NUR 210 RN Health Assessment HESI NGN
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Free NUR 210 RN Health Assessment HESI NGN Questions
The nurse is performing a health interview for a client who does not speak fluent English and has obtained an interpreter. Which action should the nurse implement?
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Use an interpreter throughout the client’s hospitalization.
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Maintain eye contact with the client when questions are asked.
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Ask the interpreter to tell the client to write down questions.
-
Give the interpreter a form that lists the interview questions.
Explanation
When communicating through an interpreter, the nurse should maintain direct eye contact and speak to the client, not the interpreter. This demonstrates respect, promotes rapport, and ensures the client feels directly included in the conversation. The interpreter’s role is to facilitate accurate translation, but the therapeutic connection must remain between the nurse and the client. The nurse should speak slowly, use simple language, and pause frequently to allow for accurate interpretation.
The nurse is assessing a client's skeletal muscle movements and strength. Which action should the nurse instruct the client to perform to evaluate prime-mover muscle groups?
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Perform sets of passive range of motion.
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Hold arms straight forward with eyes closed.
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Flex and hold as opposing force is applied.
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Stand on each foot without assistance.
Explanation
To assess prime-mover (agonist) muscle strength, the nurse instructs the client to actively flex a muscle group and maintain resistance while the nurse applies an opposing force. This evaluates both strength and coordination of the primary muscles responsible for movement. Comparing bilateral strength allows the nurse to detect weakness, asymmetry, or neuromuscular impairment. This is a standard technique for assessing muscle strength on a 0–5 scale.
While percussing the abdomen of an adult male client, the nurse encounters a musical high-pitched sound. Which does this finding indicate?
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Gas.
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Soft tissue.
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Intestinal mass.
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Full bladder.
Explanation
A musical, high-pitched sound heard during abdominal percussion is described as tympany, which occurs when the area beneath the percussed surface is filled with air or gas. Tympany is the normal percussion tone over the stomach and intestines because these organs typically contain gas. Excess tympany may suggest bowel distention or air accumulation due to intestinal obstruction.
While the nurse is taking a health history, the client announces, "I don't have time for this. This is a waste of time. I need treatment." Which response is best for the nurse to provide?
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Ignore the angry outburst and continue with the history questions.
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"I am sorry you feel that way. Perhaps you'd like to return when you have more time."
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"You sound angry. Would you like to tell me about it?"
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Move closer and place a hand on the client's shoulder to demonstrate concern.
Explanation
The nurse’s response, “You sound angry. Would you like to tell me about it?”, uses therapeutic communication by acknowledging the client’s feelings and inviting discussion in a nonjudgmental way. This approach helps de-escalate emotions, promotes trust, and encourages the client to express underlying frustrations or fears that may be interfering with care. Recognizing and validating the emotion opens the door to effective communication and collaboration.
The clinic nurse notices muscle atrophy in the right thigh and calf while performing a physical examination on a young adult. What steps should the nurse take to get further information about this finding?
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Obtain vital signs and oxygen saturation.
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Calculate the body mass index (BMI).
-
Measure degree of skin elasticity.
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Compare muscle strength bilaterally.
Explanation
The Correct Answer is:
D. Compare muscle strength bilaterally.
Detailed 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.
Which method should the nurse use to assess response to painful stimuli for a client with a marked reduction in the level of consciousness (LOC)?
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Use aromatic spirits of peppermint.
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Shake and call the client's name.
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Press firmly on the center of the sternum.
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Run a pointed object up the sole of the foot.
Explanation
When assessing a client with a decreased level of consciousness, the nurse uses progressive stimulation techniques to evaluate response. After no response to verbal or light tactile stimulation, the next step is to apply a central painful stimulus, such as pressing firmly on the sternum. This maneuver assesses the client’s ability to respond to pain and helps determine the depth of unconsciousness. The response (purposeful withdrawal, posturing, or no reaction) is then documented using the Glasgow Coma Scale.
When assessing a 24-year-old bodybuilder, the nurse is unable to palpate an apical pulse. Which action should the nurse implement?
-
Question the client about steroid use.
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Dim the lights in the examination room.
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Continue with the cardiac examination.
-
Position the client in high Fowler's position.
Explanation
In a muscular or obese individual, the apical impulse (point of maximal impulse, PMI) may not be palpable due to thick chest musculature or increased chest wall density. This is a normal finding and not necessarily an indication of a cardiac abnormality. The nurse should therefore continue with the cardiac examination, using auscultation to assess the apical pulse and heart sounds instead of palpation.
The nurse is assessing the perianal area of a female client who reports she has chronic constipation and has bright red blood on the toilet paper after having a bowel movement. Which finding should the nurse report to the healthcare provider (HCP) that is most consistent with the client's report?
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Presence of dried brown stool around the perianal area.
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Anus is moist, hairless, and has pigmented sphincter folds.
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Flabby skin sac around the anal orifice that is painless.
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Shiny blue skin sacs around anal opening and a linear split.
Explanation
Bright red blood after defecation, especially in a client with chronic constipation, is commonly associated with hemorrhoids or an anal fissure. The description of shiny blue skin sacs suggests external hemorrhoids, which can become inflamed or thrombosed, while a linear split indicates a fissure caused by straining or passage of hard stool. Both conditions cause pain and bleeding during or after bowel movements and should be reported for further evaluation and management.
The client is a 76-year-old female who arrived at the emergency department (ED) via ambulance from an assisted living facility after a fall. The client called for help using her medical alert necklace. Reports feeling dizzy and lightheaded for the past two days. Client is unable to recall the events that led up to the fall and states, "I do not know how long I was down." Past medical history includes chronic obstructive pulmonary disease (COPD), hypertension (HTN), and carotid artery stenosis. Smokes half a pack of cigarettes daily for 40 years. Attempted to quit smoking five years ago after a right carotid endarterectomy.
Nurses' Notes
1620
Received report from triage nurse. Client returning from computed tomography (CT) department. The client is alert and oriented to person, place, time, and situation. Unable to recall details of her fall. Heart rhythm regular. Lung sounds are diminished throughout. Placed on oxygen 1 L/minute via nasal cannula. Bruising noted to left arm and small laceration on the left chin from the fall. Pain rated 3 on a scale of 0 to 10. Carotid ultrasound performed at bedside. Laboratory specimens drawn. Preparing the client for transfer to the stroke unit, calling to ascertain readiness to receive client and room number.
1640
Transferred client to the stroke unit from the ED as prescribed. Situation, background, assessment, recommendation (SBAR) report given.
1655
Received client from emergency department (ED). Admitted and oriented to the stroke unit. Vital signs taken.
Flow Sheet
1600
Vital signs on arrival
· Temperature: 98.9° F (37.1° C) orally
. Heart rate: 101 beats/minute
· Respirations: 22 breaths/minute
· Blood pressure: 156/90 mm Hg
· Oxygen saturation: 92% on room air
1635
Vital signs
· Temperature: 98.6° F (37° C) orally
. Heart rate: 98 beats/minute
. Respirations: 22 breaths/minute
· Blood pressure: 160/92 mm Hg
· Oxygen saturation: 93% on 1 L/minute oxygen via nasal cannula
1700
Vital signs
· Temperature: 98.6° F (37° C) orally
. Heart rate: 100 beats/minute
· Respirations: 21 breaths/minute
· Blood pressure: 166/89 mm Hg
· Oxygen saturation: 94% on 1 L/minute
Orders
. Computed tomography (CT) of the head
· Carotid duplex ultrasound
· Complete blood count (CBC), complete metabolic panel (CMP), prothrombin time/international normalized ratio (PT/INR), partial thromboplastin time (PTT), C-reactive protein (CRP), thyroid stimulating hormone (TSH), low density lipoprotein (LDL), high density lipoprotein (HDL)
· Admit to the stroke unit
· Magnetic resonance imaging (MRI) of brain
Imaging Studies
· Computed tomography (CT) of brain: Negative.
· Carotid ultrasound: Left carotid 80% stenosis.
The nurse is admitting the client to the stroke unit and preparing to complete a focused neurological assessment.
Which assessment(s) should the nurse conduct? Select all that apply.
-
Level of consciousness
-
Romberg’s test
-
Pupil size
-
Glasgow Coma Scale
-
Cranial nerves
-
Muscle tone
-
Brudzinski reflexes
Explanation
History and Physical
The client is a 76-year-old female who arrived at the emergency department (ED) via ambulance from an assisted living facility after a fall. The client called for help using her medical alert necklace. Reports feeling dizzy and lightheaded for the past two days. Client is unable to recall the events that led up to the fall and states, "I do not know how long I was down." Past medical history includes chronic obstructive pulmonary disease (COPD), hypertension (HTN), and carotid artery stenosis. Smokes half a pack of cigarettes daily for 40 years. Attempted to quit smoking five years ago after a right carotid endarterectomy.
Nurses' Notes
1620
Received report from triage nurse. Client returning from computed tomography (CT) department. The client is alert and oriented to person, place, time, and situation. Unable to recall details of her fall. Heart rhythm regular. Lung sounds are diminished throughout. Placed on oxygen 1 L/minute via nasal cannula. Bruising noted to left arm and small laceration on the left chin from the fall. Pain rated 3 on a scale of 0 to 10. Carotid
ultrasound performed at bedside. Laboratory
specimens drawn. Preparing the client for
transfer to the stroke unit, calling to ascertain
readiness to receive client and room number.
1640
Transferred client to the stroke unit from the
ED as prescribed. Situation, background,
assessment, recommendation (SBAR) report
given.
1655
Received client from emergency department
(ED). Admitted and oriented to the stroke unit.
Vital signs taken.
Flow Sheet
1600
Vital signs on arrival
· Temperature: 98.9° F (37.1° C) orally
. Heart rate: 101 beats/minute
· Respirations: 22 breaths/minute
· Blood pressure: 156/90 mm Hg
· Oxygen saturation: 92% on room air
1635
Vital signs
· Temperature: 98.6° F (37° C) orally
. Heart rate: 98 beats/minute
. Respirations: 22 breaths/minute
· Blood pressure: 160/92 mm Hg
· Oxygen saturation: 93% on 1 L/minute
oxygen via nasal cannula
1700
Vital signs
· Temperature: 98.6° F (37° C) orally
. Heart rate: 100 beats/minute
· Respirations: 21 breaths/minute
· Blood pressure: 166/89 mm Hg
· Oxygen saturation: 94% on 1 L/minute
Orders
. Computed tomography (CT) of the head
· Carotid duplex ultrasound
· Complete blood count (CBC), complete
metabolic panel (CMP), prothrombin
time/international normalized ratio (PT/INR),
partial thromboplastin time (PTT), C-
reactive protein (CRP), thyroid stimulating
hormone (TSH), low density lipoprotein
(LDL), high density lipoprotein (HDL)
· Admit to the stroke unit
· Magnetic resonance imaging (MRI) of brain
Imaging Studies
· Computed tomography (CT) of brain:
Negative.
· Carotid ultrasound: Left carotid 80%
stenosis.
The nurse is admitting the client to the stroke unit and preparing to
complete a focused neurological assessment.
Which assessment(s) should the nurse conduct? Select all that apply.
-
Level of consciousness
-
Romberg’s test
-
Pupil size
-
Glasgow Coma Scale
-
Cranial nerves
-
Muscle tone
-
Brudzinski reflexes
Explanation
The Correct Answers are:
A. Level of consciousness, C. Pupil size, D. Glasgow Coma Scale, E. Cranial nerves, and F. Muscle tone.
Detailed Explanation:
A. Level of consciousness:
This is one of the most critical components of a neurological assessment. Changes in consciousness may indicate worsening cerebral perfusion or evolving neurological deficits following a possible cerebrovascular event. Monitoring alertness, orientation, and responsiveness provides early clues to deterioration.
C. Pupil size:
Assessing pupil size, shape, and reactivity to light helps identify cranial nerve (CN) III involvement or increased intracranial pressure. Unequal or sluggish pupils may signal neurological compromise.
D. Glasgow Coma Scale:
The Glasgow Coma Scale (GCS) objectively measures eye opening, verbal, and motor responses to quantify neurological function. This standardized scale helps track changes in neurological status over time and detect subtle deterioration.
E. Cranial nerves:
Testing the cranial nerves evaluates brainstem and cerebral function. It identifies deficits such as facial droop, dysarthria, or visual disturbances, which are key indicators of stroke or carotid artery impairment.
F. Muscle tone:
Assessing muscle tone and strength detects weakness, rigidity, or flaccidity on one side of the body — common in stroke patients. These findings help determine the location and extent of neurological injury.
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