NURS 258 Exam 1 Questions and Answers Latest Update 2025 Graded A+
In order, what are the skills required for a physical assessment? - Answers Inspection, Palpation,
Percussion and Auscultation
What is the first skill performed during a physical assessment, it often begins with the eyes as soon as
you enter the room? - Answers Inspection
There are two forms of this skill, both performed via touch.
Light-one handed to inspect texture, warmth, moisture, tenderness and pulsation.
Deep- two hands typically as a BSN, we do not perform this technique. - Answers Palpation
Skill that involves tapping the skin, however, nurses do not perform this skill. - Answers Percussion
A technique used to listen. Ear pieces pointing towards the nose. Diaphragm used to listen for high
pitch. Bell used to listen for low pitches. Recommended to warm stethoscope with hands before
performing this technique, place it directly on the skin, clean stethoscope following each pt. - Answers
Auscultation
What is the most appropriate setting for an exam room? - Answers A warm and private environment,
must have good lighting and have all equipment handy.
Developed to improve accuracy of pt identification, reduces the risk of healthcare associated
identifications, nosocomial infection, hand washing, alcohol-based hand rub, clean equipment with each
pt contact. - Answers National Patient Safety Goals for Patient Care
At what age to you NOT use the head-to-toe assessment approach? At this age it is important to do less
invasive approach first and then more invasive approach last to ensure more compliance. - Answers
Infant and Toddler
During an examination, at what age do you ask a child if he wants to sit on the exam table or in a parents
lap? Do not offer options if there are no options. If this age of child appears resistant do more invasive
items last. - Answers Preschool Child
During an examination at what age do you allow for rest periods and minimize position changes? -
Answers Older Adult
What is a safe place to start when assessing a pt? Something that should be done more frequently
following critical situations, after surgery, during blood transfusions, and changes in the pt status. -
Answers Vital Signs
, May range from 96.8-100/4°F, anything above 100.4° is considered a fever. - Answers Temperature
What are some factors that affect a persons temperature? - Answers Age, exercise, hormone level,
circadian rhythm, stress and environment.
What are the main points where temperature can be taken? - Answers Mouth-Oral
Rectum-Rectal
Underarm-Axilla
Ear-Tympanic
Forehead-Temporal
Core-Urinary Catheter, central lines
Rate taken right over the heart. Auscultate, most accurate, cardiac needs, pediatrics. - Answers Apical
Pulse
The most common area to take a pulse, thumb side of the wrist, do not use the thumb to take this pulse.
- Answers Radial Pulse
Infant 120-160 bpm
Toddler 90-140 bpm
Preschooler 80-110 bpm
School age Child 75-100 bpm
Adolescent 60-90 bpm
Adult 60-100 bpm
*A athletic/in shape person may have a pulse as low as 40bpm - Answers Pulse Ranges
Regular rate- count for 30 secondsX2
Irregular Rate-count for a full minute
-Tachycardia >100bpm
-Bradycardia<60bpm
In order, what are the skills required for a physical assessment? - Answers Inspection, Palpation,
Percussion and Auscultation
What is the first skill performed during a physical assessment, it often begins with the eyes as soon as
you enter the room? - Answers Inspection
There are two forms of this skill, both performed via touch.
Light-one handed to inspect texture, warmth, moisture, tenderness and pulsation.
Deep- two hands typically as a BSN, we do not perform this technique. - Answers Palpation
Skill that involves tapping the skin, however, nurses do not perform this skill. - Answers Percussion
A technique used to listen. Ear pieces pointing towards the nose. Diaphragm used to listen for high
pitch. Bell used to listen for low pitches. Recommended to warm stethoscope with hands before
performing this technique, place it directly on the skin, clean stethoscope following each pt. - Answers
Auscultation
What is the most appropriate setting for an exam room? - Answers A warm and private environment,
must have good lighting and have all equipment handy.
Developed to improve accuracy of pt identification, reduces the risk of healthcare associated
identifications, nosocomial infection, hand washing, alcohol-based hand rub, clean equipment with each
pt contact. - Answers National Patient Safety Goals for Patient Care
At what age to you NOT use the head-to-toe assessment approach? At this age it is important to do less
invasive approach first and then more invasive approach last to ensure more compliance. - Answers
Infant and Toddler
During an examination, at what age do you ask a child if he wants to sit on the exam table or in a parents
lap? Do not offer options if there are no options. If this age of child appears resistant do more invasive
items last. - Answers Preschool Child
During an examination at what age do you allow for rest periods and minimize position changes? -
Answers Older Adult
What is a safe place to start when assessing a pt? Something that should be done more frequently
following critical situations, after surgery, during blood transfusions, and changes in the pt status. -
Answers Vital Signs
, May range from 96.8-100/4°F, anything above 100.4° is considered a fever. - Answers Temperature
What are some factors that affect a persons temperature? - Answers Age, exercise, hormone level,
circadian rhythm, stress and environment.
What are the main points where temperature can be taken? - Answers Mouth-Oral
Rectum-Rectal
Underarm-Axilla
Ear-Tympanic
Forehead-Temporal
Core-Urinary Catheter, central lines
Rate taken right over the heart. Auscultate, most accurate, cardiac needs, pediatrics. - Answers Apical
Pulse
The most common area to take a pulse, thumb side of the wrist, do not use the thumb to take this pulse.
- Answers Radial Pulse
Infant 120-160 bpm
Toddler 90-140 bpm
Preschooler 80-110 bpm
School age Child 75-100 bpm
Adolescent 60-90 bpm
Adult 60-100 bpm
*A athletic/in shape person may have a pulse as low as 40bpm - Answers Pulse Ranges
Regular rate- count for 30 secondsX2
Irregular Rate-count for a full minute
-Tachycardia >100bpm
-Bradycardia<60bpm
