NURS 3020 Health Assessment Practice Test
Sample Questions Answers
Which of the following techniques is primarily used to assess the size, shape, and position of organs during a physical examination?
A) Inspection
B) Palpation
C) Percussion
D) Auscultation
Answer: C) Percussion
Explanation: Percussion is the technique used to assess the size, shape, and position of organs by tapping the body surface and listening to the resulting sound.
During a health assessment, which of the following is the primary purpose of the inspection technique?
A) To evaluate the patient’s physical appearance
B) To detect abnormal sounds in the body
C) To identify tenderness in the abdomen
D) To palpate the pulse rate
Answer: A) To evaluate the patient’s physical appearance
Explanation: Inspection involves visually assessing the patient for abnormalities such as changes in color, shape, or size.
When assessing a patient’s lung sounds, which of the following techniques would the nurse use?
A) Palpation
B) Percussion
C) Inspection
D) Auscultation
Answer: D) Auscultation
Explanation: Auscultation involves using a stethoscope to listen to sounds from the body, such as lung sounds, heartbeats, or bowel sounds.
A patient complains of abdominal pain. Which of the following examination techniques should be performed first?
A) Palpation
B) Inspection
C) Percussion
D) Auscultation
Answer: B) Inspection
Explanation: Inspection should always be performed first to identify any visible signs of abnormalities, such as swelling or discoloration, before proceeding to more invasive techniques like palpation.
Which of the following is considered an important psychological aspect to consider when conducting a health assessment?
A) The patient’s family history
B) The patient’s level of stress or anxiety
C) The patient’s socioeconomic status
D) The patient’s physical condition
Answer: B) The patient’s level of stress or anxiety
Explanation: Psychological factors, such as stress or anxiety, can impact the patient’s ability to communicate effectively and affect the accuracy of the health assessment.
When assessing a patient’s vital signs, which of the following would require immediate follow-up?
A) A temperature of 98.6°F
B) A blood pressure of 120/80 mmHg
C) A heart rate of 140 bpm
D) A respiratory rate of 18 breaths per minute
Answer: C) A heart rate of 140 bpm
Explanation: A heart rate of 140 bpm is abnormally high and could indicate a medical emergency, requiring immediate follow-up.
In a health assessment, which of the following techniques is used to detect tenderness or swelling in the abdomen?
A) Percussion
B) Palpation
C) Inspection
D) Auscultation
Answer: B) Palpation
Explanation: Palpation involves using the hands to feel for tenderness, swelling, or masses, particularly in the abdomen.
Which of the following best describes the purpose of health history during a clinical assessment?
A) To collect subjective information from the patient
B) To perform a physical examination
C) To measure vital signs
D) To conduct laboratory tests
Answer: A) To collect subjective information from the patient
Explanation: Health history involves gathering subjective data from the patient, including their medical history, lifestyle, and current health concerns.
Which of the following findings during a physical examination would most likely require immediate intervention?
A) Mild cough
B) Decreased breath sounds in one lung
C) Slight increase in blood pressure
D) Mild tenderness over the abdomen
Answer: B) Decreased breath sounds in one lung
Explanation: Decreased breath sounds in one lung may indicate a serious condition, such as a collapsed lung or pneumonia, requiring immediate follow-up.
What is the primary purpose of cultural considerations during a health assessment?
A) To help with the diagnosis of diseases
B) To ensure the patient understands the assessment
C) To tailor care according to the patient’s cultural beliefs and practices
D) To create a detailed health history
Answer: C) To tailor care according to the patient’s cultural beliefs and practices
Explanation: Cultural considerations help nurses provide respectful care and avoid misunderstanding, ensuring the patient feels comfortable during the assessment.
What is the best position to assess a patient’s heart sounds?
A) Supine
B) Prone
C) Lateral recumbent
D) Fowler’s position
Answer: C) Lateral recumbent
Explanation: The lateral recumbent position is often used to listen to heart sounds, especially for detecting murmurs.
During a health assessment, the nurse observes that the patient has clubbing of the fingers. What could this indicate?
A) Chronic respiratory disease
B) Diabetes mellitus
C) Acute dehydration
D) Pregnancy
Answer: A) Chronic respiratory disease
Explanation: Clubbing of the fingers is often associated with chronic respiratory diseases, such as COPD or cystic fibrosis.
Which of the following is an example of a non-verbal communication skill essential during a health assessment?
A) Asking the patient about their family history
B) Making direct eye contact with the patient
C) Writing notes on the patient’s chart
D) Providing a verbal explanation of procedures
Answer: B) Making direct eye contact with the patient
Explanation: Non-verbal communication, such as maintaining eye contact, helps build rapport and shows the nurse is engaged and attentive.
When palpating a patient’s abdomen, the nurse should begin in which quadrant?
A) Right lower quadrant
B) Left lower quadrant
C) Right upper quadrant
D) Left upper quadrant
Answer: A) Right lower quadrant
Explanation: The nurse should start in the right lower quadrant to avoid causing unnecessary pain, as this is where the appendix is located.
Which of the following would be considered a normal finding when inspecting the skin of a healthy adult?
A) Pallor
B) Cyanosis
C) Jaundice
D) Even pigmentation
Answer: D) Even pigmentation
Explanation: Healthy skin typically shows even pigmentation, with no signs of pallor, cyanosis, or jaundice.
Which of the following techniques is best for assessing a patient’s joint mobility?
A) Palpation
B) Percussion
C) Inspection
D) Range of motion
Answer: D) Range of motion
Explanation: Range of motion exercises assess joint mobility, helping to identify any restrictions or pain associated with movement.
During a health assessment, the nurse is performing auscultation of a patient’s lungs. Which of the following would be considered an abnormal finding?
A) Clear breath sounds
B) Wheezing
C) Vesicular breath sounds
D) Bronchial breath sounds
Answer: B) Wheezing
Explanation: Wheezing is an abnormal lung sound often associated with respiratory conditions like asthma or bronchitis.
A patient’s blood pressure reading is 150/95 mmHg. What is the nurse’s most appropriate next action?
A) Document the reading and monitor at the next appointment
B) Perform a follow-up assessment to confirm the reading
C) Encourage the patient to rest for 5 minutes and recheck
D) Recommend that the patient start antihypertensive medication immediately
Answer: C) Encourage the patient to rest for 5 minutes and recheck
Explanation: It’s important to recheck blood pressure after the patient has rested to ensure an accurate reading.
When assessing a patient’s cognitive function, which of the following would be considered a normal finding in a healthy adult?
A) Short-term memory loss
B) Disorientation to time and place
C) The ability to follow simple commands
D) Difficulty concentrating
Answer: C) The ability to follow simple commands
Explanation: A normal finding would be the ability to follow simple commands, which indicates intact cognitive function.
The nurse is using a stethoscope to listen to bowel sounds. Which of the following describes a normal finding?
A) Hyperactive sounds
B) Hypoactive sounds
C) Absent sounds
D) Regular gurgling noises
Answer: D) Regular gurgling noises
Explanation: Regular gurgling sounds, also known as bowel sounds, are normal and indicate the proper function of the intestines.
Which of the following is the most appropriate method for assessing a patient’s hydration status?
A) Measuring blood pressure
B) Assessing skin turgor
C) Taking a blood glucose level
D) Listening to heart sounds
Answer: B) Assessing skin turgor
Explanation: Skin turgor, or the elasticity of the skin, is a key indicator of hydration status. Poor turgor suggests dehydration.
What should the nurse do if they notice an abnormal finding during a health assessment?
A) Ignore the finding and continue the assessment
B) Inform the patient and immediately perform a diagnosis
C) Document the finding and report it to the appropriate healthcare provider
D) Discard the information as it may be unreliable
Answer: C) Document the finding and report it to the appropriate healthcare provider
Explanation: Abnormal findings should be documented accurately and communicated to the appropriate healthcare provider for further evaluation.
Which of the following is an appropriate interviewing technique during a health assessment?
A) Interrupt the patient to get clear answers
B) Ask open-ended questions to encourage communication
C) Focus only on medical symptoms
D) Avoid asking sensitive questions
Answer: B) Ask open-ended questions to encourage communication
Explanation: Open-ended questions allow patients to express themselves more fully, providing richer and more accurate information.
The nurse is performing an assessment of a patient’s respiratory rate. What is the normal range for a healthy adult?
A) 12-16 breaths per minute
B) 20-24 breaths per minute
C) 25-30 breaths per minute
D) 10-12 breaths per minute
Answer: A) 12-16 breaths per minute
Explanation: A normal respiratory rate for a healthy adult is typically 12-16 breaths per minute.
Which of the following positions is most appropriate for assessing a patient’s heart sounds?
A) Sitting upright
B) Lying flat
C) Left lateral recumbent
D) Supine with legs elevated
Answer: C) Left lateral recumbent
Explanation: The left lateral recumbent position is best for auscultating heart sounds, especially for detecting murmurs.
Which of the following is an important component of health assessment related to patient privacy?
A) Always ask the patient to speak openly about all their health concerns
B) Ensure all patient information is kept confidential and secure
C) Conduct assessments without the patient’s consent
D) Provide the patient’s information to family members for further assessment
Answer: B) Ensure all patient information is kept confidential and secure
Explanation: Maintaining patient privacy and confidentiality is critical for building trust and adhering to ethical standards.
A patient is experiencing tachypnea. Which of the following is the nurse likely to observe?
A) Slow, shallow breaths
B) Rapid, shallow breaths
C) Irregular, deep breaths
D) Slow, deep breaths
Answer: B) Rapid, shallow breaths
Explanation: Tachypnea refers to rapid, shallow breathing, which could be a sign of respiratory distress or other underlying issues.
Which of the following is the best method to assess a patient’s lymph nodes?
A) Palpation
B) Percussion
C) Inspection
D) Auscultation
Answer: A) Palpation
Explanation: Palpation is used to assess lymph nodes for tenderness, size, or abnormality.
A patient reports a sudden onset of severe headache and nausea. What should the nurse do first?
A) Administer pain medication
B) Perform a neurological assessment
C) Ask the patient to lie down
D) Send the patient for imaging immediately
Answer: B) Perform a neurological assessment
Explanation: A sudden severe headache with nausea may indicate a neurological issue, such as a stroke, so a neurological assessment is necessary.
In which situation is it most appropriate to use a Doppler device during a health assessment?
A) To assess lung sounds
B) To assess fetal heart tones
C) To measure blood pressure
D) To listen for bowel sounds
Answer: B) To assess fetal heart tones
Explanation: A Doppler device is commonly used to assess fetal heart tones, especially when they are difficult to detect with a regular stethoscope.
When performing a health assessment, which of the following techniques should be used to assess a patient’s heart rate?
A) Palpation
B) Percussion
C) Auscultation
D) Inspection
Answer: A) Palpation
Explanation: Palpation is used to assess the heart rate by feeling the pulse at various locations on the body, such as the radial or carotid artery.
Which of the following findings during an abdominal assessment would indicate the need for immediate intervention?
A) Mild tenderness on palpation
B) Absence of bowel sounds for 5 minutes
C) A visible pulsation in the upper abdomen
D) Slight distention in the lower abdomen
Answer: C) A visible pulsation in the upper abdomen
Explanation: A visible pulsation may indicate an aneurysm or other serious condition that requires urgent intervention.
What is the correct order for performing a physical assessment of the abdomen?
A) Inspection, palpation, percussion, auscultation
B) Inspection, auscultation, percussion, palpation
C) Palpation, inspection, percussion, auscultation
D) Percussion, inspection, auscultation, palpation
Answer: B) Inspection, auscultation, percussion, palpation
Explanation: The correct order for assessing the abdomen is inspection first, followed by auscultation to avoid altering bowel sounds with palpation or percussion.
A nurse is assessing the skin turgor of an elderly patient. What would be the most appropriate method to assess for dehydration?
A) Pinch the skin on the back of the hand
B) Pinch the skin on the forearm
C) Pinch the skin on the sternum
D) Pinch the skin on the abdomen
Answer: C) Pinch the skin on the sternum
Explanation: Skin turgor should be assessed on the sternum in elderly patients, as the skin on the back of the hand may lose elasticity with aging.
When a nurse is performing a cardiovascular assessment, which of the following findings would be a normal finding?
A) An S3 heart sound in a healthy adult
B) A heart murmur with radiation
C) A regular rhythm with no extra heart sounds
D) Irregular heartbeats heard without a stethoscope
Answer: C) A regular rhythm with no extra heart sounds
Explanation: A regular rhythm with no extra heart sounds is normal, indicating a healthy heart function.
Which of the following should the nurse do before performing palpation on a patient’s abdomen?
A) Ask the patient to breathe deeply and slowly
B) Ensure the patient has fasted for at least 12 hours
C) Warm the hands and ensure the patient is in a comfortable position
D) Apply pressure to the abdomen to detect masses
Answer: C) Warm the hands and ensure the patient is in a comfortable position
Explanation: It is essential to warm the hands to prevent discomfort during palpation, and the patient should be positioned comfortably.
Which of the following is considered an abnormal finding when auscultating bowel sounds?
A) High-pitched gurgling sounds
B) Occasional clicking sounds
C) Silence for more than 5 minutes
D) Rumbling sounds
Answer: C) Silence for more than 5 minutes
Explanation: Absence of bowel sounds for more than 5 minutes is considered abnormal and may indicate a serious issue, such as a bowel obstruction.
Which of the following is a potential complication associated with improper auscultation technique during a health assessment?
A) Missed abnormal lung sounds
B) Overly accurate blood pressure reading
C) Increased accuracy in bowel sound assessment
D) Inaccurate heart rate measurement
Answer: A) Missed abnormal lung sounds
Explanation: If the stethoscope is not properly placed or if auscultation is rushed, abnormal lung sounds may be missed, which can delay the diagnosis of respiratory issues.
A nurse is assessing a patient’s peripheral circulation. Which of the following findings would be most concerning?
A) Cold extremities
B) Bilateral swelling of the ankles
C) A slight decrease in capillary refill time
D) A palpable pulse in the feet
Answer: B) Bilateral swelling of the ankles
Explanation: Bilateral swelling in the ankles can indicate a systemic problem, such as heart failure or kidney disease, and requires further evaluation.
What is the primary purpose of using palpation during a health assessment?
A) To listen to internal body sounds
B) To feel for any tenderness, swelling, or masses
C) To observe visible signs of abnormalities
D) To measure body temperature
Answer: B) To feel for any tenderness, swelling, or masses
Explanation: Palpation is used to assess the physical condition of internal structures by feeling for tenderness, swelling, and masses.
The nurse is performing a neurological assessment. Which of the following is the most appropriate response if a patient exhibits an abnormal pupil reaction to light?
A) Reassure the patient that this is a normal finding
B) Record the finding and continue with the assessment
C) Notify the healthcare provider immediately
D) Advise the patient to rest their eyes for 5 minutes
Answer: C) Notify the healthcare provider immediately
Explanation: An abnormal pupil reaction can be a sign of neurological impairment, such as increased intracranial pressure, and requires immediate medical attention.
The nurse is performing an assessment of a patient’s thorax. Which of the following findings is considered normal?
A) Decreased breath sounds in the lower lobes
B) Decreased fremitus over the lungs
C) Symmetrical chest expansion
D) Absent breath sounds over the trachea
Answer: C) Symmetrical chest expansion
Explanation: Symmetrical chest expansion is a normal finding, indicating that both sides of the lungs are expanding and contracting equally.
What is the primary goal when interviewing a patient for a health history?
A) To gather only objective data
B) To ask questions to which the nurse already knows the answers
C) To establish a trusting relationship and obtain subjective data
D) To immediately begin diagnostic testing
Answer: C) To establish a trusting relationship and obtain subjective data
Explanation: The goal is to create a comfortable environment where the patient can provide valuable subjective data regarding their health history.
Which of the following is the best approach when assessing a patient’s risk for falls?
A) Ask the patient if they have fallen in the past
B) Observe the patient’s gait and balance during the assessment
C) Examine the patient’s medical history for any chronic illnesses
D) Measure the patient’s blood pressure while standing
Answer: B) Observe the patient’s gait and balance during the assessment
Explanation: Observing gait and balance helps assess the risk of falls, as physical impairments or weakness can contribute to an increased risk.
When performing auscultation of the heart, the nurse hears an extra sound between S1 and S2. What does this sound most likely represent?
A) S3 heart sound
B) S4 heart sound
C) Heart murmur
D) Aortic stenosis
Answer: A) S3 heart sound
Explanation: An S3 heart sound is often heard in conditions like heart failure and is characterized by an extra sound between S1 and S2.
When assessing a patient’s hydration status, which of the following is an early indicator of dehydration?
A) Increased blood pressure
B) Dark yellow urine
C) Swelling of the ankles
D) Elevated respiratory rate
Answer: B) Dark yellow urine
Explanation: Dark yellow urine is often an early sign of dehydration, indicating that the patient may not be drinking enough fluids.
The nurse is conducting an assessment of a patient’s lymphatic system. Which of the following findings would indicate a possible issue?
A) Non-palpable lymph nodes
B) Enlarged, tender lymph nodes
C) Symmetrical lymphatic drainage
D) Absence of axillary hair
Answer: B) Enlarged, tender lymph nodes
Explanation: Enlarged and tender lymph nodes can indicate infection, inflammation, or malignancy and require further evaluation.
A nurse is performing an abdominal exam and observes visible peristalsis in a patient with a distended abdomen. What should be the nurse’s next action?
A) Document the finding and continue with the assessment
B) Reassure the patient that this is normal and proceed with the exam
C) Immediately notify the healthcare provider for further evaluation
D) Ask the patient to lie on their side to observe the peristalsis further
Answer: C) Immediately notify the healthcare provider for further evaluation
Explanation: Visible peristalsis and abdominal distention could indicate an obstruction, which requires immediate medical evaluation.
Which of the following findings would be considered a normal variation when inspecting the ears of an adult?
A) Presence of cerumen in the ear canal
B) Redness or swelling in the external ear
C) Drainage of yellow-green fluid from the ear canal
D) Tenderness when palpating the ear
Answer: A) Presence of cerumen in the ear canal
Explanation: A small amount of cerumen (earwax) is a normal finding in the ear canal and does not typically require intervention unless it causes discomfort or hearing loss.
What should the nurse do if the patient reports pain during the palpation of a specific body area?
A) Immediately stop the palpation and reassess the area later
B) Ignore the pain and continue the assessment
C) Apply more pressure to assess the severity of the pain
D) Ask the patient to explain the pain in more detail and observe for other signs
Answer: D) Ask the patient to explain the pain in more detail and observe for other signs
Explanation: Pain should never be ignored, and the nurse should ask the patient to describe it further, looking for signs of potential underlying issues.