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Examen

NUR 215 & NUR 216 Combined Exam 2026/2027 Updated – Health Assessment Study Guide with Answers and Rationales, Instant Download

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NUR 215 & NUR 216 Combined Exam 2026/2027 Updated – Health Assessment Study Guide with Answers and Rationales, Instant Download

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NUR 215 & NUR 216 Combined Exam
2026/2027 Updated – Health Assessment
Study Guide with Answers and
Rationales, Instant Download
SECTION I: Health Assessment Techniques & General Survey
1. The nurse is preparing to assess a client's abdomen. Which sequence of
assessment techniques should the nurse use?
A. Inspection, palpation, percussion, auscultation
B. Inspection, auscultation, percussion, palpation
C. Auscultation, inspection, palpation, percussion
D. Palpation, percussion, auscultation, inspection

Correct Answer: B

Rationale: The abdominal assessment follows a modified sequence:
Inspection, Auscultation, Percussion, Palpation. Auscultation is performed before
percussion and palpation because these maneuvers can alter bowel sounds, leading
to inaccurate findings. All other body systems use Inspection, Palpation,
Percussion, Auscultation.


2. A nurse is performing a general survey on a newly admitted client. Which of
the following are components of the general survey? (Select All That Apply)
A. Level of consciousness
B. Blood pressure reading
C. Apparent state of health
D. Body temperature
E. Signs of distress
F. Client's mobility and gait

Correct Answer: A, C, E, F

, Rationale: The general survey includes observation of physical appearance,
body structure, mobility, behavior, level of consciousness, signs of distress, and
apparent state of health. Blood pressure and body temperature are vital signs
measured separately, not part of the general survey observation.


3. When performing deep palpation of the abdomen, the nurse should depress
the abdominal wall approximately:
A. 0.5 cm
B. 1–2 cm
C. 4–5 cm
D. 7–8 cm

Correct Answer: C

Rationale: Deep palpation depresses the abdominal wall approximately 4–5
cm (1.5–2 inches) using the palmar surface of the fingers. Light palpation
depresses only about 1 cm. Deep palpation assesses organ size, masses, and
tenderness.


4. A nurse is assessing a client who has a body mass index (BMI) of 32. How
should the nurse classify this client?
A. Underweight
B. Normal weight
C. Overweight
D. Obese

Correct Answer: D

Rationale: A BMI of 30 or greater is classified as obese. BMI classifications:
Underweight <18.5; Normal 18.5–24.9; Overweight 25–29.9; Obese ≥30. A BMI
of 32 falls into the obese category (Class I obesity: 30–34.9).

,5. Which of the following is the most appropriate technique for the nurse to
use when assessing the thyroid gland?
A. Deep palpation of the neck
B. Inspection only
C. Posterior approach with client seated
D. Percussion of the trachea

Correct Answer: C

Rationale: The thyroid gland is best assessed using the posterior approach (or
anterior approach) with the client seated and the neck slightly extended. The nurse
stands behind the client, places fingers on either side of the trachea, and asks the
client to swallow. This allows detection of enlargement, nodules, or asymmetry.


6. A nurse notices a client has a shuffling gait, stooped posture, and tremors at
rest. These findings are most consistent with:
A. Multiple sclerosis
B. Parkinson's disease
C. Cerebellar ataxia
D. Peripheral neuropathy

Correct Answer: B

Rationale: Parkinson's disease classically presents with a shuffling gait,
stooped/flexed posture, resting tremors (pill-rolling), bradykinesia, and rigidity.
Multiple sclerosis presents with varying neurological deficits; cerebellar ataxia
presents with wide-based gait; peripheral neuropathy typically affects sensation in
extremities.


7. When assessing a client's skin turgor, the nurse should pinch the skin over
which area?
A. Forearm
B. Sternum or forehead

, C. Abdomen
D. Thigh

Correct Answer: B

Rationale: Skin turgor is best assessed over the sternum or forehead (and
sometimes the back of the hand). These areas have less subcutaneous fat and are
more reliable indicators of hydration status. In older adults, skin turgor over the
forearm may be decreased due to normal aging.


8. A nurse is documenting a client's edema as 3+. Which description best
characterizes this finding?
A. Slight pitting, no visible distortion
B. Deeper pit, disappears rapidly
C. Deep pit, remains 10–30 seconds, obvious swelling
D. Very deep pit, remains >30 seconds, severe swelling

Correct Answer: C

Rationale: Edema scale: 1+ = slight pit, disappears rapidly; 2+ = deeper pit,
disappears in 10–15 seconds; 3+ = deep pit, remains 10–30 seconds, obvious
swelling; 4+ = very deep pit, remains >30 seconds, severe swelling. 3+ indicates
moderate to severe edema.


9. Which of the following clients is at highest risk for developing a pressure
injury?
A. A 30-year-old with a fractured femur in traction
B. A 75-year-old with incontinence and immobility
C. A 45-year-old with hypertension
D. A 22-year-old with asthma

Correct Answer: B

Información del documento

Subido en
25 de septiembre de 2026
Número de páginas
56
Escrito en
2026/2027
Tipo
Examen
Contiene
Preguntas y respuestas
$25.99

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