Health Assessment Denver School of Nursing
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Free Health Assessment Denver School of Nursing Questions
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.
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 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.
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 auscultating a client's lungs and hears high-pitched sound during inspiration and expiration, most prominent in the upper airway. How would the nurse classify this sound
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Inspiratory wheezes
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Stridor
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Rhonchi
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Crackles
Explanation
Correct Answer B: Stridor
Explanation:
Stridor is a high-pitched, harsh sound heard primarily during inspiration, though it can also be present during expiration. It originates from the upper airway (larynx or trachea) and typically indicates airway obstruction, such as from swelling, a foreign body, or laryngeal spasm. It is a medical emergency and requires immediate attention.
Why the other options are incorrect:
A) Inspiratory wheezes:
Wheezes are musical sounds heard more often in the lower airways, usually with asthma or bronchospasm, and are more prominent during expiration.
C) Rhonchi:
These are low-pitched, coarse sounds associated with mucus or secretions in the large airways, often cleared with coughing.
D) Crackles:
These are popping sounds heard during inspiration, often due to fluid in the alveoli (e.g., pneumonia, heart failure).
After inspecting a client who is being seen in the clinic for alopecia, the nurse would expect to document their findings as
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Wiry textured hair noted along the jawline.
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Mobile scalp fixated over the eyebrows with soft textured hair.
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Normocephalic head shape with light/absent hair distribution.
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Hair appears lighter in color at the roots but evenly distributed.
Explanation
Correct Answer C: Normocephalic head shape with light/absent hair distribution.
Explanation:
C) Normocephalic head shape with light/absent hair distribution is the correct documentation for alopecia, which refers to partial or complete hair loss. The term normocephalic indicates that the head shape is normal, and the description of light or absent hair accurately reflects the presentation of alopecia on physical inspection.
Why other options are incorrect:
A) Wiry textured hair noted along the jawline:
This would more likely describe hirsutism, not alopecia. Hirsutism refers to excess hair growth, particularly in areas where women typically have minimal hair.
B) Mobile scalp fixated over the eyebrows with soft textured hair:
This description is anatomically incorrect and does not relate to alopecia. The scalp and eyebrows are separate regions and are not "fixated" to one another.
D) Hair appears lighter in color at the roots but evenly distributed:
This finding may be seen with hair dye or sun exposure, not alopecia. Even hair distribution contradicts the expected presentation of hair loss.
A nurse is assessing a client who has developed raised, red, itchy welts on the skin after eating shellfish. Which of the following terms best describes these raised lesions
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Macules
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Vesicles
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Wheals
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Papules
Explanation
Correct Answer C: Wheals
Explanation:
C) Wheals are raised, reddened, and irregularly shaped lesions that are often associated with allergic reactions. They are typically itchy and can vary in size and shape. The appearance of welts after exposure to an allergen like shellfish is characteristic of wheals, as seen in urticaria (hives).
Why other options are wrong
A) Macules:
These are flat, non-palpable changes in skin color, such as freckles or flat rashes. They are not raised or itchy.
B) Vesicles:
These are small, fluid-filled blisters, such as those seen in chickenpox or herpes infections. They do not describe itchy welts.
D) Papules:
Papules are small, raised, solid lesions (like those seen in acne or insect bites), but they are not typically transient or irregular like wheals, and not associated with allergen-triggered welts.
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.
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.
A nurse is performing a physical examination on a client presenting with nasal congestion, sneezing, and a runny nose. The client reports that these symptoms occur seasonally and are accompanied by itchy eyes. Upon nasal inspection, the nurse notes that the turbinates are pale, swollen, and boggy, and there is clear, watery nasal discharge. Based on these physical findings, what type of rhinitis is most likely
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Allergic rhinitis, with pale, swollen turbinates and clear nasal discharge
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Infectious rhinitis, with swollen turbinates and yellow-green discharge
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Acute rhinitis, with red, inflamed turbinates and purulent discharge
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Chronic rhinitis, with thickened, dry turbinates and no discharge
Explanation
Correct Answer A: Allergic rhinitis, with pale, swollen turbinates and clear nasal discharge
Explanation:
A) Allergic rhinitis typically presents with pale, boggy, and swollen turbinates, along with clear, watery nasal discharge, sneezing, nasal congestion, and itchy or watery eyes. These symptoms often occur seasonally (in response to pollen or other allergens) and are due to a hypersensitivity reaction involving histamine release.
B) Infectious rhinitis, with swollen turbinates and yellow-green discharge:
Infectious rhinitis (commonly from a cold or virus) usually presents with mucopurulent (yellow or green) nasal discharge, and erythematous (red) turbinates, not pale ones. It is often accompanied by systemic signs such as fever or malaise.
C) Acute rhinitis, with red, inflamed turbinates and purulent discharge:
This describes the early phase of viral rhinitis, not allergic rhinitis. It includes red, swollen nasal mucosa, not pale, and the discharge may become thicker and discolored as the infection progresses.
D) Chronic rhinitis, with thickened, dry turbinates and no discharge:
Chronic rhinitis may cause dryness, crusting, and thickened nasal mucosa, but it does not present with the clear discharge and itching seen in allergic rhinitis. This option does not match the client’s reported symptoms or physical findings.
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