NSG 137 Post Quiz Questions
Select the best description of the tricuspid valve. A.Right atrioventricular valve B.Left semilunar valve C.Left atrioventricular valve D.right semilunar valve
A
Several changes occur in the eye with the aging process. The thickening and yellowing of the lens is referred to as: A. senile cataract B. Floaters C. macular degeneration D. Presbyopia
A
The apex of the lungs is located: A.3 to 4 cm above the inner third of the clavicles. B.at the fifth intercostal space. C.at the diaphragm. D.adjacent to the Angel of Louie.
A
The bell of the stethoscope: A. is used for soft low-pitched sounds. B. is used for high-pitched sounds. C. is held firmly against the skin. D. magnifies sounds.
A
The examiner records "positive, consensural light reflex." This is: A. the simultaneous constriction of the other pupil when one eye is exposed to bright light. B. the adaptation of the eye for near vision. C. a reflex direction of the eye toward an object attracting a person's attention. D. the convergence of the axes of the eyeballs.
A
The examiner wishes to listen in the pulmonic valve area. To do this, the stethoscope would be placed at the: A.second left interspace. B.fifth interspace, left midclavicular line. C.second right interspace. D.left lower sternal border.
A
The medical record indicates that a person has an injury to Broca's area. When meeting this person you expect: A. difficulty speaking. B. receptive aphasia. C. vixuzl disturbances. D. emotional lability.
A
The most common site of breast tumors is the: A. upper outer quadrant. B. lower inner quadrant. C. upper inner quadrant. D. lower outer quadrant.
A
A 70-year-old woman has come for a health exam. Which of the following is a common age-related change in the curvature of the spinal column ? A. Scoliosis. B. Lordosis C. Lateral scoliosis. D. Kyphosis.
D
A murmur heard after S1 and before S2 is classified as: A. diastolic B. pulmonic C. cyanotic D. systolic
D
A nurse precepting a student nurse ask, "What's the most important step in the critical-thinking process? A. Prioritizing concerns B. Clustering subjective and objective data C. Analyzing health data D. Using eveidence-based assessment techniques
D
A 64-year-old man has come for a health examination. A normal age related change in the scrotum would be:
pendulous scrotum.
A young woman has come for her first gynecologic examination. Because she has not had any children, the examiner would expect the cervix to appear:
smooth and circular.
Prostatic hypertrophy occurs frequently in older men. The symptoms that may indicate this problem are:
straining, loss of force, and sense of residual urine.
A 52-year-old patient states that when she sneezes or coughs she "wets herself a little." She is very concerned that something may be wrong with her. You know that this is called:
stress incontinence and is usually due to muscle weakness.
A pulse with an amplitude of 3+ would be considered: A.weak. B.absent. C.normal. D.increased, bounding.
D
Auscultation of the abdomen begins in the right lower quadrant (RLQ) because: A. this is the location of the pyloric sphinctor. B. peristalsis through the descending colon is usually active. C. vascular sounds are best heard in this area. D. bowel sounds are normally present here.
D
Breast asymmetry: A. indicates a neoplasm. B. increases with age and parity. C. is accompanied by enlarged axillary lymph noes. D. may be normal.
D
In a medical record, the tonsils are graded as 3+. The tonsils would be: A. halfway between the tonsillar pillars and uvula. B. visible. C. touching each other. D. touching the uvula.
D
In order to screen for deep vein thrombosis, you would: A. measure the circumference of the ankle. B. check the temperature with the palm of the hand. C. compress the dorsalis pedis pulse, looking for blood return. D. measure the calf at the widest point with a tape measure.
D
In the Rinne test, the 2 to 1 ratio refers to: A. the lengths of time until the patient no longer hears the tone and the examiner no longer hears the tone. B. the examiner hearing the tone twice as long as the patient hears it. C. the loudness of the tone heard by the two ears. D. the lengths of time until the patient stops hearing the tone by air conduction and by bone conduction.
D
It is normal to palpate a few lymph nodes in the neck of a healthy person What are the characteristics of these nodes? A.large, clumped, tender B.matted, fixed, nontender C.matted, fixed, tender, hard D.mobile, soft, nontender
D
Moving a limb toward the midline of the body is called: A. Flexion B. Extension C. Abduction D. Adduction
D
Select the most complete description of a database. A. subjective and objective data gathered by a health practitioner from the patient B. objective data obtained from a patient through inspection, percussion, palpation, and auscultation C. a summary of a patient's record, including laboratory studies D. subjective and objective data gathered from a patient plus the results of any diagnostic studies completed
D
Select the sequence of techniques used during an examination of the abdomen. A. Auscultation, inspection, palpation, percussion B. Inspection, palpation, percussion, auscultation C. Percussion, inspection, palpation, auscultation D. Inspection, auscultation, percussion, palpation
D
Select the symptom that is least likely to indicate a possible malignancy. A.History of using chewing tobacco B.History of radiation therapy tohead, neck, and upper chest C.History of large alcohol consumption D.Tenderness
D
Shifting dullness is a test for: A. hepatomegaly. B. splenic enlargement. C. inflammation of the kidney. D. ascites.
D
Striae, which occur when the elastic fibers in the reticular layer of the skin are broken following rapid or prolonged stretching, have a distinct color when of long duration. This color is: A. pink. B. blue. C. purple-blue. D. silvery white.
D
The control of body temperature is located in: A. Wernicke's area. B. the thalamus. C. the cerebellum. D. the hypothalamus.
D
The corneal reflex is mediated by cranial nerve: A. VI and IV. B. II and IV. C. II and III. D. V and VII.
D
Mr. Harrison is a 28-year-old patient who presents to your office urgently with a concern of a penile erection that has not subsided. Which term could you use in documenting this problem?
Priapism
On examination of a patient who complains of difficulty urinating, you note that the meatus has a pinpoint, constricted opening. What problem is suggested by these findings?
Urethral stricture
A 24-year-old man comes to the clinic with scrotal pain and marked erythema. Which other finding supports your impression of epididymitis as the problem?
Urinalysis shows elevated white blood cells (WBCs) and bacteria.
A patient has soft, moist, fleshy, painless papules around the anus. The examiner suspects this condition is
HPV
After completing an assessment of a 60-year-old man with a family history of colon cancer, the nurse discusses with him early detection measures for colon cancer. the nurse should mention the need for a(n):
colonscopy every 10 years.
A patient calls you for instructions prior to having a Papanicolaou (Pap) smear. The most appropriate instructions are:
"Avoid intercourse, inserting anything into the vagina, or douching within 24 hours of your appointment."
When palpating the inguinal canal for a hernia, which direction do you give the patient?
"Bear down."
Thomas is a 32-month-old boy who is brought in by his mother for a routine health examination. Which question should you ask his mother?
"Has toilet training started yet?"
Ms. T. states that 2 weeks ago she had a urinary tract infection that was treated with an antibiotic. As a part of your interview, you would definitely want to ask:
"Have you noticed any unusual vaginal discharge or itching?"
During the interview your patient reveals that she has some vaginal discharge. She is worried that it may be a sexually transmitted disease. Your most appropriate response to this would be:
"I'd like some information about the discharge. What color is it?"
A 60-year-old man has just been told he has benign prostatic hypertrophy. He has a friend who just died from cancer of the prostate, and he is concerned this will happen to him. How should the nurse respond?
"The enlargement of your prostate is caused by hormone changes and not cancer.
A 20-year-old man has indicated that he does not perform testicular self-examination. One of the facts that should be shared with him is that testicular cancer, though rare, does occur in men ages:
15 to 34 years.
You examine nailbeds for clubbing. What is the normal angle between the nail base and the nail
160 degrees
During a routine examination, you should retract the foreskin of an uncircumcised child of which age?
36 months
A 70-year-old woman complains of dry mouth. The most frequent cause of this problem is: A. related to medications she may be taking. B. related to a diminished sense of smell. C. the use of dentures. D. the aging process.
A
A barrel chest is described as: A. anteroposterior = transverse diameter. B. lateral, S-shaped curvature of the thoracic and lumbar spine. C. eliptical shape with an anteroposterior: transverse diameter in the ratio of 1:2. D. forward protrusion of the sternum with ribs sloping back at either side.
A
A common cause of a conductive hearing loss is: A. impacted cerumen. B. otitis externa (infection in the ear canal). C. acute rheumatic fever. D. a CVA (stroke).
A
A patient admittied to the hospital with asthma has the following problems identified based on an admission health history and physical assessment. Which problem is a first-level priority? A. Impaired gas exchange B. Ineffective self-health management C. Readiness for enhanced spiritual well-being D. Risk for infection
A
A positive Babinski sign is: A. dorsiflexion of the big toe and fanning of all toes. B. plantar flexion of the big toe with a ganning of all toes. C. the expected results in healthy adults. D. withdrawal of the stimulated extremity from the stimulus.
A
An amulet may be used to protect a person from: A. the evil eye. B. being kidnapped. C. exposure to bacterial infections. D. an unexpected fall.
A
Atrophic skin changes that occur with peripheral arterial insufficience include: A.thin, shiny skin with hair loss B.brown discoloration. C.thick, leathery skin. D.slow-healing blisters on the skin.
A
During the examination of the lower extremities, you are unable to palpate the popliteal pulse. You should: A.proceed with the exam. It is often impossible to palpate this pulse. B.refer the patient to a vascular surgeon for further evaluation. C.schedule the patient for a venogram. D.schedule the patient for an arteriogram.
A
Evidence-based nursing practice can be described as: A. combining clinical expertise with the use of nursing research to provide the best care for patients while considering the patient's values and circumstances. B. appraising and looking at the implications of one or two articles as they relate to the culture and the ethnicity of the patient. C. completing a literature search to find relevant articles that utilize nursing research so as to encourage nurses to use good practices. D. finding value-based resources to justify nursing actions when working with patients of diverse cultural backgrounds.
A
Examination of the shoulder includes four motions. These are: A. forward flexion, internal rotation, abduction, and external rotation B. abduction, adduction, pronation, and supination C. Circumduction, inversion, eversion, and rotation D. elevation, retraction, protraction, and circumduction
A
Identify the facial bone that articulates at a joint instead of a suture. A.Mandible B.Maxilla C.Zygomatic D.Nasal
A
Knowledge of the use of personal space is helpful for the health care provider. Personal distance is generally considered to be: A. 1.5 to 4 feet. B. 12 or more feet. C. 2 to 12 feet. D. 0 to 1.5 feet.
A
Providing resistance while the patient shrugs the shoulders is a test of the status of cranial nerve: A.XI B.IX C.V D.II
A
The sinuses that are accessible to examination are the: A. frontal and maxillary sinuses. B. ethnoid and sphenoid. C. frontal and ethmoid. D. maxillary and sphenoid.
A
Visual acuity is assessed with: A. the Snellen eye chart. B. an ophthalmoscope. C. the confrontation test. D. the Hirschberg test.
A
You are assessing a 75-year-old male who has a history of hypertension and was recently changed to a new antihypertensive medication. He reports feeling dizzy at times. How should the nurse evaluate the client's blood pressure? a. Assess blood pressure and pulse in the supine, sitting, and standing positions. b. Have the client walk around the room and assess his blood pressure after activity. c. Assess his blood pressure and pulse in the beginning and end of the examination. d. Take the blood pressure on the right arm, then 5 minutes later take the blood pressure on the left arm.
A
For which patient would testicular self-examination (TSE) be most valuable?
A 22-year-old with a history of cryptorchidism
What do you expect to find on examination of a neonate whose medical record indicates he has epispadias?
A meatus opening on the dorsal side of the glans or shaft
At change-of-shift report in the emergency room, you are told that the patient in Room 3 came in with priapism. Which statement describes the patient's problem?
A prolonged, painful erection of the penis without sexual desire has occurred.
In previewing a patient's medical record, you note that the patient was previously diagnosed with a spermatocele. How should you describe this problem?
A retention cyst in the epididymis filled with milky fluid containing sperm
Match the lymph node with the location In front of the ear behind the tip of the mandible at the base of the skull above and behind the clavicle A.Preauricular B.Supraclavicular C.Occipital D.Submental
A, D, C, B
In completing the health history for the mouth and throat, which of the following questions are to be asked? (Select all that apply.) A. Any bleeding gums? B. Any sore throat? How often? C. Do you smoke, How much/day? D. Any sinus pain or sinusitis? E. Any hoarseness, voice change?
A, B, C, E
The areas to assess as a part of behavior in the general survey include: (Select all that apply.) A. maintains eye contact unless there is a cultural taboo. B. the base is as wide as the shoulders; the walk is smooth, even, and well balanced. C. clothing is appropriate for the climate, looks clean, and is appropriate for the person's culture. D. each joint has full mobility; no involuntary movements are present
A, C
A health history of the musculoskeletal system should include which of the following? (Select all that apply.) A. Accidents or trauma to muscles and bones B. Inspect the size and contour of joints. C. Problems with activities of daily living. D. Performance of Phalen's test E. Pain or stiffness in the joints
A, C, E
Pulse pressure is: a. the difference between the systolic and diastolic pressure. b. a reflection of the viscosity of the blood. c. another way to express the systolic pressure. d.a measure of vasoconstriction.
A.
The nurse knows that one advantage of the tympanic membrane thermometer (TMT) is that A. Rapid measurement is useful for uncooperative younger children. B. Using the TMT is the most accurate method for measuring body temperature in newborn infants, C. Measuring temperature using the TMT is inexpensive. D. Studies strongly support the use of the TMT in children under the age of 6 years.
A.
Why is it important to match the appropriate-size blood pressure cuff to the person's arm and shape? a. Using a cuff that is too narrow will give a false reading that is high. b. Using a cuff that is too wide will give a false reading that is high. c. Using a cuff that is too narrow will give a false reading that is low
A.
You have reason to question the reliability of the information being provided by a patient. One way to verify the reliability within the context of the interview is to: A. rephrase the same question later in the interview. B. call the person identified as emergency contact to verify data provided. C. review the patient's previous medical records. D. provide the patient with printed history to complete and then compare the data provided.
A.
The isthmus of the thyroid gland lies just below the: A.hyoid cartilage. B.mandible. C.cricoid cartilage. D.thyroid cartilage.
C
You are examining a patient who came to the clinic because of a discharge from his penis. On anteroposterior compression of the glans, you see no discharge. What should you do?
Ask the patient to milk the shaft of the penis
Which of the following considered to be subjective? A. Temperature of 101.2 B. Pain lasting 2 hours C. Measured weight loss of 20 pounds since the previous measurement D. Pulse rate of 96
B.
Pallor
Absence of red-pink tones from the oxygenated hemoglobin in blood
On examination of a noncircumcised man, you find that the foreskin is fixed in a retracted position and the glans is swollen. What action should you take
Arrange for emergency treatment.
A patient comes to the clinic complaining of neck and shoulder pain and is unable to turn her head. The nurse suspects damage to the CN and proceeds with the examination by . A. XI; palpating the anterior and posterior triangleas B. XI; asking the patient to shrug her shoulders against resistance C. XII; percussing the sternomastoid and submandibular neck muscles D. XII; assessing for a positive Romberg sign
B
A patient has blurred peripheral vision. You suspect glaucoma, and test the visual fields. A person with normal vision would see your moving fingers temporally at: A. 60 degrees. B. 90 degrees. C. 189 degrees, D. 50 degrees.
B
A patient has come in for an examination and states, "I have this spot in front of my ear lobe on my cheek that seems to be getting bigger and is tender. What do you think it is?" The nurse notes swelling below the angle of the jaw and suspects that it could be and inflammation of his: A. Thyroid gland B. Parotid gland C. Occipital lymph node D. Submental lymph node
B
After assessing the patient's pulse, the practitioner determines it to be "normal." This would be recorded as: a. 3+ b. 2+ c. 1+ d. 0
B
Ascites is defined as: A. an abnormal enlargement of the spleen. B. an abnormal accumulation of serous fluid within the peritoneal cavity. C. a proximal part of the large intestine. D. a bowel obstruction.
B
Atrial systole occurs: A.during ventricular systole. B.during ventricular diastole. C.concurrently with ventricular systole. D.independently of ventricular function.
B
Auscultation of breath sounds is an important component of respiratory assessment. Select the most accurate description of this part of the examination. A.Hold the bell of the stethoscope against the chest wall, listen to the entire right field, then the entire left field. B.Hold the diaphragm of the stethoscope against the chest wall; listen to one full respiration in each location, being sure to do side-to-side comparisons. C.Select the bell or diaphragm depending upon the quality of sounds heard: listen for one respiration in each location, moving from side to side. D.Listen from the apices to the bases of each lung field using the bell of the stethoscope.
B
Conjunctivitis is associated with: A. absent red reflex. B. reddened conjunctiva. C. fever. D. impairment of vision.
B
Depending on the clinical situation, the nurse may establish one of four kinds of databases. A focused database is described as: A. including a complete health history and full physical examination. B. concerning mainly one problem. C. evaluation of a previously identified problem. D. rapid collection of data in conjunction with lifesaving measures.
B
During a breast examination, you detect a mass. Identify the description that is most consistent with cancer rather than benign breast disease. A. lobular, clear margins, negative skin retraction B. irregular, poorly defined, fixed C. round, firm, well demarcated D. rubbery, mobile, tender
B
During a neurologic examination, the tendon reflex fails to appear. Before striking the tendon again, the examiner might use the technique of: A. two-point discrimination. B. reinforcement. C. vibration. D. graphesthesia.
B
During an annual physical exam, your 43-year-old patient states that she doesn't perform monthly breast self-examinations. She tells you that she believes that mammograms "do a much betther job than I ever could to find a lump." You should explain to her that: A. She is correct, mammography is a good replacement for breast self-exmination. B. Mammography may not detect all palpable lumps. C. She doesn't need to perform breast self-examination as long as a physician checks her. D. Breast self-examination is unnecessary until the age of 50.
B
During the examination of the breasts of a pregnant woman, you would expect to find: A. a unilateral, obvious venous pattern. B. a blue vascular pattern over both breasts. C. peau d'orange. D. nipples retracted.
B
In assessing the carotid arteries of an older patient with cardiovascular disease, the nurse would A. palpate the artery in the upper one third of the neck. B. listen with the bell of the stethoscope to assess for bruits. C. simultaneously palpate both arteries to compare amplitude. D. instruct the patient to take slow deep breaths during auscultation.
B
In examining the ear of an adult, the canal is straightened by pulling the auricle: A. down and back. B. up and back. C. down and forward. D. up and forward.
B
In our assessment of a 20-yea-old patient with a 3-day history of nausea and vomiting you note the following: dry mucosa and deep fissures in the tongue. This is reflective of: A. a normal oral assessment. B. dehydration. C. irritation of gastric juices. D. side effects from nausea medication.
B
In performing a breast examination, you know that it is especially important to examine the upper outer quadrant of the breast. Why? A. The upper outer quadrant is where most of the suspensory ligaments attach. B. The upper outer quadrant is the location of most breast tumors. C. The upper outer quadrant is the largest quadrant of the breast. D. The upper outer quadrant is more prone to injury and calcifications than other locations in the breast.
B
Right upper quadrant tenderness may indicate pathology in the: A. sigmoid colon, spleen, or rectum. B. liver, pancreas, or ascending colon. C. appendix or ileocecal valve. D. liver and stomach.
B
Select the best description of bronchovesicular breath sounds. A.High pitched, of longer duration on inspiration than expiration B.Moderate pitch, inspiration equal to expiration C.Rustling sound, like the wind in the trees D.low pitched, inspiration greater than expiration
B
Semile tremors may resemble parkinsonism except that senile tremors do not include: A. nodding the head as if responding yes or no. B. rigidity and weakness of voluntary movements. C. tremor of the hands. D. tongue protrusion.
B
Stridor is a high-pitched, inspiratory crowing sound commonly associated with: A.pneumothorax. B.upper airway obstruction. C.congestive heart failure. D.atelectasis.
B
The Glasgow Coma Scale (GCS) is divided into three areas. They include: A. pupillary respone, a refex test, and assessing pain. B. eye opening, motor response to stimuli, and verbal response. C. response to fine touch, sterognosis, and sense of position. D. orientation, rapid alternating movements, and the Romberg test.
B
The absence of bowel sounds is established after listening for: A.1 full minute. B. 5 full minutes. C. 10 full minutes. D. 3 full minutes.
B
The cone of light in the right ear is located at: A. 7 o'clock. B. 5 o'clock. C. 2 o'clock. D. 10 o'clock.
B
The cremasteric response: A. is positive when disease of the pyramidal tract is present. B. is positive when the ipsilateral testicle elevates upon stroking of the inner aspect of the thigh. C. is a reflex of the receptors in the muscles of the abdomen. D. is not a valid neurologic examination.
B
The frenulum is: A. the free projection hanging down from the middle of the soft palate. B. the midline fold of tissue that connects the tongue to the floor of the mouth. C. the anterior border of the oral cavity. D. the arching roof of the mouth.
B
The most important reason to share information and offer brief teaching while performing the physical examination is to help: A. the examiner feel more comfortable and gains control of the situations. B. build rapport and increase the patient's confidence in the examiner. C. the patient understand his or her disease process and treatment modalities. D. the patient identify questions about his or her disease and potential areas of patient education.
B
The retinal structures viewed through the opthalmoscope are: A. The pupil, the sclera, the ciliary body, and the macula. B. the optic disc, the retinal vessels, the general background and the macula. C. the optic papilla, the sclera, the retina, and the iris. D. The cornea, the lens, the choroid, and the ciliary body.
B
The second heart sound is the result of: A.opening of the mitral and tricuspid valves. B.closing of the aortic and pulmonic valves. C.closing of the mitral and tricuspid valves. D.opening of the aortic and pulmonic valves.
B
The sensation of vertigo is the result of: A. 4th crantial nerve damage. B. pathology in the semicircular canals. C. otitis media. D. pathology in the cochlea.
B
When teaching the breast self-exam, you would inform the woman that the best time to conduct the breast self-examination is: A. on the 14th day of the menstrual cycle. B. on the 4th to 7th day of the menstrual cycle. C. just before the menstrual period. D. at the onset of the menstrual period.
B
When testing for muscle strength, the examiner does which of the following? A. Observes muscle for the degree of contraction when the individual lifts a heavy object. B. Applies the opposing force when the individual puts a joint in flexion or extension. C. Measures the degree of flexion and extension with a goniometer. D. Measures the degree of force that it takes to overcome joint flexion or extension.
B
Which of the following correctly expresses the relationship of the lobes of the lungs and their anatomic position? A.Upper lobes - lateral chest B.Lower lobes - posterior chest C.Upper lobes - posterior chest D.Lower lobes - anterior chest
B
Which of the following is an appropriate recording of a person's reason for seeking health care? A. Substernal pain radiating to left axilla, 1 hr duration B. "Grabbing" chest pain for 2 hr C. Pleurisy, 2 days' duration D. Angina pectoris, duration 2 hr.
B
Which of the following may be noted through inspection of the abdomen? A. Umbilical eversion and Murphy's sign B. Venous pattern, peristalic waves, and abdominal contour C. Peritoneal irritation, general tympany, and peristaltic waves D. Fluid waves and abdominal contour
B
Which of the following statements about cerumen is correct? A. The presence of cerumen is indicative of poor hygiene. B. The purpose of cerumen is to protect and lubricate the ear. C. Sticky honey-colored cerumen is a sign of infection. D. Cerumen is necessary for transmitting sound through the auditory canal.
B
While taking a history, the patient describes a burning, painful sensation that moves around his toes and bottoms of the feet. These symptoms are suggestive of: A. nociceptive pain. B. neuropathic pain
B
You will hear a split S2 most clearly in what area? A.Apical B.Pulmonic C.Aortic D.Tricuspid
B
Inspection: (Select all that apply.) A. uses the fingertips for tactile dicrimination of edematous areas. B. is close careful scrutiny, first of the person as a whole and then of each body system. C. begins the moment you first meet the individual and develop a "general survey." D. requires good lighting and adequate exposure
B, C, D
. Which technique of assessment is used to determine the presence of tenderness, swelling and pulsation? A. Inspection B. Palpation C. Percussion D. Auscultation
B.
During the initial interview, the examiner asks, "Mrs. J. tell me what you do when your headaches occur." with this question, the examiner is seeking information about: A. the severity of the problem. B. aggravating or relieving factors. C. the patient's perception of the problem. D. the frequency of the problem.
B.
In assessing the tonsils of a 30-year-old, you note they are involuted, granular in appearance, and have deep crypts. What would be your response to these findings? A. Refer the patient to a throat specialist. B. Nothing, this is the appearance of normal tonsils. C. Continue with the assessment looking for any other abnormal findings. D. Obtain a throat culture on the patient for possible strep infection.
B.
When performing a physical examination, safety must be considered to protect you and the patient against the spread of infection. Which of the following statements describes the most appropriate actions to be taken when performing a physical examination? A. There is no need to wash your hands after removing gloves, as long as the gloves are still intact. B. Wash your hands at the beginning of the examination and any time that you leave and re-enter the room. C. Wash your hands between the examination of each body system to prevent the spread of bacteria from one part of the body to another. D. Wear gloves throughout the entire examination to demonstrate to your patient your concern regarding the spread of infectious disease.
B.
You are assessing a patient's skin during an office visit. What technique should you use to best assess the temperature of the skin? A. Use your fingertips because they are more sensitive to small changes in temperature. B. Use the dorsal surface of your hand because the skin is thinner here than on your palms. C. Use the ulnar portion of your hand because there is increased blood supply that enhances temperature sensitivitiy. D. Use the palmar surface of your hand because it is most sensitive to temperature variations due to increased nerve supply in this area.
B.
is prepared in nursing.Select the best description of "review of systems" as part of the health history. A. A statement that describes the overall health state of the patient B. The evaluation of the past and present health state of each body system C. A documentation of the problem as described by the patient D. The recording of the objective findings of the practitioner
B.
A soon-to-be new mother of a baby boy asks you for information about circumcision. What information should you share with her?
Benefits of circumcision include decreased incidence of urinary tract infections (UTIs), phimosis, and paraphimosis.
Cyanosis
Bluish mottled color that signifies decreased perfusion
Furuncle
Boil - suppurative inflammatory skin lesion due to infected haie follicle
A high pitched, musical, squeaking adventitious lung sound is: A.crackle. B.rhonchi. C.wheeze. D.friction rub.
C
Any lump found in the breast should be referred for further evaluation. Which one of the following findings is characteristic of a malignant lesion? A. Freely movable B. Soft C. Irregular shape D. Well-defined margins
C
Cerebellar function is assessed by which of the following tests? A. Muscle size and strength B. Cranial nerve examination C. Coordination - hop on one foot D. Spinothalamic test
C
During an assessment of the spine, the patient would be asked to: A. supinate, evert, and retract. B. extend, adduct, invert, and rotate. C. flex, extend, and rotate. D. adduct and extend.
C
Erb's point is: A. the base of the heart. B. a palpable area at the midclavicular line at the apex of the heart C. the traditional auscultatory area in the 3rd left intercostal space. D. an imaginary vertical line bisecting the middle of the clavicle in each hemithorax.
C
Gynecomastia is: A. cancer of the male breast. B. presence of "mast" cells in the male breast. C. enlargement of the male breast. D. presence of supernumerary breast on the male ches.
C
Illness may be described as an imbalance of hot and cold among people of: A. Asian-American heritage. B. African-American heritage. C. Hispanic-American heritage. D. American Indian heritage.
C
Inspiration is primarily facilitated by which of the following muscles? A.Trapezia and sternomastoids B.Internal intercostals and abdominal C.Diaphragm and intercostals D.Diaphragm and abdominus rectus
C
Intermittent claudication is: A.muscular pain relieved by exercise. B.neurologic pain relieved by exercise. C.muscular pain brought on by exercise. D.neurologic pain brought on by exercise.
C
Many of the traditional definitions of health tend to focus on: A. beliefs of body and mind. B. equilibrium with others. C. physical, mental, and spiritual harmony. D. ability to perform activities of daily living.
C
Mr. B tells you, "everyone here ignores me." You respond, "ignores you!" This technique is best described as: A. validation. B. clarification. C. reflecting.
C
Normal cervical lymph nodes are: A.warm to palpation B.firm C.smaller than 1 cm. D.fixed
C
Normally the gums look pink or coral with a stippled surface. Black patients may normally have: A. gingival hypertrophy. B. retraction of the gingival margins. C. a dark, melanotic line along the gingival margins. D. spongy red gums.
C
Nursing diagnoses, based on assessment of a number of factors, give nurses a common language with which to communicate nursing findings. The best description of a nursing diagnosis is: A. used to evaluate the etiology of a disease. B. a pattern of coping. C. a concise description of actual or potential health problems or of wellness strengths. D. the patient's perception of and satisfaction with his or her own health status.
C
Positive Phalen test and Tinel sign are seen in a patient with: A. a torn meniscus B. hallux valgus C. carpal tunnel syndrome D. tennis elbow
C
Select the correct description of the left lung. A.Wider than the right lung with two lobes B.Narrower than the right lung with three lobes C.Narrower than the right lung with two lobes D.Shorter than the right lung with three lobes
C
The cover test is used to assess for: A. visual acuity. B. nystagmus. C. perpheral vision. D. muscle weakness.
C
The gag reflex can be used to test the following cranial nerve: A. Trigeminal B. Abducens C. Vagus D. Hypoglossal
C
The nurse needs to palpate the temporomandibular joint for crepitation. This joint is located just below the temporal artery and anterior to the: A. Hyoid bone B. Vagus nerve C. Tragus D. Mandible
C
The organs that aid the lymphatic system are: A. liver, lymph nodes, and stomach. B. pancreas, small intestines, and thymus. C. spleen, tonsils, and thymus. D. pancreas, spleen, and tonsils.
C
The precordium is: A.the area on the chest where the apical impulse is felt. B.a synonym for the area where the superior and inferior vena cavae return unoxygenated venous blood to the right side of the heart. C.the area on the anterior chest overlying the heart and great vessels. D.a synonym for the mediastinum.
C
The six muscles that control eye movement are innervated by cranial nerves: A. II, III, V B. II, III, VI C. III, IV, VI D. IV, VI, VII
C
To test for stereognosis, you would: A. have the person close his or her eyes, and then raise the person's arm and ask the person to describe B. touch the person with a tuning fork. C. place a coin in the person's hand and ask him or her to identify it. D. touch the person with a cold object.
C
Touch should be used during the interview (history): A. only with patients of the same sex. B. only with individuals from the Western culture. C. only if the interviewer knows the person well. D. as a way of establishing contact with the person and communicating empathy.
C
What can be determined when the nurse clusters data as part of the critical-thinking process? A. This identifies problems that may be urgent and require immediate action by the nurse. B. This step of the process involves recognizing inconsistencies in the data. C. The nurse recognizes patterns and relationships among the data. D. Risk factors can be determined so the nurse knows how to offer health teaching.
C
When auscultaing the lungs of an adult patient, the nurse notes that the low-pitched, soft breath sounds are heard over the posterior lower lobes, with inspiration being longer than expiration. The nurse interpretes that these sounds are A. normally auscultated over the traches. B. bronchial breath sounds and normal in that location. C. vesicular breath sounds and normal in that location. D. bronchovesicular breath sounds and normal in that location.
C
When auscultating the heart, your first step is to: A.identify the apical pulse. B.identify adventicious sounds. C.identify S1 amd S2. D.listen for murmurs.
C
When examining the face of a patient, the nurse is aware that the two pairs of salivary glands that are accessible to examination are the ______ and _______ glands A. Occipital; submental B. Parotid; jugulodigastric C. Parotid; submandibular D. Submandibular; occipital
C
When using a Doppler ultrasonic stethoscope, the nurse recognizes venous flow when which sound is heard? A. Low humming sound B. Regular "lab dub" pattern C. Swishing, whooshing sound D. Steady, evev, flow sound
C
Which description describes a weak, thready pulse? A."Easily papable, pounds under our fingertips." B."Greater than normal force, then collapses suddenly." C."Hard to palpate, may fade in and out, easily obliterated by pressure." D."Rhythm is regular, but force varies with alternating beats of large and small amplitude."
C
Which of the following is true for aging adults? A. Liver size increases. B. Gastric acid secretion increases. C. Decreased salivation leads to dry mouth.
C
Your patient's blood pressure is 118/82. He asks you to explain "what the numbers mean." You reply: a. "The numbers are within normal range and nothing to worry about." b. "The bottom number is the diastolic pressure and reflects the stroke volume of the heart." c. "The top number is the systolic blood pressure and reflects the stroke volume of the heart," d. "The concept of blood pressure is difficult to understand. The main thing to be concerned about is the top number, or systolic pressure."
C
Match the movement with the description. moving the arm in a circle around the shoulder moving a body part forward and parallel to the ground moving the limb away from the midline of the body moving the sole of the foot inward at the ankle moving the head around a central access A. Inversion B. Abduction C. Circumduction D. Rotation E. Protraction
C, E, B, A, D
A genogram is useful in showing information concisely. It is used specifically for: A. the eight characteristics of presenting symptoms. B. past health history, specifically hospitalizations. C. family history. D. past history.
C.
When reading a medical record you see the following notation: Patient states, "I have had a cold for about a week, and now I am having difficulty breathing." This is an example of: A. a review of systems. B. past history. C. a reason for seeking care. D. a functional assessment.
C.
Which statement indicates that the nurse understands the pain experience in the elderly? A. "Older individuals must learn to tolerate pain." B. "Pain is a normal process of aging and is to be expected." C. "Pain indicates pathology or injury and is not a normal process of aging." D. "Older individuals perceive pain to a lesser degree than younger individuals."
C.
How should you check for signs of urethritis in a male patient?
Compress the glans anteroposteriorly between your thumb and forefinger.
On examination of a male patient, you note a discharge from the urethra. What is your immediate action
Collect a smear and a culture.
"Culturally competent" implies that the nurse: A. is prepared in nursing. B. possesses knowledge of the traditions of diverse peoples. C. applies underlying knowledge to providing nursing care. D. understands the cultural context of the patient's situation.
D
A 54-year-old woman with five children has varicose veins of the lower extremities. Her most characteristic sign is: A.reduced arterial circulation. B.blanching, deathlike appearance of the extremities on elevation. C.loss of hair on feet and toes. D.dilated, tortuous superficial bluish vessels.
D
The costovertebral angle (CVA) is: A. a depression on the abdomen. B. the lower border of the rib margin formed by the medial edges of the 8th, 9th, and 10th ribs. C. the midline abdominal muscles extending from the rib cage to the pubis bone. D. the angle formed by the 12th rib and the vertebral column on the posterior thorax overlying the kidneys.
D
The first step to cultural competency by a nurse is to: A. identify the meaning of health to the patient. B. understand how a health care delivery system works. C. develop a frame of reference as to traditional health care practices. D. understand your own heritage and its basis in cultural values.
D
The largest salivary gland is located: A. within the floor of the mouth under the tongue. B. beneath the mandible at the angle of the jaw. C. at the base of the tongue. D. within the cheeks in front of the ear.
D
The nurse notices that a woman in an exercise class is unable to jump rope. The nurse is aware that to jump rope one's shoulder has to be capable of: A. inversion B. supination C. protraction D. circumduction
D
The opening of an adult's parotid gland (Stensen's duct) is opposite the: A. upper incisors. B. lower incisors. C. lower 2nd molar. D. upper 2nd molar.
D
The palpebral fissure is: A. the border between the cornea and sclera. B. Visible on the upper and lower lids at the inner canthus. C. the angle where the eyelids meet. D. the between open space the eyelids.
D
To differentiate between air conduction and bone conduction hearing loss, the examiner would perform the: A. Romberg test B. Weber test C. whisper test D. Rinne test
D
Which of the following is considered the most reliable indicator of pain? a. Vital signs b. The physical exam c. CAT scan findings d. The subjective report
D
While reviewing a medical record, a notation of 4+ edema of the right leg is noted. The best description of this type of edema is: A.mild pitting, no perceptible swelling of the leg. B.moderate pitting, indentation subsides rapidly. C.deep pitting, leg looks swollen. D.very deep pitting, indentation lasts a long time.
D
While you are performing a breast health interview with Mrs. J., she states that she has noticed pain in her left breast. Your most appropriate response to this would be: A. "Breast pain is almost always the result of fibrocystic breast tissue. So let's just ignore it." B. "Oh, I had pain like that after my son was born. It turned out to be a blocked milk duct." C. "Don't worry about the pain, breast cancer is not painful." D. "I would like some more information about the pain in your left breast."
D
A common physiologic change that occurs with pain is: A. polyuria. B. hyperventilation. C. hyperactive bowel sounds. D. tachycardia.
D.
At the conclusion of the examination, the examiner should: A. document findings before leaving the examination room. B. have findings confirmed by another practitioner, C. relate subjective findings to the objective findings for accuracy. D. summarize findings to the patient.
D.
The four areas to consider during the general survey are: A. ethnicity, sex, age, and socioeconomic status. B. physical appearance, sex, ethnicity, and affect. C. dress, affect, nonverbal behavior, and mobility. D. physical appearance, body structure, mobility, and behavior.
D.
Various parts of the hands are used during palpation. The part of the hand used for assessment of vibrations is (are) the: A. fingertips. B. index finger and thumb in opposition. C. dorsum of the hand. D. base of the fingers or ulnar surface of the hand.
D.
Which questions asked as part of a patient s health history provide information about symptoms of prostatic hyperplasia?
Do you have a weak stream when urinating?
Upon examination of the tympanic membrane, visualization of which of the following findings indicates the infection of acute purulent otitis media? A. absent light reflex, bluish drum, oval dark areas. B. retracted drum, very prominent landmarks C. oval dark area on drum D. absent light reflex, air fluid level or bubbles behind drum E. absent light reflex, reddened drum, bulging drum
E
Mrs. Baker comes to your office with her 2-year-old son. On examination, you note that the child's urinary meatus appears on the upper surface of the penis. Which term could be used in documenting this finding?
Epispadias
During a digital examination of the rectum, the nurse notices that the patient has hard feces in the rectum. The patient complains of feeling "full," has a distended abdomen, and states that she has not had a bowel movement "for several days." The nurse suspects which condition?
Fecal impaction
Macule
Flat skin lesion with only a color change, > 1 cm
Why is testicular torsion an emergency?
Gangrene can develop in a few hours
A 32-year-old male patient comes to the clinic with "some kind of a rash on my private parts that really hurts." On examination, you note clusters of small vesicles with surrounding erythema on the foreskin and glans penis. What is the likely cause of these findings?
Genital herpes
Shooting pain in the buttock or down the leg is a characteristic of which sexually transmitted infection (STI)?
Genital herpes
Serum creatinine contributes to assessment of urinary system function by providing information about which factor?
Glomerular filtration rate
A 22-year-old woman is being seen at the clinic for problems with vulvar pain, dysuria, and fever. On physical examination the nurse notices:
Herpes simples virus type 2
You could best use transillumination to aid in the identification of which condition?
Hydrocele
Keloid
Hypertrophic scar, elevated above the site of the original injury
On examination of a newborn boy, you observe that the urethral meatus opens on the ventral side of the penis. Which term can you use to describe this condition?
Hypospadias
A woman is leaving on a trip to Hawaii and has come in for a checkup. During the examination the nurse learns that she has diabetes and takes oral hypoglycemic agents. The patient needs to be concerned about which possible effect of her medications
Importance of sunscreen and avoiding direct sunlight
Jaundice
Increase in bilirubin in the blood causing a yellow color to the skin
Where do you palpate when checking for inguinal lymphadenopathy?
Inferior to the inguinal ligament and along the upper inner thigh
Erythema
Intense redness of the skin due to excess blood in the dilated superficial capillaries
Moving the sole of the foot inward at the ankle is called:
Inversion
Which finding on examination of the scrotum would you identify as abnormal?
Marked tenderness on palpation
Nevus is the medical term for what?
Mole
Which acronym should you use as a guide when palpating the femoral area for a bulge?
NAVEL
When palpating the male genitalia, where would you locate the epididymis?
On top of and behind the testicle
Papule
Palpable skin lesion of < 1 cm diameter
How do you palpate the shaft of the penis for a nodule or induration?
Palpate between your thumb and first two fingers.
Mr. Tucker is a 28-year-old patient who presents to your office with a concern that, during an erection, his penis is bent and painful. On examination, you palpate nontender, hard plaques on the lateral surface of the penis. What problem is suggested by these signs and symptoms?
Peyronie's disease
Mr. Peyser is a 38-year-old patient who presents to your office for a yearly physical examination. On exam, you note that the foreskin of the penis is very tight, preventing it from retracting over the glans. What term could be used to describe this finding?
Phimosis
If an erection occurs during your examination of a male patient's genitalia, how should you respond?
Reassure the patient that the erection is simply a physiologic response to touch.
While performing a rectal examination, the nurse notices a firm, irregularly shaped mass. What should the nurse do next?
Report the finding and refer the patient to a specialist for further examination.
The nurse is preparing for an internal genitalia examination of a woman. Which order of the examination is correct?
Speculum, bimanual, and rectrovaginal
When examining a 3-year-old, the scrotal sac feels empty. What do you ask the child to do?
Squat with the knees flexed up.
Which position do you ask a male patient to assume when palpating the right inguinal canal?
Stand with weight on left leg.
Mr. Frank, a 32-year-old patient, presents to your office with a complaint of urinary frequency. On examination, you note a painless lesion with a clear base and indurated borders located on the glans penis. With what problem is this clinical finding most consistent?
Syphilitic chancre
A patient comes to the clinic with symptoms of testicular torsion. On examination, you find the left cremasteric reflex is absent. How do you interpret this finding?
The left spermatic cord is twisted.
On previewing a patient's medical record, you see that he was diagnosed with a hydrocele 2 years ago. How do you interpret this information?
The patient had a circumscribed collection of serous fluid in the tunica vaginalis surrounding the testes.
During a routine visit, M.B., age 78, asks about small, round, flat, brown macules on the hands. Your best response after examining the area is:
These are the result of sun exposure and do not require treatment
Mr. Liggett is a 42-year-old patient who presents with a painful left testicle. On examination, you note that, when the patient is standing, there is a soft, irregular mass like a bag of worms above and behind the testis. When the patient lies down, it collapses. With which condition are these signs and symptoms consistent?
Varicocele
A patient comes to the clinic because his urine is "bright orange." Which medication should you ask him if he takes?
Warfarin
Why is it suggested that testicular self-examination (TSE) be done while taking a shower?
Warm water relaxes the scrotal sac.
Carotenemia
Yellow-orange color in light-skinned persons from large amounts of food containing carotene
Darwin's tubercle is:
a congenital, painless nodule at the helix
The configuration for individual lesions arranged in circles or arcs, as occurs with ringworm, is called
annular
H.T. has come to the clinic for a follow-up visit. Six months ago, he was started on a new medication. The class of medication is most likely to cause impotence as a side effect; therefore medicaton classes explored by the nurse are:
antihypertensives
A woman has come for health care complaining of a thick, white discharge with intense itching. These symptoms are suggestive of:
candidiasis.
Skin turgor is assessed by picking up a large fold of skin on the anterior chest under the clavicle. This is done to determine the presence of
dehydration
Mrs. J. is in your clinic for a gynecologic examination. You should plan to begin your interview with:
menstrual history because it is generally non-threatening.
A patient who is visiting the clinic complains of having "stomach pains for 2 weeks" and describes his stools as being "soft and black" for about the last 10 days. He denies taking any medications. The nurse is aware that these symptoms are most indicative of:
occult blood resulting from gastrointestinal bleeding.
Using the otoscope, the tympanic membrane is visualized. The color of the normal membrane is:
pearly gray
Purpura
red-purple lesion due to blood in tissue from breaks in blood vessels
To assess for early jaundice, you will assess
sclera and hard palate
During the examination of the genitalia of a 70-year-old woman, a normal finding would be:
thin and sparse pubic hair.