Health Assessment Final 214 National
University Questions Fully solved.
When the nurse assesses a 78-year-old patient with pneumonia, what is the priority
assessment? A. Breath sounds B. Airway patency C. Respiratory rate D. Percussion sounds -
Answer b (ABC'S)
A 45-year-old man has been admitted to the hospital with suspicion of PE. Which of the
following symptoms should the nurse report to the primary health practitioner immediately? A.
Chest pain B. Shortness of breath C. Respirations 20 breaths/min D. Productive cough - Answer
a - chest pain is assumed to be heart pain
3. A 62-year-old woman comes to the clinic with an exacerbation of asthma. Which of the
following findings indicate worsening status of her asthma? A. Increased wheezing B. Sustained
rhonchi C. Decreased respirations D. Oxygen saturation 94% - Answer a - wheezing is
associated with airway inflammation
A 3-year-old boy is brought to the emergency department with stridor, nasal flaring, intercostal
and supraclavicular retractions, and respiratory rate of 40 breaths/min. What type of situation is
this? A. Stable B. Acute C. Urgent D. Emergency - Answer D-
STRIDOR - Answer upper airway obstruction
A 92-year-old woman with a history of COPD presents with increasing shortness of breath,
decreased lung sounds in the bases, increased ankle edema, and 5-lb weight gain in 1 week.
What is the most likely problem? A. Impaired gas exchange B. Ineffective airway clearance C.
Activity intolerance D. Excess fluid volume - Answer d-patient retains fluid due to the
increased work load of the heart
Which of the following factors is the most significant risk factor for COPD? A. Increased age B.
Immune suppression C. Tobacco smoking D. Occupational exposure - Answer c
When the nurse assesses a client with respiratory symptoms, which of the following complaints
should be evaluated first? A. Chest soreness B. Dyspnea C. Cough D. Sputum - Answer d -
shortness of breath would be the first observation
When assessing a patient with atelectasis, what assessment findings are expected? Choose all
that apply. A. Shortness of breath B. Decreased breath sounds C. Decreased oxygen saturation
D. Increased tactile fremitus E. Hyperresonance - Answer A-D
, atelectasis - Answer collapsed lung; incomplete expansion of alveoli
tactile fremitus - Answer is an assessment of the low-frequency vibration of a patient's chest,
which is used as an indirect measure of the amount of air and density of tissue present within
the lungs.
Hyperresonance - Answer lower-pitched, booming sound found when too much air is present
such as in emphysema or pneumothorax
Which assessment findings would indicate that inhaled bronchodilators have been effective? A.
Expiratory wheezing, O2 saturation 94%, pallor B. Vesicular breath sounds, O2 saturation 96%,
pink C. Bronchial breath sounds, O2 saturation 100%, erythema D. Crackles, O2 saturation 90%,
circumoral cyanosis - Answer B
pallor - Answer pale appearance
erythema - Answer reddening of the skin, usually in patches
circumoral cyanosis - Answer refers to blue discoloration around the mouth only
The nurse auscultates bronchovesicular breath sounds in the second ICS near the sternum. The
nurse interprets this as A. a normal finding over the trachea. B. a normal finding over the
bronchi. C. an abnormal finding over the lung - Answer b -
trachea bifurcates at the ____ intercostal space - Answer second
___ sounds are auscultated over the trachea. - Answer bronchovesicular sounds
__________ sounds are heard over the lung fields - Answer vesicular
1. Which of the following statements describes the cardiovascular system most accurately? A. It
is a double pump circulating blood out to the lungs and body. B. It has a heart with six
chambers, great vessels, and valves. C. It includes concepts of precontractility, postcontractility,
and load. D. It functions with a conduction system that starts in the ventricles. - Answer A
In a healthy patient, the myocardial cells in the ventricle depolarize and contract during A.
prediastole. B. diastole. C. systole. D. postsystole. - Answer c - the SA node depolarizes and
the atria contract, which is the P wave on the ECG
University Questions Fully solved.
When the nurse assesses a 78-year-old patient with pneumonia, what is the priority
assessment? A. Breath sounds B. Airway patency C. Respiratory rate D. Percussion sounds -
Answer b (ABC'S)
A 45-year-old man has been admitted to the hospital with suspicion of PE. Which of the
following symptoms should the nurse report to the primary health practitioner immediately? A.
Chest pain B. Shortness of breath C. Respirations 20 breaths/min D. Productive cough - Answer
a - chest pain is assumed to be heart pain
3. A 62-year-old woman comes to the clinic with an exacerbation of asthma. Which of the
following findings indicate worsening status of her asthma? A. Increased wheezing B. Sustained
rhonchi C. Decreased respirations D. Oxygen saturation 94% - Answer a - wheezing is
associated with airway inflammation
A 3-year-old boy is brought to the emergency department with stridor, nasal flaring, intercostal
and supraclavicular retractions, and respiratory rate of 40 breaths/min. What type of situation is
this? A. Stable B. Acute C. Urgent D. Emergency - Answer D-
STRIDOR - Answer upper airway obstruction
A 92-year-old woman with a history of COPD presents with increasing shortness of breath,
decreased lung sounds in the bases, increased ankle edema, and 5-lb weight gain in 1 week.
What is the most likely problem? A. Impaired gas exchange B. Ineffective airway clearance C.
Activity intolerance D. Excess fluid volume - Answer d-patient retains fluid due to the
increased work load of the heart
Which of the following factors is the most significant risk factor for COPD? A. Increased age B.
Immune suppression C. Tobacco smoking D. Occupational exposure - Answer c
When the nurse assesses a client with respiratory symptoms, which of the following complaints
should be evaluated first? A. Chest soreness B. Dyspnea C. Cough D. Sputum - Answer d -
shortness of breath would be the first observation
When assessing a patient with atelectasis, what assessment findings are expected? Choose all
that apply. A. Shortness of breath B. Decreased breath sounds C. Decreased oxygen saturation
D. Increased tactile fremitus E. Hyperresonance - Answer A-D
, atelectasis - Answer collapsed lung; incomplete expansion of alveoli
tactile fremitus - Answer is an assessment of the low-frequency vibration of a patient's chest,
which is used as an indirect measure of the amount of air and density of tissue present within
the lungs.
Hyperresonance - Answer lower-pitched, booming sound found when too much air is present
such as in emphysema or pneumothorax
Which assessment findings would indicate that inhaled bronchodilators have been effective? A.
Expiratory wheezing, O2 saturation 94%, pallor B. Vesicular breath sounds, O2 saturation 96%,
pink C. Bronchial breath sounds, O2 saturation 100%, erythema D. Crackles, O2 saturation 90%,
circumoral cyanosis - Answer B
pallor - Answer pale appearance
erythema - Answer reddening of the skin, usually in patches
circumoral cyanosis - Answer refers to blue discoloration around the mouth only
The nurse auscultates bronchovesicular breath sounds in the second ICS near the sternum. The
nurse interprets this as A. a normal finding over the trachea. B. a normal finding over the
bronchi. C. an abnormal finding over the lung - Answer b -
trachea bifurcates at the ____ intercostal space - Answer second
___ sounds are auscultated over the trachea. - Answer bronchovesicular sounds
__________ sounds are heard over the lung fields - Answer vesicular
1. Which of the following statements describes the cardiovascular system most accurately? A. It
is a double pump circulating blood out to the lungs and body. B. It has a heart with six
chambers, great vessels, and valves. C. It includes concepts of precontractility, postcontractility,
and load. D. It functions with a conduction system that starts in the ventricles. - Answer A
In a healthy patient, the myocardial cells in the ventricle depolarize and contract during A.
prediastole. B. diastole. C. systole. D. postsystole. - Answer c - the SA node depolarizes and
the atria contract, which is the P wave on the ECG
