HESI REVIEW PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 2023 QUESTIONS WITH VERIFIED ANSWERS

HESI REVIEW PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 2023 MULTIPLE CHOICE 1. A nurse is a preceptor for a nurse who just graduated from nursing school. When caring for a patient, the new graduate nurse begins to explain to the patient the purpose of completing a physical assessment. Which of the following statements made by the new graduate nurse requires the preceptor to intervene? a) I will use the information from my assessment to figure out if your antihypertensive medication is working effectively. b) Nursing assessment data are used only to provide information about the effectiveness of your medical care. c) Nurses use data from their patient’s physical assessment to determine a patient’s educational needs. d) Information gained from physical assessment helps nurses better understand their patient’s emotional needs. ANS: B Nursing assessment data are used to evaluate the effectiveness of all aspects of a patient’s care, not just the patient’s medical care. Assessment data help to evaluate the effectiveness of medications and to determine a patient’s health care needs, including the need for patient education. Nurses also use assessment data to identify patients psychosocial and cultural needs. 2. Having misplaced his stethoscope, a nurse borrows a colleague’s stethoscope. He next enters the patient’s room and identifies himself, washes his hands with soap, and states the purpose of his visit. He performs proper identification of the patient before he auscultates her lungs. Which critical health assessment step was not performed? a) Running warm water over stethoscope for patient comfort b) Cleaning stethoscope with Betadine c) Using alcohol-based hand disinfectant d) Cleaning stethoscope with alcohol ANS: D Bacteria and viruses can be transferred from patient to patient when a stethoscope that is not clean is used. The stethoscope should be cleaned before use on each patient. Running water over the stethoscope does not kill bacteria. Betadine is an inappropriate cleaning solution and may damage the equipment. Hand sanitizer is not an approved cleaning product. 3. Which is the best examination position for a complete geriatric physical examination on a weak patient with bilateral basilar pneumonia? a) Prone position b) Sim’s position c) Supine position d) Lateral recumbent ANS: C This is the most normally relaxed position. It will not compromise the patients breathing because it is likely compromised with pneumonia. If the patient becomes short of breath easily, raise the head of the bed. This position would be easiest for an elderly weak person to get into position for an examination. Lateral recumbent and prone positions cause respiratory difficulty for any patient with respiratory difficulties. Sims position is used for assessment of the rectum and the vagina. 4. During an annual gynecological examination, a college student discusses her upcoming college break at a tropical location. After the student receives an oral contraceptive prescription, the nurse identifies the importance of skin cancer prevention education by discussing which evidence-based prevention health topic? a) Applying water-based sunscreen only before swimming b) Using tanning bed daily for 7 days before college break trip c) Applying broad-spectrum sunscreen of SPF 5 d) Taking extra precautions in the sun secondary to the prescription ANS: D Oral contraceptives can make the skin more sensitive to the sun. For this reason, the patient should be educated about the need for sun protection such as wide-brimmed hats, use of broad-spectrum sunscreen of SPF 15 or greater, not tanning during midday, and not using tanning beds. Broad-spectrum sunscreens should be applied 15 minutes before going into the sun and after swimming or perspiring. Tanning parlors, sunlamps, etc., should be avoided. Sunscreens with SPF of 15 or greater should be used. 5. A head and neck physical examination is completed on a 50-year-old female patient. All physical findings are normal except for fine brittle hair. Based on the physical findings, which of the following laboratory tests would the nurse expect to be ordered? a) Liver function test b) Lead level c) Thyroid-stimulating hormone test d) Complete blood count ANS: C Thyroid disease can make hair thin and brittle. Liver function testing is indicated for a patient who has jaundice. Lead levels and a CBC are not indicated for the presence of brittle hair. 6. A febrile preschool-aged child presents to the after-hours clinic. Varicella is diagnosed on the basis of the illness history and the presence of small, circumscribed skin lesions filled with serous fluid. The nurse documents the varicellar lesions as which type of skin lesion? a) Vesicle b) Wheal c) Papule d) Pustule ANS: A Vesicles are circumscribed, elevated skin lesions filled with serous fluid that measure less than 1 cm. Wheals are irregularly shaped, elevated areas of superficial localized edema that vary in size. They are common with bug bites and hives. Papules are palpable, circumscribed, solid elevations in the skin that are smaller than 1 cm. Pustules are elevations of skin similar to vesicles, but they are filled with pus.