NURS 190 | NURS190 Exam 1: Physical Assessment
- WCU Updated and Latest Questions and Correct
Answers with Rationale
1. Which sequence of physical assessment techniques is generally used for most body
systems except the abdomen?
A. Inspection, Palpation, Percussion, Auscultation
B. Palpation, Percussion, Inspection, Auscultation
C. Auscultation, Inspection, Palpation, Percussion
D. Inspection, Auscultation, Palpation, Percussion
Correct Answer: A
Rationale: The standard sequence for physical assessment is essential for a thorough
evaluation. Inspection is always the first step to observe the patient visually for any
obvious abnormalities. Palpation follows to feel for textures, temperature, and tenderness
in the tissues. Percussion provides information about the density and size of underlying
organs. Finally, auscultation is performed to listen to internal body sounds with a
stethoscope.
2. When assessing the abdomen, why is the sequence of techniques modified to Inspection,
Auscultation, Percussion, and Palpation?
A. To ensure the patient is comfortable before touching them.
B. To allow the bowel sounds to settle after being disturbed.
C. To prevent palpation and percussion from altering bowel sounds.
D. To make the physical exam faster for the nurse.
Correct Answer: C
Rationale: Assessment of the abdomen requires a specific order to ensure accurate data
collection. Palpation and percussion can stimulate peristalsis, which may falsely increase
bowel sounds. By auscultating immediately after inspection, the nurse hears the abdomen
in its natural state. This modification is a critical safety measure to avoid diagnostic errors.
Following this protocol ensures that the findings reflect the patient’s true physiological
condition.
3. Which part of the hand is most sensitive for assessing skin temperature?
A. Finger pads
B. Ulnar surface of the hand
C. Palmar surface of the hand
,D. Dorsal surface of the hand
Correct Answer: D
Rationale: The dorsal surface of the hand is the most sensitive area for detecting
temperature changes. This is because the skin on the back of the hand is thinner than on
the palms. When assessing a patient, the nurse should use the dorsum to compare
symmetrical body parts. This technique is particularly useful for identifying localized
inflammation or fever. Using the correct part of the hand ensures the highest accuracy in
tactile assessment.
4. What is the primary purpose of the ‘Review of Systems’ (ROS) during a health history
interview?
A. To perform a complete physical examination.
B. To evaluate the past and present health state of each body system.
C. To document only the objective data found by the nurse.
D. To provide a definitive medical diagnosis for the patient.
Correct Answer: B
Rationale: The Review of Systems is a systematic approach to gathering subjective data
about the patient’s health. It allows the nurse to uncover symptoms that the patient may
have forgotten to mention earlier. This process covers each body system to ensure no
health concerns are overlooked. It focuses entirely on the patient’s reported experiences
rather than physical findings. Successful ROS completion helps in forming a comprehensive
picture of the patient’s overall health status.
5. When using a stethoscope, what is the diaphragm best used for?
A. Low-pitched sounds like heart murmurs
B. Measuring blood pressure in infants
C. Detecting vibrations on the skin surface
D. High-pitched sounds like breath and bowel sounds
Correct Answer: D
Rationale: The diaphragm is the larger, flat side of the stethoscope chest piece. It is
specifically designed to pick up high-pitched sounds within the body. Common examples
include normal heart sounds, breath sounds, and bowel sounds. The nurse should press the
diaphragm firmly against the patient’s skin for the best clarity. Understanding when to use
the diaphragm versus the bell is a foundational nursing skill.
6. A nurse is performing percussion and hears a dull thud-like sound. Where is this sound
most likely being produced?
A. Over normal lung tissue
, B. Over a dense organ like the liver
C. Over an air-filled organ like the stomach
D. Over a bone
Correct Answer: B
Rationale: Dullness is a percussion sound characterized by a muffled thud. This sound
occurs when percussing over relatively dense organs or fluid-filled areas. Common
locations for dullness include the liver or a distended bladder. If dullness is found where air
should be, it may indicate a pathological change like pneumonia. Mastering these sounds
allows the nurse to map out the location and size of internal organs.
7. What type of data is represented by a patient stating, ‘I feel very dizzy when I stand up’?
A. Subjective data
B. Objective data
C. Collaborative data
D. Historical data
Correct Answer: A
Rationale: Subjective data consists of information provided by the patient that cannot be
measured directly. Symptoms such as pain, dizziness, and nausea fall into this category.
The nurse records these statements exactly as the patient describes them, often using
quotation marks. This data is critical for understanding the patient’s personal experience of
their illness. It complements objective data to form a complete clinical assessment.
8. Which percussion sound is expected over a normal, air-filled stomach?
A. Tympany
B. Hyperresonance
C. Resonance
D. Flatness
Correct Answer: A
Rationale: Tympany is a high-pitched, drum-like sound heard during percussion. It is the
characteristic sound found over air-filled structures like the stomach or intestines. This
sound helps the nurse identify the borders of gas-containing viscera. If tympany is absent
in these areas, it might suggest the presence of a mass or fluid. Recognizing tympany is vital
for accurate abdominal and gastrointestinal assessment.
9. What is the first step in the General Survey of a patient?
A. Observing physical appearance and behavior
- WCU Updated and Latest Questions and Correct
Answers with Rationale
1. Which sequence of physical assessment techniques is generally used for most body
systems except the abdomen?
A. Inspection, Palpation, Percussion, Auscultation
B. Palpation, Percussion, Inspection, Auscultation
C. Auscultation, Inspection, Palpation, Percussion
D. Inspection, Auscultation, Palpation, Percussion
Correct Answer: A
Rationale: The standard sequence for physical assessment is essential for a thorough
evaluation. Inspection is always the first step to observe the patient visually for any
obvious abnormalities. Palpation follows to feel for textures, temperature, and tenderness
in the tissues. Percussion provides information about the density and size of underlying
organs. Finally, auscultation is performed to listen to internal body sounds with a
stethoscope.
2. When assessing the abdomen, why is the sequence of techniques modified to Inspection,
Auscultation, Percussion, and Palpation?
A. To ensure the patient is comfortable before touching them.
B. To allow the bowel sounds to settle after being disturbed.
C. To prevent palpation and percussion from altering bowel sounds.
D. To make the physical exam faster for the nurse.
Correct Answer: C
Rationale: Assessment of the abdomen requires a specific order to ensure accurate data
collection. Palpation and percussion can stimulate peristalsis, which may falsely increase
bowel sounds. By auscultating immediately after inspection, the nurse hears the abdomen
in its natural state. This modification is a critical safety measure to avoid diagnostic errors.
Following this protocol ensures that the findings reflect the patient’s true physiological
condition.
3. Which part of the hand is most sensitive for assessing skin temperature?
A. Finger pads
B. Ulnar surface of the hand
C. Palmar surface of the hand
,D. Dorsal surface of the hand
Correct Answer: D
Rationale: The dorsal surface of the hand is the most sensitive area for detecting
temperature changes. This is because the skin on the back of the hand is thinner than on
the palms. When assessing a patient, the nurse should use the dorsum to compare
symmetrical body parts. This technique is particularly useful for identifying localized
inflammation or fever. Using the correct part of the hand ensures the highest accuracy in
tactile assessment.
4. What is the primary purpose of the ‘Review of Systems’ (ROS) during a health history
interview?
A. To perform a complete physical examination.
B. To evaluate the past and present health state of each body system.
C. To document only the objective data found by the nurse.
D. To provide a definitive medical diagnosis for the patient.
Correct Answer: B
Rationale: The Review of Systems is a systematic approach to gathering subjective data
about the patient’s health. It allows the nurse to uncover symptoms that the patient may
have forgotten to mention earlier. This process covers each body system to ensure no
health concerns are overlooked. It focuses entirely on the patient’s reported experiences
rather than physical findings. Successful ROS completion helps in forming a comprehensive
picture of the patient’s overall health status.
5. When using a stethoscope, what is the diaphragm best used for?
A. Low-pitched sounds like heart murmurs
B. Measuring blood pressure in infants
C. Detecting vibrations on the skin surface
D. High-pitched sounds like breath and bowel sounds
Correct Answer: D
Rationale: The diaphragm is the larger, flat side of the stethoscope chest piece. It is
specifically designed to pick up high-pitched sounds within the body. Common examples
include normal heart sounds, breath sounds, and bowel sounds. The nurse should press the
diaphragm firmly against the patient’s skin for the best clarity. Understanding when to use
the diaphragm versus the bell is a foundational nursing skill.
6. A nurse is performing percussion and hears a dull thud-like sound. Where is this sound
most likely being produced?
A. Over normal lung tissue
, B. Over a dense organ like the liver
C. Over an air-filled organ like the stomach
D. Over a bone
Correct Answer: B
Rationale: Dullness is a percussion sound characterized by a muffled thud. This sound
occurs when percussing over relatively dense organs or fluid-filled areas. Common
locations for dullness include the liver or a distended bladder. If dullness is found where air
should be, it may indicate a pathological change like pneumonia. Mastering these sounds
allows the nurse to map out the location and size of internal organs.
7. What type of data is represented by a patient stating, ‘I feel very dizzy when I stand up’?
A. Subjective data
B. Objective data
C. Collaborative data
D. Historical data
Correct Answer: A
Rationale: Subjective data consists of information provided by the patient that cannot be
measured directly. Symptoms such as pain, dizziness, and nausea fall into this category.
The nurse records these statements exactly as the patient describes them, often using
quotation marks. This data is critical for understanding the patient’s personal experience of
their illness. It complements objective data to form a complete clinical assessment.
8. Which percussion sound is expected over a normal, air-filled stomach?
A. Tympany
B. Hyperresonance
C. Resonance
D. Flatness
Correct Answer: A
Rationale: Tympany is a high-pitched, drum-like sound heard during percussion. It is the
characteristic sound found over air-filled structures like the stomach or intestines. This
sound helps the nurse identify the borders of gas-containing viscera. If tympany is absent
in these areas, it might suggest the presence of a mass or fluid. Recognizing tympany is vital
for accurate abdominal and gastrointestinal assessment.
9. What is the first step in the General Survey of a patient?
A. Observing physical appearance and behavior
