UR 101/ NUR101 Exam 3 – Health
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Assessment Guide ACTUAL EXAM
2026/2027 | Health Assessment Guide |
Verified Q&A | Pass Guaranteed - A+
Graded
ART A – MULTIPLE CHOICE (Q1–60)
P
Q1 (Female breast – inspection finding):
During breast inspection, the nurse observes unilateral skin dimpling when the patient raises her
arms above her head. This finding is most consistent with:
A. Fibrocystic breast changes
B. Cooper's ligament involvement by malignancy
C. Normal age-related skin laxity
D. Superficial thrombophlebitis
[CORRECT] B
Rationale: Skin dimpling occurs when malignant cells invade Cooper's ligaments, causing
fibrous tissue shortening and skin retraction (Jarvis, 2024). Fibrocystic changes present as
bilateral, diffuse tenderness without skin dimpling. Normal skin laxity is bilateral and symmetric.
Superficial thrombophlebitis (Mondor's disease) presents as a tender, cord-like structure, not
dimpling. Clinical pearl: Always inspect breasts in three positions—arms at sides, arms raised
overhead, and hands pressed on hips (pectoralis contraction)—to accentuate subtle skin
changes.
Q2 (Female breast – palpation technique):
When palpating the breast, the nurse should use which pattern to ensure complete coverage of
breast tissue including the tail of Spence?
A. Radial spoke pattern only
B. Concentric circles from the nipple outward
C. Vertical strip pattern overlapping rows
D. Random palpation of quadrants
[CORRECT] C
Rationale: The vertical strip (up-and-down) pattern is the recommended technique covering
from the clavicle to the bra line and from the sternum to the midaxillary line, including the tail of
Spence (Jarvis, 2024). Concentric circles may miss peripheral tissue. The radial pattern is
acceptable but less systematic. Random palpation risks missing areas. Clinical pearl: Use the
pads (not tips) of the middle three fingers with small circular motions of varying pressure (light,
medium, deep) and ensure coverage of all four quadrants plus the tail of Spence.
Q3 (Female breast – lymph node assessment):
, uring axillary lymph node palpation, the nurse identifies a firm, fixed, non-tender node in the
D
patient's right axilla. The most appropriate interpretation is:
A. Normal lymphatic drainage from recent infection
B. Reactive lymphadenopathy from dermatitis
C. Suspicious for metastatic breast cancer
D. Benign lipoma in the axillary tail
[CORRECT] C
Rationale: Firm, fixed, non-tender axillary lymphadenopathy is highly suspicious for metastatic
breast cancer, as malignant cells often spread first to the ipsilateral axillary nodes (Jarvis, 2024).
Reactive nodes from infection are typically mobile and tender. Benign lipomas are soft, mobile,
and not fixed to underlying tissue. Clinical pearl: Palpate the axilla by supporting the patient's
arm with one hand while using the fingertips of the other hand to press deeply into the apex of
the axilla; assess central, pectoral (anterior), subscapular (posterior), lateral, and apical node
groups.
Q4 (Female breast – BSE teaching):
A 35-year-old premenopausal woman asks when she should perform breast self-examination.
The nurse's best response is:
A. "Perform BSE on the first day of your menstrual period."
B. "Perform BSE 5–7 days after your period ends when breasts are least tender."
C. "Perform BSE daily to ensure you don't miss any changes."
D. "BSE is no longer recommended for women your age."
[CORRECT] B
Rationale: BSE should be performed 5–7 days after menstruation ends when hormonal effects
are minimal and breasts are least tender and nodular (Jarvis, 2024; ACOG, 2026). Performing
during menses is uncomfortable and may yield false positives. Daily examination is excessive
and may increase anxiety. While USPSTF does not recommend routine BSE as a screening
tool, it remains valuable for breast awareness and early detection in symptomatic women.
Clinical pearl: For postmenopausal women, recommend performing BSE on the same day each
month (e.g., the 1st) to maintain consistency.
Q5 (Female breast – abnormal finding differentiation):
A 28-year-old woman presents with a solitary, well-circumscribed, mobile, rubbery, nontender
breast mass. The most likely diagnosis is:
A. Breast cyst
B. Fibroadenoma
C. Invasive ductal carcinoma
D. Mastitis
[CORRECT] B
Rationale: Fibroadenomas classically present as well-circumscribed, mobile, rubbery, nontender
masses in women ages 15–35 (Jarvis, 2024). Breast cysts are often tender and fluctuant.
Invasive ductal carcinoma presents as fixed, irregular, hard masses. Mastitis presents with
erythema, warmth, tenderness, and fever. Clinical pearl: The "breast mouse" sign—mobility of
the mass under the fingers—is characteristic of fibroadenoma; ultrasound is the preferred
imaging modality for women under 30.
Q6 (Male genitalia – testicular assessment):
, uring testicular palpation, the nurse documents: "Right testis oval, smooth, firm, 4 cm,
D
nontender. Left testis enlarged to 5 cm with a firm, irregular 2 cm nodule on the posterior aspect.
No transillumination." The priority nursing action is:
A. Reassure the patient this is likely epididymitis
B. Document and schedule routine follow-up in 6 months
C. Immediately notify the provider for urology referral
D. Apply warm compresses and prescribe antibiotics
[CORRECT] C
Rationale: A firm, irregular, non-tender testicular nodule with no transillumination is highly
suspicious for testicular cancer and requires immediate urology referral for ultrasound and
tumor markers (Jarvis, 2024). Epididymitis presents with tenderness, warmth, and erythema.
Watchful waiting is contraindicated with suspicious testicular masses. Clinical pearl: Testicular
cancer is the most common malignancy in men ages 15–35; the 2026 USPSTF does not
recommend routine testicular self-exam for asymptomatic men, but any palpable abnormality
warrants urgent evaluation.
Q7 (Male genitalia – hernia assessment):
The nurse is assessing a 55-year-old man for an inguinal hernia. Which technique is correct?
A. Palpate the inguinal canal while the patient performs a Valsalva maneuver
B. Palpate the inguinal canal while the patient coughs
C. Inspect only; palpation is contraindicated due to risk of incarceration
D. Palpate during deep inspiration with the patient supine
[CORRECT] B
Rationale: The correct technique involves inserting the index finger into the inguinal canal via
the external ring and asking the patient to cough or bear down (Jarvis, 2024). A palpable bulge
or impulse indicates hernia. The Valsalva maneuver is less effective for this assessment.
Palpation is essential and not contraindicated. Clinical pearl: An indirect hernia passes through
the internal inguinal ring and may descend into the scrotum; a direct hernia pushes through
Hesselbach's triangle and rarely enters the scrotum—this distinction guides surgical planning.
Q8 (Male genitalia – DRE positioning):
The nurse is preparing to perform a digital rectal examination (DRE) on a 65-year-old man.
Which position is preferred for adequate prostate palpation?
A. Dorsal recumbent with knees flexed
B. Left lateral Sims' position with hips and knees flexed
C. Prone with hips elevated on pillow
D. Standing with feet shoulder-width apart
[CORRECT] B
Rationale: The left lateral Sims' position with hips and knees flexed provides optimal exposure
of the anus and allows the examiner to palpate the prostate anteriorly (Jarvis, 2024). The dorsal
recumbent position is used for female pelvic exams. The prone position is not used for DRE.
Standing position is an alternative for hernia assessment but not preferred for DRE. Clinical
pearl: In Sims' position, the patient lies on the left side with the right knee drawn up toward the
chest; this relaxes the anal sphincter and allows the examiner to insert the gloved, lubricated
index finger gently toward the umbilicus to assess the prostate.
Q9 (Male genitalia – prostate findings):
, uring DRE, the nurse palpates a prostate that is symmetrically enlarged, smooth, rubbery, with
D
a palpable median sulcus. The patient reports urinary frequency and nocturia. These findings
are most consistent with:
A. Prostate cancer
B. Acute bacterial prostatitis
C. Benign prostatic hyperplasia (BPH)
D. Prostatic abscess
[CORRECT] C
Rationale: Symmetric enlargement with preserved median sulcus and rubbery consistency is
characteristic of BPH (Jarvis, 2024). Prostate cancer presents with hard nodules and obliterated
median sulcus. Acute prostatitis presents with a boggy, exquisitely tender prostate. Prostatic
abscess is rare and presents with fluctuance and systemic signs. Clinical pearl: The normal
prostate is approximately 2–4 cm in diameter, heart-shaped, rubbery, and nontender with a
palpable median sulcus; BPH typically develops in the periurethral central zone, preserving the
lateral lobes and sulcus.
Q10 (Female genitalia – external inspection):
During external genitalia inspection, the nurse observes multiple small, flesh-colored,
cauliflower-like growths on the labia minora. These findings are consistent with:
A. Herpes simplex virus infection
B. Human papillomavirus (HPV) condyloma acuminata
C. Syphilitic chancre
D. Bartholin's cyst
[CORRECT] B
Rationale: Cauliflower-like (verrucous) growths on the vulva are characteristic of condyloma
acuminata caused by HPV (Jarvis, 2024). Herpes presents as painful vesicles and ulcers.
Syphilitic chancre is a single, painless, indurated ulcer. Bartholin's cyst presents as a unilateral
swelling at the posterior labia. Clinical pearl: HPV types 6 and 11 cause condyloma acuminata;
types 16 and 18 are high-risk and associated with cervical dysplasia and cancer—routine Pap
smear and HPV testing are essential for this patient.
Q11 (Female genitalia – speculum exam):
When inserting the vaginal speculum, the nurse should angle the blades:
A. Posteriorly toward the sacrum
B. Anteriorly toward the pubic symphysis
C. Laterally toward the ischial spines
D. Directly vertical without angulation
[CORRECT] A
Rationale: The speculum should be inserted at a downward 45-degree angle toward the
sacrum, following the natural vaginal axis (Jarvis, 2024). Inserting anteriorly causes discomfort
and may injure the urethra. Lateral or vertical insertion does not follow anatomical alignment.
Clinical pearl: Warm the speculum with warm water (not hot), apply water-soluble lubricant to
the outer blades, and insert with the blades closed and oblique; once fully inserted, rotate to
horizontal and open slowly to visualize the cervix.
Q12 (Female genitalia – bimanual exam):
N
Assessment Guide ACTUAL EXAM
2026/2027 | Health Assessment Guide |
Verified Q&A | Pass Guaranteed - A+
Graded
ART A – MULTIPLE CHOICE (Q1–60)
P
Q1 (Female breast – inspection finding):
During breast inspection, the nurse observes unilateral skin dimpling when the patient raises her
arms above her head. This finding is most consistent with:
A. Fibrocystic breast changes
B. Cooper's ligament involvement by malignancy
C. Normal age-related skin laxity
D. Superficial thrombophlebitis
[CORRECT] B
Rationale: Skin dimpling occurs when malignant cells invade Cooper's ligaments, causing
fibrous tissue shortening and skin retraction (Jarvis, 2024). Fibrocystic changes present as
bilateral, diffuse tenderness without skin dimpling. Normal skin laxity is bilateral and symmetric.
Superficial thrombophlebitis (Mondor's disease) presents as a tender, cord-like structure, not
dimpling. Clinical pearl: Always inspect breasts in three positions—arms at sides, arms raised
overhead, and hands pressed on hips (pectoralis contraction)—to accentuate subtle skin
changes.
Q2 (Female breast – palpation technique):
When palpating the breast, the nurse should use which pattern to ensure complete coverage of
breast tissue including the tail of Spence?
A. Radial spoke pattern only
B. Concentric circles from the nipple outward
C. Vertical strip pattern overlapping rows
D. Random palpation of quadrants
[CORRECT] C
Rationale: The vertical strip (up-and-down) pattern is the recommended technique covering
from the clavicle to the bra line and from the sternum to the midaxillary line, including the tail of
Spence (Jarvis, 2024). Concentric circles may miss peripheral tissue. The radial pattern is
acceptable but less systematic. Random palpation risks missing areas. Clinical pearl: Use the
pads (not tips) of the middle three fingers with small circular motions of varying pressure (light,
medium, deep) and ensure coverage of all four quadrants plus the tail of Spence.
Q3 (Female breast – lymph node assessment):
, uring axillary lymph node palpation, the nurse identifies a firm, fixed, non-tender node in the
D
patient's right axilla. The most appropriate interpretation is:
A. Normal lymphatic drainage from recent infection
B. Reactive lymphadenopathy from dermatitis
C. Suspicious for metastatic breast cancer
D. Benign lipoma in the axillary tail
[CORRECT] C
Rationale: Firm, fixed, non-tender axillary lymphadenopathy is highly suspicious for metastatic
breast cancer, as malignant cells often spread first to the ipsilateral axillary nodes (Jarvis, 2024).
Reactive nodes from infection are typically mobile and tender. Benign lipomas are soft, mobile,
and not fixed to underlying tissue. Clinical pearl: Palpate the axilla by supporting the patient's
arm with one hand while using the fingertips of the other hand to press deeply into the apex of
the axilla; assess central, pectoral (anterior), subscapular (posterior), lateral, and apical node
groups.
Q4 (Female breast – BSE teaching):
A 35-year-old premenopausal woman asks when she should perform breast self-examination.
The nurse's best response is:
A. "Perform BSE on the first day of your menstrual period."
B. "Perform BSE 5–7 days after your period ends when breasts are least tender."
C. "Perform BSE daily to ensure you don't miss any changes."
D. "BSE is no longer recommended for women your age."
[CORRECT] B
Rationale: BSE should be performed 5–7 days after menstruation ends when hormonal effects
are minimal and breasts are least tender and nodular (Jarvis, 2024; ACOG, 2026). Performing
during menses is uncomfortable and may yield false positives. Daily examination is excessive
and may increase anxiety. While USPSTF does not recommend routine BSE as a screening
tool, it remains valuable for breast awareness and early detection in symptomatic women.
Clinical pearl: For postmenopausal women, recommend performing BSE on the same day each
month (e.g., the 1st) to maintain consistency.
Q5 (Female breast – abnormal finding differentiation):
A 28-year-old woman presents with a solitary, well-circumscribed, mobile, rubbery, nontender
breast mass. The most likely diagnosis is:
A. Breast cyst
B. Fibroadenoma
C. Invasive ductal carcinoma
D. Mastitis
[CORRECT] B
Rationale: Fibroadenomas classically present as well-circumscribed, mobile, rubbery, nontender
masses in women ages 15–35 (Jarvis, 2024). Breast cysts are often tender and fluctuant.
Invasive ductal carcinoma presents as fixed, irregular, hard masses. Mastitis presents with
erythema, warmth, tenderness, and fever. Clinical pearl: The "breast mouse" sign—mobility of
the mass under the fingers—is characteristic of fibroadenoma; ultrasound is the preferred
imaging modality for women under 30.
Q6 (Male genitalia – testicular assessment):
, uring testicular palpation, the nurse documents: "Right testis oval, smooth, firm, 4 cm,
D
nontender. Left testis enlarged to 5 cm with a firm, irregular 2 cm nodule on the posterior aspect.
No transillumination." The priority nursing action is:
A. Reassure the patient this is likely epididymitis
B. Document and schedule routine follow-up in 6 months
C. Immediately notify the provider for urology referral
D. Apply warm compresses and prescribe antibiotics
[CORRECT] C
Rationale: A firm, irregular, non-tender testicular nodule with no transillumination is highly
suspicious for testicular cancer and requires immediate urology referral for ultrasound and
tumor markers (Jarvis, 2024). Epididymitis presents with tenderness, warmth, and erythema.
Watchful waiting is contraindicated with suspicious testicular masses. Clinical pearl: Testicular
cancer is the most common malignancy in men ages 15–35; the 2026 USPSTF does not
recommend routine testicular self-exam for asymptomatic men, but any palpable abnormality
warrants urgent evaluation.
Q7 (Male genitalia – hernia assessment):
The nurse is assessing a 55-year-old man for an inguinal hernia. Which technique is correct?
A. Palpate the inguinal canal while the patient performs a Valsalva maneuver
B. Palpate the inguinal canal while the patient coughs
C. Inspect only; palpation is contraindicated due to risk of incarceration
D. Palpate during deep inspiration with the patient supine
[CORRECT] B
Rationale: The correct technique involves inserting the index finger into the inguinal canal via
the external ring and asking the patient to cough or bear down (Jarvis, 2024). A palpable bulge
or impulse indicates hernia. The Valsalva maneuver is less effective for this assessment.
Palpation is essential and not contraindicated. Clinical pearl: An indirect hernia passes through
the internal inguinal ring and may descend into the scrotum; a direct hernia pushes through
Hesselbach's triangle and rarely enters the scrotum—this distinction guides surgical planning.
Q8 (Male genitalia – DRE positioning):
The nurse is preparing to perform a digital rectal examination (DRE) on a 65-year-old man.
Which position is preferred for adequate prostate palpation?
A. Dorsal recumbent with knees flexed
B. Left lateral Sims' position with hips and knees flexed
C. Prone with hips elevated on pillow
D. Standing with feet shoulder-width apart
[CORRECT] B
Rationale: The left lateral Sims' position with hips and knees flexed provides optimal exposure
of the anus and allows the examiner to palpate the prostate anteriorly (Jarvis, 2024). The dorsal
recumbent position is used for female pelvic exams. The prone position is not used for DRE.
Standing position is an alternative for hernia assessment but not preferred for DRE. Clinical
pearl: In Sims' position, the patient lies on the left side with the right knee drawn up toward the
chest; this relaxes the anal sphincter and allows the examiner to insert the gloved, lubricated
index finger gently toward the umbilicus to assess the prostate.
Q9 (Male genitalia – prostate findings):
, uring DRE, the nurse palpates a prostate that is symmetrically enlarged, smooth, rubbery, with
D
a palpable median sulcus. The patient reports urinary frequency and nocturia. These findings
are most consistent with:
A. Prostate cancer
B. Acute bacterial prostatitis
C. Benign prostatic hyperplasia (BPH)
D. Prostatic abscess
[CORRECT] C
Rationale: Symmetric enlargement with preserved median sulcus and rubbery consistency is
characteristic of BPH (Jarvis, 2024). Prostate cancer presents with hard nodules and obliterated
median sulcus. Acute prostatitis presents with a boggy, exquisitely tender prostate. Prostatic
abscess is rare and presents with fluctuance and systemic signs. Clinical pearl: The normal
prostate is approximately 2–4 cm in diameter, heart-shaped, rubbery, and nontender with a
palpable median sulcus; BPH typically develops in the periurethral central zone, preserving the
lateral lobes and sulcus.
Q10 (Female genitalia – external inspection):
During external genitalia inspection, the nurse observes multiple small, flesh-colored,
cauliflower-like growths on the labia minora. These findings are consistent with:
A. Herpes simplex virus infection
B. Human papillomavirus (HPV) condyloma acuminata
C. Syphilitic chancre
D. Bartholin's cyst
[CORRECT] B
Rationale: Cauliflower-like (verrucous) growths on the vulva are characteristic of condyloma
acuminata caused by HPV (Jarvis, 2024). Herpes presents as painful vesicles and ulcers.
Syphilitic chancre is a single, painless, indurated ulcer. Bartholin's cyst presents as a unilateral
swelling at the posterior labia. Clinical pearl: HPV types 6 and 11 cause condyloma acuminata;
types 16 and 18 are high-risk and associated with cervical dysplasia and cancer—routine Pap
smear and HPV testing are essential for this patient.
Q11 (Female genitalia – speculum exam):
When inserting the vaginal speculum, the nurse should angle the blades:
A. Posteriorly toward the sacrum
B. Anteriorly toward the pubic symphysis
C. Laterally toward the ischial spines
D. Directly vertical without angulation
[CORRECT] A
Rationale: The speculum should be inserted at a downward 45-degree angle toward the
sacrum, following the natural vaginal axis (Jarvis, 2024). Inserting anteriorly causes discomfort
and may injure the urethra. Lateral or vertical insertion does not follow anatomical alignment.
Clinical pearl: Warm the speculum with warm water (not hot), apply water-soluble lubricant to
the outer blades, and insert with the blades closed and oblique; once fully inserted, rotate to
horizontal and open slowly to visualize the cervix.
Q12 (Female genitalia – bimanual exam):
