1. The nurse is performing a thoracic assessment on a Barrel chest
client with chronic asthma and hyperin�ation of the
lungs. Which nding should be expected for this client?
2. The nurse is assessing bowel sounds for a hospitalized Note the character and
client. The nurse has heard bowel sounds in the right frequency of bowel
upper quadrant. What action should the nurse take sounds
next?
3. During inspection of a client's mouth and pharynx, Document an intact gag
the nurse places a tongue blade on the back of the re�ex.
tongue which causes the client to gag. After removing
the tongue blade, what action should the nurse take?
4. When teaching a client how to perform a monthly Upper outer quadrant.
breast self-assessment, the nurse should tell the client
that it is most important to assess which part of the
breast more closely for changes?
5. The nurse is assessing a postmenopausal client who A waist circumference is
has a BMI of 32. The client has a chest measurement greater than 35 inches in
of 42 inches, waist measurement of 45 inches, and women puts you at higher
hip measurement of 50 inches. What important mes- risk for type 2 diabetes and
sage should the nurse explain to the client to promote heart disease."
health promotion?
6. The nurse performs a physical assessment on an older Height reduction of 1.5
female client. Which change from the prior exam may inches.
be an indication of osteoporosis?
7. While conducting an interview to obtain a health histo- Sit quietly to allow the
ry, the nurse notices that the client pauses frequently client to respond comfort-
ably.
, and looks at the nurse expectantly. Which response is
best for the nurse to provide?
8. A client is in the clinical for a yearly physical examina- Ask the client to urinate
tion. Which action should the nurse take when prepar- before beginning the ex-
ing to examine the client's abdomen? amination.
9. Which respiratory condition should the nurse doc- Bradypnea.
ument after measuring a respiratory rate of 8
breaths/minute?
10. Which procedure should the nurse use to assessfor a Measure the apical pulse
pulse de cit? and compare it to the pe-
ripheral pulse.
*A pulse de cit is a palpa-
ble di erence between the
apical pulse at the point
of maximal impulse and
the radial pulse palpated
at the wrist.
11. A client has been diagnosed with bilateral lower lobe Dull, thud-like.
atelectasis. What percussion sound should the nurse
expect to hear when percussing over the client's lower
lobes?
12. A client is being assessed upon admission to the med- Inspect the hair and skin.
ical-surgical unit. The nurse is preparing to complete
a head-to-toe assessment and will begin at the head
of the client. Which technique should the nurse use to
begin the assessment?
client with chronic asthma and hyperin�ation of the
lungs. Which nding should be expected for this client?
2. The nurse is assessing bowel sounds for a hospitalized Note the character and
client. The nurse has heard bowel sounds in the right frequency of bowel
upper quadrant. What action should the nurse take sounds
next?
3. During inspection of a client's mouth and pharynx, Document an intact gag
the nurse places a tongue blade on the back of the re�ex.
tongue which causes the client to gag. After removing
the tongue blade, what action should the nurse take?
4. When teaching a client how to perform a monthly Upper outer quadrant.
breast self-assessment, the nurse should tell the client
that it is most important to assess which part of the
breast more closely for changes?
5. The nurse is assessing a postmenopausal client who A waist circumference is
has a BMI of 32. The client has a chest measurement greater than 35 inches in
of 42 inches, waist measurement of 45 inches, and women puts you at higher
hip measurement of 50 inches. What important mes- risk for type 2 diabetes and
sage should the nurse explain to the client to promote heart disease."
health promotion?
6. The nurse performs a physical assessment on an older Height reduction of 1.5
female client. Which change from the prior exam may inches.
be an indication of osteoporosis?
7. While conducting an interview to obtain a health histo- Sit quietly to allow the
ry, the nurse notices that the client pauses frequently client to respond comfort-
ably.
, and looks at the nurse expectantly. Which response is
best for the nurse to provide?
8. A client is in the clinical for a yearly physical examina- Ask the client to urinate
tion. Which action should the nurse take when prepar- before beginning the ex-
ing to examine the client's abdomen? amination.
9. Which respiratory condition should the nurse doc- Bradypnea.
ument after measuring a respiratory rate of 8
breaths/minute?
10. Which procedure should the nurse use to assessfor a Measure the apical pulse
pulse de cit? and compare it to the pe-
ripheral pulse.
*A pulse de cit is a palpa-
ble di erence between the
apical pulse at the point
of maximal impulse and
the radial pulse palpated
at the wrist.
11. A client has been diagnosed with bilateral lower lobe Dull, thud-like.
atelectasis. What percussion sound should the nurse
expect to hear when percussing over the client's lower
lobes?
12. A client is being assessed upon admission to the med- Inspect the hair and skin.
ical-surgical unit. The nurse is preparing to complete
a head-to-toe assessment and will begin at the head
of the client. Which technique should the nurse use to
begin the assessment?
