NR 305
Health Assessment for the
Practicing RN
Complete Midterm Review
(Questions & Solutions)
2025
1
,1. A 56-year-old patient exhibits a fourth heart sound (S4) upon cardiac
auscultation. Which condition is most likely responsible?
A. Mitral regurgitation
B. Left ventricular hypertrophy
C. Early diastolic filling
D. Pulmonary hypertension
ANS: B
Rationale: S4 occurs with atrial contraction into a noncompliant
ventricle, as seen in left ventricular hypertrophy due to chronic pressure
overload.
2. During a neurological exam, brisk deep tendon reflexes (3+) with
sustained clonus are noted in the ankle. These findings are most
consistent with:
A. Lower motor neuron lesion
B. Upper motor neuron lesion
C. Peripheral neuropathy
D. Neuromuscular junction disorder
ANS: B
Rationale: Hyperreflexia and clonus indicate loss of inhibitory control
from the brain or spinal cord, characteristic of upper motor neuron
lesions.
3. While assessing lung fields, the nurse elicits egophony (“E” to “A”
change) over the right lower lobe. This finding suggests:
A. Pleural effusion
B. Pneumothorax
C. Consolidation
D. Emphysema
ANS: C
2
, Rationale: In consolidation, sound vibrations transmit better, altering
“E” to “A” during auscultation.
4. A patient presents with acute abdominal pain. Which technique best
distinguishes involuntary guarding from voluntary rigidity?
A. Deep palpation in all quadrants
B. Asking the patient to breathe deeply
C. Distracting the patient during palpation
D. Assessing rebound tenderness
ANS: C
Rationale: Distraction (e.g., asking the patient to count) helps
differentiate voluntary muscle contraction from true involuntary
guarding.
5. The Trendelenburg test is used to assess the integrity of which
anatomical structure?
A. Hip abductors
B. Knee extensors
C. Ankle dorsiflexors
D. Shoulder rotators
ANS: A
Rationale: A positive Trendelenburg sign—pelvic drop on the
contralateral side—indicates weakness of the gluteus medius/minimus
(hip abductors).
6. A 45-year-old patient has a pigmented skin lesion with asymmetry,
irregular borders, color variation, and evolving size. Which action should
the nurse anticipate?
A. Document as benign nevus
B. Prepare for excisional biopsy
C. Apply topical steroid
D. Educate on sun avoidance only
3
Health Assessment for the
Practicing RN
Complete Midterm Review
(Questions & Solutions)
2025
1
,1. A 56-year-old patient exhibits a fourth heart sound (S4) upon cardiac
auscultation. Which condition is most likely responsible?
A. Mitral regurgitation
B. Left ventricular hypertrophy
C. Early diastolic filling
D. Pulmonary hypertension
ANS: B
Rationale: S4 occurs with atrial contraction into a noncompliant
ventricle, as seen in left ventricular hypertrophy due to chronic pressure
overload.
2. During a neurological exam, brisk deep tendon reflexes (3+) with
sustained clonus are noted in the ankle. These findings are most
consistent with:
A. Lower motor neuron lesion
B. Upper motor neuron lesion
C. Peripheral neuropathy
D. Neuromuscular junction disorder
ANS: B
Rationale: Hyperreflexia and clonus indicate loss of inhibitory control
from the brain or spinal cord, characteristic of upper motor neuron
lesions.
3. While assessing lung fields, the nurse elicits egophony (“E” to “A”
change) over the right lower lobe. This finding suggests:
A. Pleural effusion
B. Pneumothorax
C. Consolidation
D. Emphysema
ANS: C
2
, Rationale: In consolidation, sound vibrations transmit better, altering
“E” to “A” during auscultation.
4. A patient presents with acute abdominal pain. Which technique best
distinguishes involuntary guarding from voluntary rigidity?
A. Deep palpation in all quadrants
B. Asking the patient to breathe deeply
C. Distracting the patient during palpation
D. Assessing rebound tenderness
ANS: C
Rationale: Distraction (e.g., asking the patient to count) helps
differentiate voluntary muscle contraction from true involuntary
guarding.
5. The Trendelenburg test is used to assess the integrity of which
anatomical structure?
A. Hip abductors
B. Knee extensors
C. Ankle dorsiflexors
D. Shoulder rotators
ANS: A
Rationale: A positive Trendelenburg sign—pelvic drop on the
contralateral side—indicates weakness of the gluteus medius/minimus
(hip abductors).
6. A 45-year-old patient has a pigmented skin lesion with asymmetry,
irregular borders, color variation, and evolving size. Which action should
the nurse anticipate?
A. Document as benign nevus
B. Prepare for excisional biopsy
C. Apply topical steroid
D. Educate on sun avoidance only
3
