NUR 210 RN Health Assessment HESI NGN
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Free NUR 210 RN Health Assessment HESI NGN Questions
1. 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.
2. A client sustained a subconjunctival hemorrhage. The presence of which set of symptoms indicate that the client needs to be seen for further evaluation by an ophthalmologist?
- Acute pain, change in visual acuity, and foreign body sensation.
- Bilateral itchy, red eyes with watery discharge.
- Diminished ability to focus on close work and excessive illumination required.
- Frequent burning, irritation, and tearing of the eyes.
Explanation
A subconjunctival hemorrhage is typically painless and resolves without treatment. However, if the client experiences acute eye pain, changes in visual acuity, or a foreign body sensation, these signs suggest a more serious underlying condition such as corneal abrasion, uveitis, or globe injury. These symptoms require urgent ophthalmologic evaluation to prevent potential vision loss or complications.
3. An older adult client with a history of heart failure (HF) comes to the clinic troubled by awakening during the night in a cold sweat, accompanied by difficulty breathing, and a racing heartbeat. Which assessment should the nurse complete first?
- Assess the elasticity of the client's skin.
- Ask about any environmental allergies.
- Measure the client's core temperature.
- Auscultate the client's breath sounds.
Explanation
The client’s symptoms—awakening at night with shortness of breath, sweating, and a racing heartbeat—suggest paroxysmal nocturnal dyspnea (PND), a classic sign of worsening heart failure. The nurse should first auscultate the breath sounds to assess for pulmonary congestion or crackles caused by fluid accumulation in the lungs. This finding provides immediate information about the client’s respiratory and cardiac status and guides the need for urgent intervention to prevent respiratory distress.
4. The nurse is assessing a client for a goiter and is unable to observe the thyroid gland. Which action should the nurse take?
- Defer the thyroid exam and observe the client for signs of myxedema.
- Palpate deeply and firmly over the location of the thyroid gland.
- Document that thyroid gland size is normal with no visible goiter.
- Ask the client to swallow while palpating along the sides of the trachea.
Explanation
When the thyroid gland is not visible during inspection, the nurse should palpate the gland while the client swallows. Asking the client to swallow causes the thyroid gland to rise and fall with the trachea, making it easier to feel for enlargement, nodules, or asymmetry. This technique allows accurate assessment of the gland’s size, shape, and consistency. The thyroid is normally not visible or easily palpable unless it is enlarged.
5. The nurse is completing an assessment for a client with uncontrolled diabetes mellitus (DM) who came to the clinic reporting frequent, painful urination. Which screening test should the nurse perform first?
- Fingerstick glucose.
- Nitrazine pH strip.
- Rapid strep test.
- Urine dipstick test.
Explanation
A client with diabetes mellitus who reports frequent and painful urination is showing classic signs of a urinary tract infection (UTI) — a common complication due to increased glucose in the urine providing a favorable environment for bacterial growth. The nurse should first perform a urine dipstick test to check for leukocyte esterase, nitrites, protein, and glucose. This quick, noninvasive screening can confirm infection and guide further testing such as urine culture or antibiotic therapy.
6. 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?
- "I'm so sorry that I made you cry. I didn't mean to upset you."
- "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.
- 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.
7. 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.
8. Which assessment action should the nurse use when performing a cognitive ability exam?
- Observe physical grooming and hygiene.
- Tell the client to repeat a phrase that was said earlier.
- Ask the client to describe reactions in a difficult situation.
- Evaluate ability to brush and floss teeth.
Explanation
Assessing cognitive ability involves evaluating memory, attention, and thought processes. Asking the client to repeat a phrase that was said earlier specifically tests short-term memory, an essential part of cognitive functioning. This helps the nurse determine the client’s ability to register, retain, and recall new information — important for identifying potential cognitive impairment such as dementia or delirium.
9. 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.
10. 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?
- Perform sets of passive range of motion.
- Hold arms straight forward with eyes closed.
- Flex and hold as opposing force is applied.
- 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.
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