Health Assessment Exam 3 Practice Questions

Normal capillary refill is: A) Nails turning from blanched to pink B) > 2 seconds C) 1-2 seconds D) < 1 second

1-2 seconds Most capillaries have such small inner diameters that only one red blood cell can move through at a time.

Imagine that Tina was unable to move her right ankle. You notice that her muscles contract as she attempts to dorsiflex her ankle, but no movement occurs. How would you grade her ankle strength? A) 1/5 B) 2/5 C) 4/5 D) 3/5

A) 1/5 According to the Oxford Scale, a muscle group that has no mobility but displays visible muscle contraction is graded as a 1/5 strength.

When listening to the heart of an 18-month-old admitted to Shadow General Hospital for physical abuse, what is the normal heart rate range? A) 90-150 beats per minute B) 80-140 beats per minute C) 100-160 beats per minute D) 60-100 beats per minute

A) 90-150 beats per minute Children have smaller heart chambers and lower blood volume than adults, which results in a lower heart stroke volume.

Which of the following ethnic groups has the lowest incidence of osteoporosis? A) African Americans B) Whites C) Asians D) American Indians

A) African Americans African American adults have a decreased risk of fractures compared with white adults, and Hispanic women have a decreased risk of fractures compared with white women. The difference in fracture rates may be traced to childhood, where African American and Hispanic children have shown significantly higher bone strength than white children show. There is greater bone density at specific bone sites in African American and Hispanic children.

An 82-year-old is on the cardiac floor of Shadow General Hospital after being admitted for chest pain. Which of the following findings would be due to vessel narrowing? A) Bruits B) Tachycardia C) Harsh holosystolic murmur D) Regurgitation

A) Bruits Bruits are heard when blood flow is obstructed, causing turbulence. They are murmur-like sounds that originate from the vasculature instead of from the heart that are heard with the bell of the stethoscope.

An 86-year-old woman has been admitted to the Shadow General surgical floor after a knee replacement. She has a history of degenerative joint disease (DJD). What physical exam findings would you expect to find? A) Joint deformity B) Shuffling gait C) Postural instability D) Humpback

A) Joint deformity Persons with DJD have limitations in strength and range of motion, joint crepitus, and pain with activity that is relieved with rest. Humpback, or kyphosis, is commonly due to osteoporosis, while shuffling gait and postural instability are commonly seen in those with Parkinson's disease.

A 76-year-old is admitted to the Shadow General Hospital ICU with severe abdominal pain and nausea. On physical exam you find rebound tenderness, guarding on palpation and abdominal wall rigidity. These are common findings with what problem? A) Peritonitis B) Constipation C) Hiatal hernia D) Peptic ulcer

A) Peritonitis The physical exam findings above are indicators of peritonitis. This can be secondary to tumor, ruptured diverticulum, or infections.

A 2-month-old male child comes into the Shadow General Hospital Emergency Department with dehydration due to projectile vomiting since birth. On physical exam you note marked peristalsis (waves visible on inspection of the abdomen). This is a sign of what pathologic process? A) Pyloric stenosis B) Diastasis recti C) Enlarged kidneys D) Umbilical hernia

A) Pyloric Stenosis Infants with pyloric stenosis present with projectile vomiting as a chief complaint with marked peristalsis noted on physical exam.

Which of the following is an appropriate position to have the patient assume when auscultating for extra heart sounds or murmurs? A) Roll toward the left side B) Roll toward the right side C) Trendelenburg position D) Recumbent position

A) Roll toward the left side After auscultation in the supine position, the nurse should have the patient roll onto the left side; the examiner should listen at the apex with the bell for the presence of any diastolic filling sounds (i.e., S3 or S4) or murmurs that may be heard only in this position. The examiner should have the patient sit up and lean forward; the examiner should auscultate at the base with the diaphragm for a soft, high-pitched, early diastolic murmur of aortic or pulmonic regurgitation.

The corona is: A) a shoulder where the glans joins the shaft. B) a hood or flap of skin over the glans. C) a corpus spongiosum cone of erectile tissue. D) folds of thin skin on the scrotal wall.

A) a shoulder where the glans joins the shaft. The corona is a shoulder where the glans joins the shaft. Over the glans, the skin folds in and back on itself forming a hood or flap called the foreskin or prepuce. The penis is composed of three cylindrical columns of erectile tissue: two corpora cavernosa on the dorsal side and the corpus spongiosum ventrally. The scrotal wall consists of thin skin lying in folds, or rugae, and the underlying cremaster muscle.

Moles on the abdomen: A) are common. B) are uncommon. C) require a biopsy. D) are no cause for concern.

A) are common. Pigmented nevi (moles) are common on the abdomen. Nevi are circumscribed brown macular or papular areas. Nevi should be observed for unusual color or change in shape; biopsy or removal is indicated if nevi change, which indicates a possible malignancy.

The symptoms occurring with lactose intolerance include: A) bloating and flatulence. B) gray stools. C) hematemesis. D) anorexia.

A) bloating and flatulence. Lactose intolerance produces abdominal pain, bloating, and flatulence when milk products are consumed. Gray stools may occur with hepatitis. Hematemesis occurs with stomach or duodenal ulcers and esophageal varices. Anorexia is a loss of appetite and occurs with gastrointestinal disease, as a side effect of some medications, with pregnancy, or with psychological disorders.

Older adults have: A) decreased salivation leading to dry mouth. B) increased gastric acid secretion. C) increased liver size. D) decreased incidence of gallstones.

A) decreased salivation leading to dry mouth. Aging results in decreased salivation leading to dry mouth. Aging results in decreased gastric acid secretion. Aging results in decreased liver size. Aging results in increased incidence of gallstone formation.

The first sign of puberty in boys is: A) enlargement of the testes. B) the appearance of pubic hair. C) an increase in penis size. D) pubic hair growth extending up the abdomen.

A) enlargement of the testes. The first sign of puberty in boys is enlargement of the testes. Following the enlargement of the testes, pubic hair appears, then penis size increases. Pubic hair growth extending up the abdomen occurs after puberty.

Bundles of muscle fibers that compose skeletal muscle are identified as: A) fasciculi. B) fasciculations. C) ligaments. D) tendons.

A) fasciculi. Each skeletal muscle is composed of bundles of muscle fibers, or fasciculi. Fasciculation is localized uncoordinated, uncontrollable twitching of a single muscle group innervated by a single motor nerve fiber or filament. Ligaments are fibrous bands running directly from one bone to another. Tendons are strong fibrous cords that attach skeletal muscles to bones.

The jugular venous pressure is an indirect reflection of the: A) heart's efficiency as a pump. B) cardiac cycle. C) conduction effectiveness. D) synchronization of mechanical activity.

A) heart's efficiency as a pump. Jugular venous pressure is a reflection of the heart's ability to pump blood. If the pressure is elevated, heart failure is suspected.

The production of red blood cells in the bone marrow is called: A) hematopoiesis. B) hemolysis. C) hemoptysis. D) hemianopsia.

A) hematopoiesis. Hematopoiesis is the production of red blood cells in the bone marrow (spongelike material in the cavities of bones). Hemolysis is the breakdown of red blood cells. Hemoptysis is coughing up blood from the respiratory system. Hemianopsia is blindness in half of the normal visual field.

The penis: A) is composed of two corpora cavernosa and one corpus spongiosum. B) is a loose protective sac that is a continuation of the abdominal wall. C) and scrotum are the internal structures of the male genitals. D) size is controlled by the cremaster muscle.

A) is composed of two corpora cavernosa and one corpus spongiosum. The penis is composed of three cylindrical columns of erectile tissue: two corpora cavernosa on the dorsal side and the corpus spongiosum ventrally. The scrotum is a loose protective sac that is a continuation of the abdominal wall. The penis and scrotum are the external structures of the male genitals; the internal structures are the testis, epididymis, and vas deferens. The cremaster muscle controls the size of the scrotum.

Palpable inguinal lymph nodes are: A) normal if small (less than 1 cm), movable, and nontender. B) abnormal in adults but common in children and infants. C) normal if fixed and tender. D) abnormal and indicate the presence of malignant disease.

A) normal if small (less than 1 cm), movable, and nontender. Inguinal lymph nodes may be palpable. This is a normal finding if the nodes are small (1 cm or less), movable, and nontender. Lymph nodes may be relatively large in children, and the superficial ones often are palpable even when the child is healthy. Enlarged, tender, or fixed inguinal lymph nodes are an abnormal finding.

Heberden and Bouchard nodes are hard and nontender and are associated with: A) osteoarthritis. B) rheumatoid arthritis. C) Dupuytren contracture. D) metacarpophalangeal bursitis.

A) osteoarthritis. Osteoarthritis is characterized by hard, nontender nodules, 2 to 3 mm or more in size. These osteophytes (bony overgrowths) of the distal interphalangeal joints are called Heberden nodes, and osteophytes of the proximal interphalangeal joints are called Bouchard nodes. Swan neck, boutonnière deformity, and ulnar deviation are conditions associated with rheumatoid arthritis. Dupuytren contracture occurs with diabetes, epilepsy, and alcoholic liver disease. Chronic hyperplasia of the palmar fascia causes flexion contractures of the digits. Bursitis is an inflammation of the bursa.

In young children, the thymus gland: A) produces T lymphocytes. B) is small and begins to atrophy. C) is not important in immune function. D) produces B lymphocytes.

A) produces T lymphocytes. In young children, the thymus gland is important in developing the T lymphocytes of the immune system. The thymus is large in the fetus and young children and atrophies after puberty. The thymus has no function in adults. The thymus gland does not produce B lymphocytes.

The functions of the musculoskeletal system include: A) protection and storage. B) movement and elimination. C) storage and control. D) propulsion and preservation.

A) protection and storage. The functions of the musculoskeletal system are as follows: provide support to stand erect; allow movement; encase and protect the inner vital organs; produce the red blood cells in the bone marrow; and act as a reservoir for storage of essential minerals, such as calcium and phosphorus in the bones.

When assessing for the presence of a herniated nucleus pulposus, the examiner would: A) raise each of the patient's legs straight while keeping the knee extended. B) ask the patient to bend over and touch the floor while keeping the legs straight. C) instruct the patient to do a knee bend. D) abduct and adduct the patient's legs while keeping the knee extended.

A) raise each of the patient's legs straight while keeping the knee extended. The straight leg-raising (Lasègue) test reproduces back and leg pain and helps confirm the presence of a herniated nucleus pulposus. The examiner raises each leg straight while keeping the knee in extension. To assess for a spinal curvature, the examiner has the person bend over and touch the toes with the knee in extension. Muscle extension can be assessed by instructing the person to rise from a squatting position without using the hands for support. To assess range of motion, the leg should be abducted and adducted with the knee extended.

The ejaculatory duct is: A) the passage formed by the joining of the vas deferens and the seminal vesicle. B) a muscular duct continuous with the epididymis. C) a narrow tunnel inferior to the inguinal ligament. D) a narrow tunnel superior to the inguinal ligament.

A) the passage formed by the joining of the vas deferens and the seminal vesicle. The ejaculatory duct is the passage formed by the junction of the duct of the seminal vesicles and the vas deferens through which semen enters the urethra. The muscular duct continuous with the epididymis is the vas deferens. The femoral canal is inferior to the inguinal ligament. The inguinal canal is superior to the inguinal ligament and is a narrow tunnel passing obliquely between layers of abdominal muscle.

The abdomen normally moves with breathing until the age of ____ years. A) 4 B) 7 C) 14 D) 75

B) 7

Which of the following cardiac alterations occurs during pregnancy? A) An increase in cardiac output and blood pressure B) An increase in cardiac volume and a decrease in blood pressure C) An increased heart rate and increased blood pressure D) An increased stroke volume and decreased cardiac output

B) An increase in cardiac volume and a decrease in blood pressure During pregnancy the blood volume increases by 30% to 40%; this creates an increase in stroke volume and cardiac output and an increased pulse rate of 10 to 15 beats per minute. The arterial blood pressure decreases in pregnancy as a result of peripheral vasodilation.

Vaginal lubrication during intercourse is produced by: A) Skene glands. B) Bartholin glands. C) sebaceous glands. D) adrenal glands.

B) Bartholin glands. The vestibular (Bartholin) glands secrete a clear lubricating mucus during intercourse. Paraurethral (Skene) glands are tiny, multiple glands that surround the urethral meatus. Sebaceous glands are microscopic glands in the skin that secrete an oily/waxy matter, called sebum, to lubricate the skin and hair. The adrenal glands are endocrine glands responsible for releasing hormones in conjunction with stress through the synthesis of corticosteroids and catecholamines.

Pyrosis is: A) an inflammation of the peritoneum. B) a burning sensation in the upper abdomen. C) a congenital narrowing of the pyloric sphincter. D) an abnormally sunken abdominal wall.

B) a burning sensation in the upper abdomen. Pyrosis (heartburn) is a burning sensation in the esophagus and stomach from reflux of gastric acid. Peritonitis is an inflammation of the peritoneum. Pyloric stenosis is a congenital narrowing of the pyloric sphincter. A scaphoid abdomen abnormally caves in or is sunken.

A retention cyst in the epididymis filled with milky fluid containing sperm is called: A) a varicocele. B) a spermatocele. C) Peyronie disease. D) a prepuce.

B) a spermatocele. A spermatocele is a retention cyst in the epididymis filled with milky fluid containing sperm. A varicocele is a dilated, tortuous varicose vein in the spermatic cord. Peyronie disease is a result of hard, nontender, subcutaneous plaques on the penis that cause a painful bending of the penis during an erection. Over the glans, the skin folds in and back on itself forming a hood or flap called the foreskin or prepuce.

Claudication is caused by: A) venous insufficiency. B) arterial insufficiency. C) varicose veins. D) stasis ulcerations.

B) arterial insufficiency. Claudication is caused by arterial insufficiency. Varicose veins are venous in origin. Stasis ulcerations are venous in origin.

The ability of the heart to contract independently of any signals or stimulation is due to: A) depolarization. B) automaticity. C) conduction. D) repolarization.

B) automaticity. The heart can contract by itself, independent of any signals or stimulation from the body; this property is termed automaticity. Depolarization is the reversal of the resting potential in excitable cardiac muscle cell membranes when stimulated. Conduction is the process by which an electrical impulse is transmitted through the heart. Repolarization is the process by which the membrane potential of a cardiac muscle cell is restored to the cell's resting potential.

The first heart sound (S1) is produced by the: A) closure of the semilunar valves. B) closure of the AV valves. C) opening of the semilunar valves. D) opening of the AV valves.

B) closure of the AV valves. Correct S1 occurs with closure of the atrioventricular valves. The second heart sound (S2) occurs with closure of the semilunar valves. Normally opening of the semilunar valves is silent, but in aortic or pulmonic stenosis, an ejection click may be heard. An ejection click occurs early in systole at the start of ejection because it results from opening of the semilunar valves. A third heart sound (S3) can be heard when the ventricles are resistant to filling during the early rapid filling phase. S3 is heard when the AV valves open and atrial blood first pours into the ventricles.

Soft, pointed, fleshy papules that occur on the genitalia caused by human papillomavirus (HPV) are known as: A) chancres. B) genital warts. C) urethritis. D) varicoceles.

B) genital warts. Condylomata acuminata (genital warts) are soft, pointed, fleshy papules that occur on the genitalia and are caused by HPV. Syphilitic chancres are small, solitary, silvery papules that erode to a red, round or oval, superficial ulcer with a yellowish serous discharge. Urethritis is an infection of the urethra; the meatus edges are reddened, everted, and swollen. A varicocele is a dilated, tortuous varicose vein in the spermatic cord.

The organ in the right upper quadrant of the abdomen is the: A) spleen. B) liver. C) cecum. D) sigmoid colon.

B) liver. The liver is in the right upper quadrant of the abdomen. The spleen is in the left upper quadrant. The cecum is in the right lower quadrant. The sigmoid colon is in the left lower quadrant.

A caruncle is a(n): A) vestibular gland located on either side of the vaginal orifice. B) small, red mass protruding from the urethral meatus. C) aberrant growth of endometrial tissue. D) hard, painless nodule in the uterine wall.

B) small, red mass protruding from the urethral meatus.

A bruit heard while auscultating the carotid artery of a 65-year-old patient is caused by: A) decreased velocity of blood flow through the carotid artery. B) turbulent blood flow through the carotid artery. C) rapid blood flow through the carotid artery. D) increased viscosity of blood.

B) turbulent blood flow through the carotid artery. A carotid bruit is a blowing, swishing sound indicating blood flow turbulence. A bruit indicates atherosclerotic narrowing of the vessel.

Adnexa is (are): A) an absence of menstruation. B) uterine accessory organs. C) a membranous fold of tissue partly closing the vaginal orifice. D) painful intercourse.

B) uterine accessory organs. The adnexa of uterus (or uterine appendages) refers to the structures most closely related structurally and functionally to the uterus; these structures include the ovaries, fallopian tubes, and ligaments. Amenorrhea is the absence of menstruation. The hymen is a thin, circular or crescent-shaped fold that may cover part of the vaginal orifice or may be absent completely. Dyspareunia is the term to describe painful intercourse.

Suppose you noted that Tina's left knee was swollen. Which of the following tests should be done? A) Balloon test B) Fluid wave C) Bulge sign D) Tinel's sign

C) Bulge sign The bulge sign is a test for excess fluid accumulation in the knee. It is performed by rubbing the knee capsule in upward strokes to displace fluid and observing for the creation of a bulge when the fluid returns to its original position.

A 3-year-old child with Down's syndrome is in the cardiac ICU of Shadow General Hospital following open heart surgery. Which of the following musculoskeletal physical exam findings would you expect to find on this child? A) Fixed joints B) Lordosis C) Hyperextensible joints D) Scoliosis

C) Hyperextensible joints Children with Down's syndrome often have palmar simian crease, hyperextensible joints, and short, broad extremities.

_____________ is acute inflammation of the testes. A) Genital herpes B) Priapism C) Orchitis D) Paraphimosis

C) Orchitis Orchitis is an acute inflammation of the testes. Genital herpes is a sexually transmitted infection caused by the herpes simplex virus; the vesicles erupt on the glans or foreskin. Priapism is a prolonged painful erection of the penis. Paraphimosis occurs when the foreskin is retracted and fixed.

Which of the following guidelines may be used to identify which heart sound is S1? A) S1 is louder than S2 at the base of the heart. B) S1 coincides with the A wave of the jugular venous pulse wave. C) S1 coincides with the carotid artery pulse. D) S1 coincides with the Q wave of the QRS electrocardiogram complex.

C) S1 coincides with the carotid artery pulse. S1 coincides with the carotid artery pulse. S1 is loudest at the apex of the heart. S1 coincides with the C wave of the jugular venous pulse wave. S1 coincides with the R wave (the upstroke of the QRS complex).

_____________ is an emergency requiring surgery. A) A scrotal hernia B) Epididymitis C) Testicular torsion D) Cryptorchidism

C) Testicular torsion Testicular torsion is a sudden twisting of the spermatic cord; blood supply is cut off, and the testis can become gangrenous in a few hours. Emergency surgery is required. A scrotal hernia is usually due to indirect inguinal hernia; the scrotal sac herniates through the internal inguinal ring and passes into the scrotum. Epididymitis is an acute infection of the epididymis. Cryptorchidism is a developmental defect in which the testes have not descended.

When auscultating the heart of a newborn within 24 hours after birth, the examiner hears a continuous sound that mimics the sound of a machine. This finding most likely indicates: A) the presence of congenital heart disease. B) a normal sound because of the thinner chest wall of the newborn. C) an expected sound caused by nonclosure of the ductus arteriosus. D) pathology only when accompanied by an increased heart rate.

C) an expected sound caused by nonclosure of the ductus arteriosus. The murmur of a patent ductus arteriosus is a continuous machinery murmur, which disappears by 2 to 3 days.

A water-hammer or Corrigan pulse is associated with: A) hyperkinetic states. B) decreased cardiac output. C) aortic valve regurgitation. D) conduction disturbance.

C) aortic valve regurgitation. A water-hammer (Corrigan) pulse occurs in aortic valve regurgitation. A full, bounding pulse is associated with hyperkinetic states (exercise, anxiety, fever). A weak, thready pulse occurs with decreased cardiac output. Pulsus bigeminus occurs with conduction disturbances.

The most common sexually transmitted infection in the United States is: A) gonorrhea. B) syphilis. C) chlamydia. D) trichomoniasis.

C) chlamydia.

The leaflets of the tricuspid and mitral valves are anchored by __________________ to the _________________, which are embedded in the ventricular floor. A) endocardial ligaments; mediastinal muscles B) atrioventricular tendons; pericardial bundles C) chordae tendineae; papillary muscles D) pericardial cords; ventricular sheaths

C) chordae tendineae; papillary muscles The valves are anchored by collagenous fibers (chordae tendineae) to the papillary muscles, which are embedded in the ventricle floor.

Pyloric stenosis is a(n): A) abnormal enlargement of the pyloric sphincter. B) inflammation of the pyloric sphincter. C) congenital narrowing of the pyloric sphincter. D) abnormal opening in the pyloric sphincter.

C) congenital narrowing of the pyloric sphincter.

A patient has severe bilateral lower extremity edema. The most likely cause is: A) an infection of the right great toe. B) Raynaud phenomenon. C) heart failure. D) an aortic aneurysm.

C) heart failure. Bilateral lower extremity edema is a result of a generalized disorder such as heart failure. An infection of only one extremity would lead to unilateral edema. Raynaud phenomenon does not result in bilateral lower extremity edema. Aneurysms do not cause bilateral lower extremity edema.

Decreased estrogen levels during menopause cause: A) an enlargement of the uterus. B) pelvic muscles and ligaments to tighten. C) the ovaries to atrophy. D) the cervix to enlarge and turn blue.

C) the ovaries to atrophy. Decreased estrogen levels during menopause cause atrophy of the ovaries. Decreased estrogen levels during menopause cause the uterus to shrink related to a decrease in the myometrium. Decreased estrogen levels during menopause cause the sacral ligaments to relax and the pelvic musculature to weaken, which causes the uterus to drop. Decreased estrogen levels during menopause cause the cervix to shrink and look pale with a thick, glistening epithelium.

Arteriosclerosis refers to: A) a variation from the heart's normal rhythm. B) a sac formed by dilation in the arterial wall. C) thickening and loss of elasticity of the arterial walls. D) deposition of fatty plaques along the intima of the arteries.

C) thickening and loss of elasticity of the arterial walls. Arteriosclerosis is the thickening and loss of elasticity of the arterial walls. A dysrhythmia is a variation from the heart's normal rhythm. An aneurysm is a sac formed by dilation in the artery wall. Atherosclerosis is the deposition of fatty plaques on the intima of the arteries.

The four layers of large, flat abdominal muscles form the: A) linea alba. B) rectus abdominis. C) ventral abdominal wall. D) viscera.

C) ventral abdominal wall. The four layers of large, flat muscles form the ventral abdominal wall. These muscles are joined at the midline by a tendinous seam, the linea alba. One set of abdominal muscles, the rectus abdominis, forms a strip extending the length of the midline. The viscera are all the internal organs inside the abdominal cavity.

The semilunar valves separate the: A) atria from the ventricles. B) right atria from the left atria. C) ventricles from the arteries. D) atria from the veins.

C) ventricles from the arteries. The semilunar valves separate the ventricles from the arteries. The atrioventricular valves separate the atria and ventricles. The atrioventricular valves separate the atria and the ventricles. The septum separates the right atria from the left atria. The vena cava are not separated by a valve from the right atrium; the pulmonary veins are not separated by a valve from the left atrium.

Suppose that Tina reported pain when you assessed for costovertebral angle (CVA) tenderness. Which of the following would be true? A) CVA tenderness may indicate kidney infection B) CVA tenderness may indicate liver enlargement C) CVA tenderness is an expected finding D) CVA tenderness is a rare finding

CVA tenderness may indicate kidney infection Percussion of the costovertebral angle should evoke no pain. The elicitation of pain is indicative of inflammation in the underlying kidney or surrounding tissue.

The second heart sound is the result of which of the following? A)Opening of aortic and pulmonic valves B) Closing of aortic and pulmonic valves C) Opening of mitral and tricuspid valve D) Closing of mitral and tricuspid valve

Closing of aortic and pulmonic valves The five cardiac areas of auscultation are not the anatomical positions of the heart valves but are the best places to listen due to the direction that sounds resonate in the thorax.

If Tina had displayed limited abduction of the left shoulder, it would mean that: A) She has limited movement forward B) She has limited movement in a circular motion C) She has limited movement toward her body D) She has limited movement away from her body

D) She has limited movement away from her body Abduction is defined as a motion in which a body part is moved away from the body's midline.

A deep recess formed by the peritoneum between the rectum and the cervix is called: A) the Chadwick sign. B) a cystocele. C) a rectocele. D) a rectouterine pouch.

D) a rectouterine pouch. The rectouterine pouch (or cul-de-sac of Douglas) is the deep recess between the rectum and the cervix. The cervical mucosa during the second month of pregnancy is blue, which is termed the Chadwick sign. The cervix may also turn blue in any condition causing hypoxia or venous congestion. A cystocele is an abnormality of the pelvic musculature in which the bladder prolapses into the vagina. A rectocele is an abnormality of the pelvic musculature in which the rectum prolapses into the vagina.

Ascites is defined as: A) a bowel obstruction. B) a proximal loop of the large intestine. C) an abnormal enlargement of the spleen. D) an abnormal accumulation of serous fluid within the peritoneal cavity.

D) an abnormal accumulation of serous fluid within the peritoneal cavity. Ascites is free fluid in the peritoneal cavity. A bowel obstruction may result in abdominal distention. The proximal loop of the large intestine is the ascending colon. Splenomegaly is the term to describe an enlarged spleen.

Orchitis is (are): A) a meatus opening on the dorsal side of the glans or shaft. B) hard, subcutaneous plaques associated with painful bending of the erect penis. C) a circumscribed collection of serous fluid in the tunica vaginalis surrounding the testes. D) an acute inflammation of the testes.

D) an acute inflammation of the testes. Orchitis is an acute inflammation of the testes. Epispadias is a meatus opening on the dorsal side of the glans or shaft. Peyronie disease is a result of hard, nontender, subcutaneous plaques on the penis that cause a painful bending of the penis during an erection. A hydrocele is a circumscribed collection of serous fluid in the tunica vaginalis surrounding the testes.

In pulsus paradoxus: A) the rhythm is irregular; every other beat is premature. B) there is a deficiency of arterial blood to a body part. C) the rhythm is regular, but the force of the pulse varies with alternating beats. D) beats have weaker amplitude with respiratory inspiration and stronger amplitude with expiration.

D) beats have weaker amplitude with respiratory inspiration and stronger amplitude with expiration. In pulsus paradoxus, beats have weaker amplitude with inspiration and stronger amplitude with expiration. The rhythm is irregular and coupled in pulsus bigeminus; every other beat comes early or premature. A weak, thready pulse may result in a deficiency of arterial blood to a body part. The rhythm is regular in pulsus alternans, but the force varies with alternating beats of large and small amplitude.

The first sign of puberty in girls is: A) the first menstrual cycle (menarche). B) axillary hair development. C) rapid increase in height. D) breast and pubic hair development.

D) breast and pubic hair development. The first signs of puberty are breast and pubic hair development, beginning between 8½ and 13 years of age. These signs usually occur together, but it is not abnormal if they do not develop together. This development takes about 3 years to complete. Menarche occurs during the latter half of the sequence of breast and pubic hair development, just after the peak of growth velocity. Coarse curly hairs develop in the pubic area first and then in the axillae.

The cervical nodes drain the: A) upper arm and breast. B) hand and lower arm. C) external genitalia. D) head and neck.

D) head and neck. The cervical nodes drain the head and neck. Axillary nodes drain the breast and upper arm. The epitrochlear node drains the hand and lower arm. Inguinal nodes drain most of the lymph from the lower extremity, the external genitalia, and the anterior abdominal wall.

One of the leg's deep veins is the: A) great saphenous. B) small saphenous. C) tibial. D) popliteal.

D) popliteal. The femoral and popliteal veins are the deep veins in the leg. The superficial veins are the great and small saphenous veins. The superficial veins are the great and small saphenous veins. The anterior tibial veins extend downward from the popliteal veins.

Methods to enhance abdominal wall relaxation during examination include: A) a cool environment. B) having the patient place arms above the head. C) examining painful areas first. D) positioning the patient with the knees bent.

D) positioning the patient with the knees bent. Position the patient supine, with the head on a pillow, knees bent or on a pillow, and arms at the side. Keep the room warm to avoid chilling and tensing of muscles. Avoid having arms above the head; this increases abdominal wall tension. Painful areas should be examined last to avoid muscle guarding.

Lymphedema is: A) the indentation left after the examiner depresses the skin over swollen edematous tissue. B) a thickening and loss of elasticity of the arterial walls. C) an inflammation of the vein associated with thrombus formation. D) the swelling of an extremity caused by an obstructed lymph channel.

D) the swelling of an extremity caused by an obstructed lymph channel. Lymphedema is swelling of the limb caused by surgical removal of lymph nodes or damage to lymph nodes and vessels. Pretibial edema (pitting) occurs if an indentation is left after the examiner depresses skin over the tibia or the medial malleolus for 5 seconds. Arteriosclerosis is the thickening and loss of elasticity of the arterial walls. In deep vein thrombosis, a deep vein is occluded by a thrombus, causing inflammation, blocked venous return, cyanosis, and edema.

Tina's left tibial pulse is graded as 2+. This finding is: A)Bounding B) Increased C) Normal D) Weak

Normal Pulses are graded on a 4 point scale in which 3+ is bounding, 2+ is normal, 1+ is weak, and 0 is absent.

Humpback (kyphosis) is commonly caused by

Osteoporosis

Shuffling gait and postural instability is commonly seen in patients with

Parkinson's Disease

Suppose that you suspected ascites because Tina's abdomen is large. Which of the following assessment findings would confirm ascites? A) Shifting dullness B) Murphy's sign C) Deep organ palpation D) Peristaltic fluid wave test

Shifting dullness Ascites is the accumulation of fluid in the peritoneal space. This fluid can be detected by abdominal percussion. The distribution of fluid in the abdomen shifts according to gravity when the person changes body position. To test for ascites, percuss for dullness in the abdomen when Tina is in several different body positions.

The Left Upper Quadrant (LUQ) contains the: A) Gallbladder B) Spleen C) Liver D) Appendix

Spleen The spleen is the largest lymphatic organ. However, instead of lymph, its chambers are filled with blood.