NSG 464 Physical Assessment Midterm – Study Guide, Practice
Questions & Revision Notes
A 72 y/o teacher comes to a skilled nursing facility for rehabilitation after being in the hospital
for 6 weeks. She was treated for sepsis and respiratory failure and had to be on the ventilator
for 3 weeks. You are completing your initial assessment and are evaluating her skin condition.
On her sacrum there is a full thickness skin loss that is 5cm in diameter, with damage to the
subcutaneous tissue. The underlying muscle is not affected. You diagnose this as a pressure
ulcer. What is the stage of this ulcer?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4 - ANS ✔✔C. Stage 3
Rationale: A stage 3 ulcer is full-thickness skin loss with damage to or necrosis of subcutaneous
tissue that may extend to, but not through, the underlying muscle
For which of the following patients would a comprehensive health history be appropriate?
A. A new patient with the chief complaint of "I sprained my ankle"
B. An established patient with the chief complaint of "I have an upper respiratory infection"
C. A new patient with chief complaint of "I am here to establish care"
D. A new patient with the chief complaint of "I cut my hand" - ANS ✔✔C. A new patient with
chief complaint of "I am here to establish care"
rationale: this patient is here to establish care, and because she is new to you, a comprehensive
health history is appropriate
The components of the health history include all of the following except which one?
,A. Review of systems
B. Thorax and Lungs
C. Present Illness
D. Personal and social items - ANS ✔✔B. Thorax and Lungs
rationale: the thorax and lungs are part of the physical examination, not part of the health
history. The other answers are all part of a complete health history
Is the following information subjective or objective? Mr. M has shortness of breath that has
persisted for the past 10 days, it is worse with activity, and relieved by rest.
A. Subjective
B. Objective - ANS ✔✔A. Subjective
Rationale: This is information given by the patient about the circumstances of his chief
complaint. It doesn't represent an objective observation by the examiner
Is the following information subjective or objective? Mr. M has a respiratory rate of 32 and a
pulse rate of 120.
A. Subjective
B. Objective - ANS ✔✔B. Objective
Rationale: This is a measurement obtained by the examiner, so it is considered objective data.
The patient is unlikely to be able to give this information to the examiner
The following information is recorded in the health history: "The patient had had abdominal
pain for 1 week. The pain lasts for 30 minutes at a time, it comes and goes. The severity is 7 to 9
on a scale of 1-10. It is accompanied by nausea and vomiting. It is located in the mid-epigastric
area". Which of these categories does it belong to?
A. Chief complaint
,B. Present Illness
C. Personal and social history
D. Review of systems - ANS ✔✔B. Present Illness
Rationale: This info describes the problem of abdominal pain, which is the present illness. The
interviewer has obtained the location, timing, severity, and associated manifestations of the
pain, the setting in which it occurred, and the factors that aggravate and relieve the pain. You
will notice that it does include portions of the pertinent review of systems, but because it
related directly to the chief complaint, it is included in the history of present illness.
The following information is recorded in the health history: "The patient completed 8th grade.
He currently lives with his wife and two children. He works on old cars on the weekend. He
works in a glass factory during the week. Which category does it belong to?
A. Chief complaint
B. Present illness
C. Personal and social history
D. Review of systems - ANS ✔✔C. Personal and social history
Rationale: Personal and social history information includes educational level, family of origin,
current household status, personal interest, employment, religious beliefs, military history, and
lifestyle (including diet and exercise habits; use of alcohol, tobacco, and drugs; sexual
preferences and history). All of this information is documented in this example
The following information is recorded in the health history: "I feel really tired". Which category
does this belong to?
A. Chief complaint
B. Present illness
C. Personal and social history
D. Review of systems - ANS ✔✔A. Chief complaint
, Rationale: The chief complaint is an attempt to quote the patient's own words, as long as they
are suitable to print. It is brief, like a headline, and further details should be sought in the
present illness section. The above information is a chief complaint
The following information is recorded in the health history: "Patient denies chest pain,
palpitations, orthopnea, and paroxysmal nocturnal dyspnea". Which category does this belong
to?
A. Chief complaint
B. Present illness
C. Personal and social history
D. Review of Systems - ANS ✔✔D. Review of systems
Rationale: Review of systems documents the presence or absence of common symptoms
related to each major body system. The absence of cardiac symptoms is listed in the above
example
The following information is best placed in which category? "The patient has had 3 Cesarean
sections".
A. Adult illnesses
B. Surgeries
C. Obstetrics/Gynecologic
D. Psychiatric - ANS ✔✔B. Surgeries
Rationale: A cesarean section is a surgical procedure. Approximate dates or the age of the
patient at the time of the surgery should be recorded
The following information is best placed in which category? "The patient had a stent placed in
the left anterior descending (LAD) artery in 1999"
Questions & Revision Notes
A 72 y/o teacher comes to a skilled nursing facility for rehabilitation after being in the hospital
for 6 weeks. She was treated for sepsis and respiratory failure and had to be on the ventilator
for 3 weeks. You are completing your initial assessment and are evaluating her skin condition.
On her sacrum there is a full thickness skin loss that is 5cm in diameter, with damage to the
subcutaneous tissue. The underlying muscle is not affected. You diagnose this as a pressure
ulcer. What is the stage of this ulcer?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4 - ANS ✔✔C. Stage 3
Rationale: A stage 3 ulcer is full-thickness skin loss with damage to or necrosis of subcutaneous
tissue that may extend to, but not through, the underlying muscle
For which of the following patients would a comprehensive health history be appropriate?
A. A new patient with the chief complaint of "I sprained my ankle"
B. An established patient with the chief complaint of "I have an upper respiratory infection"
C. A new patient with chief complaint of "I am here to establish care"
D. A new patient with the chief complaint of "I cut my hand" - ANS ✔✔C. A new patient with
chief complaint of "I am here to establish care"
rationale: this patient is here to establish care, and because she is new to you, a comprehensive
health history is appropriate
The components of the health history include all of the following except which one?
,A. Review of systems
B. Thorax and Lungs
C. Present Illness
D. Personal and social items - ANS ✔✔B. Thorax and Lungs
rationale: the thorax and lungs are part of the physical examination, not part of the health
history. The other answers are all part of a complete health history
Is the following information subjective or objective? Mr. M has shortness of breath that has
persisted for the past 10 days, it is worse with activity, and relieved by rest.
A. Subjective
B. Objective - ANS ✔✔A. Subjective
Rationale: This is information given by the patient about the circumstances of his chief
complaint. It doesn't represent an objective observation by the examiner
Is the following information subjective or objective? Mr. M has a respiratory rate of 32 and a
pulse rate of 120.
A. Subjective
B. Objective - ANS ✔✔B. Objective
Rationale: This is a measurement obtained by the examiner, so it is considered objective data.
The patient is unlikely to be able to give this information to the examiner
The following information is recorded in the health history: "The patient had had abdominal
pain for 1 week. The pain lasts for 30 minutes at a time, it comes and goes. The severity is 7 to 9
on a scale of 1-10. It is accompanied by nausea and vomiting. It is located in the mid-epigastric
area". Which of these categories does it belong to?
A. Chief complaint
,B. Present Illness
C. Personal and social history
D. Review of systems - ANS ✔✔B. Present Illness
Rationale: This info describes the problem of abdominal pain, which is the present illness. The
interviewer has obtained the location, timing, severity, and associated manifestations of the
pain, the setting in which it occurred, and the factors that aggravate and relieve the pain. You
will notice that it does include portions of the pertinent review of systems, but because it
related directly to the chief complaint, it is included in the history of present illness.
The following information is recorded in the health history: "The patient completed 8th grade.
He currently lives with his wife and two children. He works on old cars on the weekend. He
works in a glass factory during the week. Which category does it belong to?
A. Chief complaint
B. Present illness
C. Personal and social history
D. Review of systems - ANS ✔✔C. Personal and social history
Rationale: Personal and social history information includes educational level, family of origin,
current household status, personal interest, employment, religious beliefs, military history, and
lifestyle (including diet and exercise habits; use of alcohol, tobacco, and drugs; sexual
preferences and history). All of this information is documented in this example
The following information is recorded in the health history: "I feel really tired". Which category
does this belong to?
A. Chief complaint
B. Present illness
C. Personal and social history
D. Review of systems - ANS ✔✔A. Chief complaint
, Rationale: The chief complaint is an attempt to quote the patient's own words, as long as they
are suitable to print. It is brief, like a headline, and further details should be sought in the
present illness section. The above information is a chief complaint
The following information is recorded in the health history: "Patient denies chest pain,
palpitations, orthopnea, and paroxysmal nocturnal dyspnea". Which category does this belong
to?
A. Chief complaint
B. Present illness
C. Personal and social history
D. Review of Systems - ANS ✔✔D. Review of systems
Rationale: Review of systems documents the presence or absence of common symptoms
related to each major body system. The absence of cardiac symptoms is listed in the above
example
The following information is best placed in which category? "The patient has had 3 Cesarean
sections".
A. Adult illnesses
B. Surgeries
C. Obstetrics/Gynecologic
D. Psychiatric - ANS ✔✔B. Surgeries
Rationale: A cesarean section is a surgical procedure. Approximate dates or the age of the
patient at the time of the surgery should be recorded
The following information is best placed in which category? "The patient had a stent placed in
the left anterior descending (LAD) artery in 1999"
