NSG 316 Exam 2 Health Assessment - GCU
, NSG 316 / NSG316 Exam 2 (LATEST EDITION) Health Assessment | 100 Complete Questions & Verified Answers | 100% Correct | Grade
A+ – GCU
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
Q1 Vital signs normal ranges?
A. No vitals
B. Only HR
C. BP 120/80 HR 60-100 Temp 98.6F RR 12-20 SpO2 95-100%
D. Only BP
Answer: C - BP 120/80 HR 60-100 Temp 98.6F RR 12-20 SpO2 95-100%
Rationale: Vitals: BP 90-120/60-80 HR 60-100 RR 12-20 Temp 97.6-99.6 SpO2 95-100% Pain 0-10.
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
Q2 Health history components?
A. Biographical chief complaint HPI past medical family social ROS
B. Only chief
C. Only ROS
D. Only past
Answer: A - Biographical chief complaint HPI past medical family social ROS
Rationale: Health history: Biographical age gender occupation, Chief complaint reason visit, HPI history present illness OLDCARTS, Past medical surgical meds
allergies, Family social smoking alcohol drugs occupation psychosocial, ROS review systems head to toe.
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
Q3 Integumentary assessment?
A. Only color
B. No assessment
C. Only turgor
D. Skin color lesions turgor hair nails capillary refill <2 sec clubbing ABCDE melanoma
Answer: D - Skin color lesions turgor hair nails capillary refill <2 sec clubbing ABCDE melanoma
Rationale: Integumentary: Skin color pallor cyanosis jaundice erythema temp moisture turgor recoil <2 sec lesions primary macule papule vesicle secondary crust ulcer
ABCDE Asymmetry Border Color Diameter Evolution melanoma Hair distribution Nails capillary refill <2 sec clubbing 180 degrees.
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
Q4 Cardiac assessment components?
A. Only rate
B. Only inspect
C. Only palpate
D. Inspect precordium palpate PMI 5th ICS MCL auscultate S1 S2 murmurs rubs gallops
Answer: D - Inspect precordium palpate PMI 5th ICS MCL auscultate S1 S2 murmurs rubs gallops
Rationale: Cardiac: Inspect precordium pulsations Palpate PMI 5th intercostal midclavicular apex <3cm lateral displacement cardiomegaly Auscultate S1 mitral tricuspid
S2 aortic pulmonic murmurs systolic diastolic rubs gallops S3 S4 rate rhythm JVD edema.
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
Q5 Respiratory assessment?
A. Only percussion
B. Only auscultate
C. Only inspect
D. Inspect chest symmetry A-P ratio 1:2 palpate expansion percussion resonance auscultate vesicular bronchial crackles wheezes
Answer: D - Inspect chest symmetry A-P ratio 1:2 palpate expansion percussion resonance auscultate vesicular bronchial crackles
wheezes
Rationale: Respiratory: Inspect chest symmetry A-P diameter 1:2 barrel chest 1:1 COPD respiratory effort rate 12-20 rhythm Palpate expansion tactile fremitus
Percussion resonance dullness consolidation hyperresonance emphysema Auscultate vesicular bronchial bronchovesicular adventitious crackles wheezes rhonchi
stridor.
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
Q6 GI abdominal assessment order?
A. Inspection last
B. Any order
C. Inspection auscultation percussion palpation to not alter bowel sounds
D. Palpation first
Answer: C - Inspection auscultation percussion palpation to not alter bowel sounds
Rationale: Abdominal order: Inspection skin contour peristalsis striae, Auscultation bowel sounds 5-30/min normoactive hypo hyper bruits vascular, Percussion tympany
dullness liver spleen span, Palpation light deep tenderness masses guarding rebound. Order inspection auscultation percussion palpation.
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
, Q7 Abdominal quadrants organs?
A. Only LUQ
B. RUQ liver gallbladder LUQ stomach spleen RLQ appendix LLQ sigmoid
C. Only RUQ
D. No quadrants
Answer: B - RUQ liver gallbladder LUQ stomach spleen RLQ appendix LLQ sigmoid
Rationale: Quadrants: RUQ liver gallbladder duodenum pancreas head right kidney hepatic flexure colon, LUQ stomach spleen pancreas tail left kidney splenic flexure
colon, RLQ appendix cecum ascending colon right ovary, LLQ sigmoid descending colon left ovary.
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
Q8 Neuro assessment LOC?
A. Only coma
B. LOC level consciousness alert lethargic obtunded stupor coma Glasgow Coma Scale GCS 15 normal E4 V5 M6
C. Only alert
D. No LOC
Answer: B - LOC level consciousness alert lethargic obtunded stupor coma Glasgow Coma Scale GCS 15 normal E4 V5 M6
Rationale: LOC: Level consciousness Alert awake oriented Lethargic drowsy but arousable Obtunded difficult arouse Stupor arouse only pain Coma unresponsive. GCS
Glasgow Coma Scale 15 normal Eye opening 4 spontaneous Verbal 5 oriented Motor 6 obeys <8 coma intubate <12 significant.
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
Q9 Pain assessment PQRST?
A. Only P
B. P Provokes Q Quality R Region S Severity T Timing OLDCARTS numeric 0-10 FACES FLACC
C. Only severity
D. No assessment
Answer: B - P Provokes Q Quality R Region S Severity T Timing OLDCARTS numeric 0-10 FACES FLACC
Rationale: Pain: PQRST Provokes what makes better worse Quality sharp dull aching Region Location Radiation Severity 0-10 scale Timing onset duration constant
intermittent OLDCARTS Onset Location Duration Character Aggravating Relieving Timing Severity Tools numeric rating visual analog Wong-Baker FACES FLACC
nonverbal.
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
Q10 Documentation SOAPIE?
A. S Subjective O Objective A Assessment P Plan I Intervention E Evaluation
B. Only S
C. Only O
D. No documentation
Answer: A - S Subjective O Objective A Assessment P Plan I Intervention E Evaluation
Rationale: Documentation: SOAP Subjective patient states Objective observed measured Assessment diagnosis Plan interventions, SOAPIE plus I Intervention E
Evaluation, PIE Problem Intervention Evaluation, Charting by exception only abnormal, Focus charting DAR Data Action Response.
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
Q11 Vital signs normal ranges?
A. Only BP
B. BP 120/80 HR 60-100 Temp 98.6F RR 12-20 SpO2 95-100%
C. No vitals
D. Only HR
Answer: B - BP 120/80 HR 60-100 Temp 98.6F RR 12-20 SpO2 95-100%
Rationale: Vitals: BP 90-120/60-80 HR 60-100 RR 12-20 Temp 97.6-99.6 SpO2 95-100% Pain 0-10.
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
Q12 Health history components?
A. Biographical chief complaint HPI past medical family social ROS
B. Only ROS
C. Only chief
D. Only past
Answer: A - Biographical chief complaint HPI past medical family social ROS
Rationale: Health history: Biographical age gender occupation, Chief complaint reason visit, HPI history present illness OLDCARTS, Past medical surgical meds
allergies, Family social smoking alcohol drugs occupation psychosocial, ROS review systems head to toe.
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
Q13 Integumentary assessment?
A. Only color
B. Only turgor
C. Skin color lesions turgor hair nails capillary refill <2 sec clubbing ABCDE melanoma
, NSG 316 / NSG316 Exam 2 (LATEST EDITION) Health Assessment | 100 Complete Questions & Verified Answers | 100% Correct | Grade
A+ – GCU
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
Q1 Vital signs normal ranges?
A. No vitals
B. Only HR
C. BP 120/80 HR 60-100 Temp 98.6F RR 12-20 SpO2 95-100%
D. Only BP
Answer: C - BP 120/80 HR 60-100 Temp 98.6F RR 12-20 SpO2 95-100%
Rationale: Vitals: BP 90-120/60-80 HR 60-100 RR 12-20 Temp 97.6-99.6 SpO2 95-100% Pain 0-10.
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
Q2 Health history components?
A. Biographical chief complaint HPI past medical family social ROS
B. Only chief
C. Only ROS
D. Only past
Answer: A - Biographical chief complaint HPI past medical family social ROS
Rationale: Health history: Biographical age gender occupation, Chief complaint reason visit, HPI history present illness OLDCARTS, Past medical surgical meds
allergies, Family social smoking alcohol drugs occupation psychosocial, ROS review systems head to toe.
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
Q3 Integumentary assessment?
A. Only color
B. No assessment
C. Only turgor
D. Skin color lesions turgor hair nails capillary refill <2 sec clubbing ABCDE melanoma
Answer: D - Skin color lesions turgor hair nails capillary refill <2 sec clubbing ABCDE melanoma
Rationale: Integumentary: Skin color pallor cyanosis jaundice erythema temp moisture turgor recoil <2 sec lesions primary macule papule vesicle secondary crust ulcer
ABCDE Asymmetry Border Color Diameter Evolution melanoma Hair distribution Nails capillary refill <2 sec clubbing 180 degrees.
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
Q4 Cardiac assessment components?
A. Only rate
B. Only inspect
C. Only palpate
D. Inspect precordium palpate PMI 5th ICS MCL auscultate S1 S2 murmurs rubs gallops
Answer: D - Inspect precordium palpate PMI 5th ICS MCL auscultate S1 S2 murmurs rubs gallops
Rationale: Cardiac: Inspect precordium pulsations Palpate PMI 5th intercostal midclavicular apex <3cm lateral displacement cardiomegaly Auscultate S1 mitral tricuspid
S2 aortic pulmonic murmurs systolic diastolic rubs gallops S3 S4 rate rhythm JVD edema.
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
Q5 Respiratory assessment?
A. Only percussion
B. Only auscultate
C. Only inspect
D. Inspect chest symmetry A-P ratio 1:2 palpate expansion percussion resonance auscultate vesicular bronchial crackles wheezes
Answer: D - Inspect chest symmetry A-P ratio 1:2 palpate expansion percussion resonance auscultate vesicular bronchial crackles
wheezes
Rationale: Respiratory: Inspect chest symmetry A-P diameter 1:2 barrel chest 1:1 COPD respiratory effort rate 12-20 rhythm Palpate expansion tactile fremitus
Percussion resonance dullness consolidation hyperresonance emphysema Auscultate vesicular bronchial bronchovesicular adventitious crackles wheezes rhonchi
stridor.
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
Q6 GI abdominal assessment order?
A. Inspection last
B. Any order
C. Inspection auscultation percussion palpation to not alter bowel sounds
D. Palpation first
Answer: C - Inspection auscultation percussion palpation to not alter bowel sounds
Rationale: Abdominal order: Inspection skin contour peristalsis striae, Auscultation bowel sounds 5-30/min normoactive hypo hyper bruits vascular, Percussion tympany
dullness liver spleen span, Palpation light deep tenderness masses guarding rebound. Order inspection auscultation percussion palpation.
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
, Q7 Abdominal quadrants organs?
A. Only LUQ
B. RUQ liver gallbladder LUQ stomach spleen RLQ appendix LLQ sigmoid
C. Only RUQ
D. No quadrants
Answer: B - RUQ liver gallbladder LUQ stomach spleen RLQ appendix LLQ sigmoid
Rationale: Quadrants: RUQ liver gallbladder duodenum pancreas head right kidney hepatic flexure colon, LUQ stomach spleen pancreas tail left kidney splenic flexure
colon, RLQ appendix cecum ascending colon right ovary, LLQ sigmoid descending colon left ovary.
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
Q8 Neuro assessment LOC?
A. Only coma
B. LOC level consciousness alert lethargic obtunded stupor coma Glasgow Coma Scale GCS 15 normal E4 V5 M6
C. Only alert
D. No LOC
Answer: B - LOC level consciousness alert lethargic obtunded stupor coma Glasgow Coma Scale GCS 15 normal E4 V5 M6
Rationale: LOC: Level consciousness Alert awake oriented Lethargic drowsy but arousable Obtunded difficult arouse Stupor arouse only pain Coma unresponsive. GCS
Glasgow Coma Scale 15 normal Eye opening 4 spontaneous Verbal 5 oriented Motor 6 obeys <8 coma intubate <12 significant.
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
Q9 Pain assessment PQRST?
A. Only P
B. P Provokes Q Quality R Region S Severity T Timing OLDCARTS numeric 0-10 FACES FLACC
C. Only severity
D. No assessment
Answer: B - P Provokes Q Quality R Region S Severity T Timing OLDCARTS numeric 0-10 FACES FLACC
Rationale: Pain: PQRST Provokes what makes better worse Quality sharp dull aching Region Location Radiation Severity 0-10 scale Timing onset duration constant
intermittent OLDCARTS Onset Location Duration Character Aggravating Relieving Timing Severity Tools numeric rating visual analog Wong-Baker FACES FLACC
nonverbal.
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
Q10 Documentation SOAPIE?
A. S Subjective O Objective A Assessment P Plan I Intervention E Evaluation
B. Only S
C. Only O
D. No documentation
Answer: A - S Subjective O Objective A Assessment P Plan I Intervention E Evaluation
Rationale: Documentation: SOAP Subjective patient states Objective observed measured Assessment diagnosis Plan interventions, SOAPIE plus I Intervention E
Evaluation, PIE Problem Intervention Evaluation, Charting by exception only abnormal, Focus charting DAR Data Action Response.
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
Q11 Vital signs normal ranges?
A. Only BP
B. BP 120/80 HR 60-100 Temp 98.6F RR 12-20 SpO2 95-100%
C. No vitals
D. Only HR
Answer: B - BP 120/80 HR 60-100 Temp 98.6F RR 12-20 SpO2 95-100%
Rationale: Vitals: BP 90-120/60-80 HR 60-100 RR 12-20 Temp 97.6-99.6 SpO2 95-100% Pain 0-10.
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
Q12 Health history components?
A. Biographical chief complaint HPI past medical family social ROS
B. Only ROS
C. Only chief
D. Only past
Answer: A - Biographical chief complaint HPI past medical family social ROS
Rationale: Health history: Biographical age gender occupation, Chief complaint reason visit, HPI history present illness OLDCARTS, Past medical surgical meds
allergies, Family social smoking alcohol drugs occupation psychosocial, ROS review systems head to toe.
DOMAIN: NSG 316 EXAM 2 HEALTH ASSESSMENT
Q13 Integumentary assessment?
A. Only color
B. Only turgor
C. Skin color lesions turgor hair nails capillary refill <2 sec clubbing ABCDE melanoma
