Health Assessment Denver School of Nursing
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Free Health Assessment Denver School of Nursing Questions
The nurse notes the following data from the head-to-toe examination of a client: 2+ pedal pulse, full sensation, and color changes in a client’s right leg (see photo). Based on this data, the nurse suspects
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Dependent rubor
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Peripheral Arterial Disease (PAD)
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Diabetic neuropathy
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Chronic venous insufficiency
Explanation
Correct Answer D: Chronic venous insufficiency
Explanation:
The image shows brownish discoloration around the ankle and lower leg, consistent with hemosiderin staining, which is a classic sign of chronic venous insufficiency. This occurs when veins in the lower legs are unable to efficiently return blood to the heart, leading to pooling of blood, edema, and skin changes. The presence of a 2+ pedal pulse and intact sensation further supports a venous issue rather than arterial or neurologic.
Why the other options are incorrect:
A) Dependent rubor:
This is a red-purple discoloration that appears when the leg is in a dependent position due to arterial insufficiency, not the chronic brown staining seen here.
B) Peripheral Arterial Disease (PAD):
PAD often presents with diminished or absent pulses, cool skin, pallor, and possibly pain with walking (claudication)—not with the discoloration shown in the photo.
C) Diabetic neuropathy:
This primarily affects sensation and may lead to foot ulcers due to loss of protective feeling, but it does not cause the discoloration evident in the image.
A nurse is assessing an elderly client who reports experiencing a blind spot in the center of their vision. Which condition is most likely present
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Macular degeneration
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Glaucoma
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Diabetic retinopathy
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Cataracts
Explanation
Correct Answer A: Macular degeneration
Explanation:
A) Macular degeneration affects the macula, the central portion of the retina responsible for sharp, central vision. In age-related macular degeneration (AMD), clients often report a central blind spot, blurring, or distortion, especially when reading or focusing on fine details. Peripheral vision typically remains intact.
Why the other options are incorrect:
B) Glaucoma:
Glaucoma damages the optic nerve, often leading to peripheral vision loss first. It typically does not cause central blind spots until the disease is advanced.
C) Diabetic retinopathy:
This condition causes patchy or fluctuating vision, blurred vision, or floaters, but it does not typically present with a single central blind spot early on.
D) Cataracts:
Cataracts cause generalized blurring, glare, and cloudy vision, but not a distinct blind spot. The lens becomes opaque, leading to overall vision reduction rather than localized loss.
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.
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 assessing a client during their physical exam. Which of the following is the most appropriate action when auscultating the thyroid
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Auscultate with the diaphragm of the stethoscope for high-pitched sounds.
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Use the bell of the stethoscope to listen for any abnormal sounds, such as a bruit
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Assess the client's vital signs for changes in blood flow to the thyroid.
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Palpate the trachea to determine whether it is midline.
Explanation
Correct Answer B: Use the bell of the stethoscope to listen for any abnormal sounds, such as a bruit.
Explanation:
B) Use the bell of the stethoscope to listen for any abnormal sounds, such as a bruit: This is the correct technique. A bruit is a low-pitched, whooshing sound caused by turbulent blood flow and may indicate increased vascularity of the thyroid, often seen in hyperthyroidism (e.g., Graves' disease). The bell is best for detecting low-pitched vascular sounds over the thyroid gland.
Why the other options are incorrect:
A) Auscultate with the diaphragm of the stethoscope for high-pitched sounds:
The diaphragm is used for high-pitched sounds like breath or bowel sounds, not vascular bruits, which are low-pitched and better detected with the bell.
C) Assess the client's vital signs for changes in blood flow to the thyroid:
Vital signs provide systemic information, not localized vascular findings in the thyroid. Auscultation is necessary to detect a bruit.
D) Palpate the trachea to determine whether it is midline:
This assesses tracheal position, not thyroid blood flow. It is important in the overall neck assessment, but it does not substitute for auscultation when evaluating thyroid vascular sounds.
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.
While performing a head-to-toe physical exam on a client the nurse tests CN X (cranial nerve 10). The cranial nerve was intact and the nurse would document it as
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Facial movements are voluntary and symmetrical.
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Tongue is midline with no deviation.
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Uvula and soft palate move upwards and midline.
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Sternocleidomastoid and trapezius muscles are strong and equal.
Explanation
Correct Answer C: Uvula and soft palate move upwards and midline
Explanation:
Cranial Nerve X (Vagus nerve) is responsible for motor function of the soft palate, pharynx, and larynx. When assessing CN X, the nurse asks the client to say “ahh” while observing the movement of the uvula and soft palate. A normal response is for the uvula and soft palate to rise symmetrically and remain midline, which indicates that CN X is intact.
Why the other options are incorrect:
A) Facial movements are voluntary and symmetrical:
This assesses Cranial Nerve VII (Facial nerve), which controls facial expression muscles, not CN X.
B) Tongue is midline with no deviation:
This finding is related to Cranial Nerve XII (Hypoglossal nerve), which controls tongue movement, not the vagus nerve.
D) Sternocleidomastoid and trapezius muscles are strong and equal:
This tests Cranial Nerve XI (Spinal Accessory nerve), which controls those specific muscles, not CN X.
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 assessing a client with suspected Raynaud's disease. Which of the following findings during the physical examination would be most consistent with this condition
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Numbness and tingling in the fingers with rapid capillary refill and normal skin color.
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Pulsating masses in the wrists and forearms with warm, flushed skin.
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Bilateral swelling of the hands and fingers, with redness upon palpation.
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Fingers that change color, turning white, then blue, and finally red with certain triggers.
Explanation
Correct Answer D: Fingers that change color, turning white, then blue, and finally red with certain triggers.
Explanation:
Raynaud’s disease is a condition characterized by vasospasm of small arteries, usually in the fingers, often triggered by cold or stress. This leads to a triphasic color change:
White (pallor): due to lack of blood flow,
Blue (cyanosis): from prolonged oxygen deprivation,
Red (hyperemia): as blood flow returns.
These episodes are typically accompanied by numbness, tingling, or pain.
Why the other options are incorrect:
A) Numbness and tingling with normal skin color and rapid capillary refill:
These findings are not consistent with Raynaud’s, which includes noticeable color changes.
B) Pulsating masses with flushed skin:
This may indicate an aneurysm or vascular abnormality, not Raynaud’s disease.
C) Bilateral swelling and redness on palpation:
This suggests inflammatory conditions such as rheumatoid arthritis, not Raynaud’s.
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