NURS 123 EXAM 2025 WITH 100%
QUALITY ANSWERS
The nurse is visiting the patient for the first time this shift. She introduces herself and asks the patient
several questions related to his condition. While doing so, and without being obvious, she is looking at
the color of his eyes and is assessing his ears and nose for discharge and the symmetry of his mouth. The
nurse is using the assessment technique known as:
Auscultation
Percussion
Inspection
Palpation - correct answers ✔✔Inspection
Inspection is the visual examination of body parts or areas. An experienced nurse learns to make
multiple observations, almost simultaneously, while becoming very perceptive of abnormalities.
Palpation uses the sense of touch. Percussion involves tapping the body with the fingertips to evaluate
the size, borders, and consistency of body organs and to discover fluid in body cavities. Auscultation is
listening with a stethoscope to sounds produced by the body.
The nurse is preparing to examine a patient who has chronic lung disease. She realizes that the patient
most likely will need to be in which position for the examination?
Sitting upright (Fowler's)
Side-lying
Prone
Supine - correct answers ✔✔Sitting upright (Fowler's)
Position patient sitting upright. This promotes full lung expansion during examination. Patients with
chronic respiratory disease will likely need to sit up throughout the examination because of shortness of
breath. Only if the patient is unable to tolerate sitting would a supine position or a side-lying position be
used.
,Which technique is most appropriate for a nurse to implement during the assessment of the abdomen?
-Palpating painful areas first
-Palpating painful masses or organ enlargement deeply and firmly
-Auscultating for 5 minutes over each quadrant or until bowel sounds are heard
-Positioning the patient in a supine position with the arms behind or over the head - correct answers
✔✔Auscultating for 5 minutes over each quadrant or until bowel sounds are heard
To auscultate bowel sounds, place the diaphragm of the stethoscope lightly over each of the four
abdominal quadrants. Listen 5 minutes over each quadrant before deciding that bowel sounds are
absent.
Painful areas are assessed last. Manipulation of a body part can increase the patient's pain and anxiety
and make the remainder of assessment difficult to complete. Placing the arms under the head or
keeping the knees fully extended can cause the abdominal muscles to tighten. Tightening of muscles
prevents adequate palpation. If masses are palpated, note size, location, shape, consistency, tenderness,
mobility, and texture. Manipulation of a body part can increase the patient's pain and anxiety and can
make the remainder of assessment difficult to complete.
Which patient position maximizes the nurse's ability to assess the patient's body for symmetry?
Supine in bed
Sitting on the side of the bed
Prone in bed
Dorsal recumbent - correct answers ✔✔Sitting on the side of the bed
Sitting upright provides full expansion of lungs and allows better visualization of symmetry of upper body
parts.
The supine position maximizes the nurse's ability to assess pulse sites. The prone position is used only to
assess extension of the hip joint. The dorsal recumbent position is used for abdominal assessment
because it promotes relaxation of abdominal muscles
The purpose of the physical assessment is to:
, -Teach patients about better health promotion
-Help select the best nursing measures
-Compare the patient's status with previous findings
-Help the nurse gather additional data - correct answers ✔✔Compare the patient's status with previous
findings
In acute care settings, you perform a brief physical assessment at the beginning of each shift to identify
changes in the patient's status for comparison with the previous assessment. After gathering data, the
nurse groups significant findings into patterns of data that reveal actual or risk nursing diagnoses. Each
abnormal finding directs the nurse to gather additional data. The information is useful in selecting the
best nursing measures to manage the patient's health problems. During the physical assessment is an
ideal time to offer patient teaching and encourage promotion of health practices, such as breast (Box 6-
1) and genital (Box 6-2) self-examination.
When performing an assessment of the cardiovascular system, the nurse evaluates the skin and nails of
the patient. Inadequate tissue perfusion is known as
edema
infiltration
ischemia
infarction - correct answers ✔✔ischemia
Inadequate tissue perfusion results in inadequate delivery of oxygen and nutrients to cells, a condition
called ischemia. This is caused by constriction of vessels or by occlusion (blockage) from clot formation.
An increased amount of deoxygenated hemoglobin may cause a change in skin color known as
cyanosis
Homan's sign
Raynaud's phenomenon
infarction - correct answers ✔✔cyanosis
QUALITY ANSWERS
The nurse is visiting the patient for the first time this shift. She introduces herself and asks the patient
several questions related to his condition. While doing so, and without being obvious, she is looking at
the color of his eyes and is assessing his ears and nose for discharge and the symmetry of his mouth. The
nurse is using the assessment technique known as:
Auscultation
Percussion
Inspection
Palpation - correct answers ✔✔Inspection
Inspection is the visual examination of body parts or areas. An experienced nurse learns to make
multiple observations, almost simultaneously, while becoming very perceptive of abnormalities.
Palpation uses the sense of touch. Percussion involves tapping the body with the fingertips to evaluate
the size, borders, and consistency of body organs and to discover fluid in body cavities. Auscultation is
listening with a stethoscope to sounds produced by the body.
The nurse is preparing to examine a patient who has chronic lung disease. She realizes that the patient
most likely will need to be in which position for the examination?
Sitting upright (Fowler's)
Side-lying
Prone
Supine - correct answers ✔✔Sitting upright (Fowler's)
Position patient sitting upright. This promotes full lung expansion during examination. Patients with
chronic respiratory disease will likely need to sit up throughout the examination because of shortness of
breath. Only if the patient is unable to tolerate sitting would a supine position or a side-lying position be
used.
,Which technique is most appropriate for a nurse to implement during the assessment of the abdomen?
-Palpating painful areas first
-Palpating painful masses or organ enlargement deeply and firmly
-Auscultating for 5 minutes over each quadrant or until bowel sounds are heard
-Positioning the patient in a supine position with the arms behind or over the head - correct answers
✔✔Auscultating for 5 minutes over each quadrant or until bowel sounds are heard
To auscultate bowel sounds, place the diaphragm of the stethoscope lightly over each of the four
abdominal quadrants. Listen 5 minutes over each quadrant before deciding that bowel sounds are
absent.
Painful areas are assessed last. Manipulation of a body part can increase the patient's pain and anxiety
and make the remainder of assessment difficult to complete. Placing the arms under the head or
keeping the knees fully extended can cause the abdominal muscles to tighten. Tightening of muscles
prevents adequate palpation. If masses are palpated, note size, location, shape, consistency, tenderness,
mobility, and texture. Manipulation of a body part can increase the patient's pain and anxiety and can
make the remainder of assessment difficult to complete.
Which patient position maximizes the nurse's ability to assess the patient's body for symmetry?
Supine in bed
Sitting on the side of the bed
Prone in bed
Dorsal recumbent - correct answers ✔✔Sitting on the side of the bed
Sitting upright provides full expansion of lungs and allows better visualization of symmetry of upper body
parts.
The supine position maximizes the nurse's ability to assess pulse sites. The prone position is used only to
assess extension of the hip joint. The dorsal recumbent position is used for abdominal assessment
because it promotes relaxation of abdominal muscles
The purpose of the physical assessment is to:
, -Teach patients about better health promotion
-Help select the best nursing measures
-Compare the patient's status with previous findings
-Help the nurse gather additional data - correct answers ✔✔Compare the patient's status with previous
findings
In acute care settings, you perform a brief physical assessment at the beginning of each shift to identify
changes in the patient's status for comparison with the previous assessment. After gathering data, the
nurse groups significant findings into patterns of data that reveal actual or risk nursing diagnoses. Each
abnormal finding directs the nurse to gather additional data. The information is useful in selecting the
best nursing measures to manage the patient's health problems. During the physical assessment is an
ideal time to offer patient teaching and encourage promotion of health practices, such as breast (Box 6-
1) and genital (Box 6-2) self-examination.
When performing an assessment of the cardiovascular system, the nurse evaluates the skin and nails of
the patient. Inadequate tissue perfusion is known as
edema
infiltration
ischemia
infarction - correct answers ✔✔ischemia
Inadequate tissue perfusion results in inadequate delivery of oxygen and nutrients to cells, a condition
called ischemia. This is caused by constriction of vessels or by occlusion (blockage) from clot formation.
An increased amount of deoxygenated hemoglobin may cause a change in skin color known as
cyanosis
Homan's sign
Raynaud's phenomenon
infarction - correct answers ✔✔cyanosis
