Question 1

The nurse is assessing a patient whose chart indicates a Grade 3 heart murmur. What action is best to hear the murmur?

Accepted Answer

A)  Ensure that the room is extremely quiet. 
B)  Use a specialized stethoscope with amplification. 
C)  Auscultate the patient's chest with a stethoscope. 
D)  Place the stethoscope diaphragm on the patient's back. 
A)  Ensure that the room is extremely quiet. 
B)  Use a specialized stethoscope with amplification. 
C)  Auscultate the patient's chest with a stethoscope. 
D)  Place the stethoscope diaphragm on the patient's back.

Question 2

A nurse conducting the general survey of a patient includes which items?

Accepted Answer

A)  Hygiene and grooming 
B)  Affect and mood 
C)  Sex and gender orientation 
D)  Sexual preferences and practices 
E)  Age 
A)  Hygiene and grooming 
B)  Affect and mood 
C)  Sex and gender orientation 
D)  Sexual preferences and practices 
E)  Age

Question 3

A nurse has finished examining a patient. What actions does the nurse take next?

Accepted Answer

A)  Document all findings. 
B)  Provide privacy for dressing. 
C)  Provide any hygiene material needed. 
D)  Tells the patient he/she can leave. 
E)  Cleans the room after the patient leaves. 
A)  Document all findings. 
B)  Provide privacy for dressing. 
C)  Provide any hygiene material needed. 
D)  Tells the patient he/she can leave. 
E)  Cleans the room after the patient leaves.

Question 4

A nurse is assisting a patient who is having an examination of the female genitalia. What action by the nurse is best?

Accepted Answer

A)  Get the provider; assist patient into lithotomy position. 
B)  Assist the patient into lithotomy position; get the provider. 
C)  Get the provider; assist patient into Sims position. 
D)  Assist the patient into Sims position; get the provider. 
A)  Get the provider; assist patient into lithotomy position. 
B)  Assist the patient into lithotomy position; get the provider. 
C)  Get the provider; assist patient into Sims position. 
D)  Assist the patient into Sims position; get the provider.

Question 5

The nurse examining a patient's skin correlates which conditions with which underlying pathology?

Accepted Answer

A)  Albinism: Full-thickness burns 
B)  Peripheral cyanosis: poor circulation 
C)  Purpura: clotting disorders 
D)  Jaundice: liver disease 
E)  Vitiligo: skin infestation 
A)  Albinism: Full-thickness burns 
B)  Peripheral cyanosis: poor circulation 
C)  Purpura: clotting disorders 
D)  Jaundice: liver disease 
E)  Vitiligo: skin infestation

Exam 20: Health History and Physical Assessment

The nurse is assessing a patient whose chart indicates a Grade 3 heart murmur. What action is best to hear the murmur?

A nurse conducting the general survey of a patient includes which items?

A nurse has finished examining a patient. What actions does the nurse take next?

A nurse is assisting a patient who is having an examination of the female genitalia. What action by the nurse is best?

The nurse examining a patient's skin correlates which conditions with which underlying pathology?

Nursing, Theory, and Professional Practice

Values, Beliefs, and Caring

Communication

Critical Thinking in Nursing

Introduction to the Nursing Process

Assessment

Nursing Diagnosis

Planning

Implementation and Evaluation

Documentation, Electronic Health Records, and Reporting

Ethical and Legal Considerations

Leadership and Management

Evidence-Based Practice and Nursing Research

Health Literacy and Patient Education

Nursing Informatics

Health and Wellness

Human Development: Conception Through Adolescence

Human Development: Young Adult Through Older Adult

Vital Signs

Ethnicity and Cultural Assessment

Spiritual Health

Public Health, Community-Based, and Home Health Care

Human Sexuality

Safety

Asepsis and Infection Control

Hygiene and Personal Care

Activity, Immobility, and Safe Movement

Skin Integrity and Wound Care

Nutrition

Cognitive and Sensory Alterations

Stress and Coping

Sleep

Diagnostic Testing

Medication Administration

Pain Management

Perioperative Nursing Care

Oxygenation and Tissue Perfusion

Fluid, Electrolytes, and Acid-Base Balance

Bowel Elimination

Urinary Elimination

Death and Loss

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