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NSG 3160 Exam 4 | Health Assessment Study
Guide | Practice Questions, Answers &
Detailed Explanations
EXAM COVERAGE SUMMARY
This comprehensive examination covers key health assessment concepts including
musculoskeletal system assessment, gastrointestinal system evaluation, genitourinary
assessment, neurological changes across the lifespan, and integumentary considerations. Topics
include joint movement terminology, arthritis differentiation, bone health and osteoporosis risk
factors, abdominal assessment techniques and findings, bowel sounds interpretation, stool
characteristic analysis, urinary assessment findings, age-related changes in body systems, and
common pathological conditions affecting these systems.
1. A 72-year-old patient reports waking up at night with shortness of breath and a cough, needing
to sit upright to breathe. Which condition is most consistent with these symptoms?
a) Right-sided heart failure
b) Paroxysmal nocturnal dyspnea
c) Pulmonary embolism
d) Asthma exacerbation
Correct Answer: b)
Rationale: Paroxysmal nocturnal dyspnea is characterized by shortness of breath that awakens
the patient from sleep, accompanied by cough, sweating, tachycardia, crackles, and pallor. The
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patient must sit upright to breathe. This occurs with left-sided heart failure where fluid backs up
into the lungs.
2. A patient presents with pain that worsens later in the day and increases with movement. Which
condition is most consistent with these findings?
a) Rheumatoid arthritis
b) Osteoarthritis
c) Gout
d) Ankylosing spondylitis
Correct Answer: b)
Rationale: Osteoarthritis symptoms worsen later in the day with increased movement and
typically affect one side of the body asymmetrically. Rheumatoid arthritis symptoms worsen in
the morning and improve with movement, affecting both sides symmetrically.
3. A patient reports black, tarry stools. The nurse understands this is most likely due to:
a) Iron supplementation
b) Upper gastrointestinal bleeding
c) Hemorrhoids
d) Bile obstruction
Correct Answer: b)
Rationale: Melena (black, tarry stools) is caused by occult blood from an upper GI bleed. Iron
supplements can cause black, non-tarry stools. Bright red blood suggests lower GI bleeding or
hemorrhoids. Clay-colored stools indicate bile obstruction.
4. During an abdominal assessment, the nurse percusses the abdomen and hears a hollow drum-
like sound predominating. The nurse correctly identifies this as:
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a) Dullness
b) Tympany
c) Hyperresonance
d) Flatness
Correct Answer: b)
Rationale: Tympany is a hollow drum-like sound that should predominate over the abdomen
because air in the intestines rises to the surface when the patient is supine. Dullness occurs over
organs or masses, while hyperresonance occurs with gaseous distention.
5. A patient performs the Phalen test and reports numbness and burning after holding the position
for 60 seconds. This finding is consistent with:
a) Rheumatoid arthritis
b) Carpal tunnel syndrome
c) Osteoarthritis
d) Gout
Correct Answer: b)
Rationale: The Phalen test reproduces numbness and burning in carpal tunnel syndrome when
the patient holds the wrist in flexion for 60 seconds. The Tinel sign, which involves percussion of
the median nerve, also produces burning and tingling along its distribution with carpal tunnel
syndrome.
6. A 55-year-old female patient is concerned about osteoporosis. Which of the following places
her at the highest risk?
a) Regular exercise routine
b) Current smoking
c) High calcium intake
d) Afro-Caribbean ethnicity
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Correct Answer: b)
Rationale: Current smoking is a significant risk factor for osteoporosis in women. Other risk
factors include advanced age, personal history of fracture as an adult, low body weight, use of
oral corticosteroids for >3 months, estrogen deficiency before age 45, low calcium intake, and
excessive alcohol consumption.
7. When auscultating the abdomen, the nurse hears loud, gurgling bowel sounds. This finding is
consistent with:
a) Paralytic ileus
b) Borborygmi
c) Peritonitis
d) Obstruction
Correct Answer: b)
Rationale: Borborygmi are loud, gurgling bowel sounds signaling increased motility or
hyperperistalsis, occurring with bowel obstruction, diarrhea, or gastritis. Hypoactive or absent
bowel sounds follow abdominal surgery, peritonitis, or obstruction.
8. A patient has difficulty swallowing and reports that food feels like it gets stuck in their throat.
The nurse documents this as:
a) Dysphagia
b) Pyrosis
c) Eructation
d) Anorexia
Correct Answer: a)
Rationale: Dysphagia is difficulty or discomfort with swallowing, occurring with disorders of the
throat or esophagus such as thrush, neurologic changes like stroke, or obstruction from a solid
mass or tumor. Pyrosis is heartburn, eructation is belching, and anorexia is loss of appetite.
NSG 3160 Exam 4 | Health Assessment Study
Guide | Practice Questions, Answers &
Detailed Explanations
EXAM COVERAGE SUMMARY
This comprehensive examination covers key health assessment concepts including
musculoskeletal system assessment, gastrointestinal system evaluation, genitourinary
assessment, neurological changes across the lifespan, and integumentary considerations. Topics
include joint movement terminology, arthritis differentiation, bone health and osteoporosis risk
factors, abdominal assessment techniques and findings, bowel sounds interpretation, stool
characteristic analysis, urinary assessment findings, age-related changes in body systems, and
common pathological conditions affecting these systems.
1. A 72-year-old patient reports waking up at night with shortness of breath and a cough, needing
to sit upright to breathe. Which condition is most consistent with these symptoms?
a) Right-sided heart failure
b) Paroxysmal nocturnal dyspnea
c) Pulmonary embolism
d) Asthma exacerbation
Correct Answer: b)
Rationale: Paroxysmal nocturnal dyspnea is characterized by shortness of breath that awakens
the patient from sleep, accompanied by cough, sweating, tachycardia, crackles, and pallor. The
, Page 2 of 107
patient must sit upright to breathe. This occurs with left-sided heart failure where fluid backs up
into the lungs.
2. A patient presents with pain that worsens later in the day and increases with movement. Which
condition is most consistent with these findings?
a) Rheumatoid arthritis
b) Osteoarthritis
c) Gout
d) Ankylosing spondylitis
Correct Answer: b)
Rationale: Osteoarthritis symptoms worsen later in the day with increased movement and
typically affect one side of the body asymmetrically. Rheumatoid arthritis symptoms worsen in
the morning and improve with movement, affecting both sides symmetrically.
3. A patient reports black, tarry stools. The nurse understands this is most likely due to:
a) Iron supplementation
b) Upper gastrointestinal bleeding
c) Hemorrhoids
d) Bile obstruction
Correct Answer: b)
Rationale: Melena (black, tarry stools) is caused by occult blood from an upper GI bleed. Iron
supplements can cause black, non-tarry stools. Bright red blood suggests lower GI bleeding or
hemorrhoids. Clay-colored stools indicate bile obstruction.
4. During an abdominal assessment, the nurse percusses the abdomen and hears a hollow drum-
like sound predominating. The nurse correctly identifies this as:
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a) Dullness
b) Tympany
c) Hyperresonance
d) Flatness
Correct Answer: b)
Rationale: Tympany is a hollow drum-like sound that should predominate over the abdomen
because air in the intestines rises to the surface when the patient is supine. Dullness occurs over
organs or masses, while hyperresonance occurs with gaseous distention.
5. A patient performs the Phalen test and reports numbness and burning after holding the position
for 60 seconds. This finding is consistent with:
a) Rheumatoid arthritis
b) Carpal tunnel syndrome
c) Osteoarthritis
d) Gout
Correct Answer: b)
Rationale: The Phalen test reproduces numbness and burning in carpal tunnel syndrome when
the patient holds the wrist in flexion for 60 seconds. The Tinel sign, which involves percussion of
the median nerve, also produces burning and tingling along its distribution with carpal tunnel
syndrome.
6. A 55-year-old female patient is concerned about osteoporosis. Which of the following places
her at the highest risk?
a) Regular exercise routine
b) Current smoking
c) High calcium intake
d) Afro-Caribbean ethnicity
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Correct Answer: b)
Rationale: Current smoking is a significant risk factor for osteoporosis in women. Other risk
factors include advanced age, personal history of fracture as an adult, low body weight, use of
oral corticosteroids for >3 months, estrogen deficiency before age 45, low calcium intake, and
excessive alcohol consumption.
7. When auscultating the abdomen, the nurse hears loud, gurgling bowel sounds. This finding is
consistent with:
a) Paralytic ileus
b) Borborygmi
c) Peritonitis
d) Obstruction
Correct Answer: b)
Rationale: Borborygmi are loud, gurgling bowel sounds signaling increased motility or
hyperperistalsis, occurring with bowel obstruction, diarrhea, or gastritis. Hypoactive or absent
bowel sounds follow abdominal surgery, peritonitis, or obstruction.
8. A patient has difficulty swallowing and reports that food feels like it gets stuck in their throat.
The nurse documents this as:
a) Dysphagia
b) Pyrosis
c) Eructation
d) Anorexia
Correct Answer: a)
Rationale: Dysphagia is difficulty or discomfort with swallowing, occurring with disorders of the
throat or esophagus such as thrush, neurologic changes like stroke, or obstruction from a solid
mass or tumor. Pyrosis is heartburn, eructation is belching, and anorexia is loss of appetite.
