NURS 7470 Exam 3 Practice Questions
Which spinal finding would be considered normal for a 72-year old patient? a. Scoliosis b. Kyphosis c. Meningocele d. Myelomeningocele
b. Kyphosis
When assessing for carpal tunnel syndrome, Tinel's sign can be performed by tapping the: a. Radial artery b. Median nerve c. Volar carpal ligament d. Dorsal aspect of the wrist
b. Median nerve
What Grade would be indicated or documented for "Normal" muscle strength?
5
Which of the following are characteristic of cardiac related cyanosis? a. Central cyanosis without acute respiratory symptoms. b. Central cyanosis involving right to left shunting . c. Central cyanosis occurs when oxygen saturation drops below 94%. d. Central cyanosis can be due to decrease in local blood circulation and increased offloading of oxygen in the peripheral tissues.
A & B: a. Central cyanosis without acute respiratory symptoms. b. Central cyanosis involving right to left shunting. Central cyanosis is seen if oxygen saturation drops between 80 to 87%. Central cyanosis occurs when the level of deoxygenated hemoglobin in the arteries is below 5 g/dL with oxygen saturation below 85%. Peripheral cyanosis occurs due to decrease in local blood circulation and increased offloading of oxygen in the peripheral tissues.
Disorientation is common when memory or attention is impaired. Consequently, orientation is generally assessed during an initial interview with a patient and should be assessed with most subsequent encounters. Select the areas you would assess to determine orientation. Select all that apply. a. The patient's responses to family situations, jobs, use of money and interpersonal conflicts. b. The time of day, day of the week, month, season, date and year, and duration of hospital stay. c. The patient's residence, the name of the hospital, city and state. d. The patient's name, and names of relatives and professional personnel they are working with.
All but A: b. The time of day, day of the week, month, season, date and year, and duration of hospital stay. c. The patient's residence, the name of the hospital, city and state. d. The patient's name, and names of relatives and professional personnel they are working with.
Select the appropriate techniques for otoscopic examination of the ear in an adult. a. Insert the speculum gently into the ear canal, directing it somewhat downward and forward. b. Pull the pinna downward and push the tragus closed. c. Hold the otoscope handle between your thumb and fingers, and brace your hand against the patient's face. d. Straighten the ear canal by pulling the auricle up and backward.
All but B: a. Insert the speculum gently into the ear canal, directing it somewhat downward and forward. c. Hold the otoscope handle between your thumb and fingers, and brace your hand against the patient's face. d. Straighten the ear canal by pulling the auricle up and backward.
Which of the following would be expected findings of an otoscopic exam? Select all that apply. a. Visible landmarks to include umbo, handle of malleus b. Bulging, pinkish, red translucent tympanic membrane c. Tympanic membrane color is pearly gray d. Light reflex reflected at the 5:00 (clock) position
All except B: a. Visible landmarks to include umbo, handle of malleus c. Tympanic membrane color is pearly gray d. Light reflex reflected at the 5:00 (clock) position
Which of the following would be considered back pain red flags that potentially may indicate significant pathology? a. History of cancer b. Immunosuppression c. Pain longer than 1 month d. Saddle anesthesia e. Pain for 3 days after heavy lifting
All except e: a. History of cancer b. Immunosuppression c. Pain longer than 1 month d. Saddle anesthesia
Which cranial nerve is responsible for sensation of the gag reflex and taste of the posterior one third of the tongue?
IX, X
Which nerve associated with patellar reflex?
L3 & L4
Which of the following is considered a normal finding for a woman in her eighth month of pregnancy?
Lordosis
Sam, is a 15 year old soccer player with pain and swelling in ins left knee. You suspect a torn meniscus in the left knee, what test would be performed to further confirm this diagnosis?
McMurray Test
Valgus Stress Test (knee)
Positive test indicated by excess valgus movement and may be indicative of MCL sprain. A positive test with knee in full extension may be indicative of damage to MCL, PCL, posterior oblique ligament, posteromedial capsule
While the client is supine, you have him fully extend one leg flat. You then flex the other knee to his chest. You notice the extended leg rising off the examining table. What is this test called?
Thomas test
To assess spinal level C6, C7, and C8, which deep tendon reflex should be tested?
Tricep
A patient presents with a complaint of a sudden flashes of light in the field of vision. What other symptom commonly accompanies this primary symptom and suggest a retinal detachment? a. Intense dizziness b. Partial loss of vision c. Severe pain to the eye d. Severe nausea and vomiting
b. Partial loss of vision
Which of the following questions asked by the examiner would be most helpful in understanding a patient complaining of acute back pain? a. "Was there any activity or injury that occurred prior to the onset of the pain?" b. "What medication do you currently take?" c. "Have you recently lost weight?" d. "Were you born with any congenital deformities of the spine?"
a. "Was there any activity or injury that occurred prior to the onset of the pain?"
Which of the following is the correct position in which to place the patient for breast palpation? a. Supine with arms over head and small pillow under shoulder of side being assessed b. Simple seated position with hands on hips c. Sitting slightly forward with breasts hanging away from chest; hands on hips d. Semi-Fowler's position with arms at side; pillow under neck
a. Supine with arms over head and small pillow under shoulder of side being assessed
Why do we develop a differential diagnosis list? a. A differential diagnosis list enables appropriate testing to promote consideration of competing diagnoses, rule out possibilities and confirm a final diagnosis. b. A differential diagnosis list ensures that the most common possible diagnoses are considered and that rare and unusual diagnoses are not considered. c. A differential diagnosis list ensures that laboratory tests, biopsy, diagnostic imaging, or other investigations are done in a timely manner. d. As a list of credible disease processes that may cause the patient's problem, a differential diagnosis list allows the practitioner to maximize patient's charges.
a. A differential diagnosis list enables appropriate testing to promote consideration of competing diagnoses, rule out possibilities and confirm a final diagnosis.
During the primary assessment, the examiner asks the patient, "Can you tell me who you are?" This question assesses: a. Airway and orientation b. Disabilty and exposure c. Breathing and circulation d. Exposure and circulation
a. Airway and orientation
The spine of a newborn infant should be palpated with the examiner noting the shape of each spinal process. If a split is noted in one of the spinal processes, which problem is suspected a. Bifid defect b. Lordosis c. Down syndrome d. Spina bifida
a. Bifid defect
Which of the following actions test the Cranial Nerves III, IV, and VI (Oculomotor, Trochlear, and Abducens)? a. Have the patient move their eyes through the six cardinal directions of gaze and look for conjugate movements in any of the six directions. b. Inspect the optic fundi with the ophthalmoscope and note size, shape and color of the optic disc. c. Have the patient clench and move the jaw from side to side as the examiner palpates the TMJ. d. Inspect the pupils for size and compare one side to the other. Assess the pupils for convergence and accommodation.
a. Have the patient move their eyes through the six cardinal directions of gaze and look for conjugate movements in any of the six directions.
You are auscultating heart sounds as part of a sports PE for a 17 year old teen who wants to play soccer. Her heart rate is 68, she denies chest pain nor palpitations. You hear a murmur at the right second intercostal space (aortic area). The murmur increases in intensity when this teenager goes from a sitting to a standing position. Previous history on the chart does not show any history of murmur on previous visit but this patient is not seen regularly. Which of the follow options would be most appropriate in this case? a. Have the patient see a cardiologists prior to clearing this patient for sports participation. b. Order a stress test and cardiac cath for this patient prior to clearing this patient for sports participation. c. Have the patient follow back up in 3-6 months to evaluate his cardiac status and then clear the patient at that time if appropriate. d. Do not clear this patient and suggest she get involved in the arts instead of sports.
a. Have the patient see a cardiologists prior to clearing this patient for sports participation.
A patient demonstrates impaired pain sensation. Which additional test is appropriate to further evaluate this finding a. Heat and cold sensation b. Ultrasonic perception c. Deep tendon reflex d. Transillumination of the involved area
a. Heat and cold sensation
Which cranial nerve is not routinely tested unless a problem is suspected? a. I b. II c. V d. XI
a. I
Which of the following findings is associated with an increased risk for skin breakdown and injury? a. Inability to feel pressure applied by a monofilament b. Inability to identify a familiar object by touch c. Inability to identify a letter drawn in the palm of the hand d. 3+ deep tendon reflexes
a. Inability to feel pressure applied by a monofilament
Which of the following statements describes an appropriate examination technique? a. Inspection can continue throughout the history taking process and during the physical examination b. During percussion, the downward snap of the striking fingers should originate from the shoulder and forearm c. The stethoscope's diaphragm is most useful in the assessment of dull, low-pitched sounds d. If your patient is especially modest, performing the respiratory examination over clothing may assist to alleviate anxiety
a. Inspection can continue throughout the history taking process and during the physical examination
Which assessment technique/test is used to assess the integrity of the anterior cruciate ligament? a. Lachman test b. Valgus stress test c. Straight leg raise d. Thomas test
a. Lachman test
Regardless of age, which of the following actually marks the beginning of adolescence? a. Onset of puberty b. Development of a conscience and a sense of morality c. Development of selfish, impatient behavioral traits d. 13th birthday
a. Onset of puberty
Which of the following is a peripheral vascular condition that results in progressive ischemia caused by insufficient perfusion? a. Peripheral atherosclerotic disease b. Arterial aneurysm c. Venous thrombosis d. Raynaud's phenomenon
a. Peripheral atherosclerotic diseas
The examiner asks the patient to close her eyes then places a vibrating tuning fork of the patient's ankle and asks her to indicate what is felt. What is being assessed? a. Peripheral nerve sensory function b. Cranial nerve sensory fx c. Primary sensory fx d. Level of consciousness
a. Peripheral nerve sensory function
For which type of problem does a family history have significance? a. Rheumatoid arthritis b. Dislocation of the radius c. Lumbosacral radiculopathy d. Bursitis
a. Rheumatoid arthritis
Choose all of the correct clinical pearls related to lymph node assessment. a. Slow nodal enlargement over weeks and months are suggestive of benign processes; rapid enlargement without inflammation is suggestive of malignancy. b. The harder the node and more discreet, the more likely it is to be benign. c. The more tender the node, the more likely it is inflammation. d. If you detect a bruit, you are most likely assessing a blood vessel rather than a lymph node. e. Lymph nodes that are soft are significant for pathology, those that are rubbery classically indicate malignancy & granulomatous infection, and hard non-tender nodes are classically an indication of lymphoma.
a. Slow nodal enlargement over weeks and months are suggestive of benign processes; rapid enlargement without inflammation is suggestive of malignancy.
A patient complains of pain and a clicking noise with jaw movement. The pain extends into the face. These symptoms are suggestive of what condition? a. Temporomandibular joint syndrome b. Rheumatoid arthritis of the jaw c. Gout in the jaw d. Bursitis of the temporomandibular joint
a. Temporomandibular joint syndrome
Which of the following techniques is an appropriate physical examination guideline? a. The sequence of the exam is designed to minimize the patient's need to change positions and to maximize the clinician's efficiency b. The episodic physical is conducted with the purpose to detect and prevent disease in asymptomatic clients c. The examination length should be the same on every patient regardless of the presenting problem d. The sequence of the exam is unimportant and should focus on efficiency of the practitioner.
a. The sequence of the exam is designed to minimize the patient's need to change positions and to maximize the clinician's efficiency
Stridor can be heard on ausculation when a client has: a. acute epiglottis b. asthma c. pleurisy d. atelectasis
a. acute epiglottis
When palpating joints, crepitus may occur when: a. irregular bony surfaces rub together b. supporting muscles are excessively spastic c. joints are excessively lax d. there is excess fluid within the synovial membrane.
a. irregular bony surfaces rub together Crepitus is felt or heard when irregular bony surfaces rub together, when two rough edges of a broken bone rub together, or with the movement of tendon inside the tendon sheath when tenosynovitis is present
A 3-year-old child 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 best supports a presentation of: a. radial head subluxation b. femoral anteversion c. osteomyelitis d. Osgood-Schlatter disease
a. radial head subluxation
Which of the following should be used to test for near vision? a. rosenbaum chart b. snellen e chart c. confrontation test d. cover-uncover test
a. rosenbaum chart
When auscultating the lungs of an elderly client, you note that over the posterior lower lobes you hear low pitched, soft breath sounds with inspiration being longer than expiration. You know that these are: a. vesicular breath sounds that are normal in this location b. bronchovesicular breath sounds that are normal in this location c. abnormal and suggestive of hyperinflated lungs d. suggestive of diminished breath sounds in this location
a. vesicular breath sounds that are normal in this location
Injuries to long bones and joints are more likely to result in fractures than in sprains until:
adolescence
During the examination of the extremities of the pregnant female, why is it important to elicit the knee and ankle deep tendon reflexes? a. Abnormal reflexes may indicate early signs of DVT. b. Abnormal reflexes, specifically, hyperreflexia may signal cortical irritability from eclampsia. c. Abnormal reflexes, specifically, hyporeflexia with proteinuria are associated with preeclampsia. d. Hyporeflexia is indicative of Gestational Diabetes
b. Abnormal reflexes, specifically, hyperreflexia may signal cortical irritability from eclampsia. Preeclampsia is associated with pregnancy induced hypertension and proteinuria. Other symptoms of preeclampsia are increased protein:creatinine ratio, impaired liver function, renal insufficiency, pulmonary edema, and cerebral or visual symptoms.
How is Proprioception (joint position sense) tested? a. With the patient's eyes closed; the examiner places a familiar object like a key in the patient's hand. The patient states what the object is. b. After demonstration of the positions, the patient closes their eyes and the examiner moves the patient's great toe up or down. The patient states what position the toe is in. c. After demonstration the tuning fork, the patient closes their eyes and the examiner touches the tuning fork to the patient's DIP joint of the great toe. For best results, the tuning fork is touched to the joint when it is and when it is not vibrating. The patient indicates they feel or don't feel the vibration. d. With the patient's eyes closed; the examiner uses two ends of a paper clip to touch a finger pad in two places simultaneously. The patient indicates if they feel one or two points of sensation.
b. After demonstration of the positions, the patient closes their eyes and the examiner moves the patient's great toe up or down. The patient states what position the toe is in.
When taking a patient's history, you are asked questions about your personal life. What is the best response to facilitate the interviewing process? a. Tell the patient that it is inappropriate to answer personal questions b. Answer briefly and then refocus on the patient's history c. Ignore the question and continue with the patient's history d. Give as much detail as possible about the asked information
b. Answer briefly and then refocus on the patient's history
The patient is able to touch each finger to his thumb in rapid sequence. What does this finding mean? The patient has: a. Intact trochlear and abducens cranial nerves b. Appropriate cerebellar fx c. An intact spinal accessory nerve d. Appropriate kinesthetic sensation
b. Appropriate cerebellar fx
Which of the following techniques is incorrect and affects the accuracy of auscultation? a. Placing the stethoscope firmly on the surface to be auscultated b. Auscultating through clothing c. Isolating one sound at a time during auscultation d. Listening for sound characteristics
b. Auscultating through clothing
Which of the areas of the mental status examination includes memory, information and vocabulary, calculations, abstract thinking and constructional ability? a. Mood b. Cognition c. Speech and Language d. Thoughts and perceptions
b. Cognition
In the older adult, which finding can occur in the absence of disease as a result of age-related changes of the chest or lungs? a. Intermittent pulmonary infiltrate and increased lung density. b. Hyperresonance due to an increasing barrel chest and a stiffer chest wall c. Intermittent productive cough without disease. d. Asymmetric expansion of the chest.
b. Hyperresonance due to an increasing barrel chest and a stiffer chest wall
Sensory neurologic testing is not usually done with children until they are: a. Preschool age b. Kindergarten age c. Middle school age d. High school age
b. Kindergarten age
Which one of the following is a proper technique for use of a speculum during a vaginal examination? a. Press introitus upward; insert closed speculum horizontally. b. Press introitus downward; insert closed speculum obliquely. c. Insert one finger followed by the opened speculum d. Allow labia to spread; insert speculum slightly open.
b. Press introitus downward; insert closed speculum obliquely.
What technique will most likely facilitate the exam of a small frightened child? a. Promise the child you won't hurt her b. Tell the child a story in order to distract her c. Use restraints to hold the child, but tell her you are playing a game with her d. Tell the child you will give her a toy or treat if she does not cry
b. Tell the child a story in order to distract her
Which of the following is accurate when assessing the S2 heart sound? a. The S2 heart sound is associated with the QRS wave in a normal ECG and it is usually found to have a higher pitch and shorter duration than S1. b. The S2 heart sound occurs at the start of diastole and it is best heard in the aortic and pulmonic areas c. The S2 heart sound is not associated with a normal physiologic split. The S3 sound is often mistaken for an S2 split. d. The S2 heart sound is best heard over the area of the point of maximal impulse using the bell of the stethoscope.
b. The S2 heart sound occurs at the start of diastole and it is best heard in the aortic and pulmonic areas
Which of the following best describes how the collection of a history should be done? a. The history is always done at the very beginning of an examination to help you identify problems. b. The history may be done before and/or after the examination. c. The history is done only if it is relevant to the situation d. The history is done at the end of the physical examination after you have identified problems.
b. The history may be done before and/or after the examination.
A common finding in markedly obese patients and pregnant women is: a. kyphosis b. lordosis c. paraphimosis d. scoliosis.
b. lordosis
A woman complains of weakness in the lower extremities. She is 2 days postpartum. Which of the following problems should the examiner consider? a. depression b. obstetric palsy c. encephalitis d. postpartum stroke
b. obstetric palsy
During digital examination of the vagina, the cervix is noted to be positioned anteriorly. Bimanual examination of this woman and palpation of the uterus confirms the position, which term best describes the finding. a. midline b. retroverted c. anteverted d. retroflexed
b. retroverted
The musculoskeletal examination should begin when: a. when joint mobility is assessed b. the patient enters the examination room after obtaining Ht and Wt c. the remainder of the physical examination is completed d. during the collection of subjective data
b. the patient enters the examination room after obtaining Ht and Wt
A pregnant patient has a pre-pregnancy weight-to-height body mass index of 22.4. The examiner expects this patient's weight gain during pregnancy to fall into which weight range? a. 20 to 26 pounds b. Less than 20 pounds c. 25 to 35 pounds d. 40 to 50 pounds
c. 25 to 35 pounds
The nurse is assessing a client's tonsils and note that they touch the uvula. The nurse would document this finding as which of the following? a. 1+ b. 2+ c. 3+ d. 4+
c. 3+
Which of the following infant reflex responses is considered normal? a. An 8-month old infant demonstrates a positive Moro reflex when startled b. A 13-month old baby toes fan in response to stroking the lateral surface of the infant's sole c. A 2-month old infant's legs flex up against the body when the infant is held in an upright position, and the dorsal side of the foot touches the table d. A 3-month year old infant's fingers fan when the examiner's finger is placed in the infant's hand
c. A 2-month old infant's legs flex up against the body when the infant is held in an upright position, and the dorsal side of the foot touches the table
How should a Breast Self Exam (BSE) should be performed? a. A Breast Self Exam (BSE) should be performed when the skin is dry since moisture tends to obscure findings. b. A Breast Self Exam (BSE) should be performed with the client lying in the left lateral position to assure accuracy. c. A Breast Self Exam (BSE) should be performed in front of the mirror performing a series of arm position changes (clasped behind head, hands on hips, leaning forward, etc) and using one of the accepted palpation techniques. d. A Breast Self Exam (BSE) should be performed using palpation techniques alone, inspection and visual changes are not relevant.
c. A Breast Self Exam (BSE) should be performed in front of the mirror performing a series of arm position changes (clasped behind head, hands on hips, leaning forward, etc) and using one of the accepted palpation techniques
An older patient tells the examiner, I have a hard time finding the right words when I am talking this symptom may be a. A precursor to a seizure disorder b. An early sx of Parkinson disease c. An indication of a dysfunction of the temporal lobe d. Associated with a problem of the vestibular apparatus
c. An indication of a dysfunction of the temporal lobe
When performing a physical examination, you should consider the examination to begin: a. After the vital signs are taken b. After the patient has put on an exam gown c. As soon as you meet the patient d. After you explain to the patient everything that you are going to so
c. As soon as you meet the patient
What technique can you use to distinguish a respiratory friction rub from a cardiac rub? a. It has a dry-crackly grating sound b. Ask the patient to hold his breath; the cardiac rub will disappear when the breath is held c. Ask the patient to hold his breath; the respiratory rub will disappear when the breath is held d. Ask the patient to perform a valsalva maneuver; the cardiac rub will disappear
c. Ask the patient to hold his breath; the respiratory rub will disappear when the breath is held
To assess muscle strength of the temporalis and masseter muscles, the examiner will ask the patient to: a. Push the jaw forward while the examiner applies counterforce b. Attempt to open the mouth while the examiner applies counterforce c. Clench the teeth while the examiner palpates the contracted muscles d. Clench the teeth together while the examiner attempts to open the mouth with a tongue blade
c. Clench the teeth while the examiner palpates the contracted muscles
What response should occur when a patient's field of gaze moves from a distant object to one close to his or her fact? a. Rapid eye movement b. Ptosis of the eye c. Constriction of the pupil d. Dilation of the iris
c. Constriction of the pupil
The examiner suspects a patient has deep vein thrombosis. The examiner dorsiflexes the patient's foot, to which the patient reports calf pain. This finding is referred to as a positive a. Allis sign b. Chadwick sign c. Homans sign d. Kehr sign
c. Homans sign
A patient makes the following statement: I sometimes feels as if the whole room is spinning. What type of neurologic dysfunction should the examiner suspect? a. Peripheral neuropathy dysfunction b. Increased intracranial pressure from a brain tumor c. Inner ear dysfunction affecting the acoustic nerve d. Lesion affecting the frontal lobe
c. Inner ear dysfunction affecting the acoustic nerve
Jack is a 52-year old obese man with a 40 year pack smoking history and he has a history of poorly controlled diabetes. Which of the following assessment findings would likely be present given Jack's history? a. Slow and uncoordinated movement with finger-nose test b. Asymmetry of the face when asked to smile and puff out his cheeks c. Instability to discern superficial touch or two-point discrimination on the legs d. Reduced muscle tone on the left side of face
c. Instability to discern superficial touch or two-point discrimination on the legs
While assessing hearing, you time the client's hearing of the tuning fork sounds when the fork is on the mastoid process and when the fork is in front of the ear. What is the purpose of this test? a. It produces lateralization of sound in the good ear. b. It determines bone conduction of sound. c. It produces a comparison of air to bone conduction. d. It determines air conduction of sound.
c. It produces a comparison of air to bone conduction.
Bones around a joint are held together by: a. muscles b. synovial membranes c. Ligaments d. tendons
c. Ligaments
The examiner squeezes the patient's biceps muscle as part of an exam. Which of the following responses verbalized by the patient is considered normal? a. That makes my arm tingle b. That makes a burning sensation go up my arm c. That is uncomfortable d. My arm is twitching
c. That is uncomfortable
When examining an adult male, what position is used to assess the patient for an inguinal hernia? a. The patient should be in a knee chest position. b. The patient should lean over the exam table with toes pointed together. c. The patient should be in a standing position. d. The patient should sit on a table with his heels together.
c. The patient should be in a standing position.
Which of the following findings should an examiner consider a normal finding if associated with pregnancy? a. decreased gag reflex b. mild seizures c. change in balance d. 4+ deep tendon reflexes
c. change in balance
When testing the brachioradialis reflex, what is the expected response? a. pronation of the forearm and flexion of the elbow b. flexion of the hand c. flexion and supination of the forearm d. extension of the forearm/elbow
c. flexion and supination of the forearm
The examiner observes a 6-month-old infant. Which of the following observations should be considered an expected finding at this age? The infant: a. walks around the room holding onto objects b. feeds self with cup and spoon c. holds a rattle or spoon d. sits without support.
c. holds a rattle or spoon
Strength of the trapezius muscle is best evaluated by having the patient: a. straighten her leg with examiner opposition b. adduct the arm c. push her head against the examiner's hand d. clench her teeth during muscle palpation
c. push her head against the examiner's hand
The characteristic barrel chest of the older adult is due to a combination of factors including a. increased muscular expansion of the chest wall. b. less fibrous alveoli. c. skeletal changes of aging. d. increased vital capacity
c. skeletal changes of aging.
Café au lait patches are numbered with each assessment of infants and young children because: a. the numbers are expected to increase each year b. coalescent lesions are a more serious finding c. the presence of more than five patches suggests neurofibromatosis d. decreasing numbers are expected with growth.
c. the presence of more than five patches suggests neurofibromatosis
The examiner is conducting an interview with the mother of an infant as part of the neurologic system examination. Which of the following responses made by the mother may indicate a need for further evaluation? a. "My baby sometimes falls asleep when I am feeding her." b. "My baby seems to jump when there is a loud noise in the room." c. "I drank a glass of wine about once a week while I was pregnant." d. "I had problems with hypertension the entire time I was pregnant."
d. "I had problems with hypertension the entire time I was pregnant."
A 23-year-old man comes to the urgent care clinic with intense left flank and lower left quadrant pain. Which patient response to history of present illness questions further supports tentative diagnoses of renal calculi or renal infection? You may only select one answer, so select the best answer. a. "I also have a headache and neck ache." b. "My left testicle and shoulder hurt as well." c."My urine has been a bright yellow." d. "I have had fever and chills for 2 days."
d. "I have had fever and chills for 2 days."
Which question asked by the examiner may help determine prevention strategies for seizures that a patient has been experiencing? a. Where do your seizures typically begin b. How do you feel after the seizure c. What goes thru your mind during the seizure d. Are there any factors or activities that seem to start the seizures?
d. Are there any factors or activities that seem to start the seizures?
Which of the following findings suggests poor peripheral perfusion? a. Rapid heart rate b. Radial pulse palpable c. Dorsalis pedis pulse with 3+ amplitude d. Capillary refill > 2 seconds
d. Capillary refill > 2 seconds
How can an examiner best gain the cooperation of a child to perform a neurologic exam? a. Ask a parent to perform the exam while the examiner observes the response b. Ask the mother or father to step out of the room c. Promise the child a toy or treat if they do what you ask d. Create a game from various aspects of the neuro exam
d. Create a game from various aspects of the neuro exam
A 40 year old male with a BMI of 42. Three weeks ago he started a high protein, low carbohydrate, diet to lose weight. Today he presents with a red, hot swollen left big toe that started about 48 hours prior. The toe is extremely painful to move or touch. He denies any known trauma. What is the most likely condition these findings should lead you to suspect? a. Bursitis b. Trauma c. Tenosynovitis d. Gout
d. Gout
Harry was painting the ceiling in his house when his right shoulder pain started. This is indicative of pain with which range of motion of the shoulder? a. Forward flexion b. circumduction c. Adduction d. Hyperextension
d. Hyperextension
On examination, the advanced practice nurse would expect what finding if a client is in right-sided heart failure? a. Decreased central venous pressure b. Decreased stroke volume c. Decreased right-sided volume d. Increased jugular venous pressure
d. Increased jugular venous pressure
What is source of the anatomical and physiologic changes that occur during pregnancy? a. Increases in blood pressure and stress on organ systems such as the liver and kidneys. b. Enlargement of the uterus and fetal growth. c. Weight gain associated with pregnancy. d. Increases in levels of estradiol, progesterone, and the pregnancy hormones (especially HCG).
d. Increases in levels of estradiol, progesterone, and the pregnancy hormones (especially HCG).
Which technique is applied throughout the entire examination and interview process? a. Auscultation b. Palpation c. Percussion d. Inspection
d. Inspection
The examiner sees two 9-month old babies on the same day. Jeremy is a black 9 & 1/2-month old who pulls himself to a standing position and holds onto a chair while standing. Nathan is a white 9 & 1/2-month old who sits alone on the floor using hands for support; his mother states he is not yet scooting or creeping on the floor. What conclusion is appropriate for the examiner to make? a. Jeremy is athletically gifted compared to Nathan b. Jeremy is advanced for his age c. Both findings are within the "normal" range and should just be noted in the medical record d. Nathan may have a developmental delay
d. Nathan may have a developmental delay
During the neurological assessment, you determine the patellar deep tendon reflex is 3+. Which statement best describes this finding? a. diminished; low normal b. very brisk, hyperactive with clonus c. average; normal d. brisker than average, not necessarily indicative of disease
d. brisker than average, not necessarily indicative of disease
Mr. C's visual acuity is 20/70. What does this designation mean? a. can see 70% of what the average person can see at 20 feet b. he can see 20% of the letters on the chart's 20/70 line c. is legally blind d. can read letters while standing 20 feet away from the chart what the average person can see standing 70 feet away from the chart
d. can read letters while standing 20 feet away from the chart what the average person can see standing 70 feet away from the chart
To promote your exam time with a 5 month old child, which approach would be the best way to facilitate the exam? a. explain the procedure to the child b. give the child your equipment to play with during the exam c. ask the parents to give a child a bottle during the exam d. conduct the physical exam on the child while the parent holds if the child is anxious
d. conduct the physical exam on the child while the parent holds if the child is anxious
When testing the plantar reflex of a 10 year old male, you note a dorsiflexion and extension of the great toe and fanning of the other toes. This finding is: a. indication the boy is left side dominant b. normal c. indicative of muscle spasms d. indication of disease of the pyramidal tract
d. indication of disease of the pyramidal tract
Order of examination is important, when examining the newborn and infant which technique should the examiner begin with? a. percussion b. auscultation c. palpation d. inspection
d. inspection
While examining range of motion (ROM) on a patient, the examiner should remember that: a. reverse tailor position is encouraged in adults with limited ROM to the hip b. active ROM is used to assess extremities with complete paralysis c. full muscle strength can be maintained with up to 75% of ROM to the related joint. d. passive ROM is normally 5 degrees greater than active ROM.
d. passive ROM is normally 5 degrees greater than active ROM.
What is a goniometer used to assess? a. bone maturity b. muscle strength c. joint proportions d. range of motion
d. range of motion
A finding that is indicative of osteoarthritis is (are): a.swan neck deformities b.Bouchard nodes c.ganglions d.Heberden nodes
d.Heberden nodes
Classic carpal tunnel syndrome would result in:
reduced abduction of the thumb
When the patient's head is rotated to the left and right, what is the examiner assessing?
sternocleidomastoid muscle
