Patient Assessment Review

d) Macule

A freckle is an example of a: a) Bullae b) Crust c) Nevi d) Macule e) Patch

c) 60-100 beats per minute

A normal adult heart rate is: a) 70-120 beats per minute b) 40-80 beats per minute c) 60-100 beats per minute d) 40-110 beats per minute

b) Mass is 1 cm, firm, and non-mobile

A woman identifies a lump when performing a BSE(breast self examination). Which set of data makes you MOST concerned? a) Mass is 0.3 cm, soft, smooth, mobile b) Mass is 1 cm, firm, non-mobile c) Mass is 1 cm, soft, smooth, mobile d) Mass is 0.2 cm, firm, smooth, mobile

b) effusion

An abnormally large amount of fluid within a synovial joint space is called: a) ascites b) effusion c) edema d) crepitus

Pitting Edema

An indentation that remains on the skin after pressure is removed

c) In the lung bases

Because crackles can be caused by fluid moving through the small airways or by the opening of small airways, where am I most likely to hear crackles when performing pulmonary auscultation? a) Center portion of the lungs in the area surrounding the heart b) Over the trachea or laryngeal area c) In the lung bases d) In the lateral middle portion of the lungs

Cyanosis

Blue tone associated with heart and lung disease

Equal radial pulse rates, rhythm, vessel elasticity, and strength.

Briefly explain what the practitioner is assessing.

Albinism

Congenital lack of pigmentation in the hair and eyes

c) Scale

Dandruff and psorias are examples of a _________ type of skin lesion. a) Fissure b) Excoriation c) Scale d) Crust e) Stria

d) Drawing the toes toward the anterior knee

Dorsiflexion is best described by which of the following? a) Rotating the sole of the foot toward the midline of the body b) Rotating the hip toward the lateral aspect of the body c) Turning the palm downward d) Drawing the toes toward the anterior knee e) Moving an extremity laterally, away from the midline of the body.

c) The number of the smallest print line the patient was able to read

During a visual acuity vision test using a Snellen Chart the patient's right eye vision is recorded as 20/25-1. What does the "25" indicate? a) The number of correct letters identified. b) The number of incorrect letters indicated by the patient c) The number of the smallest print line the patient was able to read d) The number of times the patient was required to read the line to get it correct.

b) the spleen

During percussion a dull sound is considered normal over: a) healthy lungs b) the spleen c) gastric bubble d) an ileus

Dependent Edema

Extracellular swelling associated with a limb well below the level of the heart

a) Seeking clarification

Health care provider asks in a kind way "I'm not sure I understand what you are saying. Can you please explain that to me again?" This is an example of: a) Seeking clarification b) Acknowledging the patients feelings c) Giving information d) Validating

b) masculine distribution of hair seen in females with hormonal abnormalities.

Hirsutism is best described as: a) a loss of hair, typically occurring on the head. b) masculine distribution of hair seen in females with hormonal abnormalities. c) a parasite of the hair, typically found a the base of the hairshaft. d) an abnormal tuft of hair associated with spina bifida.

a) Stridor

I am not sure if the sound I am hearing is stridor or wheezing. I hear the sound loudest over the neck so which is the correct term? a) Stridor b) Wheezing

c) +3 edema

I assess a patient for edema and my thumb leaves behind an imprint that I determine to be 6 mm in depth. I should record this as: a) +1 edema b) +2 edema c) +3 edema d) +4 edema

b) +2

I elevate the amplitude of my patient's radial pulse and determine it is what I would call normal-it is not bounding or weak. What should I use to indicate normal? a) +1 b) +2 c) +3

a) Under the tongue

In dark skinned patients widespread color changes associated with disease are most reliably detected: a) Under the tongue b) On the outer ear c) In the nail bed d) Between fingers and toes

a) Denial

In which stage of Kubler-Ross would a patient most likely say "This is not happening to me" a) Denial b) Anger c) Bargaining d) Acceptance

1. Goniometer 4. Tape Meaure

Of the following equipment listed, which would be needed for a musculoskeletal assessment? 1. Goniometer 2. Stethoscope 3. Metric ruler 4. Tape measure 5. Thermometer 6. Pen light

Palor

Paleness associated with anemia, shock or Raynauds Syndrome

d) Reflecting or Paraphrasing

Patient: "I couldn't manage to eat any dinner last night--not even the dessert." HCP: "You had difficulty eating yesterday." Patient: "Yes, I was upset after my family left." The health care provider assisted communication by ________________. a) Using silence b) Changing the subject c) Giving information d) Reflecting or Paraphrasing

d) The is an example of blocking communication by defending.

Patient: "It took 45 minutes for someone to come after I pushed my call button." Health Care Provider: "Sometimes you just have to wait." a) This is an example of blocking communication by requesting an explanation. b) This is an example of assisting communication by giving information. c) This is an example of assisting communication by verbalizing implied thoughts and feelings. d) The is an example of blocking communication by defending.

c) inflammation of the kidneys

Percussion performed over the CVA assesses for: a) aortic aneurysm b) bowel obstruction c) inflammation of the kidneys d) inflammation of the liver &/or spleen

1. Inspection 2. Auscultation 3. Percussion 4. Palpation

Place the steps in the correct order for performing a physical assessment of the abdomen. 1. Auscultation 2. Inspection 3. Palpation 4. Percussion

1. Vesicle 2. Bullae 3. Cyst

Place these fluid-filled skin lesions in order from smallest to largest. -bullae -cyst -vesicle

x- Rinne y- Weber

Placing a ringing tuning fork on the patients mastoid process and holding the tines 2 cm from the auricle best describes the [x] test. Whereas, placing a ringing tuning fork on the center of the forehead best describes the [y] test.

a) increased abdominal pain associated with release of pressure

Rebound tenderness is best described as: a) increased abdominal pain associated with release of pressure b) increased abdominal pain associated with applied pressure. c) abdominal pain associated with rotating the bent leg inward, then rebounding it quickly outward. d) abdominal pain associated with completely straightening the leg and quickly rebounding it to a bent position, while lying supine.

Erythema

Redness associated with blushing or fever

c) placing the back of hand over the area

Skin temperature is tested by: a) placing a thermometer on the skin b) placing the pads of fingers over the area c) placing the back of hand over the area d) placing the palm over the area

1-Size and Symmetry 2-Location 3-Mobility 4-Hardness

State 4 things that should be documented if a mass is found during your physical assessment. 1. Location 2. Size 3. Shape 4. Consistency (soft, firm, hard) 5. Surface (nodular, sooth) 6. Mobility (including movement w/respirations) 7. Pulsatility 8. Tenderness

c) peripheral vision

The Confrontation Test of Visual Fields assesses: a) near vision b) far vision c) peripheral vision d) pupil convergence

b) applying pressure with the thumbs over the cheek area, below the eyes and adjacent to the nose.

The maxillary sinuses are assessed by: a) applying pressure with the thumbs over the brow area adjacent to the upper, inner eye. b)applying pressure with the thumbs over the cheek area, below the eyes and adjacent to the nose. c) applying pressure with each thumb to each eye. d) inserting an otoscopic light into the patients mouth and looking for a glow across the patients cheeks and forehead.

a) cryptorchidism

The medical term for an absent testicle is: a) cryptorchidism b) hernia c) hypospadia d) melena e) paraphimosis

c) Alopecia

The medical term that describes baldness is: a) Alastrim b) Allotriodontia c) Alopecia d) Alloploidic

c) dysmenorrhea

The medical term used to describe painful mensus is: a) dysuria b) menopause c) dysmenorrhea d) menorrhagia

a) 0

The normal knee joint should demonstrate _________ degrees of internal and external rotation. a) 0 b) 5 c) 10 d) 15

c) 32

The normal number of teeth in an adult who still has their wisdom teeth is: a) 24 b) 28 c) 32 d) 36

b) amphiarthrotic

The pubic symphasis and acromioclavicular joints are consider to be __________ types of joints. a) synarthrotic b) amphiarthrotic c) diarthrotic d) immovable

a) parotid

The salivary gland that can be palpated along the anterior surface of the mandible, just anterior and inferior to the ear is the _________ gland. a) parotid b) submandibular c) sublingular d) pre-auricular

c) Kyphosis

The thoracic spine of an 80 year old woman demonstrates a hunchback appearance. Which of the following would you document in your charting? a) Normal for age b) Lordosis c) Kyphosis d) Scoliosis

b) cerumen

The yellowish brown material commonly found in the normal outer ear is: a) cerium b) cerumen c) cimbia d) cesium

c) five minutes total over all quadrants

To determine that bowel sounds are absent, you must listen continuously for _____ . a) one minute in each quadrant b) three minutes at the LLQ. c) five minutes total over all quadrants d) We can not determine that bowel sounds are absent, only a physician can do this.

c) Beau's lines

Transverse / horizontal depressions of the nail at the nail plate base near the lunula due to systemic illness or injury best describes: a) Spoon nails b) Clubbing c) Beau's lines d) Splinter hemorrhages

False

True or False: A light directed from the side of the patients' head, across the eye toward the nose should normally demonstrate a small shadow from the eyeball onto the side of the nose.

False

True or False: Active motion is best described as having the patient relax the extremity while you support and move the joint through range of motion

True

True or False: Dark-skinned clients will have increased pigmentation on the buccal mucosa and gums.

True

True or False: During a hearing acuity test the patient places their finger in the ear that is NOT being tested and jiggles it up and down.

True

True or False: It is considered normal to see slight bulging of an infants' fontanelles with crying, coughing, or vomiting.

True

True or False: Nostril flaring in children is a sign of respiratory difficulty.

True

True or False: Performing the Cardinal Gazes test assesses parallel eye movement.

True

True or False: The SBAR (Situation-Background-Assessment-Recommendation) communication tool provides a framework for communication between members of the health care team about a patient's condition. SBAR is an easy-to-remember, concrete mechanism useful for framing any conversation, especially critical ones, requiring a clinician's immediate attention and action. It allows for an easy and focused way to set expectations for what will be communicated and how between members of the team, which is essential for developing teamwork and fostering a culture of patient safety.

False

True or False: The Valsalva manuever is used to differentiate a gas-filled abdomen from a fluid-filled abdomen.

False

True or False: The colors most commonly associated with color blindness are green and yellow.

False

True or False: The foreskin of an uncircumcised male should be fully retractable by the age of 6 months

False

True or False: The normal thyroid is easily seen on inspection.

False

True or False: When communicating, most of the message is attributed to the specific words used.

False

True or False: When comparing muscle size the upper limit of normal circumference variation is 1 in.

b) Border

Using the ABCDE mnemonic for evaluating skin lesions, what does B stand for? a) Benign b) Border c) Base d) Bleeding

a) Round b) React

What do the 2 Rs stand for in PERRLA? Select all correct answers to receive credit for this question. a) Round b) React c) Reflex d) Receptor e) Recurrent

c) 12-14 inches

What is considered a normal reading distance when assessing near vision visual accuity? a) 4-6 inches b) 7-9 inches c) 12-14 inches d) Normal reading distance is whatever distance the patient requires to be able to successfully read.

While LOC may be used to indicate "level of consciousness" as well as "loss of consciousness," we specifically stated in this class that we would use it to indicate loss or consciousness. The question specifically states, "as described in class."

What is the acronym LOC stand for, as described in class?

b) Breath deeply through their mouth

When auscultating the lungs the practitioner should instruct the patient to: a) Breath normally through their nose b) Breath deeply through their mouth c) Repeat the phrase "99, 99, 99" d) Inhale and exhale forcefully

a) Diaphragm of Stethoscope

When auscultating the lungs, the health care provider should normally use the: a) Diaphragm of Stethoscope b) Bell of Stethoscope

d) Percussion

When determining diaphragmatic excursion-how far the diaphragm moves from expiration to inspiration, the practitioner uses: a) Auscultation b) Palpation c) Inspection d) Percussion

c) Sims

When examining the rectum the patient is placed in the __________ position. a) Fowler b) Prone c) Sims d) Trendelenburg

a) flex their head forward slightly to relax the muscles of the neck

When palpating the supraclavicular nodes the patient should: a) flex their head forward slightly to relax the muscles of the neck b) extend their head slightly to create slight tension in the muscles, forcing the nodes upward. c) rotate their head toward the side being examined to relax the muscles of the neck d) rotate their head away from the side being examined to create slight tension in the muscles, forcing the nodes upward.

c) Tympanic

When percussing over a pneumothorax, the expected sound is: a) Dull b) Vessicular c) Tympanic d) Resonant

b) Diaphragm

When performing auscultation of the LUNGS, what surface of the stethoscope is most commonly used? a) Bell b) Diaphragm

a) inhale deeply

When performing deep palpation of the liver you press gently up and in at the right costal margin while asking the patient to: a) inhale deeply b) exhale completely c) stop breathing d) breathe quietly

b) Privacy

Which is an example of an environmental factor that may effect communication? a) Religious beliefs b) Privacy c) Speech impairment d) Pain

b) The pupils constrict slightly when focusing close to the face.

Which of the following best describe accommodation reflex seen during the normal eye exam? a) The right pupil constricts at the same time and rate when a pen light is directed into the left eye. b) The pupils constrict slightly when focusing close to the face. c) The eyes move together through the Cardinal Gazes. d) A pen light reflection is seen at the lateral / inferior cornea of each eye

d) Fluid within the peritoneal cavity.

Which of the following best describes ascites? a) Fluid within the pleural space that may interfere with liver and splenic percussion. b) Fluid within the scrotum. c) Subcutaneous fluid that causes a firmness to the abdominal wall. d) Fluid within the peritoneal cavity. e) Fluid within paralyzed small bowel.

b) startle reflex, crying and brief cessation of breathing

Which of the following best describes the normal hearing response in an infant, less than 3 months old to a sudden noise? a) blinking of the eyes and smiling b) startle reflex, crying and brief cessation of breathing c) turns head toward source but unable to locate the sound source d) turns head toward source and recognizes the source of the sound

b) Palpation to determine chest expansion

Which of the following best explains the procedure demonstrated here? Note where hands are placed. a) Palpation to determine fremetitis b) Palpation to determine chest expansion c) Palpation to determine vibration d) Palpation to determine rib location

c) clavicle area

Which of the following is an acceptable place to test skin turgor on an adult? a) posterior hand b) anterior shin/ tibia area c) clavicle area d) anterior foot

b) Religious beliefs

Which of the following is an example of an internal factor which could effect communication? a) Tone of Voice b) Religious beliefs c) Facial Expression d) Lighting

b) Wheal

Which of the following is the correct term to describe a hive? a) Macule b) Wheal c) Nodule d) Nevi

c) Eyes that remain stationary as the head is turned to the right or left.

Which of the following statements best describe the condition "Doll's Eyes" reflex? a) Eyelids move with patient position - upright position opens eyes and reclining position closes eyes. b) A consistent blank stare regardless of stimuli. c) Eyes that remain stationary as the head is turned to the right or left. d) Eyes that move independent of each other.

d) Dorsalis Pedis

Which pulse is being assessed in the picture? a) Plantar arch b) Dorsal metatarsal c) Dorsal Digital d) Dorsalis Pedis

b) Respiratory rate 12/min. No use of accessory muscles during inspiration. AP diameter is not increased. Mucous membranes of the lips are pale pink.

Which statement describes "normal" when performing the inspection portion of the pulmonary assessment. a) Respiratory rate 14/min, active use of abdominal muscles to exhale, AP diameter is not increased, mucous membranes of the lips are pale pink. b) Respiratory rate 12/min. No use of accessory muscles during inspiration. AP diameter is not increased. Mucous membranes of the lips are pale pink. c) Respiratory rate 20/min. Patient unable to speak in complete sentences. Active contraction of abdominal muscles during exhalation. Patient exhibits pursed lip breathing. d) Respiratory rate 25/min. No use of accessory muscles during inhalation or exhalation. Mucous membranes of the lips are pale pink. Able to lie flat to breath and speaks in complete sentences.

a) By agreeing with the patient I make it difficult for the patient to later change or modify their opinion

Why is agreeing with the patient considered a block to therapeutic communication? a) By agreeing with the patient I make it difficult for the patient to later change or modify their opinion. b) It is just a fact, a health care provider should never agree with the patient. c) Agreeing with the patient avoids confrontation and confrontation is what leads to effective communication. d) Agreeing with the patient is a type of stereotyping.

Jaundice

Yellow discoloration of the skin due to liver dysfunction or hemolytic processes