Maryville University NURS 612 Advanced
Health Assessment | Exam 3 Review &
Complete Questions with Answers
2026-2027
,What HPI questions would you ask a patient who presents Onset?
with a rash? Location?
Duration?
Characteristics?
Aggravating factors?
Relieving factors?
Temporal Factors?
Severity?
In barrel chest, the anterior-posterior diameter ratio to 1
lateral diameter =
Platypnea Platypnea- SOB that is worst when the patient sits up
Bradypnea
Tachypnea Bradypnea- RR<12
Orthopnea
Tachypnea- RR>20
Orthopnea- difficulty breathing while lying flat
Pectus Excavatum is a congenital disorder which causes the chest to have a sunken or "caved in"
appearance. It is the most common congenital chest wall abnormality in children.
Pectus Caranatum Pidgeon chest- structural variation
Wheezing Musical squeaking noise heard on auscultation.
Rhochi May clear with cough.
How do you assess lymph nodes? With first three finger pads.
What is a normal finding with the supraclavicular lymph Not paplapable
nodes?
What are objective findings on skin exam? abnormal and Inspection: note color (abnormal jaundice); look for skin thickness, rashes,
normal findings during inspection? ecchymosis, moles; Normal: freckles, moles, cherry angiomas, birth marks striae;
Abnormal: rashes, ezxema, psorriasis, herpes zoster, tinea
What are objective findings during chest/lung examination Inspection
during inspection? Abnormal and normal? • Normal:
• Chest symmetrical
• Even rise and fall, RR 12-20, Bony prominences not protruding, no visible masses;
Abnormal: Abnormal:
• Barrel chest
• Flail chest
• Retraction
• Accessory muscle use
• Tripod position
,What are objective findings during chest/lung examination Palpation
during palpation/percussion? Abnormal/normal? • Normal:
• Equal thoracic expansion (thumbs at 10th rib)
• Tactile fremitus (99)
• Resonance with percussion
Diaphragmatic Excursion - the movement of the thoracic diaphragm that occurs with
inhalation and exhalation. Normal: 3-5 cm.
• Abnormal:
• Dullness to percussion - pleural effusion, pneumonia, atelectasis, pneumothorax,
asthma
• Dullness to tactile fremitus - pleural effusion
• Tracheal displacement - fibrosis, pleural effusion, adenopathy
• Thyroid enlargement -
• Hyperresonance with percussion - emphysema, pneumothorax, asthma
Diaphragmatic Excursion - the movement of the thoracic diaphragm that occurs with
inhalation and exhalation. Abnormal: less than 3 cm or greater than 5 cm.
What are subjective questions you would ask a patient with SOB, fever, chills, productive cough, audible by ear adventitious sounds
pneumonia?
Petechiae Non-blanching, less than 0.5 cm discolorations
Where are the epitrochlear nodes? Located by the elbow
Nevi More common in white people and less in african americans
ABCDE skin cancer risk assessment Asymmetry-one-half of a mole or birthmark does not match the other.
Borders-edges are irregular, ragged, notched, or blurred.
Color-color is not the same all over
Diameter- is >6mm or is growing larger
Evolution- changes in existing pigmented lesions, particularly in nonuniform,
asymmetric manner.
Causes for dullness on percussion Pneumonia, pleural effusions
If a patient has acute lymphangitis where is the site of Proximal
infection in relation to the affected lymph node?
Why are lesions transilluminated? Do differentiate fluids filled lesions from solid cysts or masses.
Basal cell carcinoma Most common form of cutaneous neoplasm.
Vitiligo White areas on the skin. More common in darker skin.
Palatine tonsils Can cause obstruction when enlarged and sleep apnea.
, Macule Flat, non-palpable lesion less than 1 cm
Increased tactile fremitus suggests? If increases may have fluid in lungs.
Egophany Intensified sound with nasal quality and e's sound like a's.
How do you distinguish a pleural friction rub from a Have patient hold breath.
pericardial friction rub?
*****What is the difference between objective and Seidel pg 618: objective: "direct observation, what you see, hear, and touch". This
subjective data? What components of the health includes vital signs and actual assessment. Subjective: "information patients offer
history are objective and subjective? * about their condition or feelings." This includes chief complaint, past medical history,
history or present illness, family history, and review of symptoms.
Rinne Test***** helps distinguish whether patient hears better by air or bone conduction. Place the
tuning fork at base of vibrating tuning fork against the patient's mastoid bone and
ask patient to tell you when the sound is no longer heard. Time this interval of bone
conduction noting number of seconds. Continue timing the interval of sound due to
by air conduction heard by the patient. Compare # of seconds air vs. bone. Air
conducted should be heard twice as long as bone conducted sounds. (If bone
conducted heard for 15 seconds, air conducted should be heard for additional 15
seconds).
Snellen Test***** The optic nerve is assessed by testing for visual acuity and peripheral vision.
Visual acuity is tested using a snellen chart, for those who are illiterate and
unfamiliar with the western alphabet, the illiterate E chart, in which the letter E faces
in different directions, maybe used. The chart has a standardized number at the end
of each line of letters; these numbers indicates the degree of visual acuity when
measured at a distance of 20 feet.
The numerator 20 is the distance in feet between the chart and the client, or the
standard testing distance. The denominator 20 is the distance from which the
normal eye can read the lettering, which correspond to the number at the end of
each letter line; therefore the larger the denominator the poorer the version.
Measurement of 20/20 vision is an indication of either refractive error or some other
optic disorder.
In testing for visual acuity you may refer to the following:
1. The room used for this test should be well lighted.
2. A person who wears corrective lenses should be tested with and without them to
check fro the adequacy of correction.
3. Only one eye should be tested at a time; the other eye should be covered by an
opaque card or eye cover, not with client's finger.
4. Make the client read the chart by pointing at a letter randomly at each line; maybe
started from largest to smallest or vice versa.
5. A person who can read the largest letter on the chart (20/200) should be checked
if they can perceive hand movement about 12 inches from their eyes, or if they can
perceive the light of the penlight directed to their yes.
Confrontation Test**** Examine visual fields by confrontation by wiggling fingers 1 foot from pt's ears,
asking which they see move.
• Keep examiner's head level with patient's head. Test of peripheral vision.
Health Assessment | Exam 3 Review &
Complete Questions with Answers
2026-2027
,What HPI questions would you ask a patient who presents Onset?
with a rash? Location?
Duration?
Characteristics?
Aggravating factors?
Relieving factors?
Temporal Factors?
Severity?
In barrel chest, the anterior-posterior diameter ratio to 1
lateral diameter =
Platypnea Platypnea- SOB that is worst when the patient sits up
Bradypnea
Tachypnea Bradypnea- RR<12
Orthopnea
Tachypnea- RR>20
Orthopnea- difficulty breathing while lying flat
Pectus Excavatum is a congenital disorder which causes the chest to have a sunken or "caved in"
appearance. It is the most common congenital chest wall abnormality in children.
Pectus Caranatum Pidgeon chest- structural variation
Wheezing Musical squeaking noise heard on auscultation.
Rhochi May clear with cough.
How do you assess lymph nodes? With first three finger pads.
What is a normal finding with the supraclavicular lymph Not paplapable
nodes?
What are objective findings on skin exam? abnormal and Inspection: note color (abnormal jaundice); look for skin thickness, rashes,
normal findings during inspection? ecchymosis, moles; Normal: freckles, moles, cherry angiomas, birth marks striae;
Abnormal: rashes, ezxema, psorriasis, herpes zoster, tinea
What are objective findings during chest/lung examination Inspection
during inspection? Abnormal and normal? • Normal:
• Chest symmetrical
• Even rise and fall, RR 12-20, Bony prominences not protruding, no visible masses;
Abnormal: Abnormal:
• Barrel chest
• Flail chest
• Retraction
• Accessory muscle use
• Tripod position
,What are objective findings during chest/lung examination Palpation
during palpation/percussion? Abnormal/normal? • Normal:
• Equal thoracic expansion (thumbs at 10th rib)
• Tactile fremitus (99)
• Resonance with percussion
Diaphragmatic Excursion - the movement of the thoracic diaphragm that occurs with
inhalation and exhalation. Normal: 3-5 cm.
• Abnormal:
• Dullness to percussion - pleural effusion, pneumonia, atelectasis, pneumothorax,
asthma
• Dullness to tactile fremitus - pleural effusion
• Tracheal displacement - fibrosis, pleural effusion, adenopathy
• Thyroid enlargement -
• Hyperresonance with percussion - emphysema, pneumothorax, asthma
Diaphragmatic Excursion - the movement of the thoracic diaphragm that occurs with
inhalation and exhalation. Abnormal: less than 3 cm or greater than 5 cm.
What are subjective questions you would ask a patient with SOB, fever, chills, productive cough, audible by ear adventitious sounds
pneumonia?
Petechiae Non-blanching, less than 0.5 cm discolorations
Where are the epitrochlear nodes? Located by the elbow
Nevi More common in white people and less in african americans
ABCDE skin cancer risk assessment Asymmetry-one-half of a mole or birthmark does not match the other.
Borders-edges are irregular, ragged, notched, or blurred.
Color-color is not the same all over
Diameter- is >6mm or is growing larger
Evolution- changes in existing pigmented lesions, particularly in nonuniform,
asymmetric manner.
Causes for dullness on percussion Pneumonia, pleural effusions
If a patient has acute lymphangitis where is the site of Proximal
infection in relation to the affected lymph node?
Why are lesions transilluminated? Do differentiate fluids filled lesions from solid cysts or masses.
Basal cell carcinoma Most common form of cutaneous neoplasm.
Vitiligo White areas on the skin. More common in darker skin.
Palatine tonsils Can cause obstruction when enlarged and sleep apnea.
, Macule Flat, non-palpable lesion less than 1 cm
Increased tactile fremitus suggests? If increases may have fluid in lungs.
Egophany Intensified sound with nasal quality and e's sound like a's.
How do you distinguish a pleural friction rub from a Have patient hold breath.
pericardial friction rub?
*****What is the difference between objective and Seidel pg 618: objective: "direct observation, what you see, hear, and touch". This
subjective data? What components of the health includes vital signs and actual assessment. Subjective: "information patients offer
history are objective and subjective? * about their condition or feelings." This includes chief complaint, past medical history,
history or present illness, family history, and review of symptoms.
Rinne Test***** helps distinguish whether patient hears better by air or bone conduction. Place the
tuning fork at base of vibrating tuning fork against the patient's mastoid bone and
ask patient to tell you when the sound is no longer heard. Time this interval of bone
conduction noting number of seconds. Continue timing the interval of sound due to
by air conduction heard by the patient. Compare # of seconds air vs. bone. Air
conducted should be heard twice as long as bone conducted sounds. (If bone
conducted heard for 15 seconds, air conducted should be heard for additional 15
seconds).
Snellen Test***** The optic nerve is assessed by testing for visual acuity and peripheral vision.
Visual acuity is tested using a snellen chart, for those who are illiterate and
unfamiliar with the western alphabet, the illiterate E chart, in which the letter E faces
in different directions, maybe used. The chart has a standardized number at the end
of each line of letters; these numbers indicates the degree of visual acuity when
measured at a distance of 20 feet.
The numerator 20 is the distance in feet between the chart and the client, or the
standard testing distance. The denominator 20 is the distance from which the
normal eye can read the lettering, which correspond to the number at the end of
each letter line; therefore the larger the denominator the poorer the version.
Measurement of 20/20 vision is an indication of either refractive error or some other
optic disorder.
In testing for visual acuity you may refer to the following:
1. The room used for this test should be well lighted.
2. A person who wears corrective lenses should be tested with and without them to
check fro the adequacy of correction.
3. Only one eye should be tested at a time; the other eye should be covered by an
opaque card or eye cover, not with client's finger.
4. Make the client read the chart by pointing at a letter randomly at each line; maybe
started from largest to smallest or vice versa.
5. A person who can read the largest letter on the chart (20/200) should be checked
if they can perceive hand movement about 12 inches from their eyes, or if they can
perceive the light of the penlight directed to their yes.
Confrontation Test**** Examine visual fields by confrontation by wiggling fingers 1 foot from pt's ears,
asking which they see move.
• Keep examiner's head level with patient's head. Test of peripheral vision.
