1
NUR 6111 Advanced Health Assessment Telehealth
Cardiovascular Exam (Liam Fitzgerald), 2026/2027
1. Before initiating the telehealth visit with Mr. Fitzgerald, the advanced
practice nurse should first verify which of the following to ensure a successful
encounter?
A) Mr. Fitzgerald has a current, valid prescription for all his medications.
B) Mr. Fitzgerald has signed a telehealth consent form and the connection is
secure and HIPAA-compliant.
C) Mr. Fitzgerald has fasted for the past 12 hours.
D) Mr. Fitzgerald has a family member present to assist with the technology.
Answer: B) Mr. Fitzgerald has signed a telehealth consent form and the
connection is secure and HIPAA-compliant.
Rationale: Before any telehealth encounter, the first priority is to obtain informed
consent for telehealth services and ensure the platform used is secure and
compliant with HIPAA regulations to protect patient privacy. Verifying
medications (A) is part of the medication reconciliation process but not the very
first step. Fasting (C) is not required for a routine telehealth cardiovascular
assessment. A family member (D) may be helpful but is not a prerequisite; the
patient's autonomy should be respected.
2. During the initial telehealth connection, Mr. Fitzgerald appears seated in a
dimly lit room with his face partially shadowed. What is the most appropriate
initial action by the nurse to optimize the visual assessment?
A) Proceed with the visit and ask him to describe his appearance.
B) Ask Mr. Fitzgerald to turn on overhead lights and adjust his camera so his face
and upper chest are well-lit.
C) Document that lighting was inadequate and reschedule the visit.
D) Assume the lighting issue is due to a poor internet connection.
pg. 1
,2
Answer: B) Ask Mr. Fitzgerald to turn on overhead lights and adjust his camera
so his face and upper chest are well-lit.
Rationale: Adequate lighting is essential for a valid telehealth physical
assessment, particularly for observing skin color, respiratory effort, facial
expressions, and signs of distress. The nurse should provide polite, clear
instructions to optimize the environment. Proceeding (A) without addressing the
problem could lead to missed clinical signs. Rescheduling (C) is premature; the
issue can likely be resolved with simple instructions.
3. Mr. Fitzgerald is using a laptop for the visit. To best evaluate his jugular
venous pressure (JVP) and carotid pulsations, the nurse should instruct him to:
A) Stand up and look directly at the camera.
B) Turn his head slightly to the left and look straight ahead while the camera is
positioned to view his neck.
C) Lie flat on his back with the camera above his head.
D) There is no way to assess JVP via telehealth; it must be an in-person exam.
Answer: B) Turn his head slightly to the left and look straight ahead while the
camera is positioned to view his neck.
Rationale: JVP can be approximated via telehealth by asking the patient to
position themselves in a semi-recumbent position (e.g., 30–45 degrees), turn their
head slightly to the left (to expose the right internal jugular vein), and look
straight ahead. The camera should be placed at the side to visualize the neck. The
patient should not lie flat (C) as that would obliterate the JVP meniscus. While a
definitive JVP measurement is challenging, visualization of distention can be
assessed. It is not impossible (D).
4. Before beginning the history-taking, the nurse asks Mr. Fitzgerald to verify his
identity using two identifiers. Which of the following is an appropriate
combination via telehealth?
A) Name and room number.
B) Name and date of birth.
pg. 2
, 3
C) Insurance card number and address.
D) Phone number and email address.
Answer: B) Name and date of birth.
Rationale: The standard two patient identifiers are the patient's name and date of
birth, which can be confirmed verbally and visually if they show an ID. Room
number (A) is for inpatients. Insurance card number and address (C, D) are not
standard identifiers for this purpose and could be considered protected
information without proper encryption if not on the platform.
5. Mr. Fitzgerald reports that his blood pressure readings at home have been
inconsistent. The nurse should first:
A) Discontinue his antihypertensive medication.
B) Instruct him on proper blood pressure measurement technique and ask him to
demonstrate.
C) Diagnose him with labile hypertension.
D) Refer him to the emergency department immediately.
Answer: B) Instruct him on proper blood pressure measurement technique and
ask him to demonstrate.
Rationale: Inconsistent home readings often result from improper technique. The
nurse should first validate the measurement method: correct cuff size, arm
position at heart level, feet flat, back supported, and rest before measurement.
The patient can demonstrate with their own device via video. Discontinuing
medication (A) is dangerous without a clear diagnosis. Labile hypertension (C) is a
possible diagnosis but requires accurate readings first. Emergency referral (D) is
not indicated for inconsistent readings without symptoms of a hypertensive crisis.
6. Mr. Fitzgerald mentions he has a digital blood pressure cuff but hasn't had it
calibrated in two years. The most appropriate advice is to:
A) Continue using the cuff as is; calibration is not important.
B) Buy a new cuff immediately.
pg. 3
NUR 6111 Advanced Health Assessment Telehealth
Cardiovascular Exam (Liam Fitzgerald), 2026/2027
1. Before initiating the telehealth visit with Mr. Fitzgerald, the advanced
practice nurse should first verify which of the following to ensure a successful
encounter?
A) Mr. Fitzgerald has a current, valid prescription for all his medications.
B) Mr. Fitzgerald has signed a telehealth consent form and the connection is
secure and HIPAA-compliant.
C) Mr. Fitzgerald has fasted for the past 12 hours.
D) Mr. Fitzgerald has a family member present to assist with the technology.
Answer: B) Mr. Fitzgerald has signed a telehealth consent form and the
connection is secure and HIPAA-compliant.
Rationale: Before any telehealth encounter, the first priority is to obtain informed
consent for telehealth services and ensure the platform used is secure and
compliant with HIPAA regulations to protect patient privacy. Verifying
medications (A) is part of the medication reconciliation process but not the very
first step. Fasting (C) is not required for a routine telehealth cardiovascular
assessment. A family member (D) may be helpful but is not a prerequisite; the
patient's autonomy should be respected.
2. During the initial telehealth connection, Mr. Fitzgerald appears seated in a
dimly lit room with his face partially shadowed. What is the most appropriate
initial action by the nurse to optimize the visual assessment?
A) Proceed with the visit and ask him to describe his appearance.
B) Ask Mr. Fitzgerald to turn on overhead lights and adjust his camera so his face
and upper chest are well-lit.
C) Document that lighting was inadequate and reschedule the visit.
D) Assume the lighting issue is due to a poor internet connection.
pg. 1
,2
Answer: B) Ask Mr. Fitzgerald to turn on overhead lights and adjust his camera
so his face and upper chest are well-lit.
Rationale: Adequate lighting is essential for a valid telehealth physical
assessment, particularly for observing skin color, respiratory effort, facial
expressions, and signs of distress. The nurse should provide polite, clear
instructions to optimize the environment. Proceeding (A) without addressing the
problem could lead to missed clinical signs. Rescheduling (C) is premature; the
issue can likely be resolved with simple instructions.
3. Mr. Fitzgerald is using a laptop for the visit. To best evaluate his jugular
venous pressure (JVP) and carotid pulsations, the nurse should instruct him to:
A) Stand up and look directly at the camera.
B) Turn his head slightly to the left and look straight ahead while the camera is
positioned to view his neck.
C) Lie flat on his back with the camera above his head.
D) There is no way to assess JVP via telehealth; it must be an in-person exam.
Answer: B) Turn his head slightly to the left and look straight ahead while the
camera is positioned to view his neck.
Rationale: JVP can be approximated via telehealth by asking the patient to
position themselves in a semi-recumbent position (e.g., 30–45 degrees), turn their
head slightly to the left (to expose the right internal jugular vein), and look
straight ahead. The camera should be placed at the side to visualize the neck. The
patient should not lie flat (C) as that would obliterate the JVP meniscus. While a
definitive JVP measurement is challenging, visualization of distention can be
assessed. It is not impossible (D).
4. Before beginning the history-taking, the nurse asks Mr. Fitzgerald to verify his
identity using two identifiers. Which of the following is an appropriate
combination via telehealth?
A) Name and room number.
B) Name and date of birth.
pg. 2
, 3
C) Insurance card number and address.
D) Phone number and email address.
Answer: B) Name and date of birth.
Rationale: The standard two patient identifiers are the patient's name and date of
birth, which can be confirmed verbally and visually if they show an ID. Room
number (A) is for inpatients. Insurance card number and address (C, D) are not
standard identifiers for this purpose and could be considered protected
information without proper encryption if not on the platform.
5. Mr. Fitzgerald reports that his blood pressure readings at home have been
inconsistent. The nurse should first:
A) Discontinue his antihypertensive medication.
B) Instruct him on proper blood pressure measurement technique and ask him to
demonstrate.
C) Diagnose him with labile hypertension.
D) Refer him to the emergency department immediately.
Answer: B) Instruct him on proper blood pressure measurement technique and
ask him to demonstrate.
Rationale: Inconsistent home readings often result from improper technique. The
nurse should first validate the measurement method: correct cuff size, arm
position at heart level, feet flat, back supported, and rest before measurement.
The patient can demonstrate with their own device via video. Discontinuing
medication (A) is dangerous without a clear diagnosis. Labile hypertension (C) is a
possible diagnosis but requires accurate readings first. Emergency referral (D) is
not indicated for inconsistent readings without symptoms of a hypertensive crisis.
6. Mr. Fitzgerald mentions he has a digital blood pressure cuff but hasn't had it
calibrated in two years. The most appropriate advice is to:
A) Continue using the cuff as is; calibration is not important.
B) Buy a new cuff immediately.
pg. 3
