NUR 216 – Health Assessment Exam 2 Set 1 Actual Exam –
Assessment Techniques, Pain, Nutrition, Integumentary,
Head/Neck, Respiratory & Cardiovascular | Complete Q&A &
Detailed Rationales | Pass Guaranteed - A+ Graded
Section 1: Assessment Techniques & General Survey (Ch. 8-9)
Q1: When performing a complete physical examination, which sequence should the
nurse follow for each body system?
A. Auscultation, percussion, palpation, inspection
B. Inspection, palpation, percussion, auscultation [CORRECT]
C. Palpation, inspection, auscultation, percussion
D. Percussion, auscultation, inspection, palpation
Correct Answer: B
Rationale: The best answer is B. In health assessment, we always inspect first to
observe for abnormalities before touching the patient, then palpate, percuss, and
auscultate last — particularly for the abdomen, where palpation before auscultation can
alter bowel sounds.
Q2: A nurse is preparing to examine a patient who has a history of tuberculosis. Which
action best demonstrates standard precautions during the physical exam?
,A. Wearing an N95 respirator for all patient contact
B. Performing hand hygiene before and after the exam and using gloves when contact
with body fluids is anticipated [CORRECT]
C. Placing the patient in a negative pressure room before the exam
D. Wearing a gown and face shield for the entire general survey
Correct Answer: B
Rationale: The best answer is B. Standard precautions apply to all patients and include
hand hygiene and appropriate PPE based on anticipated exposure; airborne precautions
like N95s and negative pressure rooms are only needed for suspected or confirmed
airborne diseases, not for every interaction.
Q3: When using a stethoscope to auscultate high-pitched sounds such as breath
sounds or normal heart sounds, which part of the stethoscope should the nurse use?
A. The bell with light pressure
B. The diaphragm with firm pressure [CORRECT]
C. The bell with firm pressure
D. The diaphragm with light pressure
Correct Answer: B
Rationale: The best answer is B. The diaphragm is designed for high-pitched sounds like
normal breath sounds, bowel sounds, and S1 and S2 heart sounds, and it works best
when pressed firmly against the skin.
, Q4: During the general survey, the nurse notices a patient has slurred speech, an
unsteady gait, and is wearing clothing inappropriate for the weather. These findings
suggest the nurse should prioritize assessment for:
A. Chronic depression
B. Acute neurological impairment or substance use [CORRECT]
C. Chronic obstructive pulmonary disease
D. Rheumatoid arthritis
Correct Answer: B
Rationale: The best answer is B. Slurred speech and unsteady gait are red flags for
acute neurological changes, stroke, or intoxication, and inappropriate clothing can
signal confusion or altered mental status — all of which require immediate further
assessment.
Q5: A patient in the emergency department has an oral temperature of 100.4°F. The
nurse documents this as:
A. Normal body temperature
B. Low-grade fever [CORRECT]
C. High-grade fever
D. Hyperpyrexia
Correct Answer: B
Assessment Techniques, Pain, Nutrition, Integumentary,
Head/Neck, Respiratory & Cardiovascular | Complete Q&A &
Detailed Rationales | Pass Guaranteed - A+ Graded
Section 1: Assessment Techniques & General Survey (Ch. 8-9)
Q1: When performing a complete physical examination, which sequence should the
nurse follow for each body system?
A. Auscultation, percussion, palpation, inspection
B. Inspection, palpation, percussion, auscultation [CORRECT]
C. Palpation, inspection, auscultation, percussion
D. Percussion, auscultation, inspection, palpation
Correct Answer: B
Rationale: The best answer is B. In health assessment, we always inspect first to
observe for abnormalities before touching the patient, then palpate, percuss, and
auscultate last — particularly for the abdomen, where palpation before auscultation can
alter bowel sounds.
Q2: A nurse is preparing to examine a patient who has a history of tuberculosis. Which
action best demonstrates standard precautions during the physical exam?
,A. Wearing an N95 respirator for all patient contact
B. Performing hand hygiene before and after the exam and using gloves when contact
with body fluids is anticipated [CORRECT]
C. Placing the patient in a negative pressure room before the exam
D. Wearing a gown and face shield for the entire general survey
Correct Answer: B
Rationale: The best answer is B. Standard precautions apply to all patients and include
hand hygiene and appropriate PPE based on anticipated exposure; airborne precautions
like N95s and negative pressure rooms are only needed for suspected or confirmed
airborne diseases, not for every interaction.
Q3: When using a stethoscope to auscultate high-pitched sounds such as breath
sounds or normal heart sounds, which part of the stethoscope should the nurse use?
A. The bell with light pressure
B. The diaphragm with firm pressure [CORRECT]
C. The bell with firm pressure
D. The diaphragm with light pressure
Correct Answer: B
Rationale: The best answer is B. The diaphragm is designed for high-pitched sounds like
normal breath sounds, bowel sounds, and S1 and S2 heart sounds, and it works best
when pressed firmly against the skin.
, Q4: During the general survey, the nurse notices a patient has slurred speech, an
unsteady gait, and is wearing clothing inappropriate for the weather. These findings
suggest the nurse should prioritize assessment for:
A. Chronic depression
B. Acute neurological impairment or substance use [CORRECT]
C. Chronic obstructive pulmonary disease
D. Rheumatoid arthritis
Correct Answer: B
Rationale: The best answer is B. Slurred speech and unsteady gait are red flags for
acute neurological changes, stroke, or intoxication, and inappropriate clothing can
signal confusion or altered mental status — all of which require immediate further
assessment.
Q5: A patient in the emergency department has an oral temperature of 100.4°F. The
nurse documents this as:
A. Normal body temperature
B. Low-grade fever [CORRECT]
C. High-grade fever
D. Hyperpyrexia
Correct Answer: B
