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Exam (elaborations)

NSU HEALTH ASSESSMENT FINAL EXAM | COMPLETE NURSING STUDY GUIDE & EXAM REVIEW 2026/2027

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NSU HEALTH ASSESSMENT FINAL EXAM | COMPLETE NURSING STUDY GUIDE & EXAM REVIEW 2026/2027

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NSU HEALTH ASSESSMENT FINAL EXAM | COMPLETE NURSING STUDY
GUIDE & EXAM REVIEW 2026/2027

An expert nurse uses this to determine their actions. - ANS ✔✔intuition

Prioritize the conditions of highest concern. - ANS ✔✔ABC+V
Airway
Breathing
Cardio
Vital Signs

This should continuously be evaluated and modified to maintain path to goal achievement - ANS
✔✔Plan of care

This type of database is used for limited or short term problems and is more focused than a complete
database. - ANS ✔✔episodic or problem centered database

This type of database helps evaluate whether pre-existing problems have gotten better or worse. - ANS
✔✔follow-up database

This type of database is formed by rapid collection of data and is often complied concurrently with life
saving measures. - ANS ✔✔emergency database

T or F: Frequency of assessment is primarily based on the clients illness and wellness needs. - ANS
✔✔True

These two concepts are at the core of nursing. - ANS ✔✔health promotion and disease prevention

T or F: Inclusion of heritage assessment is not needed in the practice of nursing. - ANS ✔✔False, needed
to provide culturally sensitive care

How have nurses helped in the efforts of cost containment, resulting in shorter stays and earlier
discharges? - ANS ✔✔nurses are making faster and more efficient assessments

Besides cost containment, why are shorter hospital stays for clients a goal in healthcare? - ANS
✔✔decrease development of nosocomial infections

What is the goal of the patient interview? - ANS ✔✔obtain subjective data

If you are unable to set aside prejudices, how should you proceed with the interview process? - ANS
✔✔seek a colleague to complete the interview

T or F: A client should remain in their street clothes unless it is an emergency. - ANS ✔✔True

Why should an examiner avoid excessive note taking? - ANS ✔✔- breaks eye contact with the client
- impeded observation of non-verbal behavior

,- attention shifting/not actively listening to client
- natural expression of the client is lost
- can make client feel threatened

An examiner should primarily ask these types of questions while conducting a health interview. - ANS
✔✔open-ended questions

When can closed ended questions be utilized? - ANS ✔✔when trying to elicit specific information

T or F: A reliable source always gives the same answers even after rephrasing the question or after time
has passed - ANS ✔✔True

This a brief spontaneous statement in the clients own words and should not be considered a diagnostic
statement. - ANS ✔✔chief complaint/reason for seeking care

What is a symptom? - ANS ✔✔subjective sensation

What is a sign? - ANS ✔✔objective abnormality detected

Why should spouses be included in the genogram? - ANS ✔✔prolonged contact with the client -> may
transfer communicable diseases or cause environmental hazard (ex. spouse smokes)

Order the steps of a physical assessment. - ANS ✔✔Inspect > palpate > percuss > auscultate

Order the steps when performing abdominal assessment. - ANS ✔✔Inspect > auscultate > palpate >
percuss

What is the reason for starting with light palpation? - ANS ✔✔accustom the client to being touched

When should deep palpation be avoided? - ANS ✔✔when there is risk for internal injury or pain

The fingertips are best to assess... - ANS ✔✔Fine tactile discrimination of skin, texture, swelling,
pulsation, determine presence of lumps

These are best for the detection of position, shape, and consistency of an organ/mass. - ANS ✔✔Fingers
and thumbs

Why is the dorsum of the hands and fingers the best for determining temperature? - ANS ✔✔Thin in this
area is thinner in comparison to palm

These are best for palpating vibrations. - ANS ✔✔Base of fingers or ulnar surface of hand

Percussion produces audible vibrations which help reveal the... - ANS ✔✔Location, density and size of
underlying structures

T or F: Percussion can help in the detection of deep abnormal masses. - ANS ✔✔False, superficial
masses; percussion vibrations penetrate ~ 5 cm deep

, This is a low pitched sound from a hollow structure. - ANS ✔✔Resonance

What is hyperresonance? - ANS ✔✔Loud, low pitched, booming sound

Hyper-resonance produced by the lungs could indicate... - ANS ✔✔emphysema

This is a high pitched drum-like sound produced by an air filled stomach. - ANS ✔✔Tympany

This is a soft, high pitched, thud like sound produced by dense organs. - ANS ✔✔Dull

This is a soft, high pitched sound produced by bones, muscles and tumors. - ANS ✔✔Flat

T or F: A stethoscope magnifies the sound. - ANS ✔✔False, blocks extraneous sounds

Name the two parts of the stethoscope and the types of sounds they are used to auscultate for. - ANS
✔✔Diaphragm: High pitched (heart, lungs, abdomen)
Bell: low pitched (blood vessels, murmurs, gallops)

This is a blowing swishing sound indicative of blood flow turbulence - ANS ✔✔Bruit

Bruit can develop secondary to... - ANS ✔✔atherosclerosis

What is a mental disorder? - ANS ✔✔an illness resulting in a person exhibiting a response which is much
greater than expected

Discuss the temperature sites and normal temperature ranges for each site. - ANS ✔✔Oral: 37 C or 98.6
F
Rectal and Temporal: 0.4-0.5 C or 0.7-1.0 F more than oral
Axillary: 0.5 C or 1.0 F less than oral

What are diurnal cycles? - ANS ✔✔Normal fluctuations in temperature of 1.0-1.5 C

T or F: Body temperature is lowest in the late afternoon/early evening. - ANS ✔✔False, highest in late
afternoon/early evening and lowest in early morning

Why is oral temperature the most accurate measurement of body temperature? - ANS ✔✔Sublingual
pocket has a rich blood supply from the carotid artery

What is the normal resting heart rate? - ANS ✔✔60-100 bpm

What is sinus arrhythmia? - ANS ✔✔heart rate increases with inspiration and decreases with expiration

If the nurse palpates an irregular pulse they should... - ANS ✔✔Auscultate the heart sounds for a
complete assessment

What is the normal respiration rate? - ANS ✔✔10-20 breaths per minute

What is the normal SpO2 level? - ANS ✔✔92-100%

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