Page 1 of 125
NURS 190 EXAM WITH VERIFIED ANSWERS DETAILED
RATIONALES GRADED A+
NURS 190: Physical Assessment — Comprehensive Exam Preparation
SECTION 1: FOUNDATIONS OF PHYSICAL ASSESSMENT & HEALTH HISTORY (Questions 1–25)
Question 1.
The nurse is preparing to perform a comprehensive physical assessment on a newly admitted
adult client. What is the nurse's priority action before beginning the examination?
A) Gather all necessary equipment and ensure proper lighting in the room
B) Review the client's complete medical history and current medication list
C) Establish a therapeutic relationship and explain the procedure to the client
D) Perform hand hygiene and apply appropriate personal protective equipment
Correct Answer: C
Rationale: Establishing trust and explaining the procedure is the priority before any physical
assessment to obtain informed consent and reduce client anxiety. While equipment
preparation, history review, and hand hygiene are important steps, therapeutic communication
must come first to ensure the client is comfortable and cooperative. The nursing process begins
with assessment of client readiness and comfort.
Question 2.
A nurse is using the SBAR communication tool to report a patient's change in condition to the
healthcare provider. What does the acronym SBAR stand for in clinical practice?
1|Page
,Page 2 of 125
A) Situation, Background, Assessment, Recommendation
B) Summary, Background, Analysis, Recommendation
C) Situation, Baseline, Assessment, Report
D) Symptoms, Background, Action, Response
Correct Answer: A
Rationale: SBAR standardizes handoff communication: Situation (what is happening now),
Background (relevant history, diagnosis, treatment), Assessment (clinical findings, vitals, what
the nurse thinks is happening), and Recommendation (what is needed). This structured format
improves patient safety by reducing communication errors during transitions of care.
Question 3.
Which of the following represents the correct sequential order of the nursing process steps
that guides all nursing practice?
A) Diagnosis, Assessment, Planning, Implementation, Evaluation
B) Assessment, Diagnosis, Planning, Implementation, Evaluation
C) Planning, Assessment, Diagnosis, Implementation, Evaluation
D) Assessment, Planning, Diagnosis, Implementation, Evaluation
Correct Answer: B
Rationale: The nursing process (ADPIE) is a systematic framework: Assessment (collect data),
Diagnosis (analyze data and identify problems), Planning (set goals and interventions),
Implementation (perform interventions), and Evaluation (assess outcomes). This order ensures
patient-centered, evidence-based care delivery.
Question 4.
A nurse is using critical thinking to prioritize patient care on a medical-surgical unit. Which
patient should the nurse assess first based on clinical urgency?
2|Page
,Page 3 of 125
A) A patient with diabetes requesting pain medication for chronic neuropathy
B) A patient with new-onset chest pain and shortness of breath
C) A patient requesting assistance to the bathroom for the first time
D) A patient who needs discharge teaching before going home tomorrow
Correct Answer: B
Rationale: Prioritization uses Maslow's hierarchy (physiological needs first) and the ABCs
(airway, breathing, circulation). Chest pain and shortness of breath may indicate a life-
threatening condition such as myocardial infarction or pulmonary embolism. Stability is
threatened, requiring immediate assessment.
Question 5.
The nurse is formulating a nursing diagnosis for a patient with limited mobility. Which of the
following is an example of a correctly written nursing diagnosis?
A) Diabetes mellitus
B) Impaired skin integrity related to immobility as evidenced by stage 2 pressure ulcer
C) Patient needs to be turned every two hours
D) The patient has a reddened area on the sacrum
Correct Answer: B
Rationale: A correctly written nursing diagnosis includes the problem (impaired skin integrity),
the related factor/etiology (immobility), and the defining characteristics/evidence (stage 2
pressure ulcer). This follows the PES format (Problem, Etiology, Signs/Symptoms). The other
options are medical diagnoses, interventions, or assessment findings.
Question 6.
During a health history interview, a patient states, "I feel perfectly fine." Which interviewing
technique is the nurse using when replying, "Can you tell me what you mean by 'perfectly
fine'?"
3|Page
, Page 4 of 125
A) Clarification
B) Reflection
C) Confrontation
D) Summarization
Correct Answer: A
Rationale: Clarification is used when the nurse needs to make something more understandable
or when the patient's statement is ambiguous. By asking the patient to define "perfectly fine,"
the nurse seeks specific details to better understand the patient's health status. This technique
promotes effective communication and accurate data collection.
Question 7.
A nurse is documenting assessment findings in the electronic health record. Which of the
following represents subjective data obtained from the patient?
A) Blood pressure of 142/88 mmHg measured in the right arm
B) Patient reports "I have a throbbing headache that started this morning"
C) Temperature of 101.2°F obtained via oral route
D) Lung sounds clear to auscultation bilaterally without adventitious sounds
Correct Answer: B
Rationale: Subjective data are symptoms described by the patient, including sensations,
feelings, perceptions, and concerns. The patient's report of a throbbing headache is subjective.
Objective data are observable and measurable findings such as vital signs, physical examination
findings, and laboratory results.
Question 8.
A nurse is preparing to conduct a health history on a patient from a different cultural
background. What is the most appropriate approach to ensure culturally competent care?
4|Page
NURS 190 EXAM WITH VERIFIED ANSWERS DETAILED
RATIONALES GRADED A+
NURS 190: Physical Assessment — Comprehensive Exam Preparation
SECTION 1: FOUNDATIONS OF PHYSICAL ASSESSMENT & HEALTH HISTORY (Questions 1–25)
Question 1.
The nurse is preparing to perform a comprehensive physical assessment on a newly admitted
adult client. What is the nurse's priority action before beginning the examination?
A) Gather all necessary equipment and ensure proper lighting in the room
B) Review the client's complete medical history and current medication list
C) Establish a therapeutic relationship and explain the procedure to the client
D) Perform hand hygiene and apply appropriate personal protective equipment
Correct Answer: C
Rationale: Establishing trust and explaining the procedure is the priority before any physical
assessment to obtain informed consent and reduce client anxiety. While equipment
preparation, history review, and hand hygiene are important steps, therapeutic communication
must come first to ensure the client is comfortable and cooperative. The nursing process begins
with assessment of client readiness and comfort.
Question 2.
A nurse is using the SBAR communication tool to report a patient's change in condition to the
healthcare provider. What does the acronym SBAR stand for in clinical practice?
1|Page
,Page 2 of 125
A) Situation, Background, Assessment, Recommendation
B) Summary, Background, Analysis, Recommendation
C) Situation, Baseline, Assessment, Report
D) Symptoms, Background, Action, Response
Correct Answer: A
Rationale: SBAR standardizes handoff communication: Situation (what is happening now),
Background (relevant history, diagnosis, treatment), Assessment (clinical findings, vitals, what
the nurse thinks is happening), and Recommendation (what is needed). This structured format
improves patient safety by reducing communication errors during transitions of care.
Question 3.
Which of the following represents the correct sequential order of the nursing process steps
that guides all nursing practice?
A) Diagnosis, Assessment, Planning, Implementation, Evaluation
B) Assessment, Diagnosis, Planning, Implementation, Evaluation
C) Planning, Assessment, Diagnosis, Implementation, Evaluation
D) Assessment, Planning, Diagnosis, Implementation, Evaluation
Correct Answer: B
Rationale: The nursing process (ADPIE) is a systematic framework: Assessment (collect data),
Diagnosis (analyze data and identify problems), Planning (set goals and interventions),
Implementation (perform interventions), and Evaluation (assess outcomes). This order ensures
patient-centered, evidence-based care delivery.
Question 4.
A nurse is using critical thinking to prioritize patient care on a medical-surgical unit. Which
patient should the nurse assess first based on clinical urgency?
2|Page
,Page 3 of 125
A) A patient with diabetes requesting pain medication for chronic neuropathy
B) A patient with new-onset chest pain and shortness of breath
C) A patient requesting assistance to the bathroom for the first time
D) A patient who needs discharge teaching before going home tomorrow
Correct Answer: B
Rationale: Prioritization uses Maslow's hierarchy (physiological needs first) and the ABCs
(airway, breathing, circulation). Chest pain and shortness of breath may indicate a life-
threatening condition such as myocardial infarction or pulmonary embolism. Stability is
threatened, requiring immediate assessment.
Question 5.
The nurse is formulating a nursing diagnosis for a patient with limited mobility. Which of the
following is an example of a correctly written nursing diagnosis?
A) Diabetes mellitus
B) Impaired skin integrity related to immobility as evidenced by stage 2 pressure ulcer
C) Patient needs to be turned every two hours
D) The patient has a reddened area on the sacrum
Correct Answer: B
Rationale: A correctly written nursing diagnosis includes the problem (impaired skin integrity),
the related factor/etiology (immobility), and the defining characteristics/evidence (stage 2
pressure ulcer). This follows the PES format (Problem, Etiology, Signs/Symptoms). The other
options are medical diagnoses, interventions, or assessment findings.
Question 6.
During a health history interview, a patient states, "I feel perfectly fine." Which interviewing
technique is the nurse using when replying, "Can you tell me what you mean by 'perfectly
fine'?"
3|Page
, Page 4 of 125
A) Clarification
B) Reflection
C) Confrontation
D) Summarization
Correct Answer: A
Rationale: Clarification is used when the nurse needs to make something more understandable
or when the patient's statement is ambiguous. By asking the patient to define "perfectly fine,"
the nurse seeks specific details to better understand the patient's health status. This technique
promotes effective communication and accurate data collection.
Question 7.
A nurse is documenting assessment findings in the electronic health record. Which of the
following represents subjective data obtained from the patient?
A) Blood pressure of 142/88 mmHg measured in the right arm
B) Patient reports "I have a throbbing headache that started this morning"
C) Temperature of 101.2°F obtained via oral route
D) Lung sounds clear to auscultation bilaterally without adventitious sounds
Correct Answer: B
Rationale: Subjective data are symptoms described by the patient, including sensations,
feelings, perceptions, and concerns. The patient's report of a throbbing headache is subjective.
Objective data are observable and measurable findings such as vital signs, physical examination
findings, and laboratory results.
Question 8.
A nurse is preparing to conduct a health history on a patient from a different cultural
background. What is the most appropriate approach to ensure culturally competent care?
4|Page
