NUR 2092/NUR2092 Final Exam V3 |
Health Assessment Q&A with Rationale |
Rasmussen University
1. What is the correct order of techniques for a physical assessment of the thorax?
A. Palpation, Percussion, Auscultation, Inspection
B. Auscultation, Inspection, Palpation, Percussion
C. Inspection, Auscultation, Percussion, Palpation
D. Inspection, Palpation, Percussion, Auscultation
Correct Answer: D
Expert Explanation: The standard sequence for most body systems is inspection first,
followed by palpation, percussion, and finally auscultation. This progression allows the
nurse to collect visual data before physically manipulating the tissue. Following this order
ensures that findings from one technique do not interfere with the results of subsequent
techniques.
2. When assessing the abdomen, why is the order of techniques modified?
A. To allow the patient to relax before deep palpation.
B. To ensure the patient’s comfort during the examination.
C. Because inspection is not necessary for abdominal assessments.
D. To prevent the stimulation of bowel sounds by palpation and percussion.
,Correct Answer: D
Expert Explanation: Auscultation of the abdomen must occur immediately after
inspection. Palpation and percussion can stimulate peristalsis, which falsely increases the
frequency of bowel sounds. By auscultating first, the nurse obtains an accurate
representation of the patient’s baseline gastrointestinal activity.
3. Which of the following is considered subjective data?
A. Blood pressure reading of 140/90 mmHg
B. Oxygen saturation levels of 95% on room air
C. A visible rash on the patient’s left arm
D. Patient reporting a sharp pain in their lower back
Correct Answer: D
Expert Explanation: Subjective data consists of information that the patient reports or
perceives, such as symptoms and feelings. Objective data, conversely, is measurable and
observable by the healthcare provider during the physical exam. Pain is a subjective
experience that can only be described by the person feeling it.
4. What does the ‘P’ in the PQRST mnemonic for pain assessment stand for?
A. Pain level
B. Physical location
C. Provocation or Palliation
, D. Patient preference
Correct Answer: C
Expert Explanation: The ‘P’ stands for Provocation or Palliation, which asks what makes
the pain worse or better. This helps the nurse understand the triggers and relief factors
associated with the patient’s condition. It is a critical component of a comprehensive pain
history and assessment.
5. To assess for cyanosis in a patient with dark skin, the nurse should check which area?
A. The dorsal surface of the hands
B. The skin over the sternum
C. The conjunctivae and mucous membranes
D. The soles of the feet
Correct Answer: C
Expert Explanation: In dark-skinned patients, skin color changes like cyanosis or jaundice
are often difficult to see on the general skin surface. The nurse should inspect areas with
less pigmentation, such as the conjunctivae, oral mucosa, and nail beds. These areas
provide a clearer indication of oxygenation status and blood flow.
6. Which technique is used to assess for tactile fremitus?
A. Percussing the lung fields for resonance
B. Auscultating breath sounds with the diaphragm
Health Assessment Q&A with Rationale |
Rasmussen University
1. What is the correct order of techniques for a physical assessment of the thorax?
A. Palpation, Percussion, Auscultation, Inspection
B. Auscultation, Inspection, Palpation, Percussion
C. Inspection, Auscultation, Percussion, Palpation
D. Inspection, Palpation, Percussion, Auscultation
Correct Answer: D
Expert Explanation: The standard sequence for most body systems is inspection first,
followed by palpation, percussion, and finally auscultation. This progression allows the
nurse to collect visual data before physically manipulating the tissue. Following this order
ensures that findings from one technique do not interfere with the results of subsequent
techniques.
2. When assessing the abdomen, why is the order of techniques modified?
A. To allow the patient to relax before deep palpation.
B. To ensure the patient’s comfort during the examination.
C. Because inspection is not necessary for abdominal assessments.
D. To prevent the stimulation of bowel sounds by palpation and percussion.
,Correct Answer: D
Expert Explanation: Auscultation of the abdomen must occur immediately after
inspection. Palpation and percussion can stimulate peristalsis, which falsely increases the
frequency of bowel sounds. By auscultating first, the nurse obtains an accurate
representation of the patient’s baseline gastrointestinal activity.
3. Which of the following is considered subjective data?
A. Blood pressure reading of 140/90 mmHg
B. Oxygen saturation levels of 95% on room air
C. A visible rash on the patient’s left arm
D. Patient reporting a sharp pain in their lower back
Correct Answer: D
Expert Explanation: Subjective data consists of information that the patient reports or
perceives, such as symptoms and feelings. Objective data, conversely, is measurable and
observable by the healthcare provider during the physical exam. Pain is a subjective
experience that can only be described by the person feeling it.
4. What does the ‘P’ in the PQRST mnemonic for pain assessment stand for?
A. Pain level
B. Physical location
C. Provocation or Palliation
, D. Patient preference
Correct Answer: C
Expert Explanation: The ‘P’ stands for Provocation or Palliation, which asks what makes
the pain worse or better. This helps the nurse understand the triggers and relief factors
associated with the patient’s condition. It is a critical component of a comprehensive pain
history and assessment.
5. To assess for cyanosis in a patient with dark skin, the nurse should check which area?
A. The dorsal surface of the hands
B. The skin over the sternum
C. The conjunctivae and mucous membranes
D. The soles of the feet
Correct Answer: C
Expert Explanation: In dark-skinned patients, skin color changes like cyanosis or jaundice
are often difficult to see on the general skin surface. The nurse should inspect areas with
less pigmentation, such as the conjunctivae, oral mucosa, and nail beds. These areas
provide a clearer indication of oxygenation status and blood flow.
6. Which technique is used to assess for tactile fremitus?
A. Percussing the lung fields for resonance
B. Auscultating breath sounds with the diaphragm
