Course | NURS-6512N-6/NURS-6512A-6-Advanced Health Assessment-2021-Fall-QTR-Term-wks-1-thru-11-(08/30/2021-11/14/2021)-PT27 |
Test | Exam – Week 11 |
Started | 11/14/21 1:37 AM |
Submitted | 11/14/21 2:35 AM |
Due Date | 11/15/21 1:59 AM |
Status | Completed |
Attempt Score | 97 out of 100 points |
Time Elapsed | 57 minutes out of 2 hours |
Instructions | Please answer each question below and click Submit when you have completed the Exam. |
Results Displayed | Submitted Answers |
You are conducting a clinical breast examination for your 30-year-old patient. Her breasts are symmetrical with bilateral, multiple tender masses that are freely moveable with well-defined borders. You recognize that these symptoms and assessment findings are consistent with: | ||||
Selected Answer: fibrocystic changes. |
Inspection of the scrotum should reveal: | ||||
Selected Answer: left scrotal sac lower than the right. |
Temporalis and masseter muscles are evaluated by: | ||||
Selected Answer: having the patient clench his or her teeth. |
During a routine prenatal visit, Ms. T. was noted as having dependent edema, varicosities of the legs, and hemorrhoids. She expressed concern about these symptoms. You explain to Ms. T. that her enlarged uterus is compressing her pelvic veins and her inferior vena cava. You would further explain that these findings: | ||||
Selected Answer: are usual conditions during pregnancy. |
Palpation of epitrochlear nodes is part of the: | ||||
Selected Answer: examination of the upper extremities. |
While examining a 30-year-old woman, you note that one breast is slightly larger than the other. In response to this finding, you should: | ||||
Selected Answer: note the finding in the patient’s record. |
A 62 year old female presents to the clinic with complains of chest pain and heart palpitations that started 3 days ago. Patient states she is healthy and only has a history of hypertension and tachycardia. Patient is currently taking Norvasc 10mg daily and Coreg 6.25 mg BID. You order an EKG and it shows heart rate above 200 beats/min and the ECG may look like a sawtooth cog. What is the most likely diagnosis of this patient? | ||||
Selected Answer: Atrial Flutter |
You are inspecting the genitalia of an uncircumcised adult male. The foreskin is tight and cannot be easily retracted. You should: | ||||
Selected Answer: inquire about previous penile infections. |
The adnexa of the uterus are composed of the: | ||||
Selected Answer: fallopian tubes and ovaries. |
A pulsation that is diminished to the point of being barely palpable would be graded as: | ||||
Selected Answer: 1 |
Which one of the following is a proper technique for use of a speculum during a vaginal examination? | ||||
Selected Answer: Press introitus downward; insert closed speculum obliquely. |
Which cranial nerves are usually evaluated during the examination of the eyes? | ||||
Selected Answer: III and VI |
Recent unilateral inversion of a previously everted nipple suggests: | ||||
Selected Answer: cancer. |
Normal changes of the aging brain include: | ||||
Selected Answer: diminished perception of touch. |
It is especially important to test for ankle clonus if: | ||||
Selected Answer: deep tendon reflexes are hyperactive. |
In the most effective percussion technique of the posterior lung fields, the patient cooperates by: | ||||
Selected Answer: folding the arms in front. |
A finding that is indicative of osteoarthritis is: | ||||
Selected Answer: Heberden nodes. |
Your older clinic patient is being seen today as a follow-up for a 2-day history of pneumonia. The patient continues to have a productive cough, shortness of breath, and lethargy and has been spending most of the day lying in bed. You should begin the chest examination by: | ||||
Selected Answer: auscultating the lung bases. |
The musculoskeletal examination should begin when: | ||||
Selected Answer: the patient enters the examination room. |
When is the mental status portion of the neurologic system examination performed? | ||||
Selected Answer: Constantly, throughout the entire interaction with a patient |
You are initially evaluating the equilibrium of Ms. Q. You ask her to stand with her feet together and arms at her sides. She loses her balance. Ms. Q. has a positive: | ||||
Selected Answer: Romberg sign. |
The family history for a patient with joint pain should include information about siblings with: | ||||
Selected Answer: genetic disorders. |
The difference in blood pressure readings between the right and the left arms is considered normal up to _____ mm Hg. | ||||
Selected Answer: 10 |
You are assessing Mr. Z.’s fluid volume status as a result of heart failure. If your finger depresses a patient’s edematous ankle to a depth of 6 mm, you should record this pitting as: | ||||
Selected Answer: 3+. |
At your first meeting with a patient, it is usually best to say: | ||||
Selected Answer: “Tell me about yourself.” |
The reliability of health-related findings and observations is the responsibility of the: | ||||
Selected Answer: professional and the patient. |
When assessing a 17-year-old for nuchal rigidity, you gently raise his head off the examination table. He involuntarily flexes his hips and knees. To confirm your suspicions associated with this positive test, you would also perform a test for the _____ sign. | ||||
Selected Answer: Kernig |
Electrical activity recorded by the electrocardiogram (ECG) tracing that denotes the spread of the stimulus through the atria is the: | ||||
Selected Answer: P wave. |
A patient you are seeing in the emergency department for chest pain is suspected of having a myocardial infarction. During the health history interview of his family history, he relates that his father had died of “heart trouble.” The most important follow-up question you should pose is which of the following? | ||||
Selected Answer: “What age was your father at the time of his death?” |
A chest radiography is performed on your patient that complains of having dyspnea, coughing productive sputum and chest pain. The image results shows consolidation and infiltrates. You compare this to your physical exam findings of distant or absent breath sounds and absent vocal fremitus. What is the most likely diagnosis? | ||||
Selected Answer: Pneumonia |
A parent is advised to restrict contact or collision sports participation for their child. An example of a sport in which this child could participate is: | ||||
Selected Answer: riflery. |
Tarry black stool should make you suspect: | ||||
Selected Answer: upper intestinal bleeding. |
For purposes of examination and communication of physical findings, the breast is divided into: | ||||
Selected Answer: four quadrants plus a tail. |
Which portion of the physical examination is best done with the patient standing? | ||||
Selected Answer: Spinal |
Palpation of a normal prostate in an older adult is likely to feel: | ||||
Selected Answer: rubbery. |
If pitting edema is unilateral, you would suspect occlusion of a: | ||||
Selected Answer: major vein. |
You are examining Mr. S., a 79-year-old diabetic man complaining of claudication. Which of the following physical findings is consistent with the diagnosis of arterial occlusion? | ||||
Selected Answer: Loss of hair over the extremity |
The strength of the trapezius muscle is evaluated by having the patient: | ||||
Selected Answer: push her head against the examiner’s hand. |
Throughout the history and physical examination, the clinician should: | ||||
Selected Answer: evaluate the whole patient. |
Which condition is considered progressive rather than reversible? | ||||
Selected Answer: Dementia |
Which one of the following techniques is used to detect a torn meniscus? | ||||
Selected Answer: McMurray test |
You are examining a patient in the emergency department who has recently sustained head trauma. In order to initially assess this patient’s neurologic status, you would: | ||||
Selected Answer: test the six cardinal points of gaze. |
An examiner has rotated a brush several times into the cervical os. The brush was withdrawn and stroked lightly on a glass slide. The slide was sprayed with fixative. Which type of specimen requires this technique for collection? | ||||
Selected Answer: Cytology smear |
Cranial nerve XII may be assessed in an infant by: | ||||
Selected Answer: observing the infant suck and swallow. |
Functional assessment is most important during the examination of a(n): | ||||
Selected Answer: older adult. |
Ulnar deviation and boutonniere deformities are characteristic of: | ||||
Selected Answer: rheumatoid arthritis. |
A 56-year-old male presents to the clinic to see the nurse practitioner with complaints of shortness of breath for 1 months, 15-pound weight gain and lower extremity edema. Vitals are as follows: HR: 120, Respirations 30, Blood Pressure: 138/90, BMI: 40; Oxygen saturation of 90%. On examination patient is noted to have jugular venous distention, enlarged liver, and crackles are noted on examination. A chest x-ray is completed and shows findings consistent with which diagnosis? Based on this scenario and imaging what is the most likely diagnosis? | ||||
Selected Answer: Right Sided Congestive Heart Failure |
An apical PMI palpated beyond the left fifth intercostal space may indicate: | ||||
Selected Answer: left ventricular hypertrophy. |
A cervical polyp usually appears as a: | ||||
Selected Answer: bright-red soft protrusion from the endocervical canal. |
While collecting personal and social history data from a woman complaining of breast discomfort, you should question her regarding: | ||||
Selected Answer: alcohol, tobacco, and caffeine use. |
The best way to ease the apprehension of a 3-year-old child before a physical examination is to: | ||||
Selected Answer: let the child hold the stethoscope while you listen. |
Which medical condition would exclude a person from sports participation? | ||||
Selected Answer: Fever |
Diabetic peripheral neuropathy will likely produce: | ||||
Selected Answer: diminished pain sensation. |
A red, hot swollen joint in a 40-year-old man should lead you to suspect: | ||||
Selected Answer: gout. |
When palpating joints, crepitus may occur when: | ||||
Selected Answer: irregular bony surfaces rub together. |
An idiopathic spasm of arterioles in the digits is termed: | ||||
Selected Answer: Raynaud disease. |
Facial muscle or tongue weakness may result in: | ||||
Selected Answer: aphasia. |
Nerves that arise from the brain rather than the spinal cord are called: | ||||
Selected Answer: cranial. |
A 25 yo AA female has come to the clinic because she has missed her menstrual period this month and 2 months before. She says her cycles are irregular and she wants to be on birth control to help regulate them. She states that her breasts have enlarged and that her nipples have turned a darker color. Your further response to this finding is to: | ||||
Selected Answer: suggest a pregnancy test |
Inquiry about nocturnal muscle spasms would be most significant when taking the musculoskeletal history of: | ||||
Selected Answer: older adults. |
The checkout station for preparticipation physical evaluation (PPE) is critical because at this point: | ||||
Selected Answer: coordination of follow-ups is reviewed. |
A 40 yr old female presents to the clinic with complaints of low back and buttock pain. Pt states the buttock pain radiates from one side to the other. On examination, the patient is noted to have limited ROM of the shoulders, chest wall, hips, and knees. Upon xray, you find gross postural changes and there is a severe deformity of the vertebral column. What is the most likely diagnosis for this patient? | ||||
Selected Answer: Lumbar Stenosis |
Kawasaki disease is suspected when assessments of a child reveal: | ||||
Selected Answer: conjunctival injection, strawberry tongue, and edema of the hands and feet. |
Loss of immediate and recent memory with retention of remote memory suggests: | ||||
Selected Answer: dementia. |
Your 15-year-old patient is athletic and thin. Radiography of an ankle injury reveals a stress fracture. You should question this patient about her: | ||||
Selected Answer: menstrual cycles. |
To spread the breast tissue evenly over the chest wall, you should ask the woman to lie supine with: | ||||
Selected Answer: one arm overhead and a pillow under her shoulder. |
A grade IV mitral regurgitation murmur would: | ||||
Selected Answer: radiate to the axilla. |
The Mini-Mental State Examination: | ||||
Selected Answer: may be used to quantitatively estimate cognitive changes. |
Assessing orientation to person, place, and time helps determine: | ||||
Selected Answer: state of consciousness. |
Anterior cruciate ligament integrity is assessed via the _____ test. | ||||
Selected Answer: Lachman |
The Denver II is a tool used to determine: | ||||
Selected Answer: whether a child is developing as expected. |
When assessing superficial pain, touch, vibration, and position perceptions, you are testing: | ||||
Selected Answer: sensory function. |
One of the most important aspects to consider in the orthopedic screening examination is: | ||||
Selected Answer: symmetry. |
The rectal past medical history of all patients should include inquiry about: | ||||
Selected Answer: hemorrhoid surgery. |
Breath sounds normally heard over the trachea are called: | ||||
Selected Answer: bronchial. |
When conducting a geriatric assessment, basic activities of daily living (ADLs) include: | ||||
Selected Answer: bathing. |
You are interviewing a 20-year-old patient with a new-onset psychotic disorder. The patient is apathetic and has disturbed thoughts and language patterns. The nurse recognizes this behavior pattern as consistent with a diagnosis of: | ||||
Selected Answer: schizophrenia. |
An elderly female was recently diagnosed with osteoporosis 2 weeks ago. What is the hallmark appearance of a patient with this diagnosis? | ||||
Selected Answer: Dowager hump |
You are performing a two-point discrimination test as part of a well physical examination. The area with the ability to discern two points in the shortest distance is the: | ||||
Selected Answer: fingertips. |
The spread of the impulse through the ventricles (ventricular depolarization) is depicted on the ECG as the: | ||||
Selected Answer: QRS complex. |
While interviewing a 70-year-old female clinic patient, she tells you that she takes ginkgo biloba and St. John’s wort. You make a short note to check for results of the: | ||||
Selected Answer: Mini-Mental State Examination. |
Adrian Thomas is a 19-year-old girl who presents to the clinic with complaints of severe, acute chest pain. Her father reports that Adrian, apart from occasional sinus infections, Adrian is not prone to respiratory problems. What potential risk factor is most important to assess with regards to Adrian’s current problem? | ||||
Selected Answer: Covid-19 contact |
When the Goodenough-Harris Drawing Test is administered to a child, the evaluator principally observes the: | ||||
Selected Answer: presence and form of body parts. |
An ophthalmoscopic eye examination involves: | ||||
Selected Answer: lens inspection. |
Darian is a 14-year-old adolescent who states his right testicle has a soft swollen mass. The testicle is not painful upon palpation. The right inguinal canal is without masses. The mass does transilluminate with a penlight. This collection of symptoms is consistent with: | ||||
Selected Answer: hydrocele |
To hear diastolic heart sounds, you should ask patients to: | ||||
Selected Answer: lie on their left sides. |
If a patient cannot shrug the shoulders against resistance, which cranial nerve (CN) requires further evaluation? | ||||
Selected Answer: CN XI, spinal accessory |
To assess a cremasteric reflex, the examiner strokes the: | ||||
Selected Answer: inner thigh and observes whether the testicle and scrotum rise on the stroked side. |
You are reviewing an ECG of a 43 year old new patient. The patient has a history of second-degree heart block. The ECG shows the PR interval is increases with each beat until a QRS is dropped. What is this type of block called? | ||||
Selected Answer: Second degree heart block, type 1: Wenckebach/Mobitz 1 |
Bimanual examination of the uterus includes: | ||||
Selected Answer: grasping the cervix between the examining fingers. |
Postural hypotension is defined as a _____ when the patient stands, compared with sitting or supine readings. | ||||
Selected Answer: systolic pressure drop of more than 15 mm Hg with a pulse rate increase |
A patient in the deepest coma would be scored a _____ on the Glasgow Coma Scale. | ||||
Selected Answer: 3 |
The goals of preparticipation sports evaluation include: | ||||
Selected Answer: identifying risk of injury or death during sports participation. |
If your patient has nipple discharge, you will most likely need a: | ||||
Selected Answer: glass slide and fixative. |
Which of the following statements is true regarding the examination of peripheral arteries? | ||||
Selected Answer: The pulses are most readily felt over bony prominences. |
The physical assessment technique most frequently used to assess joint symmetry is: | ||||
Selected Answer: inspection. |
Adrian Thompson is a 19-year-old girl who presents to the clinic with complaints of severe, acute chest pain. Her mother reports that Andrian, apart from occasional sinus infections, Andrian is not prone to respiratory problems. What potential risk factor is most important to assess with regards to Adrian’s current problem? | ||||
Selected Answer: Covid-19 contact |
You are conducting a preparticipation physical examination for a 10-year-old girl with Down syndrome who will be playing basketball. She has slight torticollis and mild ankle clonus. What additional diagnostic testing would be required for her? | ||||
Selected Answer: Cervical spine radiograph |
To assess spinal levels L2, L3, and L4, which deep tendon reflex should be tested? | ||||
Selected Answer: Patellar |
Part of the screening orthopedic component of the examination includes evaluating the person while he or she is: | ||||
Selected Answer: duck walking. |
When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? | ||||
Selected Answer: Yes |
Sunday, November 14, 2021 2:35:24 AM EST
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