NURS 6512 FINAL EXAM: WALDEN UNIVERSITY
1. Costovertebral angle tenderness should be assessed whenever you suspect the patient may have: -
2. In older adults, overflow fecal incontinence is commonly due to:
3. A 1 month old boy has been vomiting for 2 weeks. How is this symptom of GERD and pyloric stenosis further differentiated in this child’s assessment?
4. Auscultation of borborygmi is associated with:
5. When auscultating the abdomen, which finding would indicate collateral circulation between the portal and systemic venous systems? –
6. Conversion of fat-soluble wastes to water-soluble material for renal excretion is a function of the: -
7. The major function of the large intestine is: -
8. Which structure is located in the hypogastric region of the abdomen? –
9. A 45 year old man relates a several week history of severe intermittent abdominal burning sensations. He relates that the pain is relieved with small amounts of food. Before starting the physical examination, you review his laboratory work, anticipating a (n): -
10. You are caring for a patient with trigeminal neuralgia. During the assessment, the patient would describe the pain as: -
11. Your 85 year old patient is complaining of right knee pain. She has a history of osteoarthritis for which she is given anti-inflammatory medication. To assess her right knee pain, you should ask her if: - 12. A 5 year old is complaining of nondescriptive “belly pain.” Your next action should be to ask him to: - 13. The perception of pain: -
14. Patients presenting with ascites, jaundice, cutaneous spider veins, and nonpalpable liver exhibit signs of: -
15. A patient presents to the emergency department after a motor vehicle accident. The patient sustained blunt trauma to the abdomen and complains of pain in the upper left quadrant that radiates to the left shoulder. What organ is most likely injured?
16. Imaging studies reveal that a patient has dilation of the renal pelvis from an obstruction in the ureter, what condition will be documented in this patient’s health record? –
17. Visible intestinal peristalsis may indicate: -
18. Infants born weighing less than 1500g are at higher risk for:
19. Which of the following factors is not known to affect patient compliance with his or her treatment regimen? –
20. One of the most important aspects to consider in the orthopedic screening examination is: -
21. The sequence of the physical examination should be individualized to:
22. As you greet the patient, which examination technique is first implemented? –
23. Which of the following is most likely to enhance examiner reliability?
24. A 7 year old boy is brought to your office with a chief complaint of possible fracture to his left third finger. He jammed it while playing basketball 2 days ago. The mother states that she really does not think it is broken because he can move it. What is your best response? –
25. A patient presenting for the first time with typical low back pain should receive which of the following diagnostic tests?
26. Skeletal changes in older adults are the result of: -
27. A positive straight leg raise test usually indicates: -
28. What technique is performed at every infant examination during the first year of life to detect hipdislocation? -
29. Expected normal findings during inspection of spinal alignment include-
30. Temporalis and masseter muscles are evaluated by:-
31. When palpating joints, crepitus may be caused when: -
32. A 3 year old is brought to the clinic complaining of a painful right elbow. He is holding the right arm slightly flexed and pronated and refuses to move it. the mother states that symptoms started right after his older brother had been swinging him around by his arms. This presentation supports a diagnosis of: -
33. Light skin and thin body habitus are risk factors for: -
34. Risk factors for sports-related injuries include: -
35. Injuries to long bones and joints are more likely to result in fractures than in sprains until: -
36. Ligaments are stronger than bone until: -
37. The family history for a patient with joint pain should include information about siblings with: -
38. The Thomas test is used to detect: -
39. A goniometer is used to assess: -
40. During a football game, a player was struck on the lateral side of the left leg while his feet were firmly planted. He is complaining of left knee pain. To examine the left knee you should initially perform the ________ test. –
41. You note that a child has a positive Gower Sign. You know that this indicates generalized: -
42. The dowager hump is: -
43. What temporary disorder may be experienced by pregnant women during the third trimester because of fluid retention?–
44. A common finding in markedly obese and pregnant women is: -
45. A 45-year-old laborer presents with low back pain, stating that the pain comes from the right buttock and shoots down and across the right anterior thigh, down the shin to the ankle. Which examination finding is considered more indicative of nerve root compression?A 45 year old laborer presents with low back pain, stating that the pain comes from the right buttock and shoots down and across the right anterior thigh, down the shin to the ankle. Which examination finding is considered more indicative of nerve root compression? -
46. Mrs. Bower is a 57 year old patient who comes in for an office visit. Which of the following disorders is known to be hereditary? –
47. Testing of cranial nerve ________ is not routinely performed unless a problem is suspected. – I
48. The patient is able to rapidly touch each finger to his thumb in rapid sequence. What does this finding mean? –
49. Which question asked by the examiner may hellp to determine prevention strategies for seizures that a patient is experiencing? –
50. A patient has a complaint of dizziness. The patient makes the following statement: “I sometimes feel as if the whole room is spinning.” What type of neurologic dysfunction should the examiner suspect? –
51. The examiner asks the patient to close her eyes, then places a vibrating tuning fork on the patient’s ankle and asks her to indicate what is felt. What is being assessed? -
52. Which of the following findings should an examiner consider a normal finding if associated with pregnancy? – -
52. Jack is a 52 year old obese man with a history of poorly controlled diabetes. He also smokes. Based on the above data, the examiner should recognize that Jack has several risk factors for: - -
53. Mrs. Jones is a 24 year old patient who presents to your office 2 days postpartum. She complains that she is experiencing foot drop. Which of the following problems should the examiner consider? –
54. The examiner is assessing deep tendon reflex response in a 12 year old boy. The response is an expected reflex response. Which of the following scores should be documented? –
55. A 68 year old patient presents to your office for follow-up. He tells you, “I have a hard time finding the right words when I am talking;” he also is experiencing numbness. On examination, you note postural instability. This symptom may be: -
56. Motor maturation proceeds in an orderly progression from: -
57. The thalamus is the major integration center for perception of: -
58. The examiner should be concerned about neurologic competence if a social smile cannot be elicited by the time a child is ________old. -
59. Normal changes of the aging brain include: - -
60. When 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: --
61. The area of body surface innervated by a particular spinal nerve is called a: - -
62. If a patient cannot shrug the shoulders against resistance, which cranial nerve (CN) requires further evaluation? – -
63. The finger-to-nose test allows assessment of: - -
64. You ask the patient to follow a series of short commands to assess: - -
65. As Mr. B. enters the room, you observe that his gait is wide based and he staggers from side to side while swaying his trunk. You would document Mr. B.’s pattern as: -
66. When is the mental status portion of the neurologic system examination performed? -
67. An aversion to touch or being held, along with delayed or absent language development, is a characteristic of: --
68. The autonomic nervous system coordinates which of the following? -
69. The major function of the sympathetic nervous system is to: - -
70. The parasympathetic nervous system maintains the day-to-day function of: -
71. Cerebrospinal fluid serves as a: - -
72. 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: --
73. Which type of hallucination is most commonly associated with alcohol withdrawal? – -
74. On a scale of 0 to 4+, which deep tendon reflex score is appropriate for a finding of clonus in a patient? -
75. Which statement is true regarding mental status changes in older adults? – -
76. A characteristic related to syphilis or diabetic neuropathy is testicular: --
77. When collecting personal and social history data from a woman complaining of breast discomfort, you should question her regarding: - -
78. What risk factor is associated with cervical cancer? – -
79. A 23 year old female presents with severe right lower quadrant tenderness. All of the following should be considered in the differential except: - -
80. What is the initial diagnostic radiology test that should be ordered if you suspect a ruptured ovarian cyst? – -
81. A 17 year old male was brought into the emergency room with testicular/scrotal pain. The differential diagnosis should include all except: -
82. The nursing mother complains that her breasts are tender. You assess hard, shiny, and erythremicbreasts bilaterally. You should advise the patient to: - -
83. A normal vas deferens should feel: - -
84. In a woman complaining of a breast lump, it is most important to ask about: - -
85. The finding of a painless indurated lesion on the glans penis is most consistent with: - -
86. Thrombosed hemorrhoids are: - -
87. Pregnancy-related cervical changes include: -
88. You are inspecting the genitalia of an uncircumcised adult male. The foreskin is tight and cannot be easily retracted. You should: - -
89. An adolescent male is being seen for acute onset of left testicular pain. The pain started 3 hours ago. He complains of nausea and denies dysuria or fever. Your prioritized assessment should be to: -
90. A 23 year old white woman has come to the clinic because she has missed two menstrual periods. She states that her breasts have enlarged and that her nipples have turned a darker color. Your further response to this finding is: - -
91. What accommodations should be used in the position of a hearing-impaired woman for a pelvic examination? – -
92. Sexual differentiation in the fetus has occurred by _______weeks gestation. - -
93. You are performing a clinical breast examination for a 55 year old woman. While palpating the supraclavicular area, you suspect that you felt a node. In order to improve your hooked technique, you should: --
94. If a firm, transverse ridge of compressed tissue is felt bilaterally along the lower edge of a 40 year old patient’s breast, you should: --
95. A therapeutic technique for dealing with grieving individuals is to: -
96. The examination of the newborn should begin with: - -
97. Which one of the following patient characteristics is most likely to limit patient reliability during history taking? – -
98. In crying infants, it is often difficult to: - -
99. Which of the following statements accurately reflects the sensitivity and specificity of laboratory tests? –-
100. Which medical condition would exclude one from sports participation? – -
101. Your 15 year old patient is athletic and thin. Radiography of an ankle injury reveals a stress fracture. You question this patient about her: - -
102. Which of the following are examined with the patient in a reclining 45 degree position? –-
103. Functional assessment is most important during the examination of a(n): --
104. The best way to ease the apprehension of a 3 year old child before a physical examination is to: - -
105. An ophthalmoscopic eye examination involves: - -
106. When conducting a geriatric assessment, basic activities of daily living (ADLs) include: -
107. The checkout station for preparticipation physical evaluation (PPE) is critical because at this point: -
108. Which of the following is true regarding the relationship between the examiner and the patient? –
109. Which of the following factors is not known to affect patient compliance with his or her treatment regimen? –
110. One of the most important aspects to consider in the orthopedic screening examination is: -
111. As you greet the patient, which examination technique is first implemented? –
112. Which portion of the physical examination is best done with the patient standing? –
113. Which patient position facilitates inspection of the chest and shoulders? –
114. The least reliable indicator of newborn distress is: -
115. Proprioception should be assessed while the patient is: -
116. Part of the screening orthopedic component of the examination includes evaluating the person while: -
NURS 6512 Week 6 Midterm Exam: Advanced Health Assessment: Walden University
1. Before performing an abdominal examination, the examiner should:
2. During an interview, tears appear in the patient’s eyes and his voice becomes shaky. Initially, you should:
3. Which of the following is the most accurate reflection of an individual’s food intake?
4. Percussing at the right midclavicular line, below the umbilicus, and continuing upward is the correct technique for locating the:
5. A fixed image of any group that rejects its potential for originality or individuality is known as a:
6. Peritonitis produces bowel sounds that are
7. Brittle nails are typical findings in:
8. Which of the following is an expected change in the assessment of the thyroid during pregnancy?
9. You are planning to palpate the abdomen of your patient. Which part of the examiner's hand is best for palpating vibration?
10. A 5-year-old child presents with nasal congestion and a headache to assess for sinus tenderness you should palpate over the:
11. During physical examination of a 30-year-old Chinese man you notice a slight asymmetry of his face. the cranial nerve examination is normal. Your best action is to
12. Unusual white areas on the skin may be due to
13. You are using an ophthalmoscope to examine a patient’s inner eye. You rotate the lens selector clockwise, then counterclockwise to compensate for:
14. Mrs. Webb is a 38-year old patient who has been changing her lifestyle to eat in a healthy way and lose weight: during your health promotion education regarding her nutritional status, you explain the function of dietary protein as:
15. Mr. Akins is a 78-y/o patient who presents to the clinic with complaints of hearing loss. Which of the following are changes in hearing that occur in the elderly? Select all that apply.
16. The most superior part of the stomach is the
17. Mrs. Grace is a 58-year-old patient who has a diagnosis of pernicious anemia. Which B vitamin is deficient in patients with pernicious anemia?
18. A 51-y/o woman calls with complaints of weight loss and constipation. She reports enlarged hemorrhoids and rectal bleeding. You advise her to:
19. Placing the base of a vibrating tuning fork on the midline vertex of the patient’s head is a test for:
20. Which technique is most likely to result in the patients understanding of questions?
21. Mr. Williams, age 25, has recovered recently from an upper and lower respiratory infection. He describes a long-standing nasal dripping. He is seeking treatment for a mild hearing loss that has not gone away. Information concerning his chronic postnasal drip should be documented within which section of the history?
22. Nasal symptoms that imply an allergic response include:
23. Mr. Franklin is speaking with you the health care provider, about his respiratory problem. Mr. Franklin says, “I’ve had this cough for 3 days and it’s getting worse.” You reply, “Tell me more about your cough.” Mr. Franklin states, “I wish I could tell you more, that’s why I am here! You tell me what’s wrong.” Which caregiver response would be the most appropriate for enhancing communication?
24. When taking a history, you should:
25. Which of the following formats would be used for visits that address problems not yet identified in the problem-oriented medical record (POMR)?
26. Mr. and Mrs. Johnson have presented to the office with their infant son with complaints of ear drainage. When examining an infant’s middle ear, the nurse should use one hand to stabilize the otoscope against the head while using the other hand to:
27. Which question would be considered a leading question?
28. Mr. Black is a 44y/o patient who presents to the clinic with complaints of neck pain that he thinks is from his job involving computer data entry. As the examiner, you are checking the range of motion in his neck and note the greatest degree of cervical mobility is at?
29. The term denoting the caregiver’s need to do no harm to the patient is:
30. A tool used to screen adolescents for alcoholism is the:
31. Under normal circumstances, how much water is lost daily by the body?
32. You have just completed a skin assessment on Mr. Baker. During your assessment, you have transilluminated a skin lesion. During the physical examination, you know that skin lesions are transilluminated to distinguish:
33. Mr. Mills is a 55/y/o patient who presents to the office for an initial visit for health promotion. A survey of mobility and activities of activities of daily living is part of a(n):
34. Sweat glands, hair, and nails are all formed from?
35. A brief statement of the reason the patient is seeking health care is called the?
36. Which part of the information contained in the patient’s record may be used in court?
37. Which cranial nerves innervate the face?
38. In counseling a client regarding nutrition education, you explain that linoleic acid, a major fatty acid, is thought to be essential for?
39. When are open-ended questions generally most useful?
40. Knowledge of the culture or cultures represented by the patient should be used to?
41. Mrs. Berger is a 39-year-old woman who presents with a complaint of epigastric abdominal pain. You have completed the inspection of the abdomen. What is your next step in the assessment process?
42. A guideline for history taking is for caregivers to?
43. Which type of speculum should be used to examine a patient’s tympanic membrane?
44. You are palpating a patient’s thyroid and find that its broadest dimension measures 4cm. the right lobe is 25% larger than the left. These data would indicate?
45. Mr. L. presents to the clinic with severe groin pain and a history of kidney stones. Mr. L.’s son tells you that, for religious reasons, his father wishes to keep any stone that is passed into the urine filter that he has been using. What is your most appropriate response?
46. Before performing an abdominal examination, the examiner should?
47. You are examining a pregnant patient and have noted a vascular lesion. When you blanche over the vascular lesion, the site blanches and refills evenly from the center outward. The nurse documents this lesion as a?
48. As you explain your patient’s condition to her husband, you notice that he is leaning toward you and pointedly blinking his eyes. Knowing that he is from England, your most appropriate response to this behavior is to?
49. When palpating the abdomen, you should note whether the liver is enlarged in the?
50. Expected normal percussion tones include?
51. Mr. Abdul is a 40-year-old Middle Eastern man who presents to the office for a first visit with the complaint of new abdominal pain. You ate concerned about violating a cultural prohibition when you prepare to do his rectal examination. The best tactic would be to?
52. Fluorescing lesions are best distinguished using a(n)?
53. Mrs. Hartzell is a 34-year-old patient who has presented for nutritional counseling because she is a vegetarian. Deficiency of which of the following is a concern in the vegetarian diet?
54. Underestimation of blood pressure will occur if the blood pressure cuff’s width covers?
55. Mrs. Britton is a 34-year-old patient who presents to the office with complaints of skin rashes. You have noted a 4’3cm, rough, elevated area of psoriasis. This is an example of a?
56. Penicillin is considered a?
57. Small, minute bruises are called?
58. After thorough inspection of the abdomen, the next assessment step is?
59. When you are questioning a patient regarding alcohol intake, she tells you that she is only a social drinker. Which initial response is appropriate?
60. Regardless of the origin, discharge is described by noting?
61. Recommended carbohydrate content of total dietary intake (% total calories) is?
62. Tuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure?
63. Auscultation should be carried out last, except when examining the?
64. Mr. Kevin Marks is a new health care provider. What is the best method to develop cultural competence?
65. Which of the following is an “ABCD” characteristic of malignant melanoma?
66. Tracheal tug suggests the presence of a(n)?
67. Your patient presents with symptoms that lead you to suspect acute appendicitis. Which assessment finding is least likely to be associated with this condition early in its course?
68. The review of systems is a component of the:
69. Cherry angiomas are a common finding in:
70. Mr. Donalds is a 45-year-old roofer. Your inspection to determine color variations of the skin is best conducted:
71. To correctly document absent bowel sounds, one must listen continuously for:
72. The adult recommended dietary fat intake should be ____g/day.
73. Mr. Jones is a 45-year-old patient who presents for a physical examination. On examination, you note costochondral beading, enlarged skull, and bowed legs and diagnose him with rickets. A deficiency of which fat-soluble micronutrient can result in rickets?
74. A flat, nonplapable lesion is described as a macule if the diameter is:
75. Mrs. Raymonds is a 24-year-old patient who has presented for a routine concern over her current weight. In your patient teaching with her, you explain the importance of macronutrients. Which of the following is a macronutrient?
76. Which of the following organs is part of the alimentary tract?
77. Mr. Sanchez is a 45-year-old gentleman who has presented to the office for a physical examination to establish a new primary care health care provider. Which of the following describes a physical, not a cultural, differentiator?
78. To approximate vocal frequencies, which tuning fork should be used to assess hearing?
79. During percussion, a dull tone is expected to be heard over:
80. The attitudes of the health care professional:
81. When recording physical findings, which data are recorded first for all systems?
82. Spasmodic muscular contractions of the head, face, or neck are called:
83. Which of the following occurs when firm pressure is used to apply the stethoscope’s bell end-piece to the skin?
84. Differential diagnoses belong in the:
85. Pigmented, raised, warty lesions over the face and trunk should be assessed by an experienced practitioner who can distinguish:
86. Mr. Walter’s, a 32-year-old patient, tells you that his ears are “stopped up.” An objective assessment of this complaint is achieved by using the:
87. Mrs. Leonard brings her newborn infant into the pediatrician’s office for a first well-baby visit. As the health care provider, you teach her that newborns are more vulnerable to hypothermia due to:
88. Tympanic thermometers measure body temperature when a probe is placed:
89. A serous membrane that lines the abdominal cavity and forms a protective cover for many abdominal structures is the:
90. White, rounded, or oval ulcerations surrounded by a red halo and found on the oral mucosa are:
91. When assessing abdominal pain in a college-age woman, one must include:
92. Your patient is complaining of acute, intense sharp epigastric pain that radiates to the back and left scapula with nausea and vomiting. Based on this history, your prioritized physical examination should be to:
93. The infant should be placed in which position to have his or her height or length measured?
94. Mr. Marks is a 66-year-old patient who presents for a physical examination to the clinic. Which question has the most potential for exploring a patient’s cultural beliefs related to a health problem?
95. Which of the following is the most vital nutrient?
96. What finding is unique to the documentation of a physical examination of an infant?
97. Mrs. G. reports an increase in her alcohol intake over the past 5 years. To screen her for problem drinking, you would use the:
98. Mr. D. complains of a headache. During the history he mentions his use of alcohol and illicit drugs. This information would most likely belong in the:
99. You are completing a general physical examination on Mr. Rock, a 39-year-old man with complaints of constipation. When examining a patient with tense abdominal musculature, a helpful technique is to have the patient:
100. When communicating with older children and teenagers, you should be sensitive to their:
101. Periods of silence during the interview can serve important purposes, such as:
NURS 6512 Week 6 Midterm Exam: Advanced Health Assessment: Walden University
Which of the following is an expected change in the assessment
of the thyroid during pregnancy?
When recording physical finding, which data are recorded first for all systems?
In counseling a Client regarding education .,you explain that Linoleic acid, a major fatty acid, is thought to be essential for:
Peritonitis produces bowel sounds that are:
Sweat glands, hair, and nails are all formed:
The adult recommended dietary fat intake
Recommended carbohydrate content of total dietary intake (% total calories) is
Which of the formats would be used for a (POMR)
Question 141 out of 1 pointsMr. Abdul is a 40-year-old Middle Eastern man who presents to the office for a first visit with the complaint of new abdominal pain. You are concerned about violating a cultural prohibition when you prepare to do his rectal examination. The best tactic would be to:
Question 151 out of 1 pointsYour patient is complaining of acute, intense sharp epigastric pain that radiates to the back and left scapula with nausea and vomiting. Based on this history, your prioritized physical examination should be to:
Question 161 out of 1 pointsWhen examining the skull of a 4-month-old baby, you should normally find:
Question 171 out of 1 pointsMs. G. is being seen for her routine physical examination. She is a college graduate and president of a research firm. Although her exact salary is unknown, she has adequate health insurance. Most of the above information is part of Ms. G.'s _____ history.
To perform the Rinne test, place the tuning fork on the:
Question 71 out of 1 pointsWhen are open-ended questions generally most useful?
Question 80 out of 1 pointsThe review of systems is a component of the:
Fluorescing lesions are best distinguished using a(n):
Pigmented, raised, warty lesions over the face and trunk should be assessed by an experienced practitioner who can distinguish:
Mr. Franklin is speaking with you, the health care provider, about his respiratory problem. Mr. Franklin says, "I've had this cough for 3 days, and it's getting worse." You reply, "Tell me more about your cough." Mr. Franklin states, "I wish I could tell you more. That's why I'm here. You tell me what's wrong!" Which caregiver response would be most appropriate for enhancing communication?
The term denoting the caregiver's need to do no harm to the patient is:
Underestimation of blood pressure will occur if the blood pressure cuff's width covers:
Mrs. Hartzell is a 34-year-old patient who has presented for nutritional counseling because she is a vegetarian. Deficiency of which of the following is a concern in the vegetarian diet?
The most superior part of the stomach is the:
When recording physical findings, which data are recorded first for all systems?
Kevin Marks is a new health care provider. What is the best method to develop cultural competence?
Which cranial nerves innervate the face?