Health Assessment Denver School of Nursing
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Free Health Assessment Denver School of Nursing Questions
The nurse is performing a respiratory assessment on a client. While palpating the chest, the nurse considers assessing voice sounds. Which statement about assessing voice sounds is correct
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Assessing voice sounds is commonly performed in clients with suspected consolidation but is not routinely done.
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Voice sounds are routinely assessed and used to assess for lung density and underlying structures.
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Voice sounds are routinely assessed in all respiratory assessments and are essential for diagnosing pneumonia.
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Voice sounds are used only after crackles or wheezing are heard during auscultation.
Explanation
Correct Answer A: Assessing voice sounds is commonly performed in clients with suspected consolidation but is not routinely done.
Explanation:
Assessment of voice sounds (e.g., bronchophony, egophony, and whispered pectoriloquy) is a specialized technique used to evaluate for lung consolidation, such as in pneumonia. These assessments are not part of routine respiratory exams and are typically performed when abnormal findings like dullness on percussion or increased tactile fremitus are present.
Why the other options are incorrect:
B) Voice sounds are routinely assessed:
False — they are not part of routine assessments unless abnormalities are suspected.
C) Essential for diagnosing pneumonia:
While helpful, voice sound assessment is not essential and is usually used to support findings when consolidation is suspected.
D) Used only after crackles or wheezing are heard:
Voice sounds may be used after any abnormality is noted (not just crackles or wheezes), including dullness to percussion or increased fremitus.
An elderly client is recovering from hip replacement surgery. Shortly after being assisted out of bed, the client becomes anxious and restless. The nurse notes that the client's skin is pale and cool to the touch, and the client is short of breath. Which action should the nurse take first
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Check the client's oxygen saturation
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Apply supplemental oxygen via nasal cannula
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Use therapeutic communication to reduce the client's anxiety
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Assess the client's orthostatic vital signs
Explanation
Correct Answer A: Check the client's oxygen saturation
Explanation:
The client is showing signs of possible hypoxia, such as anxiety, restlessness, shortness of breath, and cool, pale skin. The first priority is to assess oxygen saturation using a pulse oximeter. This provides critical data to guide immediate interventions such as oxygen administration.
Why the other options are incorrect:
B) Apply supplemental oxygen via nasal cannula:
This may be necessary, but the nurse must first assess oxygen levels to determine the need and appropriate flow rate.
C) Use therapeutic communication to reduce anxiety:
While helpful, addressing the physiological cause of anxiety (potential hypoxia) takes precedence.
D) Assess orthostatic vital signs:
This is not the priority action in an acute respiratory situation and would delay necessary oxygen assessment and treatment.
The nurse is performing a cardiac health assessment. Which of the following findings during inspection would suggest a potential abnormality in the client's cardiovascular system
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The client's skin appears pink, warm, and dry with no cyanosis or edema.
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The chest appears symmetrical, with no visible pulsations.
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The nurse observes a visible apical impulse at the 5th ICS at the left sternal border.
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The client's jugular veins are not distended when sitting at a 45-degree angle.
Explanation
Correct Answer C: The nurse observes a visible apical impulse at the 5th ICS at the left sternal border.
Explanation:
A visible apical impulse at the 5th intercostal space (ICS) at the left sternal border is not in the normal location. The normal point of maximal impulse (PMI) should be at the 5th ICS at the midclavicular line. A PMI at the left sternal border may suggest cardiac enlargement or displacement, which is abnormal.
Why the other options are incorrect:
A) Skin pink, warm, dry, no cyanosis or edema:
These are all normal findings indicating adequate perfusion.
B) Chest symmetrical, no visible pulsations:
This is normal; visible pulsations elsewhere may suggest aneurysm or other abnormalities.
D) Jugular veins not distended at 45-degree angle:
This is a normal finding; jugular vein distention at this angle could indicate right-sided heart failure or elevated central venous pressure.
The nurse is auscultating a client's heart sounds and hears a soft, blowing sound between heartbeats. Which of the following is the most likely cause of this sound
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Splitting of heart sounds
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Pericardial friction rub
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Normal heart sound
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Heart murmur
Explanation
Correct Answer D: Heart murmur
Explanation:
A heart murmur is a soft, blowing, or whooshing sound heard between heartbeats, caused by turbulent blood flow through the heart valves or chambers. Murmurs may be innocent or indicate underlying conditions like valve stenosis or regurgitation.
Why the other options are incorrect:
A) Splitting of heart sounds:
This refers to a normal variation in timing between the aortic and pulmonic valves closing, usually heard during inspiration—not a blowing sound.
B) Pericardial friction rub:
This produces a high-pitched, scratchy or grating sound, not soft or blowing, and is associated with pericarditis.
C) Normal heart sound:
Normal heart sounds (S1 and S2) are "lub-dub" sounds, not soft blowing; any blowing sound between them is abnormal.
The nurse is conducting a physical of a client who is being seen for a yearly physical. What assessment findings would the nurse obtain to indicate the client's hearing is intact
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Weber test showed BC > AC.
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Passing an audiometric testing 2 months ago.
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Whispered voice test was performed accurately.
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Rinne Test showing AC = BC.
Explanation
Correct Answer C: Whispered voice test was performed accurately.
Explanation:
C) The whispered voice test is a quick, reliable bedside screening tool used during physical examinations to assess hearing acuity. The nurse stands approximately 2 feet behind or to the side of the client and whispers a combination of letters and numbers while the client covers the opposite ear. The client is asked to repeat what they hear. If the client accurately responds, it indicates that hearing is likely intact in that ear.
Why the other options are incorrect:
A) Weber test showed BC > AC:
This is incorrect. The Weber test does not compare bone conduction (BC) to air conduction (AC); that is assessed with the Rinne test. In the Weber test, sound should lateralize equally to both ears. This option reflects misinterpretation of both tests.
B) Passing an audiometric testing 2 months ago:
While a passed audiometric test is informative, the question asks what assessment finding the nurse would obtain during the current physical. The whispered voice test is part of the nurse’s direct assessment, while an audiometric result is historical.
D) Rinne Test showing AC = BC:
This is not normal. In normal hearing, air conduction (AC) is greater than bone conduction (BC). If AC = BC, it may suggest conductive hearing loss. Therefore, this finding does not indicate intact hearing.
A nurse is assessing a client who reports that their skin feels unusually oily and they are sweating more than usual, even when resting. The nurse explains that certain glands in the skin may be overactive. Based on this information, which layer of the skin is responsible for this change
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Basement membrane
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Subcutaneous layer
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Dermis
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Epidermis
Explanation
Correct Answer C: Dermis
Explanation:
C) Dermis: The dermis is the middle layer of the skin and contains sebaceous (oil) glands and sweat glands. These glands are responsible for producing sebum (oil) and sweat, respectively. Overactivity of these glands can lead to oily skin and excessive sweating, as reported by the client.
Why the other options are incorrect:
A) Basement membrane:
This is a thin layer that separates the epidermis from the dermis. It plays a structural role but does not contain glands involved in oil or sweat production.
B) Subcutaneous layer:
Also called the hypodermis, this layer is mainly composed of fat and connective tissue. It provides insulation and cushioning, but it does not contain sebaceous or sweat glands.
D) Epidermis:
The outermost layer of the skin. While it serves as a barrier, it does not house the glands responsible for oil and sweat production—those are located in the dermis.
An elderly client expresses concern about getting short of breath more easily during daily activities. The client asks the nurse, "Am I getting sick, or is this just old age?" Which therapeutic response by the nurse is most appropriate
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It's likely due to anxiety. Try to stay calm and breathe slowly.
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Some shortness of breath can be normal as we age because the lungs become less elastic.
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That doesn't sound normal. You should avoid activity until the provider can assess you.
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You probably just need to rest more often
Explanation
Correct Answer B: Some shortness of breath can be normal as we age because the lungs become less elastic.
Explanation:
This response provides a therapeutic and educational answer that addresses the client’s concern without dismissing it. It acknowledges that age-related changes, such as decreased lung elasticity and reduced respiratory muscle strength, can cause mild shortness of breath during exertion. However, it also opens the door for further assessment if the symptoms worsen or are unusual.
Why the other options are incorrect:
A) It's likely due to anxiety
Assumes a cause without proper assessment and may dismiss a potentially serious concern.
C) That doesn't sound normal. You should avoid activity
Discourages activity prematurely and may cause unnecessary worry without further evaluation.
D) You probably just need to rest more often.
Minimizes the client’s concern and doesn’t address the potential underlying causes.
The nurse is conducting a cardiac and peripheral vascular assessment. Which of the following findings would most likely indicate a problem with circulation
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A weak or absent dorsalis pedis pulse in one foot, with normal findings on the other foot.
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A strong, regular radial pulse in both arms.
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A regular, bounding carotid pulse bilaterally.
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A regular and strong popliteal pulse that is symmetrical bilaterally.
Explanation
Correct Answer A: A weak or absent dorsalis pedis pulse in one foot, with normal findings on the other foot.
Explanation:
An absent or weak dorsalis pedis pulse in one foot, especially when the other is normal, suggests unilateral impaired circulation and may indicate peripheral arterial disease (PAD) or an acute vascular occlusion. This finding requires prompt evaluation to prevent complications like tissue damage.
Why the other options are incorrect:
B) Strong, regular radial pulse in both arms:
This is a normal finding and indicates adequate perfusion to the upper extremities.
C) Regular, bounding carotid pulse bilaterally:
A bounding pulse may be normal or related to increased cardiac output; symmetry suggests no acute vascular issue.
D) Regular and strong popliteal pulse that is symmetrical bilaterally:
Also a normal finding, indicating good perfusion to the lower legs.
The nurse is assessing a client's capillary refill during a physical exam. Which of the following findings would require further investigation
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Capillary refill of 2 seconds in the right hand and 2 seconds in the left hand.
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Capillary refill of less than 2 seconds in the fingers and toes.
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Capillary refill greater than 5 seconds in the fingers and toes.
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Capillary refill of 2 seconds in both hands, but 1 second in both feet.
Explanation
Correct Answer C: Capillary refill greater than 5 seconds in the fingers and toes.
Explanation:
Normal capillary refill is less than 2 seconds. A refill time greater than 5 seconds suggests impaired peripheral perfusion, which may be due to conditions like shock, hypothermia, or vascular disease. This finding requires further evaluation and possible intervention.
Why the other options are incorrect:
A) 2 seconds in both hands:
This is normal and symmetric—no concern.
B) Less than 2 seconds in fingers and toes:
Also normal and indicates good perfusion.
D) 2 seconds in hands, 1 second in feet:
Both are within normal limits, and although there’s a slight variation, it’s not clinically significant.
The nurse is assessing a client with suspected right-sided heart failure. Which of the following findings would most likely be present in this client
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Elevated blood pressure and decreased peripheral pulses
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Increased jugular venous distention and edema in the lower extremities
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Hyperresonance on percussion and increased respiratory rate
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Crackles in the lungs and a dry, nonproductive cough
Explanation
Correct Answer B: Increased jugular venous distention and edema in the lower extremities
Explanation:
Right-sided heart failure leads to a back-up of blood into the systemic circulation. This results in jugular venous distention (JVD), peripheral edema, hepatomegaly, and ascites. The heart is unable to efficiently pump blood into the lungs, so pressure builds in the venous system.
Why the other options are incorrect:
A) Elevated blood pressure and decreased peripheral pulses:
These findings are more typical of arterial disease or left-sided heart failure with decreased cardiac output.
C) Hyperresonance on percussion and increased respiratory rate:
These findings are associated with pulmonary conditions such as emphysema or asthma, not heart failure.
D) Crackles in the lungs and a dry, nonproductive cough:
These are classic signs of left-sided heart failure, due to fluid backing up into the pulmonary circulation.
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