NSG 351 Exam 1 V1 | NSG 351 Health
Assessment | Actual Q&A with Rationale
(NSG351 Exam 1) | James Madison
University
1. Which technique is most appropriate when initiating a health history interview with a new
patient?
A. Asking a series of closed-ended questions to gather data quickly
B. Interrupting the patient to clarify specific medical terms immediately
C. Using open-ended questions to allow the patient to describe their concerns
D. Focusing solely on the physical symptoms reported by the patient
Answer: C
Rationale: Open-ended questions are essential for establishing rapport and allowing the
patient to provide a narrative of their health status. This approach encourages the patient
to express what is most important to them rather than being restricted by the nurse’s
agenda. It is the primary method used during the ‘working phase’ of the interview to gather
comprehensive subjective data.
2. When assessing a patient’s pulse, the nurse notes that the rhythm is irregular. What is the
next priority action?
A. Count the apical pulse for one full minute
,B. Check the pulse using a Doppler ultrasound device
C. Document the finding as normal for the patient’s age
D. Administer a PRN dose of heart medication
Answer: A
Rationale: An irregular pulse requires a more precise measurement to determine the true
heart rate and nature of the rhythm. Counting the apical pulse for a full minute is the gold
standard for assessing cardiac rate when irregularities are detected at the radial site. This
technique ensures that the nurse does not miss beats that might occur in rapid succession
or with varying intensity.
3. The nurse is performing a physical assessment and prepares to auscultate the lungs. Which
part of the stethoscope is best suited for hearing high-pitched breath sounds?
A. The bell pressed firmly to create a seal
B. The bell pressed lightly against the skin
C. The diaphragm pressed firmly against the chest wall
D. The diaphragm held loosely away from the skin
Answer: C
Rationale: The diaphragm of the stethoscope is designed to pick up high-pitched sounds,
such as normal breath sounds and bowel sounds. It should be pressed firmly against the
, patient’s skin to optimize sound transmission. In contrast, the bell is used for low-pitched
sounds like heart murmurs or bruits and should be held lightly.
4. In the PQRSTU mnemonic for pain assessment, what does the ‘Q’ represent?
A. Quantity of the pain on a scale of 0 to 10
B. Quality or character of the pain
C. Quelling factors that make the pain better
D. Quickness of the onset of the pain
Answer: B
Rationale: The ‘Q’ in PQRSTU stands for Quality, which asks the patient to describe how
the pain feels (e.g., sharp, dull, burning, or stabbing). Understanding the quality of pain can
provide clues to the underlying cause, such as neuropathic versus somatic pain. This
subjective description is a critical component of a comprehensive pain assessment.
5. While assessing the skin of an older adult, the nurse notes small, flat, brown macules on
the back of the hands. How should the nurse document these?
A. Actinic keratosis
B. Chloasma
C. Seborrheic keratosis
D. Senile lentigines
Answer: D
Assessment | Actual Q&A with Rationale
(NSG351 Exam 1) | James Madison
University
1. Which technique is most appropriate when initiating a health history interview with a new
patient?
A. Asking a series of closed-ended questions to gather data quickly
B. Interrupting the patient to clarify specific medical terms immediately
C. Using open-ended questions to allow the patient to describe their concerns
D. Focusing solely on the physical symptoms reported by the patient
Answer: C
Rationale: Open-ended questions are essential for establishing rapport and allowing the
patient to provide a narrative of their health status. This approach encourages the patient
to express what is most important to them rather than being restricted by the nurse’s
agenda. It is the primary method used during the ‘working phase’ of the interview to gather
comprehensive subjective data.
2. When assessing a patient’s pulse, the nurse notes that the rhythm is irregular. What is the
next priority action?
A. Count the apical pulse for one full minute
,B. Check the pulse using a Doppler ultrasound device
C. Document the finding as normal for the patient’s age
D. Administer a PRN dose of heart medication
Answer: A
Rationale: An irregular pulse requires a more precise measurement to determine the true
heart rate and nature of the rhythm. Counting the apical pulse for a full minute is the gold
standard for assessing cardiac rate when irregularities are detected at the radial site. This
technique ensures that the nurse does not miss beats that might occur in rapid succession
or with varying intensity.
3. The nurse is performing a physical assessment and prepares to auscultate the lungs. Which
part of the stethoscope is best suited for hearing high-pitched breath sounds?
A. The bell pressed firmly to create a seal
B. The bell pressed lightly against the skin
C. The diaphragm pressed firmly against the chest wall
D. The diaphragm held loosely away from the skin
Answer: C
Rationale: The diaphragm of the stethoscope is designed to pick up high-pitched sounds,
such as normal breath sounds and bowel sounds. It should be pressed firmly against the
, patient’s skin to optimize sound transmission. In contrast, the bell is used for low-pitched
sounds like heart murmurs or bruits and should be held lightly.
4. In the PQRSTU mnemonic for pain assessment, what does the ‘Q’ represent?
A. Quantity of the pain on a scale of 0 to 10
B. Quality or character of the pain
C. Quelling factors that make the pain better
D. Quickness of the onset of the pain
Answer: B
Rationale: The ‘Q’ in PQRSTU stands for Quality, which asks the patient to describe how
the pain feels (e.g., sharp, dull, burning, or stabbing). Understanding the quality of pain can
provide clues to the underlying cause, such as neuropathic versus somatic pain. This
subjective description is a critical component of a comprehensive pain assessment.
5. While assessing the skin of an older adult, the nurse notes small, flat, brown macules on
the back of the hands. How should the nurse document these?
A. Actinic keratosis
B. Chloasma
C. Seborrheic keratosis
D. Senile lentigines
Answer: D
