NUR 210 RN Health Assessment HESI NGN
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Free NUR 210 RN Health Assessment HESI NGN Questions
1. While completing a health assessment for a client with peripheral vascular disease (PVD), which assessment technique is most important for the nurse to implement?
- Palpate and document quality of distal pulses.
- Measure ankle-brachial index (ABI).
- Document thickened toe nails.
- Measure and record dependent ankle edema.
Explanation
For a client with peripheral vascular disease (PVD), the most important assessment is to palpate and document the quality of distal pulses (e.g., dorsalis pedis and posterior tibial pulses). This technique helps determine arterial blood flow to the extremities and identifies early signs of ischemia or worsening circulation. Weak or absent pulses indicate impaired perfusion, which requires prompt intervention to prevent tissue necrosis or ulceration.
2. After a young adult woman describes feeling palpitations when she lies on her left side, it is most important for the nurse to auscultate heart sounds at which anatomical location?
- Base of the heart at second intercostal space, right of the sternal border.
- Left third intercostal space, left lateral sternal border.
- Second intercostal space, left of the sternal border.
- Apex of the heart at left fifth intercostal space at the midclavicular line.
Explanation
The apex of the heart (also known as the point of maximal impulse or PMI) is located at the left fifth intercostal space, midclavicular line and best represents left ventricular activity. When a client feels palpitations—especially when lying on the left side—it is often due to the left ventricle’s proximity to the chest wall in that position. Auscultating at this site allows the nurse to detect extra heart sounds, murmurs, or abnormal rhythms associated with ventricular contractions.
3. Which assessment technique should the nurse use to confirm the presence of papilledema in a client with a rapidly decreasing level of consciousness?
- Percussion.
- Inspection.
- Palpation.
- Auscultation.
Explanation
Papilledema refers to swelling of the optic disc caused by increased intracranial pressure. It is identified through inspection of the optic disc using an ophthalmoscope. The nurse or healthcare provider visually examines the optic disc for signs such as blurred disc margins, elevated appearance, and engorged retinal veins. Detecting papilledema confirms rising intracranial pressure, which is a neurological emergency requiring prompt intervention.
4. Following a cerebrovascular accident (CVA), a client's prescriptions include neurologic assessments every 8 hours and bedrest. The agency assessment tool includes evaluation of the client's posture. Which action should the nurse implement?
- Observe the client's ability to sit upright or unassisted while in the bed.
- Assist the client to stand at the bedside long enough to observe posture.
- Ask the client to describe normal posture while walking and standing.
- Document that posture could not be evaluated due to prescribed bedrest.
Explanation
Since the client is on bedrest, it is unsafe to have them stand or walk. The nurse should therefore evaluate posture while the client is in bed, specifically observing their ability to maintain an upright, midline position without leaning or slumping to one side. This observation helps detect neurological deficits such as weakness, paralysis, or loss of balance, which are common after a cerebrovascular accident (CVA).
5. A mother brings her obese adolescent daughter to the clinic because for the last 6 months her daughter sleeps every day after school, has lost weight, and has not had a period for 3 months. After sending the mother to the waiting room, which assessment is most important for the nurse to implement?
- Question her about thoughts of self-harm.
- Ask the teen if she is sexually active.
- Inquire about the use of illicit drugs.
- Request a 24-hour dietary recall.
Explanation
The combination of fatigue, unexplained weight loss, and amenorrhea in an adolescent may signal depression or another underlying emotional disorder. The nurse’s first priority is to assess for suicidal ideation or self-harm, as depression in adolescents is often underrecognized and can present with changes in sleep, appetite, and menstrual cycles. Ensuring the teen’s immediate safety is paramount before exploring other potential causes or contributing factors.
6. The nurse is performing a cranial nerve exam on an older adult client. The nurse notes that the client has a reduced upward gaze, a decreased corneal reflex, a high-frequency hearing loss, and a reduced gag reflex. Which action should the nurse take next?
- Implement neurological (neuro) vital signs every 2 hours to detect Cushing's triad.
- Assess the spinal reflexes for demyelination symptoms.
- Review past history for any episodes of a cerebral cortex lesion.
- Continue the assessment of the next pairs of cranial nerves.
Explanation
The findings described—reduced upward gaze (cranial nerve III), decreased corneal reflex (cranial nerve V or VII), high-frequency hearing loss (cranial nerve VIII), and reduced gag reflex (cranial nerve IX or X)—are common age-related changes in older adults and do not necessarily indicate an acute neurological deficit. Therefore, the nurse should continue assessing the remaining cranial nerves to complete the neurological examination and document baseline findings.
7. During an assessment for jugular vein distension of a client with right-sided heart failure (HF), the nurse observes distension bilaterally using tangential lighting with the client in a semi-Fowler’s position. Which action should the nurse take next?
- Document the findings as observed.
- Position the client supine and repeat the assessment.
- Flex the client’s neck with a pillow and repeat assessment.
- Repeat without using the lighting.
Explanation
Jugular vein distension (JVD) observed bilaterally in a semi-Fowler’s position (30–45 degrees) indicates increased venous pressure, a classic finding in right-sided heart failure. Tangential lighting is the correct method to visualize JVD, and the semi-Fowler’s position is appropriate for accuracy. Because the technique and findings are correct, the nurse should document the results as observed and report them according to facility policy for correlation with other heart failure indicators.
8. When entering a male client's room, the nurse observes that he is splinting his chest with a pillow. Which follow-up assessment should the nurse complete?
- Body temperature.
- Apical-radial pulse deficit.
- Numeric pain intensity scale.
- Anteroposterior (AP) chest diameter.
Explanation
Chest splinting—holding a pillow or arm against the chest—is a common behavioral cue indicating pain, particularly after thoracic surgery, trauma, or respiratory difficulty such as pleurisy or pneumonia. The nurse should immediately assess the client’s pain level using a numeric intensity scale (0–10) to determine severity, location, and characteristics. Accurate pain assessment is essential for timely pain management and to prevent complications such as shallow breathing or atelectasis.
9. Patient Data
History and Physical
The client is a 35-year-old male with no history of any medical conditions presents to the clinic for an annual physical.
Nurses' Notes
Hearing "roaring" sounds when auscultating as well as crackles. Client has a hairy chest. Exam is taking place behind a privacy screen there are no individual rooms with doors.
Nurse analyzes the findings.
Which can the nurse do to mitigate artifacts when performing auscultation? Select all that apply.
History and Physical
The client is a 35-year-old male with no history of any medical conditions presents to the clinic for an annual physical.
Nurses' Notes
Hearing "roaring" sounds when auscultating as well as crackles. Client has a hairy chest. Exam is taking place behind a privacy screen there are no individual rooms with doors.
Nurse analyzes the findings.
Which can the nurse do to mitigate artifacts when performing auscultation? Select all that apply.
- A Reach under a gown to listen and take care that no clothing rubs on the stethoscope
- B Keep the examination room warm, and warm the stethoscope
- C Document the roaring and crackles
- D Wet the chest hair before auscultating
- E Ensure the room is as quiet as possible
Explanation
A. Reach under a gown to listen and take care that no clothing rubs on the stethoscope: Clothing rubbing against the stethoscope diaphragm can create rustling or “roaring” noises that mimic abnormal lung or heart sounds. By reaching under the gown, the nurse ensures direct skin contact and eliminates friction from fabric, allowing for clear, accurate auscultation findings. D. Wet the chest hair before auscultating: Chest hair can cause crackling or static-like noises as it brushes against the stethoscope diaphragm. Slightly moistening the hair with water or alcohol swabs helps flatten it and reduce friction, improving the clarity of heart and breath sounds during auscultation. E. Ensure the room is as quiet as possible: Environmental noise, such as talking, movement, or equipment sounds, can interfere with accurate auscultation. Conducting the examination in a quiet area minimizes background noise and allows the nurse to clearly differentiate between normal and abnormal body sounds.
10. In completing a physical assessment of a young adult, the clinic nurse observes muscular atrophy of the right thigh and calf. To gather additional data related to this finding, which action should the nurse take?
- Obtain vital signs and oxygen saturation.
- Calculate the body mass index (BMI).
- Measure degree of skin elasticity.
- Compare muscle strength bilaterally.
Explanation
Muscular atrophy indicates possible disuse, nerve injury, or reduced mobility. The nurse should assess muscle strength bilaterally to determine the degree of weakness and functional differences between limbs. Comparing strength on both sides provides essential data for identifying neuromuscular impairment, determining its impact on mobility, and guiding further evaluation or physical therapy interventions.
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