D222 NURS 3640
Comprehensive Health Assessment
Final Assessment Prep
2026
(With Solutions)
A 65-year-old patient presents with painless jaundice and weight loss. Which
assessment finding is most indicative of pancreatic cancer during health
assessment? A) Palpable gallbladder (Courvoisier’s sign) B) Tenderness in the right
upper quadrant C) Elevated bowel sounds D) Bradycardia
Answer: A) Palpable gallbladder (Courvoisier’s sign)
Rationale: A palpable, non-tender gallbladder with jaundice often suggests
obstruction of the bile duct by a tumor in the pancreas, which is a classic sign.
2. During a cardiovascular assessment, a nurse hears a “whooshing” sound over the
carotid artery. This finding most likely indicates:
A) Normal blood flow
B) Carotid artery bruit due to stenosis
C) Pericardial friction rub
D) Mitral valve prolapse
Answer: B) Carotid artery bruit due to stenosis
Rationale: A bruit indicates turbulent blood flow commonly due to partial arterial
blockage or narrowing.
3. When performing an abdominal assessment on a patient with suspected bowel
obstruction, which finding should the nurse expect?
A) Hyperactive bowel sounds early on, hypoactive later
B) Absence of bowel sounds throughout
C) Normal bowel sounds throughout
D) High-pitched bowel sounds throughout
Answer: A) Hyperactive bowel sounds early on, hypoactive later
Rationale: Early obstruction causes increased motility and hyperactive sounds; as
obstruction worsens, sounds diminish.
,4. Which cranial nerve is assessed by asking the patient to smile and puff out their
cheeks?
A) CN V (Trigeminal)
B) CN VII (Facial)
C) CN IX (Glossopharyngeal)
D) CN XI (Accessory)
Answer: B) CN VII (Facial)
Rationale: CN VII controls facial expressions including smiling and cheek puffing.
5. A nurse performing a mental status examination uses the Mini-Mental State
Examination (MMSE). What cognitive domain does the MMSE primarily assess?
A) Executive functioning
B) Orientation, attention, memory, language, and visuospatial skills
C) Motor coordination
D) Emotional intelligence
Answer: B) Orientation, attention, memory, language, and visuospatial skills
Rationale: The MMSE broadly screens cognition across these domains.
True/False
Percussion over a healthy lung produces a dull sound.
Answer: False
Rationale: Healthy lung tissue is air-filled and produces a resonant sound on
percussion; dullness suggests consolidation or fluid.
The presence of a S3 heart sound in an adult over 40 years old is always normal.
Answer: False
Rationale: S3 may be normal in children or pregnant women but often indicates
heart failure in adults over 40.
During neurological examination, testing rapid alternating movements assesses
cerebellar function.
Answer: True
Rationale: Rapid alternating movements test coordination and cerebellar
integrity.
The absence of deep tendon reflexes can indicate a peripheral neuropathy.
Answer: True
Rationale: Diminished or absent reflexes often arise from peripheral nerve or
lower motor neuron lesions.
Assessing skin turgor is a reliable method to evaluate hydration status in elderly
,patients.
Answer: False
Rationale: Aging skin loses elasticity, making turgor less reliable; alternative
assessments are preferred.
Short Answer
Describe how to assess jugular venous pressure (JVP) and the clinical significance
of an elevated JVP.
Answer:
Position the patient at 30-45 degrees, turn their head slightly away, and observe
the jugular vein pulsations. The vertical height of pulsations above the sternal
angle is measured in centimeters. An elevated JVP indicates right-sided heart
failure or increased central venous pressure.
Rationale: JVP reflects right atrial pressure and is a non-invasive way to assess
fluid overload and cardiac function.
What are the key differences between arterial and venous ulcers on physical
assessment?
Answer:
Arterial ulcers are typically painful, located on toes or pressure points, with well-
defined edges and pale wound beds. Venous ulcers are less painful, found around
the medial malleolus, with irregular edges and heavy exudate.
Rationale: Understanding these differences guides wound care and management.
What auscultation findings would you expect in a patient with mitral valve
stenosis?
Answer:
A low-pitched, diastolic murmur best heard at the apex with the bell of the
stethoscope, often with an opening snap following S2.
Rationale: Stenotic mitral valve impedes flow during diastole, creating
characteristic sounds.
Explain the significance of a positive Murphy's sign.
Answer:
Pain and inspiratory arrest upon palpation of the right upper quadrant during deep
inspiration indicate gallbladder inflammation or cholecystitis.
Rationale: Murphy’s sign is a specific clinical sign for gallbladder disease.
What components of the neurological exam assess cranial nerve function?
Answer:
Assessment includes pupillary response (CN II, III), facial muscle movement (CN
VII), hearing (CN VIII), gag reflex (CN IX, X), shoulder shrug (CN XI), and tongue
movement (CN XII).
, Rationale: Each cranial nerve controls specific motor or sensory functions.
Fill in the Blank
The __________ pulse is commonly palpated to assess peripheral circulation in the
foot.
Answer: dorsalis pedis
Rationale: The dorsalis pedis artery is accessible on the foot’s dorsum for
peripheral pulse checks.
The main technique used to assess lung consolidation is __________.
Answer: percussion
Rationale: Percussion reveals changes from resonant to dull sound indicating
consolidation.
The heart sound that corresponds to the closure of the aortic and pulmonic valves
is called __________.
Answer: S2
Rationale: S2 marks the end of systole caused by semilunar valve closure.
A common sign of meningeal irritation during neurological exam is a positive
__________ sign.
Answer: Kernig’s or Brudzinski’s
Rationale: Both indicate meningeal inflammation or irritation.
Capillary refill time greater than __________ seconds suggests impaired peripheral
perfusion.
Answer: 2
Rationale: Normal refill is under 2 seconds; prolonged refill could indicate
circulatory compromise.
Multiple Choice Continued
21. A patient reports numbness and tingling in both feet with diminished ankle
reflexes. Which condition does this most likely indicate?
A) Central stroke
B) Peripheral neuropathy
C) Multiple sclerosis
D) Guillain-Barré syndrome
Answer: B) Peripheral neuropathy
Rationale: Symmetric distal sensory changes and reflex loss are classic for
peripheral neuropathy.
22. On inspection, a bulging of the anterior fontanelle in an infant suggests:
Comprehensive Health Assessment
Final Assessment Prep
2026
(With Solutions)
A 65-year-old patient presents with painless jaundice and weight loss. Which
assessment finding is most indicative of pancreatic cancer during health
assessment? A) Palpable gallbladder (Courvoisier’s sign) B) Tenderness in the right
upper quadrant C) Elevated bowel sounds D) Bradycardia
Answer: A) Palpable gallbladder (Courvoisier’s sign)
Rationale: A palpable, non-tender gallbladder with jaundice often suggests
obstruction of the bile duct by a tumor in the pancreas, which is a classic sign.
2. During a cardiovascular assessment, a nurse hears a “whooshing” sound over the
carotid artery. This finding most likely indicates:
A) Normal blood flow
B) Carotid artery bruit due to stenosis
C) Pericardial friction rub
D) Mitral valve prolapse
Answer: B) Carotid artery bruit due to stenosis
Rationale: A bruit indicates turbulent blood flow commonly due to partial arterial
blockage or narrowing.
3. When performing an abdominal assessment on a patient with suspected bowel
obstruction, which finding should the nurse expect?
A) Hyperactive bowel sounds early on, hypoactive later
B) Absence of bowel sounds throughout
C) Normal bowel sounds throughout
D) High-pitched bowel sounds throughout
Answer: A) Hyperactive bowel sounds early on, hypoactive later
Rationale: Early obstruction causes increased motility and hyperactive sounds; as
obstruction worsens, sounds diminish.
,4. Which cranial nerve is assessed by asking the patient to smile and puff out their
cheeks?
A) CN V (Trigeminal)
B) CN VII (Facial)
C) CN IX (Glossopharyngeal)
D) CN XI (Accessory)
Answer: B) CN VII (Facial)
Rationale: CN VII controls facial expressions including smiling and cheek puffing.
5. A nurse performing a mental status examination uses the Mini-Mental State
Examination (MMSE). What cognitive domain does the MMSE primarily assess?
A) Executive functioning
B) Orientation, attention, memory, language, and visuospatial skills
C) Motor coordination
D) Emotional intelligence
Answer: B) Orientation, attention, memory, language, and visuospatial skills
Rationale: The MMSE broadly screens cognition across these domains.
True/False
Percussion over a healthy lung produces a dull sound.
Answer: False
Rationale: Healthy lung tissue is air-filled and produces a resonant sound on
percussion; dullness suggests consolidation or fluid.
The presence of a S3 heart sound in an adult over 40 years old is always normal.
Answer: False
Rationale: S3 may be normal in children or pregnant women but often indicates
heart failure in adults over 40.
During neurological examination, testing rapid alternating movements assesses
cerebellar function.
Answer: True
Rationale: Rapid alternating movements test coordination and cerebellar
integrity.
The absence of deep tendon reflexes can indicate a peripheral neuropathy.
Answer: True
Rationale: Diminished or absent reflexes often arise from peripheral nerve or
lower motor neuron lesions.
Assessing skin turgor is a reliable method to evaluate hydration status in elderly
,patients.
Answer: False
Rationale: Aging skin loses elasticity, making turgor less reliable; alternative
assessments are preferred.
Short Answer
Describe how to assess jugular venous pressure (JVP) and the clinical significance
of an elevated JVP.
Answer:
Position the patient at 30-45 degrees, turn their head slightly away, and observe
the jugular vein pulsations. The vertical height of pulsations above the sternal
angle is measured in centimeters. An elevated JVP indicates right-sided heart
failure or increased central venous pressure.
Rationale: JVP reflects right atrial pressure and is a non-invasive way to assess
fluid overload and cardiac function.
What are the key differences between arterial and venous ulcers on physical
assessment?
Answer:
Arterial ulcers are typically painful, located on toes or pressure points, with well-
defined edges and pale wound beds. Venous ulcers are less painful, found around
the medial malleolus, with irregular edges and heavy exudate.
Rationale: Understanding these differences guides wound care and management.
What auscultation findings would you expect in a patient with mitral valve
stenosis?
Answer:
A low-pitched, diastolic murmur best heard at the apex with the bell of the
stethoscope, often with an opening snap following S2.
Rationale: Stenotic mitral valve impedes flow during diastole, creating
characteristic sounds.
Explain the significance of a positive Murphy's sign.
Answer:
Pain and inspiratory arrest upon palpation of the right upper quadrant during deep
inspiration indicate gallbladder inflammation or cholecystitis.
Rationale: Murphy’s sign is a specific clinical sign for gallbladder disease.
What components of the neurological exam assess cranial nerve function?
Answer:
Assessment includes pupillary response (CN II, III), facial muscle movement (CN
VII), hearing (CN VIII), gag reflex (CN IX, X), shoulder shrug (CN XI), and tongue
movement (CN XII).
, Rationale: Each cranial nerve controls specific motor or sensory functions.
Fill in the Blank
The __________ pulse is commonly palpated to assess peripheral circulation in the
foot.
Answer: dorsalis pedis
Rationale: The dorsalis pedis artery is accessible on the foot’s dorsum for
peripheral pulse checks.
The main technique used to assess lung consolidation is __________.
Answer: percussion
Rationale: Percussion reveals changes from resonant to dull sound indicating
consolidation.
The heart sound that corresponds to the closure of the aortic and pulmonic valves
is called __________.
Answer: S2
Rationale: S2 marks the end of systole caused by semilunar valve closure.
A common sign of meningeal irritation during neurological exam is a positive
__________ sign.
Answer: Kernig’s or Brudzinski’s
Rationale: Both indicate meningeal inflammation or irritation.
Capillary refill time greater than __________ seconds suggests impaired peripheral
perfusion.
Answer: 2
Rationale: Normal refill is under 2 seconds; prolonged refill could indicate
circulatory compromise.
Multiple Choice Continued
21. A patient reports numbness and tingling in both feet with diminished ankle
reflexes. Which condition does this most likely indicate?
A) Central stroke
B) Peripheral neuropathy
C) Multiple sclerosis
D) Guillain-Barré syndrome
Answer: B) Peripheral neuropathy
Rationale: Symmetric distal sensory changes and reflex loss are classic for
peripheral neuropathy.
22. On inspection, a bulging of the anterior fontanelle in an infant suggests:
