Midterm Exam
• Question 1
1 out of 1 points
Your patient is complaining of acute, intense sharp epigastric pain that radiates to the back and left scapula with nausea and vomiting. Based on this history, your
...
Midterm Exam
• Question 1
1 out of 1 points
Your patient is complaining of acute, intense sharp epigastric pain that radiates to the back and left scapula with nausea and vomiting. Based on this history, your prioritized physical examination should be to:
• Question 2
1 out of 1 points
You are collecting a history from an 11-year-old girl. Her mother is sitting next to her in the examination room. When collecting history from older children or adolescents, they should be:
• Question 3
1 out of 1 points
A 22-year-old female nurse is interviewing an 86-year-old male patient. The patient avoids eye contact and answers questions only by saying, "Yeah," "No," or "I guess so." Which of the following is appropriate for the interviewer to say or ask?
• Question 4
1 out of 1 points
Underestimation of blood pressure will occur if the blood pressure cuff's width covers:
• Question 5
1 out of 1 points
White, rounded, or oval ulcerations surrounded by a red halo and found on the oral mucosa are:
• Question 6
1 out of 1 points
Mr. Donalds is a 45-year-old roofer. Your inspection to determine color variations of the skin is best conducted:
• Question 7
1 out of 1 points
Percussing at the right midclavicular line, below the umbilicus, and continuing upward is the correct technique for locating the:
• Question 8
1 out of 1 points
Mr. Akins is a 78-year-old patient who presents to the clinic with complaints of hearing loss. Which of the following are changes in hearing that occur in the elderly? Select all that apply.
• Question 9
1 out of 1 points
Peritonitis produces bowel sounds that are:
• Question 10
1 out of 1 points
Mr. Jones is a 45-year-old patient who presents for a physical examination. On examination, you note costochondral beading, enlarged skull, and bowed legs and diagnose him with rickets. A deficiency of which fat-soluble micronutrient can result in rickets?
• Question 11
1 out of 1 points
Which technique is most likely to result in the patient's understanding of questions?
• Question 12
1 out of 1 points
To perform the Rinne test, place the tuning fork on the:
• Question 13
1 out of 1 points
After thorough inspection of the abdomen, the next assessment step is:
• Question 14
1 out of 1 points
To approximate vocal frequencies, which tuning fork should be used to assess hearing?
• Question 15
1 out of 1 points
When examining the skull of a 4-month-old baby, you should normally find:
• Question 16
1 out of 1 points
Which of the following is the most vital nutrient?
• Question 17
1 out of 1 points
Mrs. Raymonds is a 24-year-old patient who has presented for a routine concern over her current weight. In your patient teaching with her, you explain the importance of macronutrients. Which of the following is a macronutrient?
• Question 18
1 out of 1 points
Differential diagnoses belong in the:
• Question 19
1 out of 1 points
Which type of speculum should be used to examine a patient's tympanic membrane?
• Question 20
1 out of 1 points
Inspection of the abdomen should begin with the patient supine and the examiner:
• Question 21
1 out of 1 points
When hearing is evaluated, which cranial nerve is being tested?
• Question 22
1 out of 1 points
Bulging of an amber tympanic membrane without mobility is most often associated with:
• Question 23
1 out of 1 points
When assessing abdominal pain in a college-age woman, one must include:
• Question 24
1 out of 1 points
Mr. Walters, a 32-year-old patient, tells you that his ears are "stopped up." An objective assessment of this complaint is achieved by using the:
• Question 25
1 out of 1 points
Mr. Mills is a 55-year-old patient who presents to the office for an initial visit for health promotion. A survey of mobility and activities of daily living (ADLs) is part of a(an):
• Question 26
1 out of 1 points
In examining the neck of a 34-year-old female patient, you note that the uppermost ridge of the tracheal cartilage is at the:
• Question 27
1 out of 1 points
Tuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure:
• Question 28
1 out of 1 points
When recording physical findings, which data are recorded first for all systems?
• Question 29
1 out of 1 points
The recommended minimum daily protein requirement for the normal adult is ______.
• Question 30
1 out of 1 points
Mr. Abdul is a 40-year-old Middle Eastern man who presents to the office for a first visit with the complaint of new abdominal pain. You are concerned about violating a cultural prohibition when you prepare to do his rectal examination. The best tactic would be to:
• Question 31
1 out of 1 points
What finding is unique to the documentation of a physical examination of an infant?
• Question 32
1 out of 1 points
A fixed image of any group that rejects its potential for originality or individuality is known as a(n):
• Question 33
1 out of 1 points
As part of your health promotion education for a new patient, you explain that the risk factors for skin cancer include:
• Question 34
1 out of 1 points
Which of the following is an expected change in the assessment of the thyroid during pregnancy?
• Question 35
1 out of 1 points
Which statement is true regarding the relationship of physical characteristics and culture?
• Question 36
1 out of 1 points
Which of the following occurs when firm pressure is used to apply the stethoscope's bell end-piece to the skin?
• Question 37
1 out of 1 points
George Michaels, a 22-year-old patient, tells the nurse that he is here today to "check his allergies." He has been having "green nasal discharge" for the last 72 hours. How would the nurse document his reason for seeking care?
• Question 38
1 out of 1 points
Mr. and Mrs. Johnson have presented to the office with their infant son with complaints of ear drainage. When examining an infant's middle ear, the nurse should use one hand to stabilize the otoscope against the head while using the other hand to:
• Question 39
1 out of 1 points
The infant should be placed in which position to have his or her height or length measured?
• Question 40
1 out of 1 points
Peritonitis produces bowel sounds that are:
• Question 41
1 out of 1 points
A flat, nonpalpable lesion is described as a macule if the diameter is:
• Question 42
1 out of 1 points
Mr. Sanchez is a 45-year-old gentleman who has presented to the office for a physical examination to establish a new primary care health care provider. Which of the following describes a physical, not a cultural, differentiator?
• Question 43
1 out of 1 points
Regardless of the origin, discharge is described by noting:
• Question 44
1 out of 1 points
A serous membrane that lines the abdominal cavity and forms a protective cover for many abdominal structures is the:
• Question 45
1 out of 1 points
Which of the following is an "ABCD" characteristic of malignant melanoma?
• Question 46
1 out of 1 points
You have just completed a skin assessment on Mr. Baker. During your assessment, you have transilluminated a skin lesion. During the physical examination, you know that skin lesions are transilluminated to distinguish:
• Question 47
1 out of 1 points
Macronutrients are so named because they:
• Question 48
1 out of 1 points
A brief statement of the reason the patient is seeking health care is called the:
• Question 49
1 out of 1 points
Periods of silence during the interview can serve important purposes, such as:
• Question 50
1 out of 1 points
When communicating with older children and teenagers, you should be sensitive to their:
• Question 51
1 out of 1 points
Mrs. Leonard brings her newborn infant into the pediatrician's office for a first well-baby visit. As the health care provider, you teach her that newborns are more vulnerable to hypothermia due to:
• Question 52
1 out of 1 points
Brittle nails are typical findings in:
• Question 53
1 out of 1 points
You are examining a pregnant patient and have noted a vascular lesion. When you blanche over the vascular lesion, the site blanches and refills evenly from the center outward. The nurse documents this lesion as a:
• Question 54
1 out of 1 points
Nasal symptoms that imply an allergic response include:
• Question 55
1 out of 1 points
Subjective and symptomatic data are:
• Question 56
1 out of 1 points
During percussion, a dull tone is expected to be heard over:
• Question 57
1out of 1 points
A 5-year-old child presents with nasal congestion and a headache. To assess for sinus tenderness you should palpate over the:
• Question 58
1 out of 1 points
Fluorescing lesions are best distinguished using a(n):
• Question 59
1 out of 1 points
Which question would be considered a leading question?
• Question 60
1 out of 1 points
The term denoting the caregiver's need to do no harm to the patient is:
• Question 61
1 out of 1 points
During physical examination of a 30-year-old Chinese man, you notice slight asymmetry of his face. The cranial nerve examination is normal. Your best action is to:
• Question 62
1 out of 1 points
Placing the base of a vibrating tuning fork on the midline vertex of the patient's head is a test for:
• Question 63
1 out of 1 points
A detailed description of the symptoms related to the chief complaint is presented in the:
• Question 64
1 out of 1 points
Mr. D. complains of a headache. During the history, he mentions his use of alcohol and illicit drugs. This information would most likely belong in the:
• Question 65
1 out of 1 points
Which part of the information contained in the patient's record may be used in court?
• Question 66
1 out of 1 points
Mr. Williams, age 25, has recovered recently from an upper and lower respiratory infection. He describes a long-standing nasal dripping. He is seeking treatment for a mild hearing loss that has not gone away. Information concerning his chronic postnasal drip should be documented within which section of his history?
• Question 67
1 out of 1 points
A tool used to screen adolescents for alcoholism is the:
• Question 68
1 out of 1 points
The most common form of birth trauma of the scalp is:
• Question 69
1 out of 1 points
Coarse, dry, and brittle hair is associated with which metabolic disorder?
• Question 70
1 out of 1 points
Auscultation should be carried out last, except when examining the:
• Question 71
1 out of 1 points
Mrs. Britton is a 34-year-old patient who presents to the office with complaints of skin rashes. You have noted a 4' 3-cm, rough, elevated area of psoriasis. This is an example of a:
• Question 72
1 out of 1 points
Mr. Johnson presents with a freely movable cystic mass in the midline of the high neck region at the base of the tongue. This is most likely a:
• Question 73
1 out of 1 points
In counseling a client regarding nutrition education, you explain that linoleic acid, a major fatty acid, is thought to be essential for:
• Question 74
1 out of 1 points
When you are questioning a patient regarding alcohol intake, she tells you that she is only a social drinker. Which initial response is appropriate?
• Question 75
1 out of 1 points
Ms. Jones is a 31-year-old female patient who presents for a routine physical examination. Which examination technique will be used first?
• Question 76
1 out of 1 points
Pigmented, raised, warty lesions over the face and trunk should be assessed by an experienced practitioner who can distinguish:
• Question 77
1 out of 1 points
When are open-ended questions generally most useful?
• Question 78
1 out of 1 points
Sweat glands, hair, and nails are all formed from:
• Question 79
1 out of 1 points
Nuchal rigidity is most commonly associated with:
• Question 80
1 out of 1 points
You are palpating a patient's thyroid and find that its broadest dimension measures 4 cm. The right lobe is 25% larger than the left. These data would indicate:
Selected Answer: C. a normal thyroid gland.
• Question 81
1 out of 1 points
A 17-year-old girl presents to the clinic for a sports physical. Physical examination findings reveal bradycardia, multiple erosions of tooth enamel, and scars on her knuckles. She appears healthy otherwise. You should ask her if she:
• Question 82
1 out of 1 points
In issues surrounding ethical decision making, beneficence refers to the:
• Question 83
1 out of 1 points
Mrs. Tuber is a 36-year-old patient who comes into the health center with complaints that her fingernails are not growing. Which structure is the site of new nail growth?
• Question 84
1 out of 1 points
Ms. G. is being seen for her routine physical examination. She is a college graduate and president of a research firm. Although her exact salary is unknown, she has adequate health insurance. Most of the above information is part of Ms. G.'s _____ history.
• Question 85
1 out of 1 points
The position on a clock, topographic notations, and anatomic landmarks:
• Question 86
1 out of 1 points
The most superior part of the stomach is the:
• Question 87
1 out of 1 points
Spasmodic muscular contractions of the head, face, or neck are called:
• Question 88
1 out of 1 points
Mr. Black is a 44-year-old patient who presents to the clinic with complaints of neck pain that he thinks is from his job involving computer data entry. As the examiner, you are checking the range of motion in his neck and note the greatest degree of cervical mobility is at:
• Question 89
1 out of 1 points
Expected hair distribution changes in older adults include:
• Question 90
1 out of 1 points
Which is the best way to position a patient's neck for palpation of the thyroid?
• Question 91
1 out of 1 points
As you explain your patient's condition to her husband, you notice that he is leaning toward you and pointedly blinking his eyes. Knowing that he is from England, your most appropriate response to this behavior is to:
• Question 92
1 out of 1 points
The adult recommended dietary fat intake should be _____ g/day.
• Question 93
1 out of 1 points
Tangential lighting is best used for inspecting skin:
• Question 94
1 out of 1 points
During an interview, you have the impression that a patient may be considering suicide. Which action is essential?
• Question 95
1 out of 1 points
Mrs. G. reports an increase in her alcohol intake over the past 5 years. To screen her for problem drinking, you would use the:
• Question 96
1 out of 1 points
Recommended carbohydrate content of total dietary intake (% total calories) is ____%.
• Question 97
1 out of 1 points
Mrs. Kinder is a 39-year-old patient who presents to the office with complaints of an earache. In explaining to the patient about the function of her ears, which ear structure would you tell her is responsible for equalizing atmospheric pressure when swallowing, sneezing, or yawning?
• Question 98
1 out of 1 points
Your patient presents with symptoms that lead you to suspect acute appendicitis. Which assessment finding is least likely to be associated with this condition early in its course?
• Question 99
1 out of 1 points
Which of the following organs is part of the alimentary tract?
• Question 100
1 out of 1 points
Mr. Franklin is speaking with you, the health care provider, about his respiratory problem. Mr. Franklin says, "I've had this cough for 3 days, and it's getting worse." You reply, "Tell me more about your cough." Mr. Franklin states, "I wish I could tell you more. That's why I'm here. You tell me what's wrong!" Which caregiver response would be most appropriate for enhancing communication?
Midterm Answers
1. Your patient is complaining of acute, intense sharp epigastric pain that radiates to the back and left scapula with nausea and vomiting. Based on this history, your prioritized physical examination should be to:
a. Auscultate for abdominal bruits
b. Percuss for ascites
c. Inspect for eccyhmosis of the flank
d. Assess for rebound tenderness
6. Mr. Donalds is a 45-year old roofer. Your inspection to determine color variations of the skin is best conducted
a. With illumination provided by daylight
b. Using a Wood’s light
c. Using an episcope
d. Under fluorescent lighting
8. Mr. Akins is a 78-year-old patient who presents to the clinic with complaints of hearing loss. Which of the following are changes in hearing that occur in the elderly? Select all that apply.
a. Loss of high frequency
b. Bone conduction heard longer than air conduction
c. Results from cranial nerve VII
d. Progression is slow
e. Unable to hear in a crowded room
f. Sounds may be garbled and difficult to localize
11. Which technique is most likely to result in the patient's understanding of questions?
a. Use the simplest language possible.
b. Use phrases that are commonly used by other patients in the area
c. Use proper medical and technical terminology
d. Use the patient’s own terms if possible
29. The recommended minimum daily protein requirement for the normal adult is ______
e. Selected Answer: 14% to 20% of total calories (This is a fill in the blank)
47. Macronutrients are so named because they:
a. Are required in large amounts
b. have high molecular weights.
c. Form long chemical chains
d. Tend to increase waist measurements
57. A 5-year-old child presents with nasal congestion and a headache. To assess for sinus tenderness you should palpate over the:
a. Sphenoid and frontal sinuses
b. maxillary and frontal sinuses
c. maxillary sinuses only
d. sphenoid sinuses only
92. The adult recommended dietary fat intake should be _____ g/day.
a. Selected Answer: 9 (Fill in the blank)
96. Recommended carbohydrate content of total dietary intake (% total calories) is ____%.
a. Selected Answer: 10 (Fill in the blank)
98. Your patient presents with symptoms that lead you to suspect acute appendicitis. Which assessment finding is least likely to be associated with this condition early in its course?
a. Positive psoas sign
b. Positive McBurney sign
c. Consistent right lower quadrant (RLQ) pain
d. Rebound tenderness
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