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NURS 190 PA MIDTERM EXAM QUESTIONS WITH
VERIFIED QUESTIONS DETAILED RATIONALES GRADED A+
SECTION 1: HEALTH HISTORY & INTERVIEWING (Questions 1–30)
Question 1
A nurse is preparing to assess a patient's peripheral pulses. Which technique should the nurse
use to assess the dorsalis pedis pulse?
A) Use the bell of the stethoscope to auscultate the pulse
B) Palpate the medial malleolus of the ankle
C) Palpate the lateral side of the ankle
D) Palpate the dorsum of the foot between the extensor tendons of the great toe
Answer: D
Rationale: The dorsalis pedis pulse is located on the dorsum of the foot, typically between the
first and second metatarsals, lateral to the extensor hallucis longus tendon. Options A, B, and C
describe incorrect locations or methods.
Question 2
During a health history interview, a patient reports chest pain that worsens with deep
breathing. This finding is most consistent with which condition?
A) Pericarditis
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B) Myocardial infarction
C) Pneumonia
D) Gastroesophageal reflux
Answer: A
Rationale: Pleuritic chest pain (worse with inspiration) is characteristic of pericarditis or
pleurisy. MI pain is often crushing and constant, pneumonia includes fever/cough, and GERD is
burning and postprandial.
Question 3
A nurse is using therapeutic communication with a patient who is crying. Which response is
most therapeutic?
A) "Don't cry, everything will be fine."
B) "You shouldn't be upset. It's not that bad."
C) "I can see you are upset. Would you like to talk about it?"
D) "If you don't stop crying, I'll have to leave."
Answer: C
Rationale: This response acknowledges the patient's emotion (empathy) and offers an open-
ended invitation to talk (exploring). Option A is false reassurance, Option B minimizes feelings,
and Option D is threatening.
Question 4
A nurse is preparing to give a handoff report using I-PASS. What does I-PASS stand for?
A) Illness severity, Patient summary, Action list, Situation awareness, Synthesis by receiver
B) Illness severity, Patient summary, Assessment, Situation, Synthesis
C) Information, Patient, Assessment, Summary, Synthesis
D) Introduction, Patient, Assessment, Situation, Summary
Answer: A
Rationale: I-PASS is a standardized handoff mnemonic: Illness severity (stable, unstable), Patient
summary (relevant history), Action list (to-do items), Situation awareness (what to watch for),
Synthesis by receiver (receiver repeats back).
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Question 5
A nurse is caring for a patient who speaks a different language. No interpreter is available.
Which action is most appropriate?
A) Use a family member as interpreter
B) Speak loudly and slowly
C) Use the hospital's interpreter phone service (language line)
D) Delay care until interpreter arrives
Answer: C
Rationale: Use a qualified medical interpreter (in-person, phone, video). Family members
should NOT be used (privacy, accuracy, emotional involvement). Speaking loudly does not
improve understanding.
Question 6
During a review of a low-fat cardiac diet by the nurse, Mr. Jones has nodded his head several
times in feedback. Later in the day when the nurse checks his dietary choices, it was found that
he selected several foods on the menu that were the highest in fat. The type of communication
that Mr. Jones exhibited was:
A) Congruent metacommunication
B) Therapeutic communication
C) Incongruent metacommunication
D) Elemental communication
Answer: C
Rationale: Incongruent metacommunication occurs when verbal and nonverbal messages
contradict each other. Mr. Jones nodded (nonverbal agreement) but chose high-fat foods
(behavior contradicting the message).
Question 7
What are the basic techniques of physical assessment?
A) Inspection, auscultation, percussion, and palpation
B) Inspection, palpation, percussion, and auscultation
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C) Palpation, inspection, auscultation, and percussion
D) Auscultation, palpation, inspection, and percussion
Answer: A
Rationale: The four basic techniques are inspection, auscultation, percussion, and palpation.
The order varies by body system (e.g., abdomen uses inspection, auscultation, percussion,
palpation).
Question 8
A nurse is assessing a patient's blood pressure as 148/94 mm Hg. The patient has no previous
history of hypertension. What is the appropriate next action?
A) Document as normal and continue monitoring
B) Recheck BP in the other arm after 5 minutes of rest
C) Notify provider immediately
D) Administer antihypertensive medication
Answer: B
Rationale: A single elevated reading does not diagnose hypertension. Recheck after 5 minutes
rest in both arms. Administering medication without an order is unsafe.
Question 9
A nurse is assessing a patient's respiratory rate. The patient is breathing 28 breaths per minute.
Which term describes this finding?
A) Bradypnea
B) Tachypnea
C) Apnea
D) Orthopnea
Answer: B
Rationale: Normal adult respiratory rate is 12–20 breaths/min. Tachypnea (rapid breathing) is
>20/min. Bradypnea is <12/min.
NURS 190 PA MIDTERM EXAM QUESTIONS WITH
VERIFIED QUESTIONS DETAILED RATIONALES GRADED A+
SECTION 1: HEALTH HISTORY & INTERVIEWING (Questions 1–30)
Question 1
A nurse is preparing to assess a patient's peripheral pulses. Which technique should the nurse
use to assess the dorsalis pedis pulse?
A) Use the bell of the stethoscope to auscultate the pulse
B) Palpate the medial malleolus of the ankle
C) Palpate the lateral side of the ankle
D) Palpate the dorsum of the foot between the extensor tendons of the great toe
Answer: D
Rationale: The dorsalis pedis pulse is located on the dorsum of the foot, typically between the
first and second metatarsals, lateral to the extensor hallucis longus tendon. Options A, B, and C
describe incorrect locations or methods.
Question 2
During a health history interview, a patient reports chest pain that worsens with deep
breathing. This finding is most consistent with which condition?
A) Pericarditis
,Page 2 of 104
B) Myocardial infarction
C) Pneumonia
D) Gastroesophageal reflux
Answer: A
Rationale: Pleuritic chest pain (worse with inspiration) is characteristic of pericarditis or
pleurisy. MI pain is often crushing and constant, pneumonia includes fever/cough, and GERD is
burning and postprandial.
Question 3
A nurse is using therapeutic communication with a patient who is crying. Which response is
most therapeutic?
A) "Don't cry, everything will be fine."
B) "You shouldn't be upset. It's not that bad."
C) "I can see you are upset. Would you like to talk about it?"
D) "If you don't stop crying, I'll have to leave."
Answer: C
Rationale: This response acknowledges the patient's emotion (empathy) and offers an open-
ended invitation to talk (exploring). Option A is false reassurance, Option B minimizes feelings,
and Option D is threatening.
Question 4
A nurse is preparing to give a handoff report using I-PASS. What does I-PASS stand for?
A) Illness severity, Patient summary, Action list, Situation awareness, Synthesis by receiver
B) Illness severity, Patient summary, Assessment, Situation, Synthesis
C) Information, Patient, Assessment, Summary, Synthesis
D) Introduction, Patient, Assessment, Situation, Summary
Answer: A
Rationale: I-PASS is a standardized handoff mnemonic: Illness severity (stable, unstable), Patient
summary (relevant history), Action list (to-do items), Situation awareness (what to watch for),
Synthesis by receiver (receiver repeats back).
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Question 5
A nurse is caring for a patient who speaks a different language. No interpreter is available.
Which action is most appropriate?
A) Use a family member as interpreter
B) Speak loudly and slowly
C) Use the hospital's interpreter phone service (language line)
D) Delay care until interpreter arrives
Answer: C
Rationale: Use a qualified medical interpreter (in-person, phone, video). Family members
should NOT be used (privacy, accuracy, emotional involvement). Speaking loudly does not
improve understanding.
Question 6
During a review of a low-fat cardiac diet by the nurse, Mr. Jones has nodded his head several
times in feedback. Later in the day when the nurse checks his dietary choices, it was found that
he selected several foods on the menu that were the highest in fat. The type of communication
that Mr. Jones exhibited was:
A) Congruent metacommunication
B) Therapeutic communication
C) Incongruent metacommunication
D) Elemental communication
Answer: C
Rationale: Incongruent metacommunication occurs when verbal and nonverbal messages
contradict each other. Mr. Jones nodded (nonverbal agreement) but chose high-fat foods
(behavior contradicting the message).
Question 7
What are the basic techniques of physical assessment?
A) Inspection, auscultation, percussion, and palpation
B) Inspection, palpation, percussion, and auscultation
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C) Palpation, inspection, auscultation, and percussion
D) Auscultation, palpation, inspection, and percussion
Answer: A
Rationale: The four basic techniques are inspection, auscultation, percussion, and palpation.
The order varies by body system (e.g., abdomen uses inspection, auscultation, percussion,
palpation).
Question 8
A nurse is assessing a patient's blood pressure as 148/94 mm Hg. The patient has no previous
history of hypertension. What is the appropriate next action?
A) Document as normal and continue monitoring
B) Recheck BP in the other arm after 5 minutes of rest
C) Notify provider immediately
D) Administer antihypertensive medication
Answer: B
Rationale: A single elevated reading does not diagnose hypertension. Recheck after 5 minutes
rest in both arms. Administering medication without an order is unsafe.
Question 9
A nurse is assessing a patient's respiratory rate. The patient is breathing 28 breaths per minute.
Which term describes this finding?
A) Bradypnea
B) Tachypnea
C) Apnea
D) Orthopnea
Answer: B
Rationale: Normal adult respiratory rate is 12–20 breaths/min. Tachypnea (rapid breathing) is
>20/min. Bradypnea is <12/min.
