NR302 – Health Assessment Final Comprehensive
Exam
Chamberlain College of Nursing – Latest 2025 Version
100 NCLEX-style items with full rationales
Question 1
During a comprehensive health history, a 68-year-old client states, “I can’t walk as far as I used
to.” Which response by the nurse is most appropriate to obtain additional data?
A. “Tell me more about what happens when you walk.”
B. “Do you have heart disease?”
C. “How long have you been lazy?”
D. “You should exercise more.”
Correct Answer: A
Rationale: Open-ended prompts elicit description of onset, character, and associated symptoms.
Option B leads the client, option C is judgmental, and option D gives advice before assessment is
complete.
Question 2
A client’s radial pulse is irregularly irregular at 88 bpm. Which action is most appropriate?
A. Auscultate an apical pulse for 30 seconds.
B. Count the radial pulse for 60 seconds.
C. Check a pulse oximeter reading.
D. Palpate the carotid pulse bilaterally.
Correct Answer: B
Rationale: Irregular rhythms require a full 60-second count to detect frequency and pattern;
radial is acceptable if palpable. Apical (A) is ideal but not mandatory for rate alone; oximeter (C)
may miscount with poor perfusion; bilateral carotid palpation (D) can cause bradycardia.
Question 3
When assessing skin turgor on an older adult, which site provides the most reliable data?
A. Dorsal hand
,B. Sternum
C. Forearm
D. Dorsal foot
Correct Answer: C
Rationale: Age-related loss of subcutaneous fat makes the sternum and hand unreliable; the
forearm over the distal radius maintains elasticity longest. Foot skin is thickened and less
responsive.
Question 4
A college student reports “constant fatigue.” Which question best explores the psychological
dimension?
A. “How many hours do you sleep?”
B. “What is your course load?”
C. “Have you felt sad or hopeless recently?”
D. “Do you drink energy drinks?”
Correct Answer: C
Rationale: Fatigue can mask depression; directly screening mood is priority per USPSTF. Options
A, B, and D explore physical and lifestyle causes but not psychological.
Question 5
Which technique is correct when assessing the thyroid gland?
A. Stand behind the client and palpate with the thumb.
B. Ask the client to swallow while palpating the lobes.
C. Palpate the trachea first, then move laterally 4 cm.
D. Auscultate before palpation to detect bruits.
Correct Answer: B
Rationale: Swallowing elevates the thyroid for better lobe palpation. Thumb palpation (A)
obscures texture; tracheal deviation (C) is assessed separately; auscultation (D) occurs after
palpation if nodules are felt.
Question 6
A client’s BP is 148/92 mmHg on two separate occasions. Which classification is accurate?
,A. Normal
B. Elevated
C. Stage 1 HTN
D. Stage 2 HTN
Correct Answer: C
Rationale: ACC/AHA 2025: SBP 130–139 or DBP 80–89 = Stage 1; 140/90 = Stage 1 (same);
≥140/90 is Stage 1; 148/92 meets Stage 1. (Stage 2 ≥140/90 but 148/92 is Stage 1 upper;
guidelines confirm Stage 1).
Question 7
A 4-year-old refuses to open mouth for oral assessment. Which strategy is best?
A. Use a tongue blade immediately.
B. Allow child to hold a toy stethoscope.
C. Perform assessment while parent restrains.
D. Skip oral exam and return later.
Correct Answer: B
Rationale: Offering control (toy) reduces fear and increases cooperation. Forced restraint (A, C)
escalates anxiety; delaying (D) misses urgent findings.
Question 8
A client’s oxygen saturation reads 86 % on room air but improves to 98 % when the probe is
moved to the earlobe. Which conclusion is correct?
A. Earlobe is less accurate.
B. Finger was cold or nail polish present.
C. Sensor is malfunctioning.
D. Client has ear disease.
Correct Answer: B
Rationale: Peripheral vasoconstriction or pigment falsely lowers readings; earlobe is reliable
alternative. Malfunction (C) is possible but less likely than artifact.
Question 9
During a mental-status exam, a client scores 22/30 on the MoCA. Which action is priority?
, A. Reassure client that score is normal.
B. Document and inform provider.
C. Repeat test in 1 week.
D. Ask family to complete questionnaire.
Correct Answer: B
Rationale: MoCA < 26 suggests cognitive impairment; further evaluation is required.
Reassurance (A) is inappropriate; immediate repeat (C) is not evidence-based.
Question 10
Which cranial nerve is assessed by asking the client to smile?
A. III
B. V
C. VII
D. XII
Correct Answer: C
Rationale: Facial nerve (CN VII) innervates muscles of expression.
Question 11
A client’s lungs have scattered expiratory wheezes. Which documentation is most appropriate?
A. “Crackles heard bilaterally.”
B. “Musical, high-pitched sounds during expiration.”
C. “Pleural friction rub noted.”
D. “Bronchial breath sounds.”
Correct Answer: B
Rationale: Objective, vivid description aids communication; avoids ambiguous terms like
“musical” alone but acceptable with pitch/phase.
Question 12
An older adult’s BP is 160/90 supine and 130/80 standing. Which term applies?
A. Orthostatic hypotension
B. Normal aging change
Exam
Chamberlain College of Nursing – Latest 2025 Version
100 NCLEX-style items with full rationales
Question 1
During a comprehensive health history, a 68-year-old client states, “I can’t walk as far as I used
to.” Which response by the nurse is most appropriate to obtain additional data?
A. “Tell me more about what happens when you walk.”
B. “Do you have heart disease?”
C. “How long have you been lazy?”
D. “You should exercise more.”
Correct Answer: A
Rationale: Open-ended prompts elicit description of onset, character, and associated symptoms.
Option B leads the client, option C is judgmental, and option D gives advice before assessment is
complete.
Question 2
A client’s radial pulse is irregularly irregular at 88 bpm. Which action is most appropriate?
A. Auscultate an apical pulse for 30 seconds.
B. Count the radial pulse for 60 seconds.
C. Check a pulse oximeter reading.
D. Palpate the carotid pulse bilaterally.
Correct Answer: B
Rationale: Irregular rhythms require a full 60-second count to detect frequency and pattern;
radial is acceptable if palpable. Apical (A) is ideal but not mandatory for rate alone; oximeter (C)
may miscount with poor perfusion; bilateral carotid palpation (D) can cause bradycardia.
Question 3
When assessing skin turgor on an older adult, which site provides the most reliable data?
A. Dorsal hand
,B. Sternum
C. Forearm
D. Dorsal foot
Correct Answer: C
Rationale: Age-related loss of subcutaneous fat makes the sternum and hand unreliable; the
forearm over the distal radius maintains elasticity longest. Foot skin is thickened and less
responsive.
Question 4
A college student reports “constant fatigue.” Which question best explores the psychological
dimension?
A. “How many hours do you sleep?”
B. “What is your course load?”
C. “Have you felt sad or hopeless recently?”
D. “Do you drink energy drinks?”
Correct Answer: C
Rationale: Fatigue can mask depression; directly screening mood is priority per USPSTF. Options
A, B, and D explore physical and lifestyle causes but not psychological.
Question 5
Which technique is correct when assessing the thyroid gland?
A. Stand behind the client and palpate with the thumb.
B. Ask the client to swallow while palpating the lobes.
C. Palpate the trachea first, then move laterally 4 cm.
D. Auscultate before palpation to detect bruits.
Correct Answer: B
Rationale: Swallowing elevates the thyroid for better lobe palpation. Thumb palpation (A)
obscures texture; tracheal deviation (C) is assessed separately; auscultation (D) occurs after
palpation if nodules are felt.
Question 6
A client’s BP is 148/92 mmHg on two separate occasions. Which classification is accurate?
,A. Normal
B. Elevated
C. Stage 1 HTN
D. Stage 2 HTN
Correct Answer: C
Rationale: ACC/AHA 2025: SBP 130–139 or DBP 80–89 = Stage 1; 140/90 = Stage 1 (same);
≥140/90 is Stage 1; 148/92 meets Stage 1. (Stage 2 ≥140/90 but 148/92 is Stage 1 upper;
guidelines confirm Stage 1).
Question 7
A 4-year-old refuses to open mouth for oral assessment. Which strategy is best?
A. Use a tongue blade immediately.
B. Allow child to hold a toy stethoscope.
C. Perform assessment while parent restrains.
D. Skip oral exam and return later.
Correct Answer: B
Rationale: Offering control (toy) reduces fear and increases cooperation. Forced restraint (A, C)
escalates anxiety; delaying (D) misses urgent findings.
Question 8
A client’s oxygen saturation reads 86 % on room air but improves to 98 % when the probe is
moved to the earlobe. Which conclusion is correct?
A. Earlobe is less accurate.
B. Finger was cold or nail polish present.
C. Sensor is malfunctioning.
D. Client has ear disease.
Correct Answer: B
Rationale: Peripheral vasoconstriction or pigment falsely lowers readings; earlobe is reliable
alternative. Malfunction (C) is possible but less likely than artifact.
Question 9
During a mental-status exam, a client scores 22/30 on the MoCA. Which action is priority?
, A. Reassure client that score is normal.
B. Document and inform provider.
C. Repeat test in 1 week.
D. Ask family to complete questionnaire.
Correct Answer: B
Rationale: MoCA < 26 suggests cognitive impairment; further evaluation is required.
Reassurance (A) is inappropriate; immediate repeat (C) is not evidence-based.
Question 10
Which cranial nerve is assessed by asking the client to smile?
A. III
B. V
C. VII
D. XII
Correct Answer: C
Rationale: Facial nerve (CN VII) innervates muscles of expression.
Question 11
A client’s lungs have scattered expiratory wheezes. Which documentation is most appropriate?
A. “Crackles heard bilaterally.”
B. “Musical, high-pitched sounds during expiration.”
C. “Pleural friction rub noted.”
D. “Bronchial breath sounds.”
Correct Answer: B
Rationale: Objective, vivid description aids communication; avoids ambiguous terms like
“musical” alone but acceptable with pitch/phase.
Question 12
An older adult’s BP is 160/90 supine and 130/80 standing. Which term applies?
A. Orthostatic hypotension
B. Normal aging change
