Assessment exam 1

A patient asks the nurse, "may I ask you a question?" This is an example of: a. an open-ended question b. a reflective question c. a closed question d. a double-barreled question

A closed question

A common cause of a conductive hearing loss is: a. impacted cerumen b. acute rheumatic fever c. a CVA

Impacted cerumen

Before examining a patients ear with the otoscope, you would palpate which for tenderness? a. helix, external auditory meatus, and lobule b. mastoid process, tympanis memrane, and malleus c. pinna, pars, flaccida, and antitragus d. pinna, tragus, and mastoid process

pinna, tragus, and mastoid process

Conjunctivitis is associated with: a. absent red reflex b. reddened conjunctiva c. impaired of vision d. fever

reddened conjunctiva

Which is true regarding cluster headaches? a. they may be precipitated by alcohol and daytime napping b. Their usual occurrence is two per month, each lasting 1-3 days c. they are characterized as throbbing d. they tend to be supraorbital, retro-orbital, or frontotemporal

they tend to be supraorbital, retro-orbital, or frontotemporal

When assessing a patients ear with an otoscope, the patients head should be positioned: a. tilted toward the examiner b. tilted away from the examiner c. as vertical as possible d. tilted down

tilted away from the examiner

In examining the ear of an adult, the canal is straightened by pulling the auricle: a. down and forward b. down and ack c. up and back d. up and forward

up and back

Which is an appropriate recording of a patients reason for seeking health care? a. angina pectoris, duration 2 hours b. substernal pain radiating to left axilla, 1 hour duration c."grabbing chest pain for 2 hours d. Pleurisy, 2 days duaration

"Grabbing" chest pain for 2 hours

During routine visit, M.B. age 78, asks about small, round, flat, brown macules on the hands. What is your best response after assessing the areas? a."these are the result of sun exposure and do not require treatment." b. "these are related to exposure to the sun. they may become cancerous."

"these are the result of sun exposure and do not require treatment."

providing resistance while the patient shrugs his or her shoulders is a test of which cranial nerve? a. ii b.V c. IX d. XI

II

Knowledge of the use of personal space is helpful for the health care provider. Personal distance is generally considered to be: a. 0- 1 1/2 feet b. 1 1/2- 4 feet c. 4-12 feet

1 1/2-4 feet

yoy examine the nail beds of a patient, which finding indicates a normal angle? a. 60 degrees b. 100 degrees c. 160 degrees d. 180 degrees

160 degrees

After assessing the patients pulse, the practitioner determines it to be "normal" this would be recorded as: a. 3 b. 2 c. 1 d. 0

2

Children usually come from health care with a parent. At about what age should the interviewer begin to question the child himself or herself regarding presenting symptoms? a. 5 years b. 7 years c. 9 years d. 11 years

7 years

A patient has blurred peripheral vision. You supsect glaucoma and assess the visual fields. A patient with normal vision would see your moving finger temporally at: a. 50 degrees b. 60 degrees c. 90 degrees d. 180 degrees

90 degrees

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 past health history b. a review of systems c. A functional assessment d. A reason for seeking care

A reason for seeking care

when taking a health history for a child, what information, in addition to that for an adult, is usually obtained? a. coping and stress management b. a review of immunizations received c. environmental hazard d. hospitalization history

A review of immunizations received

During an initial home visit, the patients temp. is noted to be 97.4, how would you interpret this? a. cant be evaluated without knowledge of the persons age b. it is below normal c. it should be retaken

A. can't be evaluated without knowledge of the persons age

Bluish color around the lips, hands, fingernails, feet, and toenails

Acrocyanosis

A configuration of individual lesions arranged in circles or arcs, as occurs with ringworm, is described as a: a. linear lesion b. clustered lesion c. annular lesion d. gyrate lesion

Annular lesion

With older adults, how should the examiner proceed with the interview? a. proceed in a more organized and concise manner b. consider the fatigue of the older person and break the interview into shorter segments c. ask a family member to complete some of the records while moving ahead with the interview

Ask a family member to complete some of the records while moving ahead with the interview7

What does active listening NOT include? a. taking detailed notes during the interview b. watching for clues in body language c. repeating statements back to the person to make sure you have understood d. Asking open-ended questions to explore the persons perspective

Asking open-ended questions to explore the persons perspective

The "A" in the ABCDE rule for skin cancer stands for: a. accuracy b. appearance c. asymmetry d. attenuated

Asymmetry

An area of thin shiny skin with decreased visibility of normal skin markings is most likely: a. Linchenification b. plaque c. atrophy d. keloid

Atrophy

A patient is known to be blind in the left eye, what happens to the pupils when the right eye is illuminated by a penlight beam? a. no response in pupils b. both pupils constrict c. right pupil constricts, left has no resonse

Both pupils constrict

If the thyroid gland were enlarged bilaterally, which maneuver would be appropriate for you to assess? a. check for deviation of the trachea b. listen for bruit over the carotid arteries c. Listen for a murmur over the aortic area

Check for deviation of the trachea

Large round or oval patch of light brown usually present at birth

Cafe au lait spot

Yellow-orange color in light-skinned persons from large amounts of foods containing carotene

Carotenemia

The isthmus of the thyroid gland lies just below the: a. mandible b. cricoid cartilage c. Hyoid cartilage d.Thyroid cartilage

Cricoid cartilage

Transient mottling on trunk and extremities

Cutis marmorata

Bluish mottled color that signifies decreased perfusion

Cyanosis

-Collagen -Elastic tissue

Dermis

Which two sections of the childs health history become seperate sections because of their importance to the child's current health status? a. play activities and rest patterns b. prenatal and postnatal status c. developmental and nutritional history d. accidents, injuries, and immunizations

Developmental and nutritional history

Select the best description of the secretion of the eccrine glands: a. think, milky b. Dilute saline solution c. protective lipid substance d. keratin

Dilute saline solution

Tiny, punctate red macules and papules on the cheecks, trunk, chest, back, and buttocks

Erythema toxicum

_____________ is exhibiting an accurate understanding of the other person's feelings within a communication context

Empathy

-Basal layer -Uniformly thin - Stratum corneum

Epidermis

Intense redness of the skin due to excess blood in the dilated superficial capillaries

Erythema

Identify the blood vessel that runs diagonally across the sternomastoid muscle a. Temporal artery b. Carotid artery c. external jugular vein d. internal jugular vein

External jugular vein

A genogram is used for which reasons? a. past history b. past health history c. family history d. 8 characteristics of presenting symptoms

Family history

On examination, the infants fontanels should feel: a. tense or bulging b. depressed or sunken c. firm, slightly concave, and well defined d. pulsating

Firm, slightly concave, and well defined

Which sinuses can you assess through examination? a. ethmoid and sphenid b. frontal and ethmoid c. maxillary and sphenoid

Frontal and ethmoid

Lower half of body turns red, upper half blanches

Harlequin

You conduct an admission interview. Because you are expecting a phone call, you stand near the door. Which would be a more appropriate approach a. arrange to have someone page you so you can sit on the side of the bed b. have someone else answer the phone so you can sit facing the patient c. use this approach given the circumstances d. arrange for a free time of interruptions after the initial physical examination is complete

Have someone else answer the phone so you can sit facing the patient

Which is least likely to indicate a possible malignancy? a. history radiation therapy to the head, neck, or upper chest b. history of chewing tobacco c. history of large alcohol consumption d. marked tenderness

History of large alcohol consumption

Functional assessment measures how a person manages day to day activities. The impact of adoption on the daily activities of a child is referred to as: a. Developmental history b. instrumental activities of daily living c. reason for seeking care d. interpersonal relationship assesment

Interpersonal relationship assessment

Which statement best describes interpretation as a communication technique? a. Interpretation is the same as clarification b. interpretation is a summary of a statement made by a patient c. interpretation is used to focus on a particular aspect of what the patient has just said d. interpretation is based on the interviewer's inference from the data that have been present

Interpretation is based on the interviewers inference from the data that have been presented

Increase in bilirubin in the blood causing a yellow color in the skin

Jaundice

Herpes zoster infection is characterized by: a. a bacterial cause b. lesion on only one side of body c. absence of pain or edema d. pustular lesions

Lesion on only one side of body

What is the cause of the red reflex? a. Petechial hemorrhages in the sclera b. Diabetic retinopathy c. light reflecting from the retina d. blood in the vitreous

Light reflecting from the retina

Which facial bones articulate at a joint instead of a suture? a. zygomatic b. maxilla c. nasal d. mandible

Mandible

It is normal to palpate a few lymph nodes in the neck of a healthy person. What are the characteristics of these nodes? a. Mobile, soft, nontender b. large, clumped, tender c. matted, fixed, tender, hard

Matted, fixed, tender, hard

The cover test is used to assess for:

Muscle weakness

For what or with whom should touch be used during the interview? a. only with individuals from a western culture b. as a routine way of establishing contact with the person and communicating empathy c. Only if the interview knows the person well

Only if the interview knows the person well

The palpebral fissure is: a. border between the cornea and sclera b. open sace between the eyelids c. angle where the eyelids meet d. visible on the upper and lower lids at the inner canthus

Open space between eyelids

Absence of red-pink tones from the oxygenated hemoglobin in blood

Pallor

When assessing the toungue you should a. palpate the u-shaped area under the tongue b. check tongue color for cyanosis

Palpate the u-shaped area under the tongue

The sensation of vertigo may indicate: a. otitis media b. pathology in the semicurcular canals

Pathology in the semicurcular canals

The 4 areas to consider during the general survey include: a. Ethnicity, gender, age, and socioeconomic status b. physical appearance, gender, ethnicity, and affect c. dress, affect, nonverbal behavior, and mobility d. Physical appearance, body structure, mobility, and behavior

Physical appearance, body structure, mobility, and behavior

during the otoscopic examination of a child younger than 3 years, the examiner: a. pulls the pinna up and back b. pull the pinna down

Pull the pinna down

Mr. B tells you, "everyone here ignores me." you respond, "ignores you?" This technique is best described as a. clarification b. selective listening c. reflecting d. validation

Reflecting

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. Review the patients previous medical records c. Call the persons identified as the emergency contact to verify the data provided d. Provide the patient with a printed history to complete and then compare the data provided

Rephrase the same question later in the interview

To assess for early jaundice, you will assess: a. sclera and hard palate b. nail beds c. lips d. all visible skin surfaces

Sclera and hard palate

The yellowing of the lens due to aging is described as a. presbyopia b. floaters c. macular degeneratiom d. senile cataract

Senile cataract

Because of adolescents developmental level not all interviewing techniques can be used with them. Which techniques should be avoided? a. Facilitation and clarification b. Confrontation and explanation c. Empathy and interpretations d. Silence and reflection

Silence and reflection

A risk factor for melanoma is: a. brown eyes b. darkly pigmented skin c. skin that freckles or burns before tanning d. use of sunscreen products

Skin that freckles or burns before tanning

Visual acutiy is assessed with: a. snellen eye chart b. ophthalmoscope c. Hirschberg test d. Confrontation test

Snellen eye chart

A throbbing, unilateral pain associated with nausea, vomiting, and photophobia is characteristic of: a. cluster headache b. subarachnoid hemorrhage c. migraine headache d. tension headache

Subarachnoid hemorrhage

-Adipose tissue -Aids protection by cushioning

Subcutaneous layer

Pulse pressure is described as: 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

The difference between the systolic and diastolic pressure

Checking for skin temperature is best accomplished by using: a. the palmar surface of the hands b. the ventral surface of the hands c. the fingertips d. the dorsal surface of the hands

The dorsal surface of the hands

What is the best description of "reveiw of systems" as a part of the health history? a. the evaluation of the past and present health state of each body system b. a documentation of the problem as described by the patient c. the recording of the objective findings of the practitioner

The evaluation of the past and present health state of each body system

The statement, "reason for seeking care" has replaced the "chief complaint," this change is significant because: a. The "chief complaint" is really a diagnostic statement b. the new term allows another individual to supply the necessary information c. the newer term incorporates wellness need

The newer term incorporates wellness need

Which demonstrates a good understanding of the interview process? a. the nurse stops the patient each time something is said that is not understood b. The nurse spends more time listening to the pateint than talking c. the nurse is consistently thinking of his or her next response so the pateint will know he or she is understood

The nurse spends more time listening to the patient than talking

Which retinal structures can be viewed through the ophthalmoscope? a. the optic disc, the retinal vessels, the general backround b. the cornea, the lens, the choroid, and the ciliary body c. The optic papilla, the sclera, the retina, and the iris

The optic disc, the retinal vessels, the general backround

The examinor suspects a patient has coarctation of the aorta. which assessment finding supports this suspicion? a. the thigh pressure is higher than the arm b. the thigh pressure is equal to the arm c. the thigh pressure is unrelated to the arm d. the pressure is lower than in the arm

The pressure is lower than in the arm

When assessing hearing acuity in a 6 month old child, the examiner would: a. use an audiometer b. observe for shyness and withdrawl c. watch for head turning when saying the childs names

Watch for head turning when saying the childs name

Which statement best describes the purpose of health history? a. to provide opportunity for interaction between the patient and examiner b. to provide a form foor obtaining the patients biographic information c. to document the normal and abnormal findings of a physical assessment d. to provide a database of subjective information about the patients past and present health

To provide a database of subjective information about the patients past and present health

Bell palsy is characterized by: a. unilateral paralysis of half of the face b. bulging eyeballs c. a face that appears masklike d. A puffy, edematous face

Unilateral paralysis of half of the face

An 18-month old child is brought into the clinic for a health screening visit. To assess the height of the child: a. use a tape measure b. use a horizontal measuring board c. have the child stand on the upright scale

Use a horizontal measuring board

When interviewing a patient who does not speak English, the examiner should: a. take advantage of family members who are readily available and willing to assist b. use a qualified medical interpreter who is culturally literate c. seeks as much information as possible and then continue with the physical examination

Use a qualified medical interpreter who is culturally literate

The function of the nasal turbinates is to:

Warm the inhaled air

The largest salivary gland is located:

Within the cheeks in front of the ear

The hearing receptors are located in which region? a. vestibule b. semicurcular canals c. middle ear d. cochlea

cochlea

Darwins tubercle indicates: a. an overgrowth of scar tissue b. a blocked sebaceous gland c. a sign of gout called tophi d. a congenital, painless nodule at the helix

a congenital, painless nodule at the helix

The practicioner entering the examining room to meet a patient for the first time, states "Hello, I'm M.M. and im here to gather some information from you and to perform your examination. This will take about 30 minutes. D.D. is a student working with me. If it's all right with you, she will remain during the examination." which of the following must be added to cover all aspects of the interview contract? a. A statement regarding confidentiality, patient costs, and the expectations of each person. b. The purpose of the interveiw and the role of the interviewer c. Time and place of the interview and a confidentiality statement d. an explicit purpose the interview and a description of the physical examination, including diagnostic studies

a. A statement regarding confidentiality, patient costs, and the expectations of each person.

During an initial interview, the examiner says, "Mrs. J., tell me what you do when your headaches occur?" This is an example of which type of information? a. the patients perception of the problem b. aggravating or relieving factors c. the frequency of the problem

aggravating or relieving factors

A patient with a head injury has clear, watery drainage from the ear. How should you proceed? a. place a cotton ball loosely at the entrance to the ear canal b. assess for the presence of glucose in the drainage c. perform pneumatic otoscopy to assess for drum hypomobility

assess for the presence of glucose in the drainage

Which changes regarding height and weight occur during the 80s and 90s? a. both increase b. weight increases, and height decreases c. both decrease d. both remain the same as during the 70s

both decrease

When preparing the physical setting for an interview, the interviewer should: a. set the room temperature between 64° F and 66° F. b. reduce noise by turning the volume on the television or radio down. c. conduct the interview at eye level and at a distance of 4 to 5 feet. d. stand next to the patient to convey a professional demeanor.

conduct the interview at eye level and at a distance of 4 to 5 feet.

You note a lesion during a skin assessment. Which is the best way to document this finding? a. raised, irregular lesion the size of a quarter, located on dorsum of left hand b. Open lesion with no drainage or odor, approximately 1/4 inch in diameter c. pedunculated lesion below left scapula with consistent red color and no drainage or odor d. dark brown raised lesion, with irregular border, on dorsum of right foot, 3 cm in size, with no drainage

dark brown raised lesion, with irregular border, on dorsum of right foot, 3 cm in size, with no drainage

You are assessing a 75 year old patients oral cavity. which of the following would most likely be present? a. decreased ability to identify odors b. finer and less prominent nasal hair c. an increased production of saliva

decreased ability to identify odors

Flattening of the angle between the nail and its base is: a. found in subacute bacterial endocarditis b. a description of spoon shaped nails c. related to calcium deficiency d. described as clubbing

described as clubbing

Mean arterial pressure: a. the arithmetic average of systolic and diastolic pressure b. the driving force of blood during systole c. diastolic pressure plus one third of the pulse pressure d. corresponding to phase 3 Korotkoff

diastolic pressure plus one third of the pulse pressure

You are teaching a patient of an infant the health promotion activities to reduce the risk for acute otitis media. Which would you include in the teaching plan? a. using pacifers b. increasing group daycare c. avoiding breastfeeding d. eliminating smoking in the house and car

eliminating smoking in the house and car

Normal cervical notes are: a. smaller than 1 cm b. warm to palpation c. fixed d. firm

fixed

You are assessing a patient's gait. What do you expect to find? a. gait is varied, depending on the height of the person b. gait is equal to the length of the arm c. gait is as wide as the shoulder width

gait is as wide as the shoulder width

Sensorineural hearing loss might be related to: a. gradual nerve degeneration b. foreign bodies c. impacted cerumen d. perforated tympanic membrane

gradual nerve degeneration

Cephalhematoma is associated with: a. Superiosteal hemorrhage b.increased intercranial pressure c. down syndrome d. cerebral palsy

increased intercranial pressure

What is the most common cause for nose bleeds? a. the turbinates b. the columellae c. kiesselback plexus d. the meatus

kiesselbach plexus