GCU NSG 316 FINAL EXAM - HEALTH
ASSESSMENT COMPREHENSIVE STUDY
GUIDE
1. When assessing a patient’s peripheral vascular system, the nurse notes a grade of 2+ for
the dorsalis pedis pulse. How should this finding be documented?
A. Normal or brisk
B. Weak or thready
C. Absent or non-palpable
D. Bounding or full
Answer: A
Conceptual Explanation: In the standard 0 to 4+ scale for pulses, 0 is absent, 1+ is
weak/thready, 2+ is normal, 3+ is full, and 4+ is bounding.
2. Which physical examination technique is primarily used to detect tenderness over the
costovertebral angle (CVA)?
A. Light palpation
B. Deep palpation
,C. Blunt percussion
D. Indirect percussion
Answer: C
Conceptual Explanation: Blunt percussion (or fist percussion) over the CVA is the
standard technique to assess for kidney inflammation or stones.
3. During a respiratory assessment, the nurse hears low-pitched, snoring sounds that clear
with coughing. These are identified as:
A. Sibilant wheezes
B. Pleural friction rub
C. Rhonchi
D. Fine crackles
Answer: C
Conceptual Explanation: Rhonchi are low-pitched, continuous sounds caused by
secretions in large airways and often clear with a cough.
4. A patient presents with a ‘strawberry tongue.’ This clinical finding is most characteristic of
which condition?
A. Vitamin B12 deficiency
B. Oral candidiasis
C. Leukoplakia
, D. Scarlet fever
Answer: D
Conceptual Explanation: Scarlet fever (and Kawasaki disease) are classic causes of a
bright red, bumpy strawberry tongue.
5. When performing the Rinne test, a patient reports that bone conduction is longer than air
conduction (BC > AC). This indicates:
A. Conductive hearing loss
B. Sensorineural hearing loss
C. Normal hearing
D. Presbycusis
Answer: A
Conceptual Explanation: Normal hearing or sensorineural loss shows AC > BC. If BC is
longer than or equal to AC, it signifies conductive hearing loss.
6. The nurse is assessing the CN VII (Facial Nerve). Which action should the nurse ask the
patient to perform?
A. Stick out the tongue
B. Smile and puff out the cheeks
C. Shrug the shoulders against resistance
D. Clench the teeth
ASSESSMENT COMPREHENSIVE STUDY
GUIDE
1. When assessing a patient’s peripheral vascular system, the nurse notes a grade of 2+ for
the dorsalis pedis pulse. How should this finding be documented?
A. Normal or brisk
B. Weak or thready
C. Absent or non-palpable
D. Bounding or full
Answer: A
Conceptual Explanation: In the standard 0 to 4+ scale for pulses, 0 is absent, 1+ is
weak/thready, 2+ is normal, 3+ is full, and 4+ is bounding.
2. Which physical examination technique is primarily used to detect tenderness over the
costovertebral angle (CVA)?
A. Light palpation
B. Deep palpation
,C. Blunt percussion
D. Indirect percussion
Answer: C
Conceptual Explanation: Blunt percussion (or fist percussion) over the CVA is the
standard technique to assess for kidney inflammation or stones.
3. During a respiratory assessment, the nurse hears low-pitched, snoring sounds that clear
with coughing. These are identified as:
A. Sibilant wheezes
B. Pleural friction rub
C. Rhonchi
D. Fine crackles
Answer: C
Conceptual Explanation: Rhonchi are low-pitched, continuous sounds caused by
secretions in large airways and often clear with a cough.
4. A patient presents with a ‘strawberry tongue.’ This clinical finding is most characteristic of
which condition?
A. Vitamin B12 deficiency
B. Oral candidiasis
C. Leukoplakia
, D. Scarlet fever
Answer: D
Conceptual Explanation: Scarlet fever (and Kawasaki disease) are classic causes of a
bright red, bumpy strawberry tongue.
5. When performing the Rinne test, a patient reports that bone conduction is longer than air
conduction (BC > AC). This indicates:
A. Conductive hearing loss
B. Sensorineural hearing loss
C. Normal hearing
D. Presbycusis
Answer: A
Conceptual Explanation: Normal hearing or sensorineural loss shows AC > BC. If BC is
longer than or equal to AC, it signifies conductive hearing loss.
6. The nurse is assessing the CN VII (Facial Nerve). Which action should the nurse ask the
patient to perform?
A. Stick out the tongue
B. Smile and puff out the cheeks
C. Shrug the shoulders against resistance
D. Clench the teeth
