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RN Health Assessment Competency
Exam — Code: RN-HA-COMP | 100-
Question Advanced Practice Exam 2026
| Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1. A nurse is assessing a 68-year-old patient who reports progressive
exertional dyspnea and fatigue. Which assessment finding is most
concerning for decreased cardiac output?
A. Bilateral dependent ankle edema
B. Bounding peripheral pulses
C. Narrow pulse pressure
D. Warm, flushed extremities
Answer: Narrow pulse pressure
Rationale: A narrow pulse pressure can occur when stroke volume and cardiac
output are reduced. In an older adult with dyspnea and fatigue, this finding
warrants further cardiovascular assessment for impaired ventricular function or
other causes of reduced forward flow.
, 2. During assessment of a patient with suspected increased intracranial
pressure, which finding should the nurse recognize as an early indicator?
A. Fixed and dilated pupils
B. Decerebrate posturing
C. Altered level of consciousness
D. Cushing triad
Answer: Altered level of consciousness
Rationale: A change in level of consciousness is often one of the earliest signs of
increasing intracranial pressure. Fixed pupils, posturing, and Cushing triad
generally indicate more advanced neurologic deterioration.
3. A patient reports substernal chest pressure radiating to the jaw. The nurse
notes diaphoresis, pallor, and nausea. What is the priority assessment?
A. Bowel sounds
B. Peripheral vision
C. Cardiorespiratory status
D. Deep tendon reflexes
Answer: Cardiorespiratory status
Rationale: The symptoms strongly suggest acute myocardial ischemia.
Immediate assessment of airway, breathing, circulation, oxygenation, vital
signs, cardiac rhythm, and perfusion is the priority.
4. When assessing jugular venous pressure, which position generally provides
the most reliable visualization?
A. Supine with the head flat
B. Sitting upright at 90 degrees
C. Head of bed elevated approximately 30–45 degrees
D. Prone with the head turned laterally
Answer: Head of bed elevated approximately 30–45 degrees
,Rationale: Jugular venous pressure is commonly assessed with the patient
positioned at approximately 30–45 degrees. This angle allows the nurse to
visualize venous pulsations and estimate right atrial pressure.
5. A patient has a blood pressure of 86/54 mmHg, heart rate 122/min, cool
clammy skin, and delayed capillary refill. Which finding is most consistent
with the overall assessment?
A. Hypervolemia
B. Compensated or evolving shock
C. Increased intracranial pressure
D. Isolated hypertension
Answer: Compensated or evolving shock
Rationale: Hypotension, tachycardia, cool clammy skin, and delayed capillary
refill indicate inadequate tissue perfusion. Tachycardia may initially compensate
for declining circulating volume or cardiac output.
6. During respiratory assessment, which finding most strongly suggests
consolidation of lung tissue?
A. Hyperresonance to percussion
B. Increased tactile fremitus over the affected area
C. Diminished vocal resonance throughout both lungs
D. Absent bronchial breath sounds over the trachea
Answer: Increased tactile fremitus over the affected area
Rationale: Consolidated lung tissue transmits vibrations more effectively than
air-filled lung. Increased tactile fremitus, bronchial breath sounds, dull
percussion, and increased vocal resonance can accompany consolidation.
7. A patient with chronic obstructive pulmonary disease has an oxygen
saturation of 89% and is speaking comfortably without acute distress.
Which additional finding requires the most immediate evaluation?
, A. Barrel-shaped chest
B. Chronic productive cough
C. New confusion and increasing somnolence
D. Use of pursed-lip breathing
Answer: New confusion and increasing somnolence
Rationale: New neurologic changes may indicate worsening hypoxemia,
hypercapnia, or respiratory failure. The change in mental status is more
concerning than chronic COPD findings.
8. During abdominal assessment, which sequence should the nurse use?
A. Palpation, percussion, auscultation, inspection
B. Inspection, auscultation, percussion, palpation
C. Auscultation, inspection, palpation, percussion
D. Percussion, palpation, inspection, auscultation
Answer: Inspection, auscultation, percussion, palpation
Rationale: Auscultation is performed before percussion and palpation because
manipulating the abdomen can alter bowel sounds. Inspection precedes all
other techniques.
9. A nurse palpates a patient's abdomen and finds involuntary rigidity and
guarding. Which interpretation is most appropriate?
A. Normal response to light palpation
B. Possible peritoneal irritation
C. Expected finding after eating
D. Mild dehydration
Answer: Possible peritoneal irritation
Rationale: Involuntary rigidity and guarding can indicate peritoneal
inflammation and potentially an acute surgical abdomen. The finding requires
prompt further evaluation.
RN Health Assessment Competency
Exam — Code: RN-HA-COMP | 100-
Question Advanced Practice Exam 2026
| Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1. A nurse is assessing a 68-year-old patient who reports progressive
exertional dyspnea and fatigue. Which assessment finding is most
concerning for decreased cardiac output?
A. Bilateral dependent ankle edema
B. Bounding peripheral pulses
C. Narrow pulse pressure
D. Warm, flushed extremities
Answer: Narrow pulse pressure
Rationale: A narrow pulse pressure can occur when stroke volume and cardiac
output are reduced. In an older adult with dyspnea and fatigue, this finding
warrants further cardiovascular assessment for impaired ventricular function or
other causes of reduced forward flow.
, 2. During assessment of a patient with suspected increased intracranial
pressure, which finding should the nurse recognize as an early indicator?
A. Fixed and dilated pupils
B. Decerebrate posturing
C. Altered level of consciousness
D. Cushing triad
Answer: Altered level of consciousness
Rationale: A change in level of consciousness is often one of the earliest signs of
increasing intracranial pressure. Fixed pupils, posturing, and Cushing triad
generally indicate more advanced neurologic deterioration.
3. A patient reports substernal chest pressure radiating to the jaw. The nurse
notes diaphoresis, pallor, and nausea. What is the priority assessment?
A. Bowel sounds
B. Peripheral vision
C. Cardiorespiratory status
D. Deep tendon reflexes
Answer: Cardiorespiratory status
Rationale: The symptoms strongly suggest acute myocardial ischemia.
Immediate assessment of airway, breathing, circulation, oxygenation, vital
signs, cardiac rhythm, and perfusion is the priority.
4. When assessing jugular venous pressure, which position generally provides
the most reliable visualization?
A. Supine with the head flat
B. Sitting upright at 90 degrees
C. Head of bed elevated approximately 30–45 degrees
D. Prone with the head turned laterally
Answer: Head of bed elevated approximately 30–45 degrees
,Rationale: Jugular venous pressure is commonly assessed with the patient
positioned at approximately 30–45 degrees. This angle allows the nurse to
visualize venous pulsations and estimate right atrial pressure.
5. A patient has a blood pressure of 86/54 mmHg, heart rate 122/min, cool
clammy skin, and delayed capillary refill. Which finding is most consistent
with the overall assessment?
A. Hypervolemia
B. Compensated or evolving shock
C. Increased intracranial pressure
D. Isolated hypertension
Answer: Compensated or evolving shock
Rationale: Hypotension, tachycardia, cool clammy skin, and delayed capillary
refill indicate inadequate tissue perfusion. Tachycardia may initially compensate
for declining circulating volume or cardiac output.
6. During respiratory assessment, which finding most strongly suggests
consolidation of lung tissue?
A. Hyperresonance to percussion
B. Increased tactile fremitus over the affected area
C. Diminished vocal resonance throughout both lungs
D. Absent bronchial breath sounds over the trachea
Answer: Increased tactile fremitus over the affected area
Rationale: Consolidated lung tissue transmits vibrations more effectively than
air-filled lung. Increased tactile fremitus, bronchial breath sounds, dull
percussion, and increased vocal resonance can accompany consolidation.
7. A patient with chronic obstructive pulmonary disease has an oxygen
saturation of 89% and is speaking comfortably without acute distress.
Which additional finding requires the most immediate evaluation?
, A. Barrel-shaped chest
B. Chronic productive cough
C. New confusion and increasing somnolence
D. Use of pursed-lip breathing
Answer: New confusion and increasing somnolence
Rationale: New neurologic changes may indicate worsening hypoxemia,
hypercapnia, or respiratory failure. The change in mental status is more
concerning than chronic COPD findings.
8. During abdominal assessment, which sequence should the nurse use?
A. Palpation, percussion, auscultation, inspection
B. Inspection, auscultation, percussion, palpation
C. Auscultation, inspection, palpation, percussion
D. Percussion, palpation, inspection, auscultation
Answer: Inspection, auscultation, percussion, palpation
Rationale: Auscultation is performed before percussion and palpation because
manipulating the abdomen can alter bowel sounds. Inspection precedes all
other techniques.
9. A nurse palpates a patient's abdomen and finds involuntary rigidity and
guarding. Which interpretation is most appropriate?
A. Normal response to light palpation
B. Possible peritoneal irritation
C. Expected finding after eating
D. Mild dehydration
Answer: Possible peritoneal irritation
Rationale: Involuntary rigidity and guarding can indicate peritoneal
inflammation and potentially an acute surgical abdomen. The finding requires
prompt further evaluation.
