NRSG 2220 Health Assessment Exam 1 Modules 1-3
Questions With Complete Solutions
Apex Correct Answers bottom of the heart found at the 5th ICS
- point of maximal impact
Arrhythmia Correct Answers skipped beats/palpitation
Arterial Pulses Correct Answers - Arm: brachial/radial/ulnar
- Leg: femoral/popliteal/dorsalis pedis/posterior tibial artery
Aseptic Technique Correct Answers - for all activities to
prevent or break the chain of infection
- two categories: medical asepsis (clean technique) and surgical
asepsis (sterile technique)
Auscultation Correct Answers assesses characteristics of sound
(pitch/loudness/quality/duration)
- third step of the physical assessment (EXCEPT for abdominal
assessments where it is second)
Auscultation Landmarks Correct Answers - anterior tropic wall
(front)
- midclavicular line
Base Correct Answers top of the heart at the 2nd ICS
Biots Respirations Correct Answers like Cheyne-stokes
respirations but irregular pattern
,Cardinal Signs of Acute Infection Correct Answers - redness
- heat
- swelling
- pain
- loss of function
Cardiovascular: Physical Assessment Correct Answers -
Jugular vein: check pulse
- Carotid: check pulse, inspect, palpate, auscultate
- Precordium: palpate, inspect, auscultate --> listen for S1 and
S2, listen at each landmark (aortic/tricuspid/pulmonic/mitral)
Categories of Pain: Duration Correct Answers Acute --> rapid
onset; mild to severe; autonomic response
Chronic --> long lasting (even after the problem gone; comes
and goes)
Categories of Pain: Etiology Correct Answers Nociceptive -->
damage to peripheral tissues/nerves
Neuropathic --> lesion in peripheral or central nerves
Phantom --> real; post amputation; pain where receptors or
nerves used to be
Categories of Pain: Localization/Location Correct Answers
Cutaneous --> superficial
Somatic --> diffuse; originates in bone/vessels/nerves
Visceral --> originating in organs; poorly localized
Referred --> any pain originating in one part of the body but is
perceived in a different area
, Categories of Pain: Origin Correct Answers Physical --> cause
can be identified
Psychogenic --> cause can NOT be identified
Referred --> any pain originating in one part of the body but is
perceived in a different area
Characteristics of the Nursing Process Correct Answers -
Systematic --> part of an ordered sequence of activities
- Dynamic --> interaction and overlap of phases
- Interpersonal --> patient at the core
- Outcome Oriented --> nurses and patients work together to
find outcomes
- Universally Applicable --> framework for all activities
Cheyne-Stokes Respirations Correct Answers alternating
period of deep, rapid breathing and then apnea; regular pattern
Common Portals of Exit Correct Answers - respiratory
- GI
- genitourinary
- breaks in the skin
- blood/tissues
Common Responses to Pain Correct Answers Psychologic -->
involuntary response to pain
Behavioral --> responses that reflect body movement
Affective --> responses that reflect mood/emotions (ex: crying)
Communication Techniques Correct Answers - Restatement --
> pt elaborates about content
- Reflection --> summarize main themes
Questions With Complete Solutions
Apex Correct Answers bottom of the heart found at the 5th ICS
- point of maximal impact
Arrhythmia Correct Answers skipped beats/palpitation
Arterial Pulses Correct Answers - Arm: brachial/radial/ulnar
- Leg: femoral/popliteal/dorsalis pedis/posterior tibial artery
Aseptic Technique Correct Answers - for all activities to
prevent or break the chain of infection
- two categories: medical asepsis (clean technique) and surgical
asepsis (sterile technique)
Auscultation Correct Answers assesses characteristics of sound
(pitch/loudness/quality/duration)
- third step of the physical assessment (EXCEPT for abdominal
assessments where it is second)
Auscultation Landmarks Correct Answers - anterior tropic wall
(front)
- midclavicular line
Base Correct Answers top of the heart at the 2nd ICS
Biots Respirations Correct Answers like Cheyne-stokes
respirations but irregular pattern
,Cardinal Signs of Acute Infection Correct Answers - redness
- heat
- swelling
- pain
- loss of function
Cardiovascular: Physical Assessment Correct Answers -
Jugular vein: check pulse
- Carotid: check pulse, inspect, palpate, auscultate
- Precordium: palpate, inspect, auscultate --> listen for S1 and
S2, listen at each landmark (aortic/tricuspid/pulmonic/mitral)
Categories of Pain: Duration Correct Answers Acute --> rapid
onset; mild to severe; autonomic response
Chronic --> long lasting (even after the problem gone; comes
and goes)
Categories of Pain: Etiology Correct Answers Nociceptive -->
damage to peripheral tissues/nerves
Neuropathic --> lesion in peripheral or central nerves
Phantom --> real; post amputation; pain where receptors or
nerves used to be
Categories of Pain: Localization/Location Correct Answers
Cutaneous --> superficial
Somatic --> diffuse; originates in bone/vessels/nerves
Visceral --> originating in organs; poorly localized
Referred --> any pain originating in one part of the body but is
perceived in a different area
, Categories of Pain: Origin Correct Answers Physical --> cause
can be identified
Psychogenic --> cause can NOT be identified
Referred --> any pain originating in one part of the body but is
perceived in a different area
Characteristics of the Nursing Process Correct Answers -
Systematic --> part of an ordered sequence of activities
- Dynamic --> interaction and overlap of phases
- Interpersonal --> patient at the core
- Outcome Oriented --> nurses and patients work together to
find outcomes
- Universally Applicable --> framework for all activities
Cheyne-Stokes Respirations Correct Answers alternating
period of deep, rapid breathing and then apnea; regular pattern
Common Portals of Exit Correct Answers - respiratory
- GI
- genitourinary
- breaks in the skin
- blood/tissues
Common Responses to Pain Correct Answers Psychologic -->
involuntary response to pain
Behavioral --> responses that reflect body movement
Affective --> responses that reflect mood/emotions (ex: crying)
Communication Techniques Correct Answers - Restatement --
> pt elaborates about content
- Reflection --> summarize main themes
