Health Assessment Denver School of Nursing
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Free Health Assessment Denver School of Nursing Questions
The nurse is assessing a client's carotid arteries. Which of the following actions should the nurse take to ensure a safe and accurate assessment of the carotid arteries
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Auscultate the carotid artery to assess the pulse rate more accurately.
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Palpate both carotid arteries simultaneously to check for symmetry.
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Auscultate for bruits using the bell of the stethoscope.
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Palpate the carotid arteries while the client is lying flat in bed.
Explanation
Correct Answer C: Auscultate for bruits using the bell of the stethoscope.
Explanation:
When assessing the carotid arteries, the nurse should auscultate for bruits—which are abnormal "whooshing" sounds indicating turbulent blood flow from narrowing or plaque buildup. The bell of the stethoscope is used because bruits are low-pitched sounds.
Why the other options are incorrect:
A) Auscultate to assess pulse rate:
Pulse rate should be assessed by palpation, not auscultation of the carotid artery.
B) Palpate both carotid arteries simultaneously:
This is unsafe and can reduce blood flow to the brain, risking syncope (fainting).
D) Palpate while client is lying flat in bed:
The client should be in a sitting or slightly elevated position to properly assess the carotids and reduce risk of obstructing airflow or circulation.
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 interviewing a 60-year-old client who presents with difficulty breathing. The client reports smoking 1 pack of cigarettes per day since the age of 28. How should the nurse document the client's smoking history
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28 pack years
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168 pack years
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32 pack years
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60 packs per day
Explanation
Correct Answer C: 32 pack years
Explanation:
Pack years are calculated using the formula:
Number of packs per day × Number of years smoked
This client smoked 1 pack/day from age 28 to 60, which is 32 years.
So, 1 pack/day × 32 years = 32 pack years
Why the other options are incorrect:
A) 28 pack years:
This reflects years since starting, not the actual number of years smoked.
B) 168 pack years:
Likely a result of multiplying years by something other than the number of packs per day (incorrect math).
D) 60 packs per day:
This misinterprets the question. The client smokes 1 pack/day, not 60. This is not a valid way to document smoking history.
During a routine health assessment, a nurse is performing a tongue examination on a 60-year-old client. The nurse observes the following:
The tongue appears moist, pink, and has a thin, white coating that is evenly distributed.
The papillae on the tongue are uniform and appear normal.
The client is able to protrude the tongue and move it laterally without difficulty or discomfort.
The nurse notes that the ventral surface of the tongue is smooth, with no visible lesions or swelling.
Which of the following findings would the nurse document as normal based on this examination
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Tongue is moist, pink, thinly coated, papillae are uniform, and the client moves the tongue freely without pain.
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Tongue appears pale, with a thick white coating, papillae are atrophic, and client has difficulty moving the tongue.
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Tongue is dry with a thick yellow coating and decreased mobility, and client reports soreness.
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Tongue has a red, inflamed appearance with a thick white coating and lesions on the ventral surface.
Explanation
Correct Answer A: Tongue is moist, pink, thinly coated, papillae are uniform, and the client moves the tongue freely without pain.
Explanation:
A healthy tongue should be moist, pink, and may have a thin white coating that is evenly distributed. Uniform papillae are a sign of normal texture and taste bud health. The client’s ability to move the tongue laterally and protrude it without discomfort suggests intact function of the hypoglossal nerve (CN XII). The ventral surface should be smooth and free of lesions or swelling. All of these findings are consistent with a normal oral examination.
Why the other options are incorrect:
B) Tongue appears pale, with a thick white coating, papillae are atrophic, and client has difficulty moving the tongue.
A pale tongue with a thick white coating and atrophic papillae may indicate anemia, fungal infection (like oral candidiasis), or nutritional deficiencies, especially if mobility is impaired.
C) Tongue is dry with a thick yellow coating and decreased mobility, and client reports soreness.
A dry, yellow-coated tongue with soreness and reduced mobility could suggest dehydration, infection, or inflammation such as glossitis.
D) Tongue has a red, inflamed appearance with a thick white coating and lesions on the ventral surface.
A red, inflamed tongue with thick white coating and lesions is abnormal and may be seen in oral thrush, viral infections, or other pathological conditions requiring further evaluation.
The nurse is reviewing the echocardiogram results of a client with a history of heart failure. The report shows an ejection fraction (EF) of 35%. Based on this finding, which type of cardiac dysfunction does the client most likely have
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Diastolic dysfunction
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Right-sided heart failure
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Normal cardiac function
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Systolic dysfunction
Explanation
Correct Answer D: Systolic dysfunction
Explanation:
An ejection fraction (EF) measures the percentage of blood the left ventricle pumps out with each contraction. A normal EF is 55%–70%. An EF of 35% indicates reduced pumping ability, which is characteristic of systolic dysfunction, also known as heart failure with reduced ejection fraction (HFrEF).
Why the other options are incorrect:
A) Diastolic dysfunction:
Occurs when the heart has normal EF but impaired filling due to stiff ventricles—EF usually remains within normal limits.
B) Right-sided heart failure:
Can occur with or without a reduced EF and typically relates to symptoms like peripheral edema and JVD. EF is a measure of left ventricular function, so a low EF specifically points to left-sided systolic dysfunction.
C) Normal cardiac function:
An EF of 35% is significantly below normal, indicating abnormal function.
The nurse is assessing heart sounds in a client and is using the stethoscope to detect a split S2. What part of the stethoscope should the nurse use for this client
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The diaphragm is best for detecting high-pitched sounds, such as a split S2.
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The diaphragm is best for detecting low-pitched sounds, such as a split S2.
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The bell is best for detecting high-pitched sounds, such as a split S2.
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The bell is best for hearing low-pitched sounds, such as a split S2.
Explanation
Correct Answer A: The diaphragm is best for detecting high-pitched sounds, such as a split S2.
Explanation:
The split S2 (second heart sound) is a high-pitched sound that occurs when the aortic and pulmonic valves close at slightly different times. The diaphragm of the stethoscope is designed to detect high-pitched sounds such as S1, S2, splits, and most murmurs. It should be pressed firmly against the chest.
Why the other options are incorrect:
B) The diaphragm is best for detecting low-pitched sounds:
Incorrect — low-pitched sounds like S3 and S4 are best heard with the bell, not the diaphragm.
C) The bell is best for detecting high-pitched sounds:
Incorrect — the bell is used for low-pitched sounds.
D) The bell is best for hearing low-pitched sounds, such as a split S2:
Incorrect — while the bell is for low-pitched sounds, the split S2 is high-pitched and best heard with the diaphragm.
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.
When assessing a client with chronic obstructive pulmonary disease (COPD), which of the following should the nurse consider
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Target oxygenation saturation for these clients is generally 88–92%.
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These clients do not need respiratory assessments due to their diagnosis.
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High-flow oxygen should be administered to maintain oxygen saturations above 95%
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A respiratory rate of 10–20 breaths per minute should be maintained in these clients
Explanation
Correct Answer A: Target oxygenation saturation for these clients is generally 88–92%.
Explanation:
For clients with COPD, especially those with chronic CO₂ retention, the goal is to maintain an oxygen saturation between 88–92%. Giving too much oxygen can suppress their hypoxic drive to breathe, potentially leading to respiratory depression. Oxygen therapy should be carefully titrated and monitored.
Why the other options are incorrect:
B) No need for respiratory assessments:
This is incorrect. Clients with COPD require regular respiratory assessments to monitor for exacerbation or deterioration.
C) Maintain O₂ saturations above 95% with high-flow oxygen:
This can be dangerous in COPD clients, as excessive oxygen may reduce their respiratory drive.
D) Maintain a respiratory rate of 10–20 breaths per minute:
While this range is normal for healthy adults, COPD clients may have slightly higher baseline rates, and the focus should be on overall respiratory effort and effectiveness—not just rate.
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.
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.
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