PCHA LATEST 2026 PRACTICE EXAM QUESTIONS AND
ANSWERS GRADED A+
✔✔The findings from an assessment of a 70-year-old patient with swelling in his ankles
include jugular venous distention to the jaw when the head of his bed is elevated 45
degrees. The nurse knows that this finding indicates: - ✔✔increased pressure in the
right side of the heart.
✔✔During assessment of the cardiovascular system, it is important to: - ✔✔all of the
above
- use the bell and diaphragm when auscultating heart sounds
- assess for systemic signs of cardiovascular disease
- perform a thorough patient history
✔✔Assessment findings which may indicate cardiac disease include: - ✔✔pitting edema
✔✔In assessing a patient's major risk factors for heart disease, which would the nurse
want to include when taking a history? - ✔✔all of the above
- cigarette smoking
- hypertension
- high blood cholesterol
✔✔The patient has 20/100 vision. When the patient asks the nurse what this means,
the correct response would be: - ✔✔"This is a variation from normal and means that you
see at 20 feet what average eyes would see at 100 feet."
✔✔The patient presents to the hospital Emergency Department with a dilated left pupil,
left ptosis, and inability to look up, down, or medially with the left eye. These signs may
indicate a problem with: - ✔✔Left oculomotor nerve (CN III)
✔✔The patient visits the clinic complaining of excessive tearing in the left eye. The
nurse should assess the patient's eye for: - ✔✔lacrimal sac obstruction.
✔✔The patient comes to the clinic for a routine well patient yearly physical exam. The
patient has no complaints at this visit, and no history of any chronic illnesses. Upon
examining the nasal cavity, the nasal septum is symmetrical with scant amount of clear
drainage; no masses or lesions are noted. No other symptoms are noted. These
findings are: - ✔✔normal findings
✔✔The size of the normal pupil is determined by: - ✔✔all of the above
- amount of light entering the eye
- closeness of the object being visualized
- function of cranial nerves II (optic) and III (oculomotor)
, ✔✔The patient comes to the clinic complaining of blurred vision when reading the
newspaper. After testing the patient's near vision, the nurse explains to the patient that
he has impaired near vision and discusses a possible reason for the condition. The
nurse determines the patient has understood the teaching when the patient states
presbyopia is usually due to: - ✔✔decreased ability of the lens to accommodate
✔✔Which of the following best describes the test performed to assess the function of
cranial nerve XII (hypoglossal)? - ✔✔Ask the patient to stick out his tongue and observe
for midline position.
✔✔Which of the following is true regarding assessment of the thyroid gland? - ✔✔The
physical characteristics of the thyroid gland tell you little about thyroid function.
✔✔The patient has come to the clinic with a chief complaint of a "lump under my chin".
In the history, you note that the patient smokes and uses smokeless tobacco (tobacco
placed under the tongue). Upon physical exam, the practitioner notes enlarged,
nontender (2cm) submental lymph nodes. In an effort to identify the cause of the node
enlargement, you would assess the: - ✔✔inner aspect of the lips and cheeks
✔✔With palpation of the sinus areas, what would be a normal finding? - ✔✔The patient
would feel firm pressure with your palpation but no pain.
✔✔A patient is unable to differentiate between sharp and dull stimulation to both sides
of the face. The nurse suspects: - ✔✔damage to the trigeminal nerve (CN V)
✔✔When assessing visual acuity using the Snellen chart, the practitioner should: -
✔✔Assess with and without correction (reading glasses should not be worn).
✔✔The nurse documents PERRLA following assessment of a patient's eyes. One
finding that supports this data is: - ✔✔constriction of the pupils when an object is
brought closer to the eye.
✔✔The nurse has just completed a lymph node assessment on a 60-year-old healthy
patient. The nurse knows that most lymph nodes in healthy adults are normally: - ✔✔not
palpable
✔✔Which of the following is an expected normal finding when examining the function of
the extraocular eye muscles? - ✔✔parallel movement of both eyes
✔✔The patient is at the clinic for an eye examination. The nurse suspects that the
patient has a ptosis of one eye. How would the nurse check for this? - ✔✔Observe the
distance between the upper and lower eyelid (palpebral fissure).
ANSWERS GRADED A+
✔✔The findings from an assessment of a 70-year-old patient with swelling in his ankles
include jugular venous distention to the jaw when the head of his bed is elevated 45
degrees. The nurse knows that this finding indicates: - ✔✔increased pressure in the
right side of the heart.
✔✔During assessment of the cardiovascular system, it is important to: - ✔✔all of the
above
- use the bell and diaphragm when auscultating heart sounds
- assess for systemic signs of cardiovascular disease
- perform a thorough patient history
✔✔Assessment findings which may indicate cardiac disease include: - ✔✔pitting edema
✔✔In assessing a patient's major risk factors for heart disease, which would the nurse
want to include when taking a history? - ✔✔all of the above
- cigarette smoking
- hypertension
- high blood cholesterol
✔✔The patient has 20/100 vision. When the patient asks the nurse what this means,
the correct response would be: - ✔✔"This is a variation from normal and means that you
see at 20 feet what average eyes would see at 100 feet."
✔✔The patient presents to the hospital Emergency Department with a dilated left pupil,
left ptosis, and inability to look up, down, or medially with the left eye. These signs may
indicate a problem with: - ✔✔Left oculomotor nerve (CN III)
✔✔The patient visits the clinic complaining of excessive tearing in the left eye. The
nurse should assess the patient's eye for: - ✔✔lacrimal sac obstruction.
✔✔The patient comes to the clinic for a routine well patient yearly physical exam. The
patient has no complaints at this visit, and no history of any chronic illnesses. Upon
examining the nasal cavity, the nasal septum is symmetrical with scant amount of clear
drainage; no masses or lesions are noted. No other symptoms are noted. These
findings are: - ✔✔normal findings
✔✔The size of the normal pupil is determined by: - ✔✔all of the above
- amount of light entering the eye
- closeness of the object being visualized
- function of cranial nerves II (optic) and III (oculomotor)
, ✔✔The patient comes to the clinic complaining of blurred vision when reading the
newspaper. After testing the patient's near vision, the nurse explains to the patient that
he has impaired near vision and discusses a possible reason for the condition. The
nurse determines the patient has understood the teaching when the patient states
presbyopia is usually due to: - ✔✔decreased ability of the lens to accommodate
✔✔Which of the following best describes the test performed to assess the function of
cranial nerve XII (hypoglossal)? - ✔✔Ask the patient to stick out his tongue and observe
for midline position.
✔✔Which of the following is true regarding assessment of the thyroid gland? - ✔✔The
physical characteristics of the thyroid gland tell you little about thyroid function.
✔✔The patient has come to the clinic with a chief complaint of a "lump under my chin".
In the history, you note that the patient smokes and uses smokeless tobacco (tobacco
placed under the tongue). Upon physical exam, the practitioner notes enlarged,
nontender (2cm) submental lymph nodes. In an effort to identify the cause of the node
enlargement, you would assess the: - ✔✔inner aspect of the lips and cheeks
✔✔With palpation of the sinus areas, what would be a normal finding? - ✔✔The patient
would feel firm pressure with your palpation but no pain.
✔✔A patient is unable to differentiate between sharp and dull stimulation to both sides
of the face. The nurse suspects: - ✔✔damage to the trigeminal nerve (CN V)
✔✔When assessing visual acuity using the Snellen chart, the practitioner should: -
✔✔Assess with and without correction (reading glasses should not be worn).
✔✔The nurse documents PERRLA following assessment of a patient's eyes. One
finding that supports this data is: - ✔✔constriction of the pupils when an object is
brought closer to the eye.
✔✔The nurse has just completed a lymph node assessment on a 60-year-old healthy
patient. The nurse knows that most lymph nodes in healthy adults are normally: - ✔✔not
palpable
✔✔Which of the following is an expected normal finding when examining the function of
the extraocular eye muscles? - ✔✔parallel movement of both eyes
✔✔The patient is at the clinic for an eye examination. The nurse suspects that the
patient has a ptosis of one eye. How would the nurse check for this? - ✔✔Observe the
distance between the upper and lower eyelid (palpebral fissure).
