NSG 3160 HEALTH ASSESSMENT EXAM 4B - COMPREHENSIVE
200-QUESTION COMPLETE WITH 100% VERIFIED ANSWERS
Table of Contents
Section Domain Approx. Page
Questions Reference
1 Abdominal & Gastrointestinal 35 Page 1
Assessment
2 Neurological Assessment 40 Page 4
3 Respiratory Assessment 35 Page 8
4 Cardiovascular & Peripheral 40 Page 11
Vascular Assessment
5 Musculoskeletal & 50 Page 15
Comprehensive Integration
Section 1: Abdominal & Gastrointestinal Assessment (Questions 1-35)
1. During an abdominal assessment, the nurse uses light palpation
primarily to:
A. Detect deep masses
B. Assess for tenderness and superficial organs
C. Evaluate the liver span
D. Elicit rebound tenderness
B. Assess for tenderness and superficial organs
Rationale: Light palpation is used to detect superficial tenderness,
,muscle guarding, and skin texture without causing pain or damaging
underlying structures.
2. A patient reports sharp pain in the right upper quadrant after eating
a fatty meal. The nurse suspects a disorder of which structure?
A. Appendix
B. Stomach
C. Gallbladder
D. Spleen
C. Gallbladder
Rationale: The gallbladder is located in the right upper quadrant, and
pain exacerbated by fatty foods is a classic sign of cholecystitis or biliary
colic.
3. Which assessment technique should the nurse perform first during
an abdominal examination?
A. Palpation
B. Percussion
C. Auscultation
D. Inspection
D. Inspection
Rationale: Inspection is always the first technique performed in an
abdominal assessment to observe contour, symmetry, and skin integrity
before manipulating the abdomen.
4. The nurse is assessing for Murphy's sign. A positive sign indicates
inflammation of the:
A. Appendix
B. Gallbladder
C. Liver
,D. Pancreas
B. Gallbladder
Rationale: Murphy's sign is elicited by hooking the fingers under the
right costal margin and asking the patient to take a deep breath. A
positive sign (inspiratory arrest) indicates gallbladder inflammation.
5. To assess for rebound tenderness, the nurse should:
A. Press deeply and slowly into the abdomen
B. Press deeply, then release the hand quickly
C. Lightly palpate the abdomen in a clockwise direction
D. Percuss the abdomen for tympany
B. Press deeply, then release the hand quickly
Rationale: Rebound tenderness is assessed by pressing deeply into the
abdomen and quickly releasing the pressure. Pain upon release
indicates peritoneal irritation.
6. A patient has a suspected abdominal aortic aneurysm. The nurse
should:
A. Deeply palpate the abdomen to measure the mass
B. Auscultate for a bruit and avoid deep palpation
C. Percuss the abdomen for dullness
D. Ask the patient to cough during palpation
B. Auscultate for a bruit and avoid deep palpation
Rationale: Deep palpation of a suspected abdominal aortic aneurysm is
contraindicated due to the risk of rupture. Auscultation for a bruit is the
appropriate assessment.
7. The normal finding when percussing the abdomen is:
A. Dullness over the stomach
B. Tympany over the intestines
, C. Resonance over the liver
D. Flatness over the bladder
B. Tympany over the intestines
Rationale: Tympany is the predominant sound heard over the intestines
due to the presence of air. Dullness is heard over solid organs like the
liver.
8. The nurse is assessing a patient for ascites. Which technique is most
appropriate?
A. Auscultating for bruits
B. Percussing for shifting dullness
C. Light palpation of the right lower quadrant
D. Deep palpation of the left upper quadrant
B. Percussing for shifting dullness
Rationale: Shifting dullness and fluid wave are specific assessment
techniques used to detect ascites (fluid accumulation) in the abdomen.
9. A patient complains of pain at McBurney's point. The nurse
suspects:
A. Cholecystitis
B. Appendicitis
C. Gastritis
D. Diverticulitis
B. Appendicitis
Rationale: McBurney's point is located in the right lower quadrant,
halfway between the umbilicus and the anterior iliac crest, and is the
classic location for appendicitis pain.
10. During auscultation of the abdomen, the nurse hears high-pitched,
gurgling sounds occurring 5 to 30 times per minute. The nurse
200-QUESTION COMPLETE WITH 100% VERIFIED ANSWERS
Table of Contents
Section Domain Approx. Page
Questions Reference
1 Abdominal & Gastrointestinal 35 Page 1
Assessment
2 Neurological Assessment 40 Page 4
3 Respiratory Assessment 35 Page 8
4 Cardiovascular & Peripheral 40 Page 11
Vascular Assessment
5 Musculoskeletal & 50 Page 15
Comprehensive Integration
Section 1: Abdominal & Gastrointestinal Assessment (Questions 1-35)
1. During an abdominal assessment, the nurse uses light palpation
primarily to:
A. Detect deep masses
B. Assess for tenderness and superficial organs
C. Evaluate the liver span
D. Elicit rebound tenderness
B. Assess for tenderness and superficial organs
Rationale: Light palpation is used to detect superficial tenderness,
,muscle guarding, and skin texture without causing pain or damaging
underlying structures.
2. A patient reports sharp pain in the right upper quadrant after eating
a fatty meal. The nurse suspects a disorder of which structure?
A. Appendix
B. Stomach
C. Gallbladder
D. Spleen
C. Gallbladder
Rationale: The gallbladder is located in the right upper quadrant, and
pain exacerbated by fatty foods is a classic sign of cholecystitis or biliary
colic.
3. Which assessment technique should the nurse perform first during
an abdominal examination?
A. Palpation
B. Percussion
C. Auscultation
D. Inspection
D. Inspection
Rationale: Inspection is always the first technique performed in an
abdominal assessment to observe contour, symmetry, and skin integrity
before manipulating the abdomen.
4. The nurse is assessing for Murphy's sign. A positive sign indicates
inflammation of the:
A. Appendix
B. Gallbladder
C. Liver
,D. Pancreas
B. Gallbladder
Rationale: Murphy's sign is elicited by hooking the fingers under the
right costal margin and asking the patient to take a deep breath. A
positive sign (inspiratory arrest) indicates gallbladder inflammation.
5. To assess for rebound tenderness, the nurse should:
A. Press deeply and slowly into the abdomen
B. Press deeply, then release the hand quickly
C. Lightly palpate the abdomen in a clockwise direction
D. Percuss the abdomen for tympany
B. Press deeply, then release the hand quickly
Rationale: Rebound tenderness is assessed by pressing deeply into the
abdomen and quickly releasing the pressure. Pain upon release
indicates peritoneal irritation.
6. A patient has a suspected abdominal aortic aneurysm. The nurse
should:
A. Deeply palpate the abdomen to measure the mass
B. Auscultate for a bruit and avoid deep palpation
C. Percuss the abdomen for dullness
D. Ask the patient to cough during palpation
B. Auscultate for a bruit and avoid deep palpation
Rationale: Deep palpation of a suspected abdominal aortic aneurysm is
contraindicated due to the risk of rupture. Auscultation for a bruit is the
appropriate assessment.
7. The normal finding when percussing the abdomen is:
A. Dullness over the stomach
B. Tympany over the intestines
, C. Resonance over the liver
D. Flatness over the bladder
B. Tympany over the intestines
Rationale: Tympany is the predominant sound heard over the intestines
due to the presence of air. Dullness is heard over solid organs like the
liver.
8. The nurse is assessing a patient for ascites. Which technique is most
appropriate?
A. Auscultating for bruits
B. Percussing for shifting dullness
C. Light palpation of the right lower quadrant
D. Deep palpation of the left upper quadrant
B. Percussing for shifting dullness
Rationale: Shifting dullness and fluid wave are specific assessment
techniques used to detect ascites (fluid accumulation) in the abdomen.
9. A patient complains of pain at McBurney's point. The nurse
suspects:
A. Cholecystitis
B. Appendicitis
C. Gastritis
D. Diverticulitis
B. Appendicitis
Rationale: McBurney's point is located in the right lower quadrant,
halfway between the umbilicus and the anterior iliac crest, and is the
classic location for appendicitis pain.
10. During auscultation of the abdomen, the nurse hears high-pitched,
gurgling sounds occurring 5 to 30 times per minute. The nurse
