General Assessment
Skin, Hair, Nails
Eyes
Ears
Nose/Mouth
100

This type of data includes patients report of nausea, vomiting and fever

Subjective data

100

the skin's primary protective outer layer

epidermis

100

This documentation term describes pupils that are equal, round, reactive to light, and reactive to accommodation. What is the term?

PERRLA

100

During a whispered voice test, the nurse stands at this distance from the client's unoccluded ear. What is the distance?

30-60cm

100

During a nose assessment, the nurse observes pale nasal mucosa and clear discharge. What do these findings most likely indicate?

Allergies

200

The four major techniques used in an objective health assessment

Inspection, Palpation, Percussion, Auscultation

200

a lesion that presents with widespread pinpoint, non-blanching, red-purple spots

petechiae

200

During a visual acuity challenge, a client reads the 20/40 line while standing 20 feet from the Snellen chart. What does the denominator indicate?

The distance at which a person with normal vision can read that line

200

The nurse observes a normal tympanic membrane during otoscopic examination. Which color describes a healthy tympanic membrane?

pearly-grey

200

The nurse asks a client to say “Ah” while inspecting the pharynx. Which finding indicates a normal response?

The uvula and soft palate rise centrally

300

The mnemonic PQRST is used to assess this

Pain and symptom severity/quality

300

the degree of a normal angle between the nail plate and proximal nail fold

160 degrees

300

 During ophthalmoscopic examination, which finding is expected in a healthy optic disc?

a creamy yellow disc with distinct margins

300

During an otoscopic examination, the nurse is assessing a 4-year-old child. Which action correctly straightens the child’s external auditory canal?

pull auricle down and back

300

While inspecting a client’s oral cavity, the nurse notes a thick white patch on the buccal mucosa. Which interpretation is most appropriate?

The finding may represent leukoplakia and requires follow-up

400

A nurse should do this when an assessment reveals a life-threatening abnormality

 initiate an immediate safety response and assess/support airway, breathing, and circulation as indicated

400

a bluish discoloration of the lips and nail beds 

cyanosis

400

The nurse is assessing pupillary accommodation. Which instruction should the nurse give the client?

Look at a distant object and then focus on a test object held approximately 10 cm from the nose

400

The nurse notes that a client’s external auditory canal contains a yellow or green, foul-smelling discharge. What is the priority interpretation of this finding?

The finding may indicate infection or a foreign body

400

 A client reports tenderness over the forehead and cheeks during a sinus assessment. Which technique should the nurse use to further assess the frontal sinuses?

Apply gentle upward pressure with the thumb over the eyebrow

500

the process of comparing assessment findings with expected findings to identify health problems

Clinical judgment or data interpretation

500

the nurse's priority when a patient has a irregular lesion with asymmetry, uneven border, color variation, and recent size change

arrange further follow up

500

While testing the pupillary light reflex, the nurse shines a penlight into the client’s left eye. The left pupil constricts, but the right pupil does not change. Which structure is most likely impaired?

The right oculomotor nerve

500

A client reports ear pain. The nurse finds that palpation of the tragus and gentle movement of the auricle increase the pain. Which condition is most consistent with this assessment finding?

External ear infection

500

The nurse asks a client to protrude the tongue during an oral assessment. Which finding indicates a possible abnormality of hypoglossal nerve function?

The tongue deviates to one side