N112 QUIZ ASSESSMENT NCLEX PREP ANSWERED
PERFECTLY!!
A Nurse is preparing to perform an Abdominal examination of a patient. The best
position to place the client is
Answers :Supine with head raised slightly and knees slightly flexed
Rationale: The Position relaxes the abdominal muscles- a totally supine position
makes the abdominal muscles to be taut
A Nurse is assessing a clients muscle strength. The nurse asks the patient to hold
his hands up and supinated as if holding a tray. Nurse then tells the patient to close
eyes and clients left hand turns and moves downward slightly. Nurse interprets this
as
Answers :Pronator drift-
Rationale:
A Nurse is preparing to measure the apical pulse of a client. The nurse places the
diaphragm of the stethoscope on which cardiac site?
Answers :Mitral area
A Nurse is assessing a patient with history of cardiac problems- where should the
nurse place the stethoscope to hear S1 the loudest?
Answers :5ICS, MCL
A nurse is performing a musculoskeletal assessment on a client and finds that the
client is right handed. The nurse would document which one of the following as
abnormal findings?
Answers :Presence of Fasciculations:
Rationale- These are fine muscle twitches which are normally not present.
Hypertrophy on a client's dominant side is considered normal at 1cm- muscle
, strength is graded from 0-5 with 0 being paralysis and 5 being normal.
Symmetrical muscle movement is a normal finding.
A Nurse is performing an abdominal assessment on a client. The nurse determines
which of the following findings should be reported to the physician?
Answers :Pulsations between the umbilicus and pubis
Rationale: Presence of pulsation in that area indicates presence of aortic aneurysm-
should be reported to physician
What is the proper sequence for the abdominal exam
Answers :Inspect, Auscultate, percuss and palpate
A Nurse is getting ready to palpate a client's spleen. Which position would the
nurse use to facilitate palpation?
Answers :Right Side Lying
When measuring abdominal girth in a client with ascites, the nurse would place the
client in which position?
Answers :Standing
After performing an initial abdominal assessment on a client with a diagnosis of a
cholelithiasis, the nurse documents that the bowels sounds are normal. Which of
the following sounds would be considered as norma?
Answers :Relatively high pitched clicks or gurgles auscultated on all four
quadrants
A Nurse performing an abdominal assessment on a patient inspects the skin of the
abdomen- the nurse performs what technique next?
PERFECTLY!!
A Nurse is preparing to perform an Abdominal examination of a patient. The best
position to place the client is
Answers :Supine with head raised slightly and knees slightly flexed
Rationale: The Position relaxes the abdominal muscles- a totally supine position
makes the abdominal muscles to be taut
A Nurse is assessing a clients muscle strength. The nurse asks the patient to hold
his hands up and supinated as if holding a tray. Nurse then tells the patient to close
eyes and clients left hand turns and moves downward slightly. Nurse interprets this
as
Answers :Pronator drift-
Rationale:
A Nurse is preparing to measure the apical pulse of a client. The nurse places the
diaphragm of the stethoscope on which cardiac site?
Answers :Mitral area
A Nurse is assessing a patient with history of cardiac problems- where should the
nurse place the stethoscope to hear S1 the loudest?
Answers :5ICS, MCL
A nurse is performing a musculoskeletal assessment on a client and finds that the
client is right handed. The nurse would document which one of the following as
abnormal findings?
Answers :Presence of Fasciculations:
Rationale- These are fine muscle twitches which are normally not present.
Hypertrophy on a client's dominant side is considered normal at 1cm- muscle
, strength is graded from 0-5 with 0 being paralysis and 5 being normal.
Symmetrical muscle movement is a normal finding.
A Nurse is performing an abdominal assessment on a client. The nurse determines
which of the following findings should be reported to the physician?
Answers :Pulsations between the umbilicus and pubis
Rationale: Presence of pulsation in that area indicates presence of aortic aneurysm-
should be reported to physician
What is the proper sequence for the abdominal exam
Answers :Inspect, Auscultate, percuss and palpate
A Nurse is getting ready to palpate a client's spleen. Which position would the
nurse use to facilitate palpation?
Answers :Right Side Lying
When measuring abdominal girth in a client with ascites, the nurse would place the
client in which position?
Answers :Standing
After performing an initial abdominal assessment on a client with a diagnosis of a
cholelithiasis, the nurse documents that the bowels sounds are normal. Which of
the following sounds would be considered as norma?
Answers :Relatively high pitched clicks or gurgles auscultated on all four
quadrants
A Nurse performing an abdominal assessment on a patient inspects the skin of the
abdomen- the nurse performs what technique next?
