INACE Patient Assessment and Evaluation 5

Question 1

A nursing assistant is asked to observe a patient's stool. Which observation is MOST important to report?

Accepted Answer

Stool that is black, tarry, and has a foul odor

Answer

Brown, formed stool of normal consistency

Answer

Stool passed once daily in the morning

Answer

Stool that is slightly soft in consistency

Question 2

A patient complains of chest pain and shortness of breath. The nursing assistant should:

Accepted Answer

Call for the nurse immediately and stay with the patient

Answer

Reassure the patient and help them relax

Answer

Ask the patient to rate their pain and check back in an hour

Answer

Help the patient walk to the nurses' station to report it

Question 3

Which finding during a neurological observation should be reported to the nurse?

Accepted Answer

Patient's right arm is weaker than the left arm

Answer

Patient can squeeze both hands with equal strength

Answer

Patient can follow verbal instructions without difficulty

Answer

Patient is alert and oriented to time and place

Question 4

A nursing assistant measures a patient's blood glucose using a glucometer and gets a reading of 48 mg/dL. The correct action is to:

Accepted Answer

Give the patient orange juice and report to the nurse immediately

Answer

Document the reading and check again at the next scheduled time

Answer

Assume the device is inaccurate and repeat in 30 minutes

Answer

Encourage the patient to rest and monitor for symptoms

Question 5

When assessing a patient for dehydration, which finding is MOST consistent with this condition?

Accepted Answer

Dry mouth, sunken eyes, and dark concentrated urine

Answer

Skin springs back immediately when pinched

Answer

Moist mucous membranes and clear urine

Answer

Bounding pulse and flushed skin

Question 6

A nursing assistant notices a patient's drainage tube is putting out less fluid than usual and the patient's abdomen appears more distended. This should be:

Accepted Answer

Reported to the nurse immediately as it may indicate a blockage

Answer

Noted and documented at the end of the shift only

Answer

Ignored since output can vary throughout the day

Answer

Corrected by repositioning the tube without notifying the nurse

Question 7

Which question is MOST appropriate for a nursing assistant to ask when using a standardized pain assessment?

Accepted Answer

'On a scale of 0 to 10, how would you rate your pain right now?'

Answer

'Do you want me to call the doctor for you?'

Answer

'You look fine — are you sure you are in pain?'

Answer

'Would you like me to give you something for the pain?'