texture on palpation
Q3) A 75-year-old man reports he stopped playing cards with his friends because their voices sounded mumbled. How does the nurse explain the cause of this change?
A) Sudden low-frequency hearing loss
B) Accumulation of earwax in the outer ear
C) Damage to the middle ear from ear infections
D) Gradual high-frequency hearing loss
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23
Chapter 22: Conducting a Head-to-Toe Examination
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Q1) Which techniques does a nurse routinely use to collect data when assessing the lower extremities of a patient? (Select all that apply.)
A) Inspecting of legs, ankles, and feet for skin characteristics and hair distribution
B) Assessing for knee stability with the drawer test, McMurray test, or Apley test
C) Palpating lower legs and feet for temperature, pulses, and tenderness
D) Assessing for nerve root compression with straight leg raises
E) Palpating hips for stability and tenderness
F) Testing for patellar and Achilles deep tendon reflexes bilaterally
Q2) Which assessments are routine examination techniques of the upper extremities?
A) Palpating the epitrochlear lymph nodes for size and tenderness
B) Palpating the arms for skin characteristics, symmetry, tenderness, and deformities
C) Testing the range of motion and muscle strength comparing one arm with the other
D) Testing triceps, biceps, and brachioradialis deep tendon reflexes bilaterally
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24
Chapter 23: Documenting the Comprehensive Health Assessment
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Q1) 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
Q2) Which data do nurses document under the category of past health history?
A) Chronic diseases
B) Immunizations received
C) Allergies to medications or food
D) Causes of death of the patient's parents
Q3) Which documentation by a nurse is most descriptive?
A) Heart sounds normal.
B) Few ectopic beats heard during auscultation.
C) S1 murmur is heard at second right sternal border.
D) Pulse within normal limits.
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Chapter 24: Adapting Health Assessment to the Hospitalized Patient
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Q1) 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.
Q2) During the assessment, the nurse determines that the patient's Glasgow Coma Scale score is 15. What is the meaning of this number for this patient?
A) This patient is fully conscious.
B) This patient has movement but does not open the eyes or speak.
C) This patient is unable to respond to any stimuli.
D) This patient opens the eyes but does not speak or move.
Q3) 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
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