NR 304 Final Exam – Questions With Practical
Solutions
Purpose of the health history Correct Answer - collect subjective data,
providing a complete picture of the person's past and present health.
General survey (please bring me bananas) Correct Answer - physical
appearance, body structure, mobility, behavior
Examples of subjective data Correct Answer - sore throat, headache,
tinnitus, vertigo
Alert Correct Answer - wide awake and highly aware
Examples of objective data Correct Answer - audible wheeze, fever,
pressure ulcer, melena
Lethargic Correct Answer - not fully alert drifts off to sleep when not
stimulated but can be aroused by name
Stuporus Correct Answer - requires painful stimuli to get a brief
response; may have no verbal response
Comatose Correct Answer - in a coma; extremely sleepy
Anthropometric measurements Correct Answer - noninvasive
quantitative measurement based on height and weight
Heart rate normal findings Correct Answer - regular rhythm
2+ force
60-100 bpm
Regular respiratory rate and oxygen saturation Correct Answer - 12-20
breaths per minute
95-100% SPO2 sat. (room air)
Blood pressure normal rate Correct Answer - 120/80
, Peripheral pulse classification Correct Answer - absent (0)
weak (1+)
normal (2+)
bounding (3-4+)
Anuria Correct Answer - absence of urine
nocturia Correct Answer - excessive urination at night
(BPH guy)
Dysuria Correct Answer - painful urination
Polyuria Correct Answer - excessive urination
Hematauria Correct Answer - blood in the urine
Oliuria and oliguria Correct Answer - decreased urine output
Tachy mucous membranes Correct Answer - dehydration, tenting, low
bp, tachycardia,
Right side heart failure Correct Answer - edema
jvd
bounding pulses
fluid overload
Client complaining of new onset calf/foot pain. Nurse notes that the leg below
the knee is cool & pale, peripheral pulses are absent (0) and (0) with doppler.
What is the PRIORITY nursing of action? Correct Answer - NOTIFY HCP
IMMEDIATELY
Arterial insufficiency Correct Answer - any condition that slows or stops
the flow of blood through your arteries
Petechiae Correct Answer - small, pinpoint hemorrhages
(vitamin k deficiency/DIC)
pruritis Correct Answer - severe itching
Solutions
Purpose of the health history Correct Answer - collect subjective data,
providing a complete picture of the person's past and present health.
General survey (please bring me bananas) Correct Answer - physical
appearance, body structure, mobility, behavior
Examples of subjective data Correct Answer - sore throat, headache,
tinnitus, vertigo
Alert Correct Answer - wide awake and highly aware
Examples of objective data Correct Answer - audible wheeze, fever,
pressure ulcer, melena
Lethargic Correct Answer - not fully alert drifts off to sleep when not
stimulated but can be aroused by name
Stuporus Correct Answer - requires painful stimuli to get a brief
response; may have no verbal response
Comatose Correct Answer - in a coma; extremely sleepy
Anthropometric measurements Correct Answer - noninvasive
quantitative measurement based on height and weight
Heart rate normal findings Correct Answer - regular rhythm
2+ force
60-100 bpm
Regular respiratory rate and oxygen saturation Correct Answer - 12-20
breaths per minute
95-100% SPO2 sat. (room air)
Blood pressure normal rate Correct Answer - 120/80
, Peripheral pulse classification Correct Answer - absent (0)
weak (1+)
normal (2+)
bounding (3-4+)
Anuria Correct Answer - absence of urine
nocturia Correct Answer - excessive urination at night
(BPH guy)
Dysuria Correct Answer - painful urination
Polyuria Correct Answer - excessive urination
Hematauria Correct Answer - blood in the urine
Oliuria and oliguria Correct Answer - decreased urine output
Tachy mucous membranes Correct Answer - dehydration, tenting, low
bp, tachycardia,
Right side heart failure Correct Answer - edema
jvd
bounding pulses
fluid overload
Client complaining of new onset calf/foot pain. Nurse notes that the leg below
the knee is cool & pale, peripheral pulses are absent (0) and (0) with doppler.
What is the PRIORITY nursing of action? Correct Answer - NOTIFY HCP
IMMEDIATELY
Arterial insufficiency Correct Answer - any condition that slows or stops
the flow of blood through your arteries
Petechiae Correct Answer - small, pinpoint hemorrhages
(vitamin k deficiency/DIC)
pruritis Correct Answer - severe itching
