Exam 8: Health Assessment

The nurse assesses an adult patient with a cardiopulmonary illness and hears a grating sound over the lower lateral lung during inspiration that does not clear with coughing.What would the nurse most likely document as a result of the assessment findings?

The nurse is performing an abdominal assessment.Which action indicates proper technique?

The nurse assesses the adult patient's spine.Which expected finding does the nurse identify about the patient's alignment and posture?

The nurse is preparing to auscultate the pulmonic area.At which site should the nurse place the stethoscope?

The nurse is assessing a patient with a cast extending from just below the left knee to the toes.Which assessment contains a desirable patient outcome?

The nurse is preparing to begin the thoracic assessment of a patient.What is the initial step of the thoracic assessment?

An older adult is being assessed by the nurse.Which finding does the nurse consider abnormal when assessing the patient's risk for fall?

How often should the nurse perform a general assessment of the patient?

The nurse is instructing a patient how to breathe during auscultation of the lungs.Instruction by the nurse has been effective if the patient breathes in which manner?

The nurse is performing a neurological assessment.Which patient behaviors demonstrate a level of consciousness within normal limits?

The patient has iron deficiency anemia.What sign causes the nurse to intervene as a priority?

The nurse is concerned with possible impaired peripheral perfusion after performing a patient's assessment.Which assessment finding about the patient's lower extremities supports the nurse's suspicion?

The nurse assesses a patient with light skin and observes normally shaped nail beds exhibiting pallor and a slight bluish color.Which would the nurse implement first?

The patient is being assessed for a possible respiratory problem.In which position should the patient be placed to facilitate chest expansion during a thoracic assessment?

The nurse assesses a patient with arterial occlusive disease in the lower extremities.Which activity by the nurse is most appropriate?

The nurse assesses the oral mucosa for pathological color changes.Which finding would the nurse see in the patient's mouth, and what does it indicate?

The nurse begins to assess the patient's respiratory system.Which assessment by the nurse best determines the patient's diaphragmatic excursion?

The nurse observes yellow sclerae while assessing the patient's eyes.What does the nurse look for to validate this finding?

The nurse is teaching a nursing student the correct technique for assessing an apical pulse.Which method when used by the student demonstrates adequate knowledge?