ATI: Comprehensive Physical Assessment of an Adult.Final Test 2026\2027.
A nurse is preparing to perform a comprehensive physical assessment on a client. Which of the
following actions should the nurse plan to take first?
Develop a plan of care
Explanation: The first action the nurse should take using the nursing process is to assess the client and
develop a plan of care. The nursing process follows the steps of assessment, analysis, planning,
implementation, and evaluation.
A nurse is teaching a newly licensed nurse about using a stethoscope. Which of the following
instructions should the nurse include?
"Insert the earpieces at a downward angle toward your nose."
Explanation: The nurse should insert the earpieces at a downward angle toward their nose because this
helps ensure that sounds are effectively transmitted to their eardrums.
A nurse is performing a physical examination of the spine for an older adult client. The nurse
should identify that which of the following findings is common with aging?
Kyphosis
Explanation: Kyphosis, a pronounced "hunchback" curvature of the spine, is an abnormal angulation of the
posterior curve of the thoracic spine, usually a result of osteoporosis. It is most common in older adults
and tends to increase with aging. This pronounced convexity of the thoracic spine is also common in older
clients who have had vertebral fractures.
A nurse is palpating a tender area of a client's abdomen. The nurse slowly applies pressure over
the area with their fingertips, then quickly releases it. The client reports increased pain on the
release of pressure. Which of the following findings should the nurse document?
Rebound tenderness
Explanation: The nurse should document that the client is experiencing rebound tenderness, which is an
increase in pain when deep palpation over a tender area is released. Rebound tenderness in the right
lower quadrant at McBurney's point (one third the distance from the anterior iliac crest to the umbilicus)
is an indication of acute appendicitis.
A nurse is preparing to conduct a Romberg test on a client. The nurse should explain to the client
that the Romberg test is used to assess which of the following characteristics?
A nurse is preparing to perform a comprehensive physical assessment on a client. Which of the
following actions should the nurse plan to take first?
Develop a plan of care
Explanation: The first action the nurse should take using the nursing process is to assess the client and
develop a plan of care. The nursing process follows the steps of assessment, analysis, planning,
implementation, and evaluation.
A nurse is teaching a newly licensed nurse about using a stethoscope. Which of the following
instructions should the nurse include?
"Insert the earpieces at a downward angle toward your nose."
Explanation: The nurse should insert the earpieces at a downward angle toward their nose because this
helps ensure that sounds are effectively transmitted to their eardrums.
A nurse is performing a physical examination of the spine for an older adult client. The nurse
should identify that which of the following findings is common with aging?
Kyphosis
Explanation: Kyphosis, a pronounced "hunchback" curvature of the spine, is an abnormal angulation of the
posterior curve of the thoracic spine, usually a result of osteoporosis. It is most common in older adults
and tends to increase with aging. This pronounced convexity of the thoracic spine is also common in older
clients who have had vertebral fractures.
A nurse is palpating a tender area of a client's abdomen. The nurse slowly applies pressure over
the area with their fingertips, then quickly releases it. The client reports increased pain on the
release of pressure. Which of the following findings should the nurse document?
Rebound tenderness
Explanation: The nurse should document that the client is experiencing rebound tenderness, which is an
increase in pain when deep palpation over a tender area is released. Rebound tenderness in the right
lower quadrant at McBurney's point (one third the distance from the anterior iliac crest to the umbilicus)
is an indication of acute appendicitis.
A nurse is preparing to conduct a Romberg test on a client. The nurse should explain to the client
that the Romberg test is used to assess which of the following characteristics?
