Health Assessment Denver School of Nursing
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Free Health Assessment Denver School of Nursing Questions
. A client returning to the medical-surgical unit calls the nurse for a new complaint of "9/10 leg pain and swelling" after a surgical procedure. What other priority assessment findings should the nurse look for
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Observe for atrophy of the lower leg muscles.
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Inspect for elevational claudication bilaterally.
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Check ankle-brachial index (ABI) on the affected leg.
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Evaluate for pain with dorsiflexion of the foot.
Explanation
Correct Answer D: Evaluate for pain with dorsiflexion of the foot.
Explanation:
Pain with dorsiflexion of the foot, known as a positive Homan's sign, may indicate deep vein thrombosis (DVT). While Homan’s sign is not definitive on its own, in the presence of unilateral leg pain, swelling, and recent surgery, it is a priority assessment for possible venous thromboembolism, a potentially life-threatening complication.
Why the other options are incorrect:
A) Observe for atrophy of the lower leg muscles:
Muscle atrophy develops over time, not acutely post-surgery, and is not a priority in this context.
B) Inspect for elevational claudication bilaterally:
Claudication is associated with arterial insufficiency, not venous problems like DVT.
C) Check ankle-brachial index (ABI) on the affected leg:
ABI assesses arterial circulation, not venous thromboembolism. This is not the priority concern here.
The nurse is assessing a client's cough and notes the presence of sputum. Which characteristics should the nurse document when describing the sputum
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Onset, duration, and associated chest pain
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Smoking history, hazard exposure, and dyspnea
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Color, amount, consistency, and odor
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Breath sounds, respiratory rate, and lung expansion
Explanation
Correct Answer C: Color, amount, consistency, and odor
Explanation:
When assessing and documenting sputum, the nurse should include specific characteristics such as:
Color (e.g., clear, yellow, green, bloody)
Amount (e.g., scant, moderate, copious)
Consistency (e.g., thin, thick, frothy)
Odor (e.g., foul-smelling, odorless)
These details help in diagnosing respiratory infections, chronic lung conditions, and other pulmonary issues.
Why the other options are incorrect:
A) Onset, duration, and associated chest pain:
These describe the cough itself, not the sputum.
B) Smoking history, hazard exposure, and dyspnea:
Important for overall respiratory assessment but not specific to sputum description.
D) Breath sounds, respiratory rate, and lung expansion:
These are findings from a physical respiratory assessment, not sputum characteristics.
A nurse is assessing a client with a pressure injury on the sacral area. The wound is deep, showing full-thickness skin loss but does not expose underlying muscle or bone. There is visible subcutaneous tissue, and the wound appears to have some slough. Based on this description, which of the following stages best describes this pressure injury
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Stage IV
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Stage I
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Stage II
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Stage III
Explanation
Correct Answer D: Stage III
Explanation:
Stage III pressure injuries involve full-thickness skin loss, where subcutaneous fat may be visible, but bone, tendon, or muscle are not exposed. Slough (yellowish dead tissue) may be present but does not obscure the depth of tissue loss. These wounds may include undermining or tunneling, and the injury extends through the dermis into the subcutaneous tissue.
Why the other options are incorrect:
A) Stage IV:
Involves exposed bone, muscle, or tendon. Since the wound described does not expose these deeper structures, it is not a Stage IV.
B) Stage I:
Characterized by non-blanchable redness of intact skin. There is no open wound or tissue loss, so this does not apply.
C) Stage II:
Involves partial-thickness skin loss with exposed dermis. The wound is usually shallow with no visible fat or slough, so the injury described is too deep to be classified as Stage II.
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 conducting a respiratory assessment on a newly admitted client with a history of chronic obstructive pulmonary disease (COPD). Which of the following findings is most likely to be observed
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Barrel-shaped chest
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Bradypnea with shallow respirations
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Clear breath sounds bilaterally
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Inspiratory pleural friction rub
Explanation
Correct Answer A: Barrel-shaped chest
Explanation:
A barrel-shaped chest is a classic physical finding in clients with COPD, especially those with emphysema. It results from chronic lung hyperinflation, which increases the anterior-posterior diameter of the chest, giving it a rounded, barrel-like appearance.
Why the other options are incorrect:
B) Bradypnea with shallow respirations:
Clients with COPD often exhibit tachypnea and use of accessory muscles, not typically bradypnea.
C) Clear breath sounds bilaterally:
Breath sounds in COPD are usually diminished, and may include wheezes or crackles due to mucus or airway obstruction.
D) Inspiratory pleural friction rub:
This is associated with pleuritis or pleural effusion, not COPD. It presents as a grating sound, not typical in chronic COPD.
The nurse palpates a thrill over the client's precordium during a cardiac assessment. What is the most appropriate action for the nurse to take
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Attempt to relieve the thrill by palpating the area more firmly to assess for changes.
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Document the thrill as a normal finding and continue with the assessment
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Ignore the finding if the client is not experiencing any pain or discomfort.
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Report the thrill to the healthcare provider as it indicates turbulent blood flow.
Explanation
Correct Answer D: Report the thrill to the healthcare provider as it indicates turbulent blood flow.
Explanation:
A thrill is a palpable vibration over the precordium and is never a normal finding. It usually indicates turbulent blood flow, often associated with murmurs due to valvular defects or other cardiac abnormalities. The nurse should report it to the healthcare provider for further evaluation.
Why the other options are incorrect:
A) Attempt to relieve the thrill by palpating more firmly:
This is inappropriate. A thrill is a clinical finding—not something to "relieve" by palpation.
B) Document as a normal finding:
A thrill is not normal and should not be documented as such.
C) Ignore the finding if no pain is present:
Even if the client has no pain, a thrill still indicates an underlying issue that requires attention.
When performing the health history on a client the nurse understands that the most important question to ask about the moles on the client's face, chest and arms is
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Have any of your moles changed in the past 6 months?
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Do your siblings have similar moles on them?
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How old was your mom when the "suspicious lesion" on the skin was found?
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Do you wear sunscreen during the summer and spring
Explanation
Correct Answer A: Have any of your moles changed in the past 6 months?
Explanation:
A) Asking about recent changes in a mole is the most important question, as changes in size, shape, color, or symmetry are key warning signs of malignant melanoma or other forms of skin cancer. The nurse is screening for the ABCDE characteristics of melanoma (Asymmetry, Border irregularity, Color variation, Diameter >6 mm, and Evolution or change).
Why the other options are incorrect:
B) Do your siblings have similar moles on them?
While family history of skin cancer is relevant, simply having similar moles is not as clinically significant as whether the client’s moles are actively changing.
C) How old was your mom when the "suspicious lesion" on the skin was found?
This may contribute to understanding family risk, but it is not as immediately important as assessing the client’s current mole behavior and characteristics.
D) Do you wear sunscreen during the summer and spring?
This helps assess risk for sun damage, but it does not address the immediate concern of whether a mole may be suspicious or malignant. Active mole changes take priority in health history.
The nurse is assessing a client with a history of stable angina. Which of the following findings during the assessment would be most consistent with this condition
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Severe, sharp chest pain radiating to the back and left arm
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Chest pain triggered by physical exertion and relieved by rest or medication
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Persistent shortness of breath without chest pain
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Chest pain that occurs unpredictably and lasts more than 30 minutes
Explanation
Correct Answer B: Chest pain triggered by physical exertion and relieved by rest or medication
Explanation:
Stable angina is a type of chest pain that typically occurs with predictable triggers, such as physical activity or emotional stress, and is relieved by rest or nitroglycerin. It usually lasts a few minutes and resolves once the demand on the heart decreases.
Why the other options are incorrect:
A) Severe, sharp chest pain radiating to the back and left arm:
This could suggest aortic dissection or acute coronary syndrome, not typical of stable angina, which is usually pressure-like, not sharp.
C) Persistent shortness of breath without chest pain:
This could indicate heart failure or another pulmonary issue, not classic for stable angina.
D) Chest pain that occurs unpredictably and lasts more than 30 minutes:
This is more consistent with unstable angina or a myocardial infarction, both of which require urgent intervention
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.
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.
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