NUR 210 RN Health Assessment HESI NGN
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Free NUR 210 RN Health Assessment HESI NGN Questions
1. Which focused assessment technique should the nurse use for a client admitted with possible dehydration?
- A. Grasp skin fold of the posterior forearm.
- B. Press skin over a bony prominence.
- C. Measure the circumference of the calf.
- D. Check hands for parchment-like appearance.
Explanation
To assess for dehydration, the nurse evaluates skin turgor by gently grasping and releasing a fold of skin—commonly on the posterior forearm or sternum. If the skin remains tented or slowly returns to its normal position, this indicates poor skin elasticity caused by fluid loss or dehydration. This method provides a quick, reliable bedside assessment of fluid balance.
2. A client reports episodes of syncope. Which assessment finding should the nurse anticipate?
- A. 3+ carotid pulse volume bilaterally.
- B. Positive jugular vein distention (JVD) bilaterally.
- C. Decreased blood pressure during orthostatic measurement.
- D. Grade 3 systolic murmur auscultated at the pulmonic site.
Explanation
Syncope (fainting) often results from a temporary decrease in cerebral perfusion caused by a drop in blood pressure. When assessing orthostatic vitals, a significant decrease in systolic (≥20 mmHg) or diastolic (≥10 mmHg) blood pressure, or an increase in heart rate, indicates orthostatic hypotension. This condition can cause dizziness, lightheadedness, and fainting when the client moves from lying to standing, explaining the reported episodes of syncope.
3. An older adult client with a recent history of a cerebrovascular accident (CVA) presents with right hemiparesis. The nurse tests the deep tendon reflexes on the right side and elicits a brisk 4+ response. Which interpretation of this finding is accurate?
- A. Absent or sluggish response consistent with a lower motor neuron lesion.
- B. A normal reflex response.
- C. Flaccid paralysis.
- D. Hyperactive response consistent with an upper motor neuron disorder.
Explanation
A 4+ deep tendon reflex indicates a hyperactive response with possible clonus. This finding is characteristic of an upper motor neuron lesion, such as one resulting from a cerebrovascular accident (CVA). Damage to the upper motor neurons removes inhibitory control over lower motor neurons, resulting in exaggerated reflexes, muscle spasticity, and increased tone on the affected side. These findings are consistent with right-sided hemiparesis following a stroke.
4. A woman comes to the clinic for her first prenatal visit. The nurse is conducting a health history and the woman begins to cry when asked about previous pregnancies. Which response is best for the nurse to provide?
- A. "I'm so sorry that I made you cry. I didn't mean to upset you."
- B. "Why don't I come back in a few minutes after you are more composed."
- C Offer a tissue and sit quietly until the crying subsides.
- D. Allow the client to compose herself then change the subject.
Explanation
The best therapeutic response is to offer a tissue and remain present in silence while the client cries. This demonstrates empathy, compassion, and emotional support, allowing the client to express feelings freely without interruption or judgment. Silence is a powerful therapeutic communication technique that gives the client space to process emotions while maintaining trust and rapport.
5. The nurse is examining the abdomen of an older adult male client who expresses suprapubic tenderness on palpation. The client reports that it sometimes feels like there is still pressure in that area after urination. Which additional finding should the nurse expect with continued interview of the client?
- A. Black tarry stools.
- B. A cloudy discharge.
- C. An overactive bladder.
- D. A weak urinary stream.
Explanation
Suprapubic tenderness and a feeling of incomplete bladder emptying in an older male often indicate urinary retention due to benign prostatic hyperplasia (BPH). As the prostate enlarges, it compresses the urethra, resulting in symptoms such as hesitancy, weak urinary stream, dribbling, and a sensation of pressure after urination. Recognizing these symptoms is key to assessing for BPH and preventing complications such as urinary tract infections.
6. The nurse observes that a client is experiencing melena. Which serum laboratory test should the nurse monitor in response to this finding?
- A. White blood cell count (WBC).
- B. Blood urea nitrogen (BUN).
- C. Hematocrit.
- D. Glucose.
Explanation
Melena refers to black, tarry stools caused by digested blood from an upper gastrointestinal (GI) bleed. This condition can result in blood loss and anemia, making it essential for the nurse to monitor the client’s hematocrit (and hemoglobin) to evaluate the extent of blood loss and the risk of hypovolemia. A declining hematocrit level indicates ongoing bleeding or inadequate replacement of lost blood volume.
7. 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.
8. 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?
- A. Obtain vital signs and oxygen saturation.
- B. Calculate the body mass index (BMI).
- C. Measure degree of skin elasticity.
- D. 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.
9. 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?
- A. Perform sets of passive range of motion.
- B. Hold arms straight forward with eyes closed.
- C. Flex and hold as opposing force is applied.
- D. 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.
10. 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?
- A. Ignore the angry outburst and continue with the history questions.
- B. "I am sorry you feel that way. Perhaps you'd like to return when you have more time."
- C. "You sound angry. Would you like to tell me about it?"
- D. 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.
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