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WEST COAST UNIVERSITY NURS 190 – HEALTH
ASSESSMENT AND PHYSICAL EXAMINATION
COMPREHENSIVE PRACTICE EXAM 2
QUESTIONS WITH ANSWERS AND RATIONALES
|100% PASS |GRADED A+ 2026/27
1. A nurse is preparing to perform a comprehensive health assessment on
an adult client. Which action should the nurse take first?
a) Auscultate the abdomen
b) Inspect the general appearance
c) Palpate the lymph nodes
d) Percuss the posterior thorax
Verified Answer: b
Rationale: The first step in a comprehensive health assessment is
inspection, which begins with observing the client's general appearance,
including posture, hygiene, affect, and overall physical status.
Auscultation, palpation, and percussion follow a systematic approach
(inspection, palpation, percussion, auscultation for most systems except
the abdomen, where auscultation precedes palpation).
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2. During inspection of a client's skin, the nurse notes a flat, non-
palpable discoloration that is less than 1 cm in diameter. How should the
nurse document this finding?
a) Papule
b) Nodule
c) Macule
d) Wheal
Verified Answer: c
Rationale: A macule is a flat, non-palpable, circumscribed area of skin
color change less than 1 cm in diameter (e.g., freckle, petechia). A
papule is elevated, firm, and < 1 cm. A nodule is elevated, firm, and > 1
cm. A wheal is an elevated, transient, pruritic lesion (e.g., hives).
3. The nurse is assessing a client's pupillary response to light. Which
cranial nerve is primarily responsible for this reaction?
a) Cranial Nerve II (Optic)
b) Cranial Nerve III (Oculomotor)
c) Cranial Nerve IV (Trochlear)
d) Cranial Nerve VI (Abducens)
Verified Answer: b
Rationale: The pupillary light reflex is mediated by Cranial Nerve II
(Optic, afferent/sensory) and Cranial Nerve III (Oculomotor,
efferent/motor). The efferent pathway (pupillary constriction) is
controlled by the parasympathetic fibers of CN III. CN IV controls
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downward and inward eye movement. CN VI controls lateral eye
movement.
4. A client reports a history of "black tarry stools." The nurse recognizes
this as a sign of which condition?
a) Upper gastrointestinal bleeding
b) Lower gastrointestinal bleeding
c) Lactose intolerance
d) Hemorrhoid irritation
Verified Answer: a
Rationale: Black, tarry stools (melena) indicate upper gastrointestinal
bleeding (e.g., peptic ulcer, gastritis, esophageal varices) due to
digestion of blood by gastric acid and enzymes. Lower GI bleeding
typically causes bright red blood (hematochezia) or maroon stools.
Lactose intolerance causes diarrhea, not black stools. Hemorrhoids cause
bright red blood on the stool surface.
5. The nurse is auscultating the lungs and hears continuous, high-pitched
musical sounds during expiration. How should this be documented?
a) Crackles
b) Rhonchi
c) Wheezes
d) Pleural friction rub
Verified Answer: c
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Rationale: Wheezes are continuous, high-pitched, musical sounds heard
during expiration (or inspiration) due to narrowed airways (e.g., asthma,
COPD). Crackles are discontinuous, popping sounds (fluid in alveoli).
Rhonchi are low-pitched, snoring sounds (secretions in large airways).
Pleural friction rub is a grating sound (inflamed pleura).
6. When assessing a client's jugular venous pressure (JVP), the nurse
should position the client at which angle?
a) Supine, flat on the bed
b) 0 degrees (completely flat)
c) 30 to 45 degrees
d) 90 degrees (sitting upright)
Verified Answer: c
Rationale: JVP is assessed with the client positioned at 30-45 degrees.
This angle allows visualization of the internal jugular vein pulsations.
Supine (0 degrees) makes the jugular veins engorged and difficult to
assess. Sitting upright (90 degrees) makes them collapse.
7. The nurse is performing a neurological assessment and asks the client
to stand with feet together and close their eyes. This tests which
function?
a) Cerebellar function (Romberg test)
b) Cranial nerve I function
c) Motor strength of the lower extremities
d) Peripheral sensation
WEST COAST UNIVERSITY NURS 190 – HEALTH
ASSESSMENT AND PHYSICAL EXAMINATION
COMPREHENSIVE PRACTICE EXAM 2
QUESTIONS WITH ANSWERS AND RATIONALES
|100% PASS |GRADED A+ 2026/27
1. A nurse is preparing to perform a comprehensive health assessment on
an adult client. Which action should the nurse take first?
a) Auscultate the abdomen
b) Inspect the general appearance
c) Palpate the lymph nodes
d) Percuss the posterior thorax
Verified Answer: b
Rationale: The first step in a comprehensive health assessment is
inspection, which begins with observing the client's general appearance,
including posture, hygiene, affect, and overall physical status.
Auscultation, palpation, and percussion follow a systematic approach
(inspection, palpation, percussion, auscultation for most systems except
the abdomen, where auscultation precedes palpation).
,2 | Page
2. During inspection of a client's skin, the nurse notes a flat, non-
palpable discoloration that is less than 1 cm in diameter. How should the
nurse document this finding?
a) Papule
b) Nodule
c) Macule
d) Wheal
Verified Answer: c
Rationale: A macule is a flat, non-palpable, circumscribed area of skin
color change less than 1 cm in diameter (e.g., freckle, petechia). A
papule is elevated, firm, and < 1 cm. A nodule is elevated, firm, and > 1
cm. A wheal is an elevated, transient, pruritic lesion (e.g., hives).
3. The nurse is assessing a client's pupillary response to light. Which
cranial nerve is primarily responsible for this reaction?
a) Cranial Nerve II (Optic)
b) Cranial Nerve III (Oculomotor)
c) Cranial Nerve IV (Trochlear)
d) Cranial Nerve VI (Abducens)
Verified Answer: b
Rationale: The pupillary light reflex is mediated by Cranial Nerve II
(Optic, afferent/sensory) and Cranial Nerve III (Oculomotor,
efferent/motor). The efferent pathway (pupillary constriction) is
controlled by the parasympathetic fibers of CN III. CN IV controls
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downward and inward eye movement. CN VI controls lateral eye
movement.
4. A client reports a history of "black tarry stools." The nurse recognizes
this as a sign of which condition?
a) Upper gastrointestinal bleeding
b) Lower gastrointestinal bleeding
c) Lactose intolerance
d) Hemorrhoid irritation
Verified Answer: a
Rationale: Black, tarry stools (melena) indicate upper gastrointestinal
bleeding (e.g., peptic ulcer, gastritis, esophageal varices) due to
digestion of blood by gastric acid and enzymes. Lower GI bleeding
typically causes bright red blood (hematochezia) or maroon stools.
Lactose intolerance causes diarrhea, not black stools. Hemorrhoids cause
bright red blood on the stool surface.
5. The nurse is auscultating the lungs and hears continuous, high-pitched
musical sounds during expiration. How should this be documented?
a) Crackles
b) Rhonchi
c) Wheezes
d) Pleural friction rub
Verified Answer: c
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Rationale: Wheezes are continuous, high-pitched, musical sounds heard
during expiration (or inspiration) due to narrowed airways (e.g., asthma,
COPD). Crackles are discontinuous, popping sounds (fluid in alveoli).
Rhonchi are low-pitched, snoring sounds (secretions in large airways).
Pleural friction rub is a grating sound (inflamed pleura).
6. When assessing a client's jugular venous pressure (JVP), the nurse
should position the client at which angle?
a) Supine, flat on the bed
b) 0 degrees (completely flat)
c) 30 to 45 degrees
d) 90 degrees (sitting upright)
Verified Answer: c
Rationale: JVP is assessed with the client positioned at 30-45 degrees.
This angle allows visualization of the internal jugular vein pulsations.
Supine (0 degrees) makes the jugular veins engorged and difficult to
assess. Sitting upright (90 degrees) makes them collapse.
7. The nurse is performing a neurological assessment and asks the client
to stand with feet together and close their eyes. This tests which
function?
a) Cerebellar function (Romberg test)
b) Cranial nerve I function
c) Motor strength of the lower extremities
d) Peripheral sensation
