Comprehensive Practice Exam with Questions, Answers & Rationales Questions and Answers
with detailed Rationales | Updates | 100% Correct
Institution: Galen College of Nursing
Course: NSG 3160 – Health Assessment
Content Areas:
• General Survey & Vital Signs
• Integumentary System
• Head, Neck, Eyes, Ears, Nose, Throat (HEENT)
• Respiratory System
• Cardiovascular System
• Peripheral Vascular & Lymphatic
• Abdomen
• Musculoskeletal System
• Neurological System
• Pediatric & Developmental Assessment
• Older Adult Assessment
• Cultural & Communication Considerations
• Documentation & Clinical Judgment
,SECTION 1: GENERAL SURVEY & VITAL SIGNS (Questions 1–15)
Question 1
A nurse is assessing a patient's general appearance. Which component
is included in the general survey?
A. Auscultation of lung sounds
B. Measurement of blood pressure
C. Observation of posture, hygiene, and level of consciousness
D. Palpation of the abdomen
Answer: C
Rationale: The general survey includes observation of overall
appearance, posture, hygiene, level of consciousness, skin color, and
signs of distress. Vital signs are part of the survey but not the only
component.
Question 2
A nurse is measuring a patient's oral temperature. The patient just
drank a cup of hot coffee. What should the nurse do?
,A. Wait 15–30 minutes before measuring
B. Take the temperature rectally instead
C. Document the temperature as is
D. Use an axillary temperature
Answer: A
Rationale: Hot or cold liquids can alter oral temperature readings. The
nurse should wait 15–30 minutes after ingestion to obtain an accurate
oral temperature.
Question 3
A nurse is assessing a patient's pulse. Which finding should be
documented as abnormal?
A. Radial pulse 70 bpm, regular
B. Radial pulse 110 bpm, irregular
C. Radial pulse 60 bpm, strong
D. Radial pulse 80 bpm, regular
Answer: B
Rationale: A heart rate above 100 bpm (tachycardia) and an irregular
rhythm are abnormal findings that require further evaluation.
, Question 4
A nurse is measuring blood pressure. The patient's arm is above heart
level. Which effect will this have on the reading?
A. Falsely high
B. Falsely low
C. No effect
D. Increased diastolic only
Answer: B
Rationale: If the arm is above heart level, blood pressure readings may
be falsely low due to decreased hydrostatic pressure. The arm should be
at heart level.
Question 5
A nurse is assessing a patient's respiratory rate. Which finding requires
immediate intervention?
A. 16 breaths/min, regular
B. 28 breaths/min, labored
C. 14 breaths/min, even
D. 18 breaths/min, unlabored
with detailed Rationales | Updates | 100% Correct
Institution: Galen College of Nursing
Course: NSG 3160 – Health Assessment
Content Areas:
• General Survey & Vital Signs
• Integumentary System
• Head, Neck, Eyes, Ears, Nose, Throat (HEENT)
• Respiratory System
• Cardiovascular System
• Peripheral Vascular & Lymphatic
• Abdomen
• Musculoskeletal System
• Neurological System
• Pediatric & Developmental Assessment
• Older Adult Assessment
• Cultural & Communication Considerations
• Documentation & Clinical Judgment
,SECTION 1: GENERAL SURVEY & VITAL SIGNS (Questions 1–15)
Question 1
A nurse is assessing a patient's general appearance. Which component
is included in the general survey?
A. Auscultation of lung sounds
B. Measurement of blood pressure
C. Observation of posture, hygiene, and level of consciousness
D. Palpation of the abdomen
Answer: C
Rationale: The general survey includes observation of overall
appearance, posture, hygiene, level of consciousness, skin color, and
signs of distress. Vital signs are part of the survey but not the only
component.
Question 2
A nurse is measuring a patient's oral temperature. The patient just
drank a cup of hot coffee. What should the nurse do?
,A. Wait 15–30 minutes before measuring
B. Take the temperature rectally instead
C. Document the temperature as is
D. Use an axillary temperature
Answer: A
Rationale: Hot or cold liquids can alter oral temperature readings. The
nurse should wait 15–30 minutes after ingestion to obtain an accurate
oral temperature.
Question 3
A nurse is assessing a patient's pulse. Which finding should be
documented as abnormal?
A. Radial pulse 70 bpm, regular
B. Radial pulse 110 bpm, irregular
C. Radial pulse 60 bpm, strong
D. Radial pulse 80 bpm, regular
Answer: B
Rationale: A heart rate above 100 bpm (tachycardia) and an irregular
rhythm are abnormal findings that require further evaluation.
, Question 4
A nurse is measuring blood pressure. The patient's arm is above heart
level. Which effect will this have on the reading?
A. Falsely high
B. Falsely low
C. No effect
D. Increased diastolic only
Answer: B
Rationale: If the arm is above heart level, blood pressure readings may
be falsely low due to decreased hydrostatic pressure. The arm should be
at heart level.
Question 5
A nurse is assessing a patient's respiratory rate. Which finding requires
immediate intervention?
A. 16 breaths/min, regular
B. 28 breaths/min, labored
C. 14 breaths/min, even
D. 18 breaths/min, unlabored
