Health Assessment: practice problems and exam questions

Assessment in nursing practice: vital signs and the values derived from them, the Glasgow Coma Scale, APGAR, Braden, Morse and NEWS2 scores, body mass index and the reading of a blood gas, with the conversions that go with them.

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Cram pack (PDF)Formula sheets, method steps and practice problems with full solutions, ready to print.

Topics in this course

  1. Clinical assessment scoresGCS, APGAR, MAP and BMI · Braden, Morse, NEWS2 and shock index · risk categories and interpretationcalculations
  2. Arterial blood gas interpretationacid–base classification · compensation and expected values · mixed disorders and gas exchangecalculations
  3. Nursing fundamentalskey terms and facts · applying the concepts · cases and analysismultiple choice
  4. Nursing math & unit conversionsmetric, weight and household units · temperature, 24-hour clock and rounding · dimensional analysis chainscalculations

Exam tips for Health Assessment

  • Score every item of a scale separately before you add; most errors are one level off.
  • Know the range of each score: GCS 3–15, APGAR 0–10, Braden 6–23, Morse 0–125.
  • A score supports your judgement; a single very abnormal value matters even when the total is low.

Worked examples

Clinical assessment scoresEasy
A? / 2+P? / 2+G? / 2+A? / 2+R? / 2Σ?

Practice exercise (made-up values, not clinical guidance). At 5 minutes after birth, a practice newborn has pink skin all over, a heart rate of 125/min, a grimace when stimulated, active movement and slow, irregular breathing with a weak cry. What is the APGAR score?

5 minHR 125/min

Find APGAR

Show hints
  1. Five signs: Appearance, Pulse, Grimace, Activity, Respiration; each scores 0, 1 or 2.
  2. Pulse: none 0, below 100/min 1, 100/min or more 2.
  3. Appearance scores 2 and Pulse scores 2.
Show the answer and the step-by-step solution

APGAR score: five signs, each scored 0, 1 or 2, checked at 1 and 5 minutes after birth. Appearance (colour): blue or pale 0, pink body with blue extremities 1, pink all over 2. Pulse: absent 0, below 100/min 1, 100/min or more 2. Grimace (reflex irritability): none 0, grimace 1, cry, cough or sneeze 2. Activity (tone): limp 0, some flexion 1, active movement 2. Respiration: absent 0, slow or irregular with a weak cry 1, good with a strong cry 2. A total of 7–10 is reassuring, 4–6 moderately abnormal and 0–3 low.

Score each sign

Appearance: pink skin all over → 2
Pulse: 125/min → 2
Grimace: a grimace when stimulated → 1
Activity: active movement → 2
Respiration: slow, irregular breathing with a weak cry → 1

Add

APGAR = 2 + 2 + 1 + 2 + 1 = 8

Answer

APGAR = 8
Arterial blood gas interpretationMedium

Practice values: Na⁺ 151 mmol/L, glucose 17.6 mmol/L and urea 22.7 mmol/L. Calculate the serum osmolality Osm = 2·Na⁺ + glucose + urea to the nearest whole number.

Na⁺ 151 mmol/Lglucose 17.6 mmol/Lurea 22.7 mmol/L

Find Osm (mOsm/kg)

Show hints
  1. Sodium and its anions make most of the osmolality: 2·Na⁺.
  2. Add glucose and urea as they are; all values are in mmol/L.
  3. 2·151 = 302.
Show the answer and the step-by-step solution

Derived values: calculated serum osmolality is 2·Na⁺ + glucose + urea with all values in mmol/L (2·Na⁺ + glucose/18 + BUN/2.8 with glucose and BUN in mg/dL); normal is about 275–295 mOsm/kg. The P/F ratio is PaO₂ divided by FiO₂ as a fraction. The alveolar oxygen pressure is PAO₂ = FiO₂·(760 − 47) − PaCO₂/0.8 mmHg at sea level, and the A–a gradient is PAO₂ − PaO₂.

Calculated osmolality

Osm = 2·151 + 17.6 + 22.7 = 342.3 ≈ 342 mOsm/kg

Answer

Osm = 342 mOsm/kg

How practising works

  • “Practise this course” mixes problems from all its topics, like a real exam.
  • Every problem has new values, so you learn the method instead of an answer.
  • Stuck? Open a small hint first, and the full explanation only when you need it.
  • Mock exams are timed and have no hints, and you get your score and a full review at the end.

Calculators for this course

Nursing unit converter (mg, mcg, kg, lb, mL, tsp, °F, °C)Glasgow Coma Scale calculator (GCS and GCS-P)APGAR score calculatorBraden scale calculator (pressure injury risk)Morse fall scale calculator (fall risk)NEWS2 score calculator (National Early Warning Score 2)Mean arterial pressure calculator (MAP)Anion gap calculator (albumin-corrected, delta ratio)

Related courses

NCLEX-style practice questions (RN)Nursing Fundamentals and Clinical PracticeNCLEX-PN-style practice questions (LPN/LVN)Respiratory Care and Oxygen TherapyLab Values for NursesInfection Control and Patient SafetyNursing MathMedical-Surgical Nursing
Practise this course for freePractise this courseTake a mock exam5 free problems every day. No card needed.