CALAMBA DOCTORS’ COLLEGE

Virborough Subdivision, Parian, Calamba City, Laguna

Tel. No. (049) 545-9921

COLLEGE OF NURSING

NCM 101
HEALTH ASSESSMENT
SKILLS LABORATORY

PRELIM EXAMINATION

Name: __________________ Date: _______

Year and Section: ________ Professor: Mae Ladra, RN MAN
Lucelle Lumbres, RN MAN

INSTRUCTION: NO ERASURE OR ANY ALTERATIONS. USE BLACK BALLPEN ONLY

I. MULTIPLE CHOICE
Choose the one best answer for each question.

1. To prepare for the assessment of a client visiting a neighborhood health clinic, the
nurse should first
A. Discuss the client’s symptoms with other team members
B. Plan for potential laboratory procedures
C. Review client’s health record
D. Determine potential health care resources

2. In the course of performing a client's physical assessment, the nurse has changed from
using the diaphragm of the stethoscope to using the bell. The nurse is most likely
assessing which of the following?
A. Heart sounds
B. Bowel sounds
C. Breath sounds
D. Femoral pulse

3. Which of the following methods is correct for examining the ear of an adult patient
with an otoscope?
A. Gently pull the auricle up and back.
B. Gently pull the auricle down and back.
C. Use the largest speculum that will fit comfortably in the patient's ear.
D. Both A and C

4.Assessment of the ears includes which of the following?

A. Inspection
B. Palpation
C. Examination with an otoscope
D. All of the above

5. A whispered voice test includes which of the following?

A. Having the patient wiggle a finger in the opposite ear.
B. Whispering while standing 1 to 2 feet from the patient's ear.
C. Playing soothing music in the examination room.
D. Both A and B.

6. The Rinne and Weber tests measure which of the following?

A. Air and bone conduction
B. Movement of the tympanic membrane
C. Tenderness of the mastoid area
D. Nodules in the auricles

7. When performing the cover test, a nurse notices that the client's left eye turns outward.
How should the nurse document this finding in the client's record?
a. Strabismus
b. Exotropia
c. Presbyopia
d. Esotropia

8. The emergency department nurse is assessing for kidney tenderness in a client who has
presented with complaints of dysuria and back pain. What assessment technique should
the nurse utilize?
A. Deep palpation
B. Indirect percussion
C. Moderate palpation
D. Blunt percussion

9. A nurse is completing an assessment that will involve gathering subjective and

objective data. Which of the following assessment techniques will best allow the nurse to
collect objective data?
A. Inspection
B. Therapeutic communication
C. Interviewing
D. Active listening

10. Before beginning a physical assessment of a client, the nurse should first
A. wash both hands with soap and water.
B. determine whether the client is anxious.
C. ask the client to remove all clothing.
D. request a family member to be present.

11. While examining a client, the nurse plans to palpate temperature of the skin by using
the
A. fingertips of the hand.
B. ulnar surface of the hand.
C. dorsal surface of the hand.
D. palmar surface of the hand.

12. The nurse is caring for a 63-year-old Asian American who can neither read nor speak
English. What would be the appropriate chart to use to assess this patient’s vision?

A. Allen

B. Snellen E

C. Ishihara

D. PEARLA

13. A patient has a nursing diagnosis of disturbed visual sensory perception. Which of the
following is the most appropriate outcome for this patient’s care planning?

A. Patient will remain independent in own home.

B. Patient will obtain a seeing eye dog.

C. Patient will obtain contact lenses to improve self-concept.

D. Patient will remain free from harm resulting from a loss of vision.

14. A patient has been found to have abnormal vision. What would be the nurse’s next
step?

A. Refer patient to an ophthalmologist.

B. Refer patient to social services to get money for glasses.

C. Refer the patient to a community-based support group.

D. Encourage the patient to adopt a healthier diet.

15. A 52-year-old patient with myopia calls the ophthalmology clinic very upset. She
tells the nurse, “I keep seeing semi-clear spots floating across my vision. What is wrong
with me?” What would be the most appropriate response by the nurse?

A. “It is not an uncommon finding in people older than 40 years for this to happen. They
are called ‘floaters’.”

B. “Please come into the clinic right away so we can see what is wrong.”

C. “Because it is almost five o’clock, please go to the emergency department right away.
This sounds very serious.”

D. “I have an opening tomorrow at 2 in the afternoon. Can you come in then?”

16. An infant has red, dry, and irritated eyes. These findings are consistent with a
problem in what part of the eye?

A. Vitreous chamber

B. Aqueous chamber

C. Lacrimal apparatus

D. Sinus

17. A patient calls the clinic and tells the nurse that the doctor told her that she has

“ otalgia.” The patient cannot remember what the doctor explained this to be.

How would the nurse most appropriately respond?

A. “Otalgia is a dysfunction of the ear.”

B. “Otalgia is pain in the ear.”

C. “Otalgia is the beginning of hearing loss.”

D. “Otalgia is a disease of the inner ear.”

18. A 52-year-old patient fails the Romberg’s test. The nurse explains that this might
indicate a dysfunction in what part of the ear?
A. The bones of the middle ear

B. The Eustachian tubes

C. The pinna

D. The vestibular portion of the inner ear

19. A nurse is writing a care plan for a patient who has been found to have a progressive
hearing loss. What would be an appropriate outcome for this patient?

A. Patient’s ear canal will be free from cerumen.

B. Patient will have normal hearing.

C. Patient will maintain adequate balance.

D. Patient will explain a plan to accommodate hearing impairment.

20. Physical assessment findings are information that is:

A. is a potential risk to health
B. has an organic cause
C. is an actual problem that can lead to nursing interventions
D. requires medical intervention

II. LABELING

INSTRUCTION: IDENTIFY EACH PHOTO. NO ERASURE

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