26 Health assessment Question and
Answers
Upon auscultation of a client's lung fields, the nurse hears a continuous high-pitched sound on
expiration. These are characteristics of which adventitious breath sound? - CORRECT
ANSWER✅✅✅wheezes
The nurse should use the bell of the stethoscope during auscultation of: - CORRECT
ANSWER✅✅✅A heart murmur
When percussing the liver, the sound should be: - CORRECT ANSWER✅✅✅dull
Percussion of the bone should be - CORRECT ANSWER✅✅✅flat
percussion of the abdomen should be - CORRECT ANSWER✅✅✅tympanic
percussion of hyper- inflated lung tissue is - CORRECT ANSWER✅✅✅hyperresonant
percussion of normal lung tissue is - CORRECT ANSWER✅✅✅resonant
The nurse is assessing a client's thorax and lungs. Which finding would indicate the need for
further assessment? - CORRECT ANSWER✅✅✅auscultation of short, high-pitched
popping sounds during inspiration
crackles
The nurse is palpating a client's precordium. Which result is an expected clinical finding? -
CORRECT ANSWER✅✅✅Palpable pulsation over the mitral area
, The nurse is caring for a client who just informed her that he noticed some blood in the toilet
after a bowel movement. The nurse assesses the client's anal area and notes a deep linear
separation in the skin that extends into the dermis. The nurse recognizes that this skin lesion is
characteristic of: - CORRECT ANSWER✅✅✅fissure
what is a fissure - CORRECT ANSWER✅✅✅as a deep linear separation in the skin that
extends into the dermis.
characteristics of an ulcer are - CORRECT ANSWER✅✅✅An ulcer appears as a loss of
epidermis and dermis and may bleed
The nurse is caring for an 88-year-old male admitted 2 days ago for dehydration. The nurse
brings the client his breakfast tray and notes that the client appears to be having difficulty
understanding what she is saying to him today. Which nursing action is most appropriate -
CORRECT ANSWER✅✅✅Check the client's ear canals for cerumen (ear wax)
The nurse is preparing to do a focused assessment of the abdomen on a client following an
abdominal hysterectomy. Which intervention is most important for the nurse to do prior to the
physical assessment? - CORRECT ANSWER✅✅✅ask the patient to empty their bladder
A nurse is teaching a young female client about breast cancer prevention. The client asks at what
age she needs to begin having mammograms. What is the nurse's best response? - CORRECT
ANSWER✅✅✅"According to the American and Canadian Cancer Societies, your first
mammogram should be done at age 40 and then yearly after that."
A nurse is preparing to auscultate a client's abdomen for the presence of bowel sounds. Which is
the appropriate action of the nurse? - CORRECT ANSWER✅✅✅Warm the diaphragm of
the stethoscope.
The nurse weighs the client using a portable bed scale. The obtained weight is 10 lb (4.5 kg)
more than the nurse expected. What action does the nurse take next? - CORRECT
ANSWER✅✅✅Ensure equipment is not hanging into the sling
Answers
Upon auscultation of a client's lung fields, the nurse hears a continuous high-pitched sound on
expiration. These are characteristics of which adventitious breath sound? - CORRECT
ANSWER✅✅✅wheezes
The nurse should use the bell of the stethoscope during auscultation of: - CORRECT
ANSWER✅✅✅A heart murmur
When percussing the liver, the sound should be: - CORRECT ANSWER✅✅✅dull
Percussion of the bone should be - CORRECT ANSWER✅✅✅flat
percussion of the abdomen should be - CORRECT ANSWER✅✅✅tympanic
percussion of hyper- inflated lung tissue is - CORRECT ANSWER✅✅✅hyperresonant
percussion of normal lung tissue is - CORRECT ANSWER✅✅✅resonant
The nurse is assessing a client's thorax and lungs. Which finding would indicate the need for
further assessment? - CORRECT ANSWER✅✅✅auscultation of short, high-pitched
popping sounds during inspiration
crackles
The nurse is palpating a client's precordium. Which result is an expected clinical finding? -
CORRECT ANSWER✅✅✅Palpable pulsation over the mitral area
, The nurse is caring for a client who just informed her that he noticed some blood in the toilet
after a bowel movement. The nurse assesses the client's anal area and notes a deep linear
separation in the skin that extends into the dermis. The nurse recognizes that this skin lesion is
characteristic of: - CORRECT ANSWER✅✅✅fissure
what is a fissure - CORRECT ANSWER✅✅✅as a deep linear separation in the skin that
extends into the dermis.
characteristics of an ulcer are - CORRECT ANSWER✅✅✅An ulcer appears as a loss of
epidermis and dermis and may bleed
The nurse is caring for an 88-year-old male admitted 2 days ago for dehydration. The nurse
brings the client his breakfast tray and notes that the client appears to be having difficulty
understanding what she is saying to him today. Which nursing action is most appropriate -
CORRECT ANSWER✅✅✅Check the client's ear canals for cerumen (ear wax)
The nurse is preparing to do a focused assessment of the abdomen on a client following an
abdominal hysterectomy. Which intervention is most important for the nurse to do prior to the
physical assessment? - CORRECT ANSWER✅✅✅ask the patient to empty their bladder
A nurse is teaching a young female client about breast cancer prevention. The client asks at what
age she needs to begin having mammograms. What is the nurse's best response? - CORRECT
ANSWER✅✅✅"According to the American and Canadian Cancer Societies, your first
mammogram should be done at age 40 and then yearly after that."
A nurse is preparing to auscultate a client's abdomen for the presence of bowel sounds. Which is
the appropriate action of the nurse? - CORRECT ANSWER✅✅✅Warm the diaphragm of
the stethoscope.
The nurse weighs the client using a portable bed scale. The obtained weight is 10 lb (4.5 kg)
more than the nurse expected. What action does the nurse take next? - CORRECT
ANSWER✅✅✅Ensure equipment is not hanging into the sling
