Japan National Nursing Examination Health Assessment and Physical Examination: practice questions

Japan National Nursing Examination · Japan · Ministry of Health, Labour and Welfare (MHLW), Japan

Original practice questions written to the published syllabus · not past papers

10worked here, free

97written to this exam in this subject

15syllabus units

What this subject covers

Seeing the patient before the numbers

In the exams: NORCET: Mains — nursing practice, case-scenario based (100 questions); NMC Test of Competence — CBT: Part B — Clinical (100 marks, 68% to pass); NMC Test of Competence — OSCE: APIE — assessment, planning, implementation, evaluation (4 linked stations); Japan National Nursing Examination: Foundations of nursing and professional practice (Core across both sections); NMCN Professional Examination: Foundations and fundamentals of nursing (Core paper); Nursing Council of Kenya Licensure Examination: Fundamentals and clinical skills (Core); Saudi Nursing Licensure Examination: Health promotion and community (Core); NMBA Outcomes-Based Assessment: Assessment, planning, implementation and evaluation (The structure of the practical stations)

What Assessment Is For
Taking a History
The Observations, Done Properly
Looking at the Patient
Assessment in Groups Who Present Differently
From Assessment to Action
Assessing Breathing in Detail
Assessing Circulation in Detail
Neurological Assessment
Pain as an Assessment
Assessing Nutrition, Hydration and Elimination
Assessment Over Time
Assessment in the OSCE, and in the First Job
Common Assessment Errors

Where the 97 questions fall

How our questions for Japan National Nursing Examination spread across the units of Health Assessment and Physical Examination. Difficulty: 29 easy, 53 medium, 15 hard.

End-of-manual check	12
The Observations, Done Properly	8
What Assessment Is For	6
Taking a History	6
Looking at the Patient	6
Assessment in Groups Who Present Differently	6
From Assessment to Action	6
Assessing Breathing in Detail	6
Assessing Circulation in Detail	6
Neurological Assessment	6
Pain as an Assessment	6
Assessing Nutrition, Hydration and Elimination	6
Assessment Over Time	6
Common Assessment Errors	6
Assessment in the OSCE, and in the First Job	5

10 practice questions, worked

Choose an answer, then open the working. Each explanation says why the right answer is right and why the others are not.

1 · What Assessment Is For · medium

Why does assessment of an acutely unwell patient follow airway, breathing, circulation, disability, exposure?

It is the alphabetical order of the body systems
It is the quickest order to record on the chart
It follows the order used on every admission form
It is the order in which problems kill

Answer and working

D. It is the order in which problems kill

A blocked airway kills faster than a breathing problem, which kills faster than a circulation problem. The sequence addresses the most immediately fatal problem first.

Further reading: Laisha original question, written to the SUNYRA nursing manual: Health Assessment and Physical Examination

2 · Assessment in Groups Who Present Differently · easy

How do older adults often present with serious illness?

With confusion or a fall
Always with a high fever
Always with severe chest pain
With a rash over the trunk

Answer and working

A. With confusion or a fall

Older people frequently present atypically — infection without fever, heart attack without pain, and illness as confusion or a fall.

Further reading: Laisha original question, written to the SUNYRA nursing manual: Health Assessment and Physical Examination

3 · Assessment in Groups Who Present Differently · easy

Who can help assess a patient who cannot give a history?

Only the most senior doctor on duty that day
Nobody, until the patient can speak
Family and carers who know their normal
Other patients in the same bay

Answer and working

C. Family and carers who know their normal

When the patient cannot speak for themselves, those who know their normal provide essential collateral history.

Further reading: Laisha original question, written to the SUNYRA nursing manual: Health Assessment and Physical Examination

4 · Assessing Breathing in Detail · medium

Why does it matter whether a patient can clear their own sputum?

Sputum volume determines the ward the patient goes to
Sputum colour alone decides the antibiotic
Clearing sputum is only cosmetic
A patient who cannot clear secretions is at risk of airway problems

Answer and working

D. A patient who cannot clear secretions is at risk of airway problems

A patient unable to clear secretions may need physiotherapy, positioning or suction, and is at risk of collapse and infection.

Further reading: Laisha original question, written to the SUNYRA nursing manual: Health Assessment and Physical Examination

5 · Pain as an Assessment · easy

Pain has no machine. What does that make it?

An observation that need not be recorded
A measurement only doctors can take
A sign that is always overestimated
The observation most open to assumption

Answer and working

D. The observation most open to assumption

Without an instrument, pain depends on the patient's report and the nurse's attention, which makes it vulnerable to assumption and bias.

Further reading: Laisha original question, written to the SUNYRA nursing manual: Health Assessment and Physical Examination

6 · Assessment Over Time · medium

What should set how often a patient is reassessed?

The ward's fixed schedule for everyone
The availability of equipment
How unwell they are and how fast they are changing
The patient's preference only

Answer and working

C. How unwell they are and how fast they are changing

Frequency follows severity and rate of change, not the convenience of the round.

Further reading: Laisha original question, written to the SUNYRA nursing manual: Health Assessment and Physical Examination

7 · Assessment in the OSCE, and in the First Job · easy

In an assessment station, what does finishing properly include?

Stating findings, their meaning and what you would do next
Packing away equipment as quickly as possible
Asking the examiner whether you passed
Leaving the patient without any comment

Answer and working

A. Stating findings, their meaning and what you would do next

Stations are lost in the last seconds; finishing means summarising findings, interpreting them, stating next actions and making the patient comfortable.

Further reading: Laisha original question, written to the SUNYRA nursing manual: Health Assessment and Physical Examination

8 · Assessment in the OSCE, and in the First Job · medium

Why does following a fixed assessment structure help under observation?

Examiners only mark candidates who use one approved national structure
It removes the need to think during the station
It gives something to fall back on when nerves strike
It makes the station shorter

Answer and working

C. It gives something to fall back on when nerves strike

Nerves impair improvisation; a practised structure keeps the assessment complete.

Further reading: Laisha original question, written to the SUNYRA nursing manual: Health Assessment and Physical Examination

9 · Common Assessment Errors · easy

What is lost by assessing a patient from the end of the bed?

Nothing, since looking is enough
Only the blood pressure reading
Only the patient's name
Skin temperature, pulse character and calf tenderness

Answer and working

D. Skin temperature, pulse character and calf tenderness

Many signs require touch or uncovering the patient; end-of-bed assessment misses them.

Further reading: Laisha original question, written to the SUNYRA nursing manual: Health Assessment and Physical Examination

10 · Common Assessment Errors · medium

On a busy ward several staff see a patient and nobody checks the wound. What error is this?

Assessing too thoroughly
Recording too much detail
Reassessing too often
Assuming somebody else has already looked

Answer and working

D. Assuming somebody else has already looked

Shared care creates gaps where each person assumes another checked. Explicit ownership closes them.

Further reading: Laisha original question, written to the SUNYRA nursing manual: Health Assessment and Physical Examination

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