NUR2092 Health Assessment Final Study Guide Questions LATEST 2022-2023

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NUR2092 Health Assessment Final Study Guide Questions & Answers, Rasmussen College 2021 Abnormal resp sound: Snap crackle pop: Crackles. Cardiac cycle, ventricles are pushing blood out of the ventricl... es is : Systole Nurse is assessing an older adults instrumentals of activities of daily living :Shopping Obese client, BP cuff is standard size: Nurse anticipates false high reading. Know Erb’s point and Mitral Valve locations. Patients skin is shiny and tight without hair: Peripheral Artery Disease: Round Dry ulcer on Medial Malleolus. Know what Clubbing Is! Enlargement of the fingers and nails, angle greater than 180. Nodules: 1-2 cm Person goes in for regular yearly exam and mentions engaging in light exercise: Nurse would ask what the client means by light exercise. Swans necks and Buttners deformities are with: Rheumatoid Arthritis. Thoracic Expansion assesses? Lung movement Swishing sounds loudest in 4th intercostal space left sternal border: Problem with Tricuspid Valve. . Edema: 2mm pitting: +1 Edema Red Black Tarry Stool: Duodenal Ulcer Glascow Coma Scale: Eye opening, verbal response, and motor response. Patellar reflex doesn’t work what should you do? HAve patient lock his arms together and try to pull them apart Abnormal response to Romberg test? Losing Balance. Cranial Nerve number 5&7 facial touch Stage 3 pressure ulcers. Wong baker face pain scale. Deep Tendon reflexes: equal antecubital fossa (location) Fracture picture: Know the difference between compound, compression, commuted, and pathologic Know about Barrel Chest vs Kyphosis, vs pectus excavatum, Tinnitus is ringing buzzing crackling in ear. Crepitus is crunching grating sound of clients knee. Rashes: Herpetiform Vertigo is….. What is the last thing a culture gives up when adapting to a new culture? Foods Patient has Nephrolithiasis and percusses in costovertebral angle. Expect to find pain on percussion Primary secondary tertiary. …. Colonoscopy is secondary Finger rub test …. Tests for Gross hearing ability. Skin color is included in general survey. Non Modifiable colon cancer risk factor is: AGE OVER 50!!! Dorsiflexion Bronchophony is ….. Diagnosis with Pneumonia …. Nurse can clearly hear 99 in left lower lobe Kahoot: 1. What occurs in the diagnosis step of the nursing process? Clustering and Interpreting Data 2. Which Statement will elicit the most information? What are your symptoms today? 3. What are the characteristics of lymph nodes in clients with an acute infection? Enlarged and tender 4. A client has a left femur fracture repair, which is of the most concern to the nurse? Left foot is cold and pale 5. What is a symptom of nephrolithiasis? Flank Pain 6. How does the nurse document raised 0.6 cm, firm lesion noted on a client’s arm? Papule 7. Where can bronchial breath sounds be heard? Tracheal Area 8. 58 year old finds small lump in breast, what data history risk factor breast cancer? She had radiation treatment for Hodgkin's disease at age 17 9. Which assessment is appropriate for evaluating cerebellar function? Rapid Alternating fingers 10. Perform spinal assessment and note excessive inward curvature of the lumbar spine, this is: Lordosis. 11. What is a sign of right sided congestive heart failure: Jugular venous distention 12. A raised firm lesion almost 4 cm: TUMOR 13. What order does nurse auscultate heart valves? Apical, Pulmonic, Tricuspid, Mitral 14. Assessing ROM clients ankles nurse expects client to perform Dorsiflexion and Inversion 15. Which guideline may be used to identify which heart sounds is S1? S1 coincides with the carotid pulse 16. Heberden and Bouchard nodes are associated with what condition? Osteoarthritis 17. What does tactile fremitus assess? Difference in density of lung tissue 18. Swooshing sounds loudest at 2nd intercostal space, Rt border. Problem valve? Aortic 19. Romberg: Pt sways and moves feet farther apart. Document?Positive Romberg Sign 20. Pt s/s: severe headache, vomiting and rash. Nurse would suspect meningitis IF THE RASH DOES NOT BLANCH WITH PRESSURE. 21. Common change seen in geriatric clients?Skin thins due to loss of collagen 22. What is an appropriate tool to evaluate pain on a 5 year old with a broken arm? WongBaken Faces pain scale 23. Muscle is relaxed and nurse moves body part? Passive ROM 24. Heard loudest at 2nd intercostal space, Rt and Left of sternal borders: S2 25. s/s nurse considers cataracts as diagnosis: Clouding of the lense of the right eye 26. Ausculates ABD aorta, hears swishing sound. Nurse suspects? An aneurysm 27. 50 year old to have colonoscopy. What level of health promotion is this? Secondary Prevention 28. What is a non-modifiable colon cancer risk factor? African American 29. Tongue movement and tongue strength. This tests cranial nerves? 7- hypoglossal PRACTICE QUESTIONS: 1. The nursing student is learning blood pressure techniques and asks the instructor what is a normal blood pressure reading? Which of the following would be appropriate response for the instructor? (c) a. Ask the client what is usual for them b. A normal reading is 140/80 c. Normal is considered to be less than 120/80 and above 100/60 d. “That depends on the client” 2. “A 65yr old man with emphysema and bronchitis ahs come to the clinic for a follow up appointment. On assessment of his skin the nurse might expect to find the following. (a) a. Clubbing of the nails b. Scleroderma c. Pedal erythema d. anasarca 3. When the client’s chart includes a notation that Petechiae have been observed, what finding does the nurse expect during inspection? (a) a. Purplish-red pinpoint lesions b. Deep purplish or red patches of skin c. Small raised fluid-filled pinkish nodules d. Generalized reddish discoloration of an area of skin 4. Which of the following situations will result in a falsely high blood pressure? Select all that apply (a,c.) a. The blood pressure cuff is too narrow for the extremity. b. The cuff has a small tear on the side of it c. The person is sitting with his or her legs crossed d. The nurse does not inflate the cuff high enough. 5. The nurse is assessing capillary refill on a client and notes a color return that takes 4 seconds on each hand. The nurse would correctly document this finding as which of the following? (b) a. Normal b. Sluggish c. Absent d. Brisk 6. The nurse has discovered decreased skin turgor in a patient and nows that this in an expected finding in which of the following conditions? (C) a. During childhood growth spurts b. Cases of severe obesity c. An individual who is severely dehydrated d. With conditions of connective tissue disorders such as scleroderma 7. A Mother brings her newborn in for an assessment and asks, “Is there something wrong with my baby? His head seams so big.” The nurse knows the following about relative portions of the head and trunk of the newborn. (A) a. HEad circumference should be greater than chest circumference at bitrh. b. At birth, the head is one fifth the total length c. The head size reaches 90% of its final size when the child is 3 y.o d. When the anterior fontanel closes at 2 months, the head will be more proportioned to the body. 8. The Nurse educator is preparing an education module for the nursing staff on the epidermal layer of skin. Which of the following would be included in the module? (A) a. The epidermis is replaced every 4 weeks b. The epidermis is very vascular c. The epidermis is thick and tough [Show More]

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