Health Assessment- BSN 246 HESI REVIEW 2024
Comprehensive Questions And Verified Answers/ Complete
Solutions With Rationales|Get It 100% Accurate!!
The nurse is performing a thoracic assessment on a client with chronic asthma
and hyperinflation of the lungs. Which finding should be expected for this client? -
ans -Barrel chest
The nurse is assessing bowel sounds for a hospitalized client. The nurse has heard
bowel sounds in the right upper quadrant. What action should the nurse take
next? - ans -Note the character and frequency of bowel sounds
The nurse enters an examination room to conduct a routine health assessment on
an adolescent female client, who is accompanied by her mother. Which action by
the nurse is likely to facilitate accurate responses to personal and social history
questions? - ans -Request that the mother leave the exam room.
While performing a mental status exam (MSE), the nurse asks a client to
remember three unrelated words and repeat them later. The client was able to
repeat the words as directed. Which computer documentation is accurate? - ans -
"Short-term memory is intact."
Which technique should the nurse implement when performing a Weber test? -
ans -Place a vibrating tuning fork midline on top of the head
Which technique should the nurse use to assess a client for scoliosis? - ans -
Observe spine while the client is erect and bent forward
Which term should the nurse use to document in the client's medical record for a
high-pitched scratchy sound during auscultation of the heart? - ans -Friction rub
While performing a head-to-toe assessment, the nurse assesses the client's
pupillary accommodation. During the second portion of the test, the nurse notes
that the client's pupils constrict and there is convergence of the axes of the eyes.
What action should the nurse implement next? - ans -Document a normal finding.
, The nurse performs the Weber and Rinne tests to assess which cranial nerve? -
ans -VIII - vestibulocochlear
The nurse uses a tongue depressor to assess a client's mouth. Which structure
should the nurse be able to visualize? - ans -Pharynx
As a part of a routine health assessment, the nurse assesses the kidneys as part of
the abdominal assessment. Which assessment finding should the nurse conclude
is normal when palpating the client's right kidney? - ans -A round smooth mass
that slides between the fingers.
A client reports lower abdominal pain and a feeling of pressure in the bladder.
Which assessment finding indicates acute urinary retention? - ans -Dull sound
percussed over bladder.
*Clients with acute urinary retention may present with lower abdominal pain and
bladder distension. Percussion (tapping on the body wall) is performed to detect
differences in pitch. A dull sound produced when percussing a distended urinary
bladder is an indication of urinary retention.
The nurse examines the skin of an older adult client. Which skin variation is
considered a normal finding for a client in this age group? - ans -Lentigines.
*Lentigines or commonly referred to as liver spots are irregularly shaped dark
spots on the skin caused by aging and extensive sun exposure. This skin variation
is a normal finding in an older adult client.
During a client's routine well-woman physical exam, the nurse examines the
breasts. Which assessment technique should the nurse implement to evaluate for
any abnormal lumps? - ans -With both arms at client's side, lift one arm and
palpate the axilla.
The nurse is completing a physical exam on an adult client. Which thyroid finding
is considered normal? - ans -Gland is not palpable.
Comprehensive Questions And Verified Answers/ Complete
Solutions With Rationales|Get It 100% Accurate!!
The nurse is performing a thoracic assessment on a client with chronic asthma
and hyperinflation of the lungs. Which finding should be expected for this client? -
ans -Barrel chest
The nurse is assessing bowel sounds for a hospitalized client. The nurse has heard
bowel sounds in the right upper quadrant. What action should the nurse take
next? - ans -Note the character and frequency of bowel sounds
The nurse enters an examination room to conduct a routine health assessment on
an adolescent female client, who is accompanied by her mother. Which action by
the nurse is likely to facilitate accurate responses to personal and social history
questions? - ans -Request that the mother leave the exam room.
While performing a mental status exam (MSE), the nurse asks a client to
remember three unrelated words and repeat them later. The client was able to
repeat the words as directed. Which computer documentation is accurate? - ans -
"Short-term memory is intact."
Which technique should the nurse implement when performing a Weber test? -
ans -Place a vibrating tuning fork midline on top of the head
Which technique should the nurse use to assess a client for scoliosis? - ans -
Observe spine while the client is erect and bent forward
Which term should the nurse use to document in the client's medical record for a
high-pitched scratchy sound during auscultation of the heart? - ans -Friction rub
While performing a head-to-toe assessment, the nurse assesses the client's
pupillary accommodation. During the second portion of the test, the nurse notes
that the client's pupils constrict and there is convergence of the axes of the eyes.
What action should the nurse implement next? - ans -Document a normal finding.
, The nurse performs the Weber and Rinne tests to assess which cranial nerve? -
ans -VIII - vestibulocochlear
The nurse uses a tongue depressor to assess a client's mouth. Which structure
should the nurse be able to visualize? - ans -Pharynx
As a part of a routine health assessment, the nurse assesses the kidneys as part of
the abdominal assessment. Which assessment finding should the nurse conclude
is normal when palpating the client's right kidney? - ans -A round smooth mass
that slides between the fingers.
A client reports lower abdominal pain and a feeling of pressure in the bladder.
Which assessment finding indicates acute urinary retention? - ans -Dull sound
percussed over bladder.
*Clients with acute urinary retention may present with lower abdominal pain and
bladder distension. Percussion (tapping on the body wall) is performed to detect
differences in pitch. A dull sound produced when percussing a distended urinary
bladder is an indication of urinary retention.
The nurse examines the skin of an older adult client. Which skin variation is
considered a normal finding for a client in this age group? - ans -Lentigines.
*Lentigines or commonly referred to as liver spots are irregularly shaped dark
spots on the skin caused by aging and extensive sun exposure. This skin variation
is a normal finding in an older adult client.
During a client's routine well-woman physical exam, the nurse examines the
breasts. Which assessment technique should the nurse implement to evaluate for
any abnormal lumps? - ans -With both arms at client's side, lift one arm and
palpate the axilla.
The nurse is completing a physical exam on an adult client. Which thyroid finding
is considered normal? - ans -Gland is not palpable.
