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PCHA Final Exam Questions and Answers 2025, Exams of Communication

Pennsylvania State University - DuBoisCommunication

A set of final exam questions and verified correct answers for pcha (patient care and health assessment). It covers topics such as patient interviews, physical assessments, vital signs, and respiratory system assessment. The questions are designed to test understanding of key concepts and clinical applications, making it a useful resource for students preparing for their exams. Multiple-choice questions with verified answers, offering a comprehensive review of essential topics in patient care and health assessment. It is particularly useful for nursing and medical students.

Typology: Exams

2024/2025

Available from 09/16/2025

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PCHA Final Exam Questions | 100% Correct
Answers | Verified | Latest 2025 Version
A patient tells the nurse that he is very nervous, nauseated and that he "feels hot". This type of data
would be considered: - ✔✔subjective
Because the physical environment in which an interview takes place is an important consideration for the
success of an interview, the interviewer should: - ✔✔reduce noise by turning off televisions and cell
phones
A nurse is taking complete health histories on all the patients attending a wellness workshop. While
conducting an interview with a patient, the nurse asks, "Can you tell me a little about yourself?" This
question is an example of: - ✔✔an open-ended question
During an interview, a parent of a hospitalized child is sitting in an open position. As the interviewer
begins to discuss the child's treatment, however, the parent suddenly crosses the arms against the chest
and crosses the legs. Based on the understanding that nonverbal modes of communication provide clues
to understanding feelings, the sudden change in body position would suggest that the parent is: -
✔✔uncomfortable talking about his child's treatment
A 59-year-old patient is returning to the outpatient clinic for a follow up visit. The patient has a history of
ulcerative colitis. The patient states he has been having "black stools" for the last 24 hours. Which of the
following would be the most complete way for the nurse to document the patient's reason for seeking
care? - ✔✔J.M. is a 59-year-old patient here for having "black stools" for the past 24 hours.
Which of the following statements best describes the purpose of a health history? - ✔✔to provide a
database of subjective information about the patient's past and current health.
The inspection phase of the physical assessment: - ✔✔begins the moment you first meet the person and
develop a "general survey".
A patient is at the clinic for a physical examination. He states that he is "very anxious" about the physical
exam. What steps can the examiner take to make the patient more comfortable? - ✔✔Appear unhurried
and confident when examining the patient.
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Download PCHA Final Exam Questions and Answers 2025 and more Exams Communication in PDF only on Docsity!

PCHA Final Exam Questions | 100% Correct

Answers | Verified | Latest 202 5 Version

A patient tells the nurse that he is very nervous, nauseated and that he "feels hot". This type of data would be considered: - ✔✔subjective Because the physical environment in which an interview takes place is an important consideration for the success of an interview, the interviewer should: - ✔✔reduce noise by turning off televisions and cell phones A nurse is taking complete health histories on all the patients attending a wellness workshop. While conducting an interview with a patient, the nurse asks, "Can you tell me a little about yourself?" This question is an example of: - ✔✔an open-ended question During an interview, a parent of a hospitalized child is sitting in an open position. As the interviewer begins to discuss the child's treatment, however, the parent suddenly crosses the arms against the chest and crosses the legs. Based on the understanding that nonverbal modes of communication provide clues to understanding feelings, the sudden change in body position would suggest that the parent is: - ✔✔uncomfortable talking about his child's treatment A 59-year-old patient is returning to the outpatient clinic for a follow up visit. The patient has a history of ulcerative colitis. The patient states he has been having "black stools" for the last 24 hours. Which of the following would be the most complete way for the nurse to document the patient's reason for seeking care? - ✔✔J.M. is a 59-year-old patient here for having "black stools" for the past 24 hours. Which of the following statements best describes the purpose of a health history? - ✔✔to provide a database of subjective information about the patient's past and current health. The inspection phase of the physical assessment: - ✔✔begins the moment you first meet the person and develop a "general survey". A patient is at the clinic for a physical examination. He states that he is "very anxious" about the physical exam. What steps can the examiner take to make the patient more comfortable? - ✔✔Appear unhurried and confident when examining the patient.

When performing a physical examination, safety must be considered to protect the examiner and the patient against the spread of infection. Which of the following statements describes the most appropriate actions the examiner should take when performing a physical examination? - ✔✔Wash hands at the beginning of the examination and any time that one leaves and re-enters the room. A 50-year-old patient who is taking anti-hypertensive medications returns to the clinic to have their blood pressure (BP) checked. The last BP was 146/88. The BP reported to the nurse is 168/96. Both blood pressures were taken at the brachial site. Which of the following is true regarding blood pressure assessment in this patient? Choose all that apply:

  1. The patient should be allowed to adequately rest prior to assessing the blood pressure.
  2. The width of the cuff should cover 40% of the circumference of the upper arm.
  3. The position of the arm used for blood pressure assessment should be above the level of the heart.
  4. Goal blood pressure for this patient should be systolic less than 120 mm Hg and diastolic less than 80 mmHg.
  5. The last audible sound auscultated during blood pressure assessment should be recorded for the systolic reading.
  6. An unsupported arm may be used for an accurate blood pressure measure - ✔✔1, 2, 4 While caring for a patient with heart disease, the nurse notices an irregularity in the rhythm of the patient's radial pulse. The previous assessment did not reveal an irregular pulse. What would be the BEST action to take? - ✔✔count the patient's apical pulse for one minute Which of the following statements is true regarding use of the tympanic thermometer? - ✔✔The practitioner needs to wait at least 10 minutes to obtain the temperature if the patient has been outdoors. Which of the following is true regarding an oral temperature? - ✔✔The thermometer should be placed in the posterior sublingual pocket of the mouth. The nurse is taking a blood pressure on a patient; the patient's baseline blood pressure is unknown. The nurse does not have any previous information about the patient's blood pressure measurements, nor is the patient able to give any information about previous blood pressure readings. Which of the following techniques would be the MOST accurate way to measure this patient's blood pressure? - ✔✔Inflate the blood pressure cuff 30 mm Hg above the point at which the palpated pulse disappeared.

The patient is admitted to the hospital after a three day history of severe vomiting and diarrhea secondary to a bacterial infection of the colon. The patient is otherwise in good health with no chronic illnesses. The baseline blood pressure is 130/84, pulse 78. During the admission assessment, what might the nurse expect the patient's vital signs to be based on the illness? (All blood pressures taken in the supine (lying) position). - ✔✔Pulse: 130, Blood Pressure: 90/50, Resp: 24, Temp: 102°F The nurse is observing a student who is listening to a patient's lungs. Which action by the student indicates a need to review respiratory assessment skills? - ✔✔The student auscultates over the scapulae. Mrs. M. is admitted for pneumonia in her right middle lobe. Where would the practitioner expect to auscultate decreased or adventitious breath sounds? - ✔✔On the anterior and lateral chest, between the 4th and 6th ribs approximately, starting from the midaxillary line to the right sternal border. Your client has a long history of chronic obstructive pulmonary disease. Which of the following are you most likely to observe? - ✔✔all of the above

  • an anterior-posterior (AP) : transverse diameter ratio of 1:1.
  • pursed lip breathing
  • tripod position when sitting A 25-year-old female college student comes to the Emergency Department after she has fallen down the stairs. She has sudden, sharp pain on the right side of her chest with shortness of breath. Thoracic expansion is asymmetrical, with little movement of her right side. Her trachea is deviated toward the left side. She has hyperresonant percussion sounds on the right chest and resonant sounds on the left chest. There are no breath sounds heard on the right. This description is most consistent with: - ✔✔pneumothorax Expected assessment findings in the normal adult lung include the presence of: - ✔✔resonant percussion tones over lung tissue and symmetrical thoracic expansion. When auscultating the posterior lower lung lobes of the adult client, the practitioner notes low pitched, soft breath sounds with inspiration being longer than expiration. The practitioner knows that these are: - ✔✔vesicular breath sounds and are normal in that location Which of the following techniques is appropriate during auscultation of breath sounds? - ✔✔Listen to at least one full respiration (inspiration and expiration) in each location.

The angle of Louis: - ✔✔is a landmark used to mark tracheal bifurcation anteriorly. When inspecting the anterior chest of an adult, the nurse should assess for: (choose all that apply)

  1. diaphragmatic excursion.
  2. symmetric chest expansion.
  3. the presence of breath sounds.
  4. the shape and configuration of the chest wall.
  5. retractions or bulging
  6. skin temperature
  7. use of accessory muscles - ✔✔2, 4, 5, 7 The nurse has noted unequal chest expansion and recognizes that this occurs when: - ✔✔part of the lung is obstructed or collapsed When listening to heart sounds, the nurse knows that which of the following statements concerning S1 is true? - ✔✔S1 is caused by closure of the mitral and tricuspid valves. Ms. Key has a visible apical impulse in the seventh to eighth left intercostal space lateral to the midclavicular line. Upon palpation, the impulse, which feels like a short 'tap', is approximately 5 cm in diameter and feels more forceful than usual. These physical finding indicate: - ✔✔left ventricular enlargement Which of the following is true regarding an S3 heart sound? - ✔✔S3 occurs early in diastole. Normal physiologic splitting of S2 occurs due to: - ✔✔early aortic valve closure and late pulmonic valve closure. When listening to heart sounds, the nurse knows that the valve closures that can be heard best at the base of the heart are: - ✔✔aortic; pulmonic

The patient presents to the hospital Emergency Department with a dilated left pupil, left ptosis, and inability to look up, down, or medially with the left eye. These signs may indicate a problem with: - ✔✔Left oculomotor nerve (CN III) The patient visits the clinic complaining of excessive tearing in the left eye. The nurse should assess the patient's eye for: - ✔✔lacrimal sac obstruction. The patient comes to the clinic for a routine well patient yearly physical exam. The patient has no complaints at this visit, and no history of any chronic illnesses. Upon examining the nasal cavity, the nasal septum is symmetrical with scant amount of clear drainage; no masses or lesions are noted. No other symptoms are noted. These findings are: - ✔✔normal findings The size of the normal pupil is determined by: - ✔✔all of the above

  • amount of light entering the eye
  • closeness of the object being visualized
  • function of cranial nerves II (optic) and III (oculomotor) The patient comes to the clinic complaining of blurred vision when reading the newspaper. After testing the patient's near vision, the nurse explains to the patient that he has impaired near vision and discusses a possible reason for the condition. The nurse determines the patient has understood the teaching when the patient states presbyopia is usually due to: - ✔✔decreased ability of the lens to accommodate Which of the following best describes the test performed to assess the function of cranial nerve XII (hypoglossal)? - ✔✔Ask the patient to stick out his tongue and observe for midline position. Which of the following is true regarding assessment of the thyroid gland? - ✔✔The physical characteristics of the thyroid gland tell you little about thyroid function. The patient has come to the clinic with a chief complaint of a "lump under my chin". In the history, you note that the patient smokes and uses smokeless tobacco (tobacco placed under the tongue). Upon physical exam, the practitioner notes enlarged, nontender (2cm) submental lymph nodes. In an effort to identify the cause of the node enlargement, you would assess the: - ✔✔inner aspect of the lips and cheeks

With palpation of the sinus areas, what would be a normal finding? - ✔✔The patient would feel firm pressure with your palpation but no pain. A patient is unable to differentiate between sharp and dull stimulation to both sides of the face. The nurse suspects: - ✔✔damage to the trigeminal nerve (CN V) When assessing visual acuity using the Snellen chart, the practitioner should: - ✔✔Assess with and without correction (reading glasses should not be worn). The nurse documents PERRLA following assessment of a patient's eyes. One finding that supports this data is: - ✔✔constriction of the pupils when an object is brought closer to the eye. The nurse has just completed a lymph node assessment on a 60-year-old healthy patient. The nurse knows that most lymph nodes in healthy adults are normally: - ✔✔not palpable Which of the following is an expected normal finding when examining the function of the extraocular eye muscles? - ✔✔parallel movement of both eyes The patient is at the clinic for an eye examination. The nurse suspects that the patient has a ptosis of one eye. How would the nurse check for this? - ✔✔Observe the distance between the upper and lower eyelid (palpebral fissure). When performing the whisper test to assess hearing, which of the following would be appropriate? - ✔✔Whisper words or numbers 1 - 2 feet behind the client and ask the client to repeat them. The patient comes to the clinic with a suspected lesion of cranial nerve XI (spinal accessory). How would the nurse assess for this? - ✔✔Ask the client to shrug his shoulders against resistance and turn his head side-to-side against resistance. Which of the following best describes the test the nurse should use to assess the function of cranial nerve X? - ✔✔Ask the patient to say "ahhh" and watch for movement of the soft palate and uvula. The practitioner shines a light straight toward the bridge of the nose of the client. A bright dot of light appears at the 3 o'clock position in the left eye and 10 o'clock position in the right eye. This finding is known as a/an: - ✔✔abnormal corneal light reflex

The nurse is aware that which of the following statements is true regarding testicular cancer? - ✔✔all of the above

  • About half of all testicular cancers are found in males ages 20 - 34 years old.
  • For asymptomatic adolescents and adult males, the U.S. Preventive Health Services Task Force does not recommend routine screening (self-screening or clinical screening) for testicular cancer.
  • Men with a history of undescended testes are at risk for development of testicular cancer. Which of the following statements made by the patient regarding testicular self-exam would indicate a need for further education? - ✔✔"I should examine the testicles when I take a cool or cold shower." Mrs. L., a 25 - year- old female, comes to your clinic for a routine physical exam. While performing her breast exam, she tells you she has never had anyone teach her how to properly examine her breasts and asks that you educate her on the breast self exam. Which of the following is true regarding assessment of the breasts? - ✔✔A & D
  • To perform a breast self-exam, press the three middle fingers in a circular motion and follow an up and down method.
  • The best time to perform the breast self exam is right after the menstrual period. During a discussion for a men's health group, the nurse relates that the group with the highest incidence of prostate cancer is: - ✔✔African-American The nurse is collecting subjective data prior to the female genitourinary exam. The patient describes pain and cramping before and during her menstrual period. How would the nurse document this finding? - ✔✔dysmenorrhea Normal inspection findings for the female genitourinary examination include: - ✔✔all of the above
  • Vaginal discharge is small, clear, and nonirritating.
  • Labia minora are dark pink and symmetric
  • No lesions are present except for occasional sebaceous cysts
  • Anus has coarse skin of increased pigmentation. Life style factors related to breast cancer risk include: - ✔✔A & B
  • drinking alcohol
  • obesity ROM should be performed with and without palpation to reveal findings such as crepitation of the joint.
  • ✔✔true Which of the following is true regarding assessment of the muscle? - ✔✔Muscle tone is assessed with muscles in their resting state or with slight resistance. Active range of motion should be performed before muscle strength testing because: - ✔✔if muscle strength were tested before ROM, more marked contraction of the muscle may cause pain in the client and therefore skew the ROM findings. When testing range of motion of the shoulders, the practitioner should: - ✔✔with arms at sides and elbows extended, ask the patient to move both arms forward and up to test forward flexion. Which of the following is true regarding assessment of the elbow? - ✔✔ROM for the elbow is flexion, extension, supination and pronation. Which of the following is the MOST COMPLETE description of the nurse's physical assessment of joints? - ✔✔Assess symmetry of paired joints: inspect and palpate each joint for swelling, warmth, tenderness, and irregularity, testing range of motion and muscle strength. Mr. J. has documented osteoarthritis with Heberden's and Bouchard's nodes. In what location would you look for these? - ✔✔DIP and PIP joint When examining the foot the practitioner should: - ✔✔all of the above
  • Palpate the patient's entire foot and around each toe.
  • Test ROM by assessing dorsiflexion, plantar flexion, inversion, eversion, and flexion and extension of toes.
  • Assess muscle strength by testing dorsiflexion and plantar flexion against resistance. The nurse is assessing the neurologic status of a patient who has a late-stage brain tumor. With the reflex hammer, the nurse draws a light stroke up the lateral side of the sole of the foot and inward, across the

The patient arrives to the Emergency Department following a motorcycle accident in which the patient was thrown from a motorcycle. Initial tests show the patient has completely severed the spinal cord only at the level of the third thoracic vertebrae. The anterior horn cells are intact. What would be the most likely findings upon examination of this client? - ✔✔Severe muscle weakness or paralysis (spinal shock) below the level of the lesion initially (24-48 hours), followed by spastic paralysis within several days or weeks. While performing a neurologic exam on , the nurse notes rapid rhythmic contraction of muscle groups while testing the ankle (Achilles) reflex. This finding is referred to as: - ✔✔clonus The practitioner places a key in the hand of the patient; the patient identifies it as a penny. What term would the nurse use to describe the result of this sensory exam? - ✔✔Astereognosis The nurse is testing the deep tendon reflexes of a patient who is in the clinic for an annual physical examination. When striking the Achilles tendon, the nurse is unable to elicit a reflex. The nurse's next response should be to: - ✔✔assess for the reflex again while asking the patient to lock her fingers and "pull". One of the earliest and most sensitive signs of a change in the patient's condition is: - ✔✔Change in level of consciousness. Lower motor neurons differ from upper motor neurons primarily in that lesions of the lower motor neurons - ✔✔cause hyporeflexia and flaccidity. The nurse is testing the patient's deep tendon reflexes. The nurse holds the reflex hammer with the dominant hand between the thumb and index finger. A striking motion is generated with the wrist, and the tendon is tapped briskly with a smooth, direct arc. The hammer is left in place over the tendon as the reflex occurs. Critique the nurse's technique. - ✔✔The hammer should be removed after the tendon is tapped. A painful stimuli may be performed to assess level of consciousness. - ✔✔true The patient is brought into the Emergency Department after being involved in a motor vehicle accident. Upon completion of the neurologic exam, the nurse records a 'zero' response for the patellar reflex. Based on this finding, the nurse suspects damage at what segment of the spinal cord? - ✔✔L2, 3, 4

The patient is diagnosed with a lesion of the posterior (dorsal) column. What would be the expected sensory findings of this individual? - ✔✔B & C

  • inability to recognize objects when placed in the hand
  • inability to recognize finger position The nurse is assessing dermatome levels of the patient. The nurse notes the patient has numbness in the area around the umbilicus. Which spinal nerve is associated with this finding? - ✔✔T The patient reports an inability to firmly hold a pencil at times due to numbness and tingling in the thumb. The patient also reports "neck pain." When performing the neurologic assessment, the nurse notes decreased sensory response on both thumbs bilaterally. Based on these findings, where would the nurse expect the lesion to be? - ✔✔sixth cervical nerve (C6) When assessing for orientation, it is important to ask the patient for as much detail as possible regarding person, place, time and situation. - ✔✔true A lesion involving the left half of the spinal cord segments C5-C8 would produce the following sensory findings: - ✔✔contralateral loss of pain and temperature, ipsilateral loss of proprioception, 2 point discrimination and vibration below the level of the lesion.