NR 509 - Final Exam Questions and Answers

How to get patient to open up? - ANSWER - effective reassurance - meaningful reassurance - moving closer to patient What is the order of meeting a patient and conducting an interview? - ANSWER - preparation - se ...

How to get patient to open up? - ANSWER - effective reassurance - meaningful reassurance - moving closer to patient What is the order of meeting a patient and conducting an interview? - ANSWER - preparation - sequence of interview - culture context of the interview How can the size of BP cuff and position of the brachial artery affect the patient's BP reading? - ANSWER Cuff too small = High BP Cuff too large = Low BP Brachial artery below heart = High BP Brachial artery above the heart = Low BP Constitutional Symptoms are: - ANSWER Fatigue, weakness, fever/chills, night sweats, weight changes, or pain. Benign tumors that result from overgrowth of capillaries? - ANSWER Cherry angiomas What can acanthosis nigricans clue into? - ANSWER Diabetes What labs do you check for vitiligo? - ANSWER TSH, T3, T4, and CBC What are scattered erythematous; raised on skin, over 1 cm; plaque- Raised papule - rough, dry, silver, grey. Found mostly over joints? - ANSWER Psoriasis What are herald spot with bullseye like papule with branches emanating from it occur on back, chest. Red raised? - ANSWER Pityriasis Rosea What are malar, erythema (mid cheeks, spans bridge of nose), relative sparing of nasolabial folds, periungual erythema, interphalangeal erythema? - ANSWER Systemic Lupus Erythematosus What are rash, often in red bullseye pattern (erythema migrans), caused by tick bite. Symptoms are flu-like, fever, HA, fatigue - ANSWER Lyme Disease What do you check for when patient has cellulitis? - ANSWER Ulcer for signs of infection How does retinal detachment present? - ANSWER sudden, painless, unilateral vision loss What cranial nerve are you assessing when checking lateral gaze? - ANSWER Cranial nerve 6 - Abducens What conditions do not have red reflexes? - ANSWER cataracts, detached retina, the vitreous, artificial eye, or retinoblastoma in children Eye condition in which there is a sudden vision loss, unilateral, painful; associated with multiple sclerosis? - ANSWER Optic Neuritis What is a signature sign of otitis externa? (swimmer's ear) - ANSWER Painful movement of the tragus Eye condition where there is a leakage of outside blood vessels in the eye, absent of pain; vision is not affected - ANSWER Subconjunctival hemorrhage Where to palpate for strep lymph nodes? - ANSWER Anterior cervical Where to palpate for mono lymph nodes? - ANSWER Posterior cervical Eye condition where the eye is severe, aching, deep pain; decreased vision, pupil dilated/fixed? - ANSWER Glaucoma Lung condition where there is dullness replaced with resonance, dyspnea, pleuritic pain, cough, fever; localized bronchophony/egophony? - ANSWER Pneumonia Lung condition where the patient coughs sometimes with thick mucoid, sputum, especially near end of an attack, episodic wheezing and dyspnnea, but cough may occur alone. Often history of allergies - ANSWER Asthma Heart condition where patient does a clenching movement over the sternum? - ANSWER Myocardium What ventricle are you feeling when palpating anterior cardiac surface? - ANSWER Right ventricle What valve are you listening to at the apex of the heart? - ANSWER Mitral valve What position do you have to put your patient in to listen for mitral stenosis? - ANSWER Left lateral decubitus position What causes an s3 heart sound? - ANSWER Ventricular compliance What are signs of thrombophlebitis? - ANSWER Redness, swelling, warmth How to grade a bounding pulse? - ANSWER 3+ Why do venous sufficiency cause edema, swelling, and ulceration? - ANSWER Chronic obstruction & incompetent valves What is this test: Patient's LE color changes with first raising LE while supine, then having patient sit up and observing color changes by it turning back to pin within <10 seconds? - ANSWER Buerger test What is a Buerger test done for? - ANSWER Chronic arterial insufficiency What causes saddle numbness and urinary retention? - ANSWER Cauda equina syndrome What are signs of degenerative pain? - ANSWER weakness, fatigue, malaise What is a musculoskeletal condition where there is tender, pain, stiffness of joints, usually with symmetric involvement? - ANSWER Rheumatoid Arthritis What type of ROM limitation can you see in Rheumatoid Arthritis? - ANSWER Swan neck deformities Where does pain present with lateral epicondylitis present? - ANSWER 1 cm distal to the lateral epicondyle and possibly in the extensor muscles How do you check for nystagmus? - ANSWER Gait, dysarthria, vestibular, internuclear opthalmoplegia How is nystagmus identified? - ANSWER By involuntary jerking of eye movement How do you check for meningitis in the femoral nerve? - ANSWER Brudzinski sign How do you check for meningitis in the sciatic nerve? - ANSWER Kernig sign What is a severe neurological condition with a sudden headache accompanied with n/v and neck stiffness - ANSWER Subarachnoid hemorrhage Which cranial nerve are you testing for when touch the soft palate and viewing the uvula? - ANSWER Cranial nerve 10 - vagus What is cranial nerve 1 - ANSWER Olfactory - nose How do you test for cranial nerve 11? - ANSWER Shrug shoulder resistence What cranial nerve are you testing for when checking lateral gaze? - ANSWER Cranial nerve 6 - abducens What does vasovagal syncope cause? - ANSWER drop in BP and heart rate What does a pronator drift indicate? - ANSWER an upper motor neuron issue What refers to a loss of voice that accompanies disease affecting the larynx or its nerve supply? - ANSWER Aphonia What refers to less severe impairment in the volume, quality, or pitch of the voice? For example, a person may be hoarse or only able to speak in a whisper. - ANSWER Dysphonia What refers to a defect in the muscular control of the speech apparatus and is caused by lesions of the central or peripheral nervous system, parkinsonism, and cerebellar disease? - ANSWER Dysarthria What refers to a disorder in producing or understanding language. It is often caused by lesions in the dominant cerebral hemisphere, usually the left? - ANSWER Aphasia When performing breast exam: an abnormal mass, how would fibroadenoma appear? - ANSWER Very mobile When performing breast exam: an abnormal mass, how would a cyst appear? - ANSWER Mobile When performing breast exam: an abnormal mass, how would cancer appear? - ANSWER Fixed to skin or underlying tissue, may cause dimpling of skin What is the biggest risk factor for breast cancer? - ANSWER Age Which lymph nodes is most commonly involved in breast cancer? - ANSWER Central nodes (axillary) Where is the pain felt with diverticulitis? - ANSWER Left lower quadrant Where is pain felt with appendicitis? - ANSWER RLQ How is Hep A transmitted? - ANSWER fecal-oral route Type of incontinence that results from weakened urethral sphincter and increases intra-abdominal pressure raise the bladder pressure to levels that exceed urethral resistance? - ANSWER Stress incontinence Type of incontinence that results from detrusor contractions being stronger than normal and overcoming the normal urethral resistence - ANSWER Urge incontinence Type of incontinence that results from detrusor contractions being insufficient to overcome urethral resistance causing retention. the bladder is typically flaccid and large, even after effort to void - ANSWER Overflow incontinence Type of incontinence resulting from the patient being functionally unable to reach th