N3153 Dallas Health Assessment Exam 2
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Free N3153 Dallas Health Assessment Exam 2 Questions
Which is a function of the musculoskeletal system? Select all that apply.
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Production of red blood cells.
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Protection of organs.
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Energy production.
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Movement/mobility.
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Reservoir for minerals.
Explanation
Correct Answers: A, B, D, and E.
The musculoskeletal system serves multiple vital functions. Red blood cells are produced in the red bone marrow through hematopoiesis (A). Bones form a protective framework around vital organs — the skull protects the brain, the ribcage protects the heart and lungs (B). Muscles and bones work together to produce movement and mobility (D). Bones serve as a major reservoir for minerals, particularly calcium and phosphorus, which are released into the bloodstream as needed (E). Energy production (C) is primarily a function of the metabolic/cellular system — specifically the mitochondria — not the musculoskeletal system.
Match the following skin lesion terms to their correct definitions.
A) A flat, discolored area of skin with no change in texture.
B) A small fluid-filled blister less than 0.5 cm.
C) A raised, itchy, irregular area of skin caused by localized edema.
D) Lesions arranged in a circular or ring-shaped pattern.
E) Lesions clustered together in one area.
F) Lesions distributed along a nerve pathway, as seen in shingles.
Which term matches "A raised, itchy, irregular area of skin caused by localized edema"?
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Zosterform.
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Vesicle.
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Wheal.
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Macule.
Explanation
Correct Answer: C) Wheal.
A wheal is a raised, irregularly shaped area of localized skin edema (swelling) that is typically pale in the center with a red flare at the borders. It is characteristically seen in allergic reactions and urticaria (hives) and is transient, often disappearing within hours. A zosterform pattern describes lesions that follow a nerve pathway, as seen in herpes zoster (shingles). A vesicle is a small, fluid-filled blister under 0.5 cm in diameter. A macule is a flat, non-palpable discolored spot on the skin with no surface elevation or depression, such as a freckle.
The patient states, "I hear a crunching, grating sound when I kneel." What is the likely cause?
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Fluid in the knee joint.
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A loose tendon.
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A bone spur.
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Crepitation.
Explanation
Correct Answer: D) Crepitation.
Crepitation (or crepitus) is the term used to describe a crunching, grating, or crackling sound and sensation produced when roughened or damaged joint surfaces rub against each other during movement. It is commonly associated with osteoarthritis, cartilage deterioration, and joint degeneration, and is a classic physical assessment finding elicited during range of motion evaluation. Fluid in the knee joint (effusion) typically produces a feeling of fullness, swelling, or a ballottement sign — not a grating sound. A loose tendon may produce a snapping sensation but not a grating sound. A bone spur could contribute to crepitus but is the structural cause, not the term for the sound itself — crepitation is the correct clinical descriptor for this finding.
The nurse is assessing a patient experiencing COVID-19 who reports anorexia due to a decreased sense of smell and taste. Which cranial nerve is likely affected? Select all that apply.
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Cranial nerve I
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Cranial nerve III
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Cranial nerve VII
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Cranial nerve IX
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Cranial nerve XII
Explanation
Correct Answers: A) Cranial nerve I, C) Cranial nerve VII, and D) Cranial nerve IX
COVID-19 is well known to cause anosmia (loss of smell) and ageusia (loss of taste). Cranial nerve I (Olfactory) is responsible for the sense of smell and is directly impaired in COVID-19. Cranial nerve VII (Facial) carries taste sensation from the anterior two-thirds of the tongue. Cranial nerve IX (Glossopharyngeal) carries taste sensation from the posterior one-third of the tongue. Damage to any of these nerves explains the reported loss of smell and taste leading to anorexia.
Cranial nerve III (Oculomotor) controls eye movement and pupil constriction — it has no role in smell or taste. Cranial nerve XII (Hypoglossal) controls tongue movement but is not involved in taste or smell sensation.
The patient is able to elevate his shoulders bilaterally until the nurse presses down on his shoulders. How should the nurse document his muscle strength?
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0/5.
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1/5.
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2/5.
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3/5.
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4/5.
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5/5.
Explanation
Correct Answer: E) 4/5.
The Medical Research Council (MRC) muscle strength scale rates muscle strength from 0 to 5. A score of 4/5 means the patient can move the joint through full range of motion and maintain it against gravity, but gives way when resistance is applied by the examiner. This describes exactly what is observed — the patient elevates his shoulders fully (against gravity) but cannot maintain the position when the nurse applies downward pressure. A score of 5/5 would mean the patient maintains full strength even against maximal resistance. A score of 3/5 means movement against gravity only with no resistance tolerated at all. Scores of 0–2 represent absent or minimal muscle activity with no functional movement against gravity.
The nurse is reviewing the laboratory and assessment findings of a patient suspected of having metabolic syndrome. Which of the following findings support this diagnosis? Select all that apply.
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Triglyceride level of 160 mg/dL.
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Waist circumference of 42 inches (male).
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Blood pressure of 118/78 mmHg.
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Fasting blood glucose of 110 mg/dL.
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HDL cholesterol of 55 mg/dL (female).
Explanation
Correct Answers: A, B, and D.
Metabolic syndrome is diagnosed when three or more of the following criteria are met: triglycerides ≥150 mg/dL, waist circumference >40 inches in men or >35 inches in women, blood pressure ≥130/85 mmHg, fasting glucose ≥100 mg/dL, and HDL <40 mg/dL in men or <50 mg/dL in women. A triglyceride level of 160 mg/dL (A) exceeds the 150 threshold. A waist circumference of 42 inches in a male (B) exceeds the 40-inch cutoff. A fasting glucose of 110 mg/dL (D) exceeds the 100 mg/dL threshold. A blood pressure of 118/78 mmHg (C) is normal and does not meet the ≥130/85 criterion. An HDL of 55 mg/dL in a female (E) is actually above the 50 mg/dL threshold, meaning it is protective rather than a risk factor.
The nurse is assessing a female patient who reports severe abdominal pain in the right lower quadrant (RLQ). Which condition should the nurse suspect? Select all that apply.
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Peptic ulcer
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Appendicitis
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Hemorrhoids
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Cholecystitis
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Tubal (ectopic) pregnancy
Explanation
Correct Answers: B) Appendicitis and E) Tubal (ectopic) pregnancy
The appendix is anatomically located in the RLQ, making appendicitis the classic cause of RLQ pain. A ruptured or inflamed fallopian tube (ectopic pregnancy) in a female also presents with RLQ or RLQ-adjacent pain and is a gynecological emergency that must always be considered in women of childbearing age.
Peptic ulcer disease causes epigastric pain, not RLQ pain. Hemorrhoids cause perianal/rectal discomfort, not abdominal quadrant pain. Cholecystitis is associated with the right upper quadrant (RUQ), not the RLQ.
The nurse assesses a patient's neurologic function. Which sign could indicate injury to the cerebellum? Select all that apply.
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Uncoordinated finger-nose-finger test.
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Smooth, balanced gait.
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Lost sense of smell.
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Positive Romberg test.
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Slow alternating movements.
Explanation
Correct Answers: A, D, and E.
The cerebellum is responsible for coordination, balance, and smooth, controlled movement. An uncoordinated finger-nose-finger test (A) indicates cerebellar dysfunction affecting fine motor coordination. A positive Romberg test (D) reflects impaired balance and proprioceptive integration, both cerebellar functions. Slow alternating movements or dysdiadochokinesia (E) — the inability to perform rapid alternating movements — is a classic sign of cerebellar lesions. A smooth, balanced gait (B) is a normal finding and would actually indicate intact cerebellar function. Loss of smell (anosmia) (C) is associated with cranial nerve I (olfactory nerve) damage, not cerebellar injury.
A nurse is assessing a patient's mole and is concerned it may be cancerous. Which of the following findings align with the ABCDE rule and should be reported to the healthcare provider? Select all that apply.
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The mole has patches of black, brown, and red colors within it.
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The mole is 5mm in size.
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The mole is asymmetrical, with one half different in shape from the other.
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The mole has an irregular and notched border.
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The mole is uniform in color with a light brown shade throughout.
Explanation
Correct Answers: A, C, and D.
The ABCDE rule for melanoma assessment stands for Asymmetry, Border irregularity, Color variation, Diameter greater than 6mm, and Evolution. Option A is correct because multiple colors (black, brown, red) within a mole represent abnormal color variation (C). Option C is correct because asymmetry — one half not matching the other — is a direct red flag (A). Option D is correct because an irregular, notched border is a hallmark warning sign (B). Option B is incorrect because 5mm is actually below the concerning threshold of greater than 6mm. Option E is incorrect because uniform light brown coloring is a normal, benign characteristic and does not meet any ABCDE criteria.
The nurse is performing a health history and physical assessment on a patient with chronic rheumatoid arthritis (RA). Which symptom(s) should the nurse anticipate?
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Non-tender osteophytes of the finger joints
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Deterioration of articular cartilage surfaces
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Joint pain that is worse later in the day
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Bilateral swelling and tenderness of joints
Explanation
Correct Answers: B) Deterioration of articular cartilage surfaces and D) Bilateral swelling and tenderness of joints
RA is a systemic autoimmune disease that causes symmetric, bilateral inflammation of synovial joints, leading to progressive deterioration of articular cartilage. Bilateral swelling and tenderness are hallmark clinical features. The inflammatory pannus erodes cartilage and bone over time, explaining the articular cartilage deterioration.
Non-tender osteophytes are bony outgrowths characteristic of osteoarthritis, not RA. RA joint pain is typically worse in the morning (morning stiffness lasting more than one hour), not later in the day — making option C incorrect.
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