1. During pregnancy, dyspnea accompanied by increased respiratory rate, cough, rales, or
respiratory distress raises concerns of:
peripartum cardiomyopathy
Explanation:
Dyspnea accompanied by increased respiratory ra
...
1. During pregnancy, dyspnea accompanied by increased respiratory rate, cough, rales, or
respiratory distress raises concerns of:
peripartum cardiomyopathy
Explanation:
Dyspnea accompanied by increased respiratory rate, cough, rales, or respiratory distress raises
concerns of possible infection, asthma, pulmonary embolus, or peripartum cardiomyopathy.
2. The middle section of the thoracic cavity containing the esophagus, trachea, heart, and
great vessels is the:
mediastinum
Explanation:
The middle section of the thoracic cavity containing the esophagus, trachea, heart, and great
vessels is the mediastinum. The right and left pleural cavities, are on either side of the
mediastinum and those contain the lungs. The visceral pleura encloses the lung. The pericardium
surrounds the heart.
3. A patient is unable to identify the smell of an orange. This inability could reflect an
abnormality in cranial nerves:
CN I
Explanation:
Cranial Nerve I is the olfactory nerve responsible for the sense of smell. To test the sense of
smell, the examiner presents the patient with familiar and nonirritating odors. A person should
normally perceive odor on each side and correctly identify the source. Cranial Nerves II and III
assess vision and pupillary reaction. Cranial Nerve VIII tests the hearing and balance.
4. A transient ischemic attack is:
a transient episode of neurologic dysfunction by focal brain, spinal cord, or retinal ischemia,
without acute infarction
Explanation:
TIA is now defined as “a transient episode of neurological dysfunction caused by focal brain,
spinal cord, or retinal ischemia, without acute infarction.” Ischemic stroke is “an infarction of
central nervous system tissue” that may be symptomatic or silent. The other terms are not related
to the new definitions.
5. The term asteatosis refers to:
skin that is dry, flaky, rough, and often itchy
Explanation:
Physiologic changes of aging include loss of elastic turgor, and wrinkling. Skin that appears dry,
flaky, rough, and itchy is termed asteatosis. Sun exposure can cause damage to the skin
resembling an appearance as weather beaten, thickened, yellowed, and deeply furrowed.
Seborrheic keratosis appear as raised, yellowish lesions that feel greasy, velvety, or warty.
Painful vesicular lesions in a dermatomal distribution may suggest herpes zoster.
6. An enlarged liver with a smooth tender edge may suggest:
right-sided heart failure.
Explanation:
An enlarged liver with a smooth, tender edge suggests inflammation, as in hepatitis, or venous
congestion, as in right-sided heart failure. Cirrhosis, hematochromatosis (increased amount of
iron in the blood), and lymphoma produce an enlarged liver with a firm, nontender edge. An
enlarged liver that is firm or hard and has an irregular edge or surface suggests hepatocellular
carcinoma.
7. New onset hypertension with proteinuria or end-organ damage is:
preeclampsia
Explanation:
Chronic hypertension occurs when systolic BP (SBP) >140 mm Hg or diastolic BP (DBP) >90
mm Hg documented prior to pregnancy, before 20 weeks, or beyond 12 weeks postpartum.
Gestational hypertension refers to elevated blood pressure detected after 20 weeks gestation in
the absence of proteinuria. Pre-eclampsia occurs in a woman who was previously normotensive
but now has new onset hypertension with either proteinuria or end-organ damage. Primary
hypertension, formerly known as essential hypertension, is a disorder which is associated with
elevated blood pressure and an unidentifiable cause.
8. The psoas muscle group and muscles of the abdominal wall assist with:
flexion
Explanation:
The psoas muscle group and muscles of the abdominal wall assist with flexion. The deep
intrinsic muscles of the back assist with extension. The abdominal muscles and intrinsic muscles
of the back assist with rotation. Lateral bending uses the abdominal muscles and intrinsic
muscles of the back.
9. "Preterm small for gestational age" (SGA) infants are prone to:
hypocalcemia
Explanation:
"Preterm appropriate for gestational age" (AGA) infants are prone to respiratory distress
syndrome, apnea, patent ductus arteriosus with left-to-right shunt, and infection. "Preterm small
for gestational age" (SGA) infants are more likely to experience asphyxia, hypoglycemia, and
hypocalcemia.
10. Swelling noted 1-2 inches below the knee joint and on the medial surface of the knee
would be suggestive of:
anserine bursitis
Explanation:
Swelling 1-2 inches below the knee joint and on the medial surface would be suggestive of
anserine bursitis. Swelling over the tibial tubercle suggests infrapatellar bursitis. Swelling over
the patella suggests prepatellar bursitis. Semimembranous bursitis would be suggested by
swelling on the posterior and medial surface of the knee.
11. A patient states that the only way he can sleep at night is to use several pillows or to sleep
upright in a recliner. This sleep pattern is most consistent with:
obstructive lung disease
Explanation:
With obstructive lung disease, the patient experiences orthopnea, dyspnea that occurs when the
patient lies down but improves with sitting. Therefore, the patient would use several pillows or
sleep upright in a recliner. Orthopnea is seen in obstructive lung disease, mitral stenosis, and
heart failure. Paroxysmal nocturnal dyspnea describe episodes of sudden dyspnea that cause the
patient to awaken from sleep where the patient must sit up, walk, or stand for it to resolve.
Coughing and wheezing may also occur. Angina pectoris commonly creates chest pain or
shortness of breath. Jugular venous pressure reflects right atrial pressure and volume status. In
cases of cardiac or pulmonary dysfunction, jugular venous pressures usually raise.
12. A positive obturator sign would elicit pain in the:
right hypogastric area
Explanation:
Assessment of the obturator sign is performed by flexing. By flexing the patient's right thigh at
the hip with the knees bent, rotating the leg internally at the hip. If this causes increased pain in
the right epigastric area, then the obturator sign is positive. Hypogastric pain occurs as the
obturator muscle rubs an inflamed appendix.
13. The lateral bone that serves as a strut between the scapula and the sternum is known as
the:
clavicle
Explanation:
The lateral bone that serves as a strut between the scapula and the sternum is known as the
clavicle. The humerus is the long bone of the upper arm. The acromion process is an extension of
the spine of the scapula and located at the highest point of the shoulder. The thick curved
extension of the superior border of the scapula is referred to as the coracoid process.
14. When examining the foot of a patient, the nurse practitioner notes focal heel tenderness
on palpation of the plantar fascia. This could be suggestive of:
plantar fasciitis
Explanation:
Focal heel tenderness on palpation of the plantar fascia suggests plantar fasciitis. Bone spurs may
be present on the calcaneus as bony projections and may cause numbness, tenderness, or pain.
Localized tenderness on examination of the ankle joint could be suggestive of arthritis, infection
of the ankle, or ligamentous injury. Tenderness along the posterior medial malleolus suggests
posterior tibial tendinitis.
15. When examining the conjunctiva and sclera, have the patient look upward and then:
depress both lower lids with your thumbs, exposing the sclera and conjunctiva
Explanation:
When examining the conjunctiva and the sclera, the best way to expose these structures is to
have the patient look upward and depress both lower lids with your thumbs. Covering one eye
while visualizing the other eyes checks for visual acuity. Observing for excessive tearing or
dryness assesses the lacrimal apparatus. Checking the position of the lids may identify variations
and abnormalities in the eyelids.
16. The groove of the metacarpophalangeal joint can be palpated by having the patient:
flex his hand
Explanation:
The groove of the metacarpophalangeal joints can be palpated by having the patient flex his
hand.
17. A patient complains of shooting pains below the knee radiating into the lateral leg and
calf. This type of low back pain is referred to as:
radicular low back pain
Explanation:
Radicular low back pain, or sciatica, presents with shooting pains below the knee, into the lateral
leg or posterior calf. It may be accompanied by paresthesias and/or weakness in the affected leg.
Mechanical low back pain often arises from muscle and ligament injuries (~70%) or age-related
intervertebral disc or facet disease. Common symptoms include aching pain in the lumbosacral
area that radiates to the upper leg. Common risk factors include heavy lifting, poor conditioning,
and obesity. Lumbar spinal stenosis or "pseudoclaudication" refers to pain in the back or legs
with walking that improves with rest, lumbar flexion, or both.
18. When assessing a 3-month-old for developmental dysplasia of the hips (DDH), which one
of the following symptoms would be suspicious of dysplasia?
Limitation of abduction of the affected extremity, shortening of the femur and positive Ortolani's
sign
Explanation:
Developmental dysplasia of the hips (DDH) presents with limitation of abduction, shortening of
the extremity, as the head of the femur does not fit into the acetabulum, and a positive Ortolani's
(it clicks when maneuvered). DDH presents with asymmetry of the gluteal folds.
19. A patient presents with right upper quadrant and upper abdominal pain. Acute
cholecystitis is suspected because the pain radiates to the:
right scapula area
Explanation:
Acute cholecystitis presents with right upper quadrant and upper abdominal pain radiating to the
right scapular area. It is usually steady and aching. Pain in the epigastric area could be associated
with peptic ulcer or dyspepsia. Cancer of the stomach can present with epigastric pain. Acute
mechanical colon obstruction presents with pain in the lower abdomen.
20. The preauricular lymph node is located:
in front of the ear
Explanation:
The preauricular lymph nodes are located in front of the ear. The tonsillar lymph nodes are at the
angle of the mandible. The occipital lymph nodes are located at the base of the skull posteriorly.
The posterior auricular nodes are superficial to the mastoid process.
21. Cessation of the menses for 12 months is termed:
menopause
Explanation:
Menopause is defined as cessation of menses for 12 months, progressing through several stages
of erratic cyclical bleeding. Oligomenorrhea is infrequent bleeding with menses occurring
greater than 35-day intervals, or 4-9 menstrual cycles per year. Menorrhagia refers to excessive
or prolonged menstrual flow occurring at regular intervals. Metrorrhagia refers to intermenstrual
bleeding.
22. The gastrocnemius and soleus muscles are located by palpating the:
posterior surface of the lower leg
Explanation:
The gastrocnemius and soleus muscles are located by palpating the posterior surface of the lower
leg.
23. One cause of nasal septum perforation may be:
intranasal use of cocaine
Explanation:
Perforation of the nasal septum could be caused by trauma, surgery, and intranasal use of cocaine
or amphetamines. Nasal polyps obstruct air flow but there is no relationship to nasal septum
perforation. Cystic fibrosis or chronic sinusitis are not associated with nasal perforation.
24. Tenderness in the costovertebral angles may signify:
pyelonephritis
Explanation:
Because the kidney lies directly under the costovertebral angle, tenderness over this area would
be related to renal issues such as renal stones or pyelonephritis.
25. A patient presents with an altered level of consciousness. He/she is considered in a
stuporous state if he/she:
arouses from sleep after exposure to painful stimuli, exhibits slow verbal responses, and easily
lapses into an unresponsive state
Explanation:
A stuporous patient arouses from sleep after exposure to painful stimuli, verbal responses are
slow, and lapses into an unresponsive state. A lethargic patient appears drowsy but opens the
eyes, looks at the examiners, answers the questions, and then falls asleep. An obtunded patient
opens the eyes and looks at the examiner, but responds slowly and is somewhat confused. A
comatose patient remains unarousable with eyes closed. There is no evident response to inner
need or external stimuli.
26. A flat affect can be an identifiable finding in an older adult who has:
depression
Explanation:
Flat affect occurs in depression, Parkinson’s disease, or Alzheimer’s disease.
27. Pain and crepitus over the patella suggests:
roughening of the patellar undersurface
Explanation:
Pain and crepitus over the patella suggests roughening of the patellar undersurface that
articulates with the femur. Tenderness over the patellar tendon or inability to extend the knee
suggests a partial or complete tear of the patellar tendon. A degenerative patella produces pain
with compression and patellar movement during quadriceps contraction. Swelling above and
adjacent to the patella suggest synovial thickening or effusion of the knee joint.
28. A child with a heart murmur audible at the lower left sternal border would be suggestive
of:
ventricular septal defect
Explanation:
This type murmur is not considered a normal finding in children. The murmur associated with a
ventricular septal defect is audible at the lower left sternal border. A child with a heart murmur
located at the midsternum or upper right sternal border and associated with a click could be
suggestive of aortic valve stenosis. A murmur located at the upper left sternal border with a
prominent ejection click in early systole could be suggestive of pulmonary valve stenosis.
29. In order to visualize the opening of Stensen's duct, examine the:
buccal mucosa opposite the second molar
Explanation:
The largest salivary gland is the parotid gland and it lies within the cheeks in front of the ear
extending from the zygomatic arch down to the angle of the jaw. Its duct, Stensen's duct, runs
forward to an opening on the buccal mucosa opposite the second molar. If blood comes out
through Stensen's duct when it is palpated, this could suggest parotid cancer. If pus is expelled, it
suggests suppurative parotitis. With mumps, the orifice of the Stensen duct appears erythematous
and enlarged. The submandibular gland is the size of a walnut. It lies beneath the mandible at the
angle of the jaw. Wharton's duct runs up and forward to the floor of the mouth and opens at
either side of the frenulum. The smallest, the almond-shaped sublingual gland, lies within the
floor of the mouth under the tongue. It has many small openings along the sublingual fold under
the tongue.
30. Hyperalgesia refers to:
increased sensitivity to pain
Explanation:
Analgesia refers to absence of pain sensation; hypalgesia to decreased sensitivity to pain;
hyperalgesia to increased sensitivity; and anesthesia to absence of touch sensation.
31. The part of the brain that maintains homeostasis is the:
hypothalamus
Explanation:
The hypothalamus maintains homeostasis and regulates temperature, heart rate, and blood
pressure. The hypothalamus affects the endocrine system and governs emotional behaviors such
as anger and sexual drive. Hormones secreted in the hypothalamus act directly on the pituitary
gland.
32. A 80 year old male visits the nurse practitioner for an annual well exam. History reveals
two falls in the prior 12 months and difficulty with balance. The next step the nurse
practitioner should take is:
obtain cognitive and functional assessment
Explanation:
High-risk older adults, namely those with a single fall in the past 12 months with abnormal gait
and balance and those with two or more falls in the prior 12 months, an acute fall, and/or
difficulties with gait and balance, require further assessment to determine the reasons for the
falls. Obtaining relevant medical history, physical exam, cognitive and functional assessment and
determining multifactorial fall risks are essential to the preventing future falls.
33. Which one of the following symptoms would be seen in a 39 week gestational age patient
who was suspected of having HELLP syndrome?
Vomiting, flu - like symptoms, and platelet count < 100,000
Explanation:
HELLP syndrome is a life-threatening pregnancy complication usually considered to be a variant
of pre-eclampsia. Both conditions usually occur during the later stages of pregnancy, or
sometimes after childbirth. Its characteristics: H (hemolysis), EL (elevated liver enzymes) and
LP (low platelet count).
34. Flexion contracture of the knee suggests hamstring tightness or:
limb paralysis
Explanation:
Flexion contracture (inability to extend fully) is seen in hamstring tightness or limb paralysis.
Swelling over the patella suggests prepatellar bursitis. Stumbling or "giving way" of the knee
during the heel strike phase of gait suggests quadriceps weakness or abnormal patellar tracking.
35. A protrusion of the membranes that cover the spine and the spinal cord itself, through a
defect in the bony encasement of the vertebral column is known as:
a meningomyelocele
Explanation:
A meningomyelocele is defined as the protrusion of the membranes that cover the spine and the
spinal cord itself, through a defect in the bony encasement of the vertebral column. A
developmental congenital disorder caused by the incomplete closing of the embryonic neural
tube is known as spina bifida. A protrusion of the spinal cord through a defect in the vertebral
arch is referred to as a myelocele. An omphalocele is a type of abdominal wall defect in which
the intestines, liver, and occasionally other organs remain outside of the abdomen in a sac.
36. Static stabilizers of the shoulder are referred to as those structures that are:
bony structures of the shoulder girdle
Explanation:
Static stabilizers are incapable of movement and include the bony structures of the shoulder
girdle, the labrum, the articular capsule, and the glenohumeral ligaments that add to joint
stability. Dynamic stabilizers are capable of movement and include the SITS muscles of the
rotator cuff (supraspinatus, infraspinatus, teres minor, and subscapularis). These muscles move
the humerus and compress and stabilize the humeral head within the glenoid cavity.
37. With inspection of the male infant's penis, the urethral orifice appears on the dorsal
surface of the glans. This finding is consistent with:
epispadias
Explanation:
With inspection of the male infant's penis, the urethral orifice appears on the dorsal surface of the
glans. This finding is consistent with epispadias. A chordee refers to the fixed downward bowing
of the penis. With inspection of the male infant's penis, the urethral orifice appears on the ventral
surface of the glans. This finding is consistent with hypospadias. Cryptorchidism is a term used
to describe undescended testicles in a male.
38. The nurse practitioner should base a response to a parent's question about the prognosis
of acute lymphoblastic leukemia (ALL) on which of the following statement:
A majority of children go into remission and remain symptom free when treatment is completed
Explanation:
The majority of children diagnosed with the most common form of leukemia, acute
lymphoblastic leukemia, go into remission and remain symptom free when treatment is complete
and will have an 85% disease free survival rate. With the majority of children surviving 5 years
or longer, it is inappropriate to refer to leukemia as a fatal disease. The research statement is true,
but it does not address the parent's concern. About 95% of children achieve remission within the
first month of chemotherapy.
39. To assess for strabismus in a child, use the:
cover-uncover test
Explanation:
The cover-uncover test assesses coordination of eye muscle movement when one eye is covered.
It is always assessed bilaterally. Strabismus is identified when the covered eye is found to deviate
from its forward focus. Snellen eye chart assesses visual acuity; ophthalmoscope is used to
visually assess the fundus of the eye. Pupillary reaction tests the ability of the eyes to react to
light and accommodate.
40. While assessing the cranial nerves, the nurse practitioner touches the cornea lightly with a
wisp of cotton. This maneuver assesses which cranial nerve?
Cranial Nerve V (CN V)
Explanation:
Touching the cornea and assessing for a reflex assesses cranial nerve V. (sensory)
41. When examining the foot of a patient, the nurse practitioner notes tenderness of the
posterior medial malleolus. This could be suggestive of:
tibial tendinitis
Explanation:
Tenderness along the posterior medial malleolus suggests posterior tibial tendinitis. Bone spurs
may be present on the calcaneus as bony projections and may cause numbness, tenderness, or
pain. Localized tenderness on examination of the ankle joint could be suggestive of arthritis,
infection of the ankle, or ligamentous injury. Focal heel tenderness on palpation of the plantar
fascia suggests plantar fasciitis.
42. Upon examination of the vagina, the entire anterior vaginal wall, together with the
bladder and urethra create a bulge. This condition is most consistent with a:
cystourethrocele
Explanation:
When the entire anterior vaginal wall, together with the bladder and urethra, is involved in the
bulge, a cystourethrocele is present. A cystocele is a bulge of the upper two-thirds of the anterior
vaginal wall and the bladder above it. It results from weakened supporting tissues. A prolapsed
urethral mucosa forms a swollen red ring around the urethral meatus. A urethral caruncle is a
small, red, benign tumor visible at the posterior part of the urethral meatus.
43. A 3 year-old presents with a history of fever and cough over the past 24 hours. Findings on
exam reveal: temperature of 102°F, apical heart rate of 157 beats/minute, and respiratory rate
of 40 breaths/minute. Tachypnea in this child is most likely related to
the child's febrile state
Explanation:
In children, heart and respiratory rates will increase with fever. For every degree of fever the
respiratory rate will increase 3-4 breaths/minutes and the heart rate will increase 8-10
beats/minute.
44. A female patient presents with a profuse, yellowish, green vaginal discharge that is
malodorous. This vaginal discharge is most consistent with:
Trichomonal vaginitis
Explanation:
Trichomonas vaginalis causes trichomonal vaginitis. Presenting symptoms include a profuse,
yellowish, green vaginal discharge that is malodorous. Candidal vaginitis produces a white and
curd-like thin discharge that is rarely malodorous. With bacterial vaginosis, the discharge can be
gray or white, thin, malodorous (fishy), and not usually profuse. The discharge associated with
gonorrhea is usually thick and bloody.
45. When assessing plantar reflexes, the nurse practitioner strokes the lateral aspect of the
sole from the heel to the ball of the right foot. Absence of movement of the big toe is noted.
This finding could be suggestive of a pathologic lesion in which segmented level of the spine?
Lumbar 5 and Sacral 1
Explanation:
Superficial (cutaneous) reflexes and their corresponding spinal segments include the following:
Abdominal reflexes: upper thoracic 8, 9, 10 and lower thoracic 10, 11, 12; Plantar: lumbar 5 and
sacral 1; and Anal: sacral 2, 3, 4.
46. Which disorder of the eye can be detected with the cover-uncover and the Hirschberg test?
Strabismus
Explanation:
Strabismus is misalignment of the eyes and can be assessed using the cover-uncover teats and the
Hirschberg test (corneal light reflex). With the cover-uncover test, eye muscle weakness is seen
as eye deviation when the eye is uncovered. With Hirschberg's test, an asymmetric light reflex
indicates a deviation. Cataracts are visualized by a cloudiness or opacity in the lens.
Conjunctivitis is diagnosed by observation of a discharge from the eyes and erythema of the
conjunctiva. Amblyopia is diagnosed by visual assessment and testing by an optometrist or
ophthalmologist.
47. If fetal movement cannot be perceived after 24 weeks gestation, all of the following may be
considered except:
normal finding
Explanation:
If fetal movement cannot be perceived after 24 weeks, consider error in calculating gestational
age, fetal death or severe morbidity, or false pregnancy. Confirm fetal health and gestational age
with an ultrasound.
48. To palpate an indirect inguinal hernia in a woman, have her stand and palpate in the labia
majora and:
palpate upward to just lateral to the pubic tubercles
Explanation:
To palpate an indirect inguinal hernia in a woman, have her stand and palpate in the labia majora
and upward to just lateral to the pubic tubercles.
49. Bilateral exophthalmos suggests:
Grave's disease
Explanation:
Exophthalmos is an abnormal protrusion of the eye. When it presents bilaterally, it is suggestive
of Grave's disease, a form of hyperthyroidism. Unilateral exophthalmos may be due to Grave's
disease or to a tumor or inflammation of the orbit. Hashimoto's thyroiditis, hypothyroidism, and
goiter do not present with exophthalmos.
50. If regular uterine contractions occur prior to 37 weeks gestation, this could be:
preterm labor
Explanation:
Before 37 weeks, regular uterine contractions with or without pain and bleeding are abnormal,
suggesting preterm labor.
51. A form of aphasia in which the person has difficulty speaking and understanding words
and is unable to read or write is termed:
global aphasia
Explanation:
With global aphasia, the person has difficulty speaking and understanding words and is unable to
read or write. In Broca's aphasia, speech is confluent, slow, with few words and laborious effort.
Inflection and articulation are impaired but words are meaningful, with nouns, transitive verbs,
and important adjectives. Small grammatical words are often dropped. With anomic aphasia, the
person has word-finding difficulties and because of the difficulties, the person struggles to find
the right words for speaking and writing. With Wernicke's aphasia, speech is fluent, often rapid,
voluble, and effortless. Inflection and articulation are good, but sentences lack meaning and
words are malformed (paraphasias) or invented (neologisms). Speech may be totally
incomprehensible.
52. When examining the knee, a fluid wave on the medial side between the patella and the
femur is noted. This positive sign for effusion of the knee is known as the:
bulge sign
Explanation:
When examining the knee, a fluid wave on the medial side between the patella and the femur is
noted. This positive sign for effusion is known as the bulge sign. A positive balloon sign in the
knee is the presence of a palpable fluid wave with a returning fluid wave into suprapatellar
pouch. Balloting the patella occurs by compressing the suprapatellar pouch and pushing the
patella sharply against the femur, causing fluid to return to the suprapatellar pouch. McMurray's
test checks for tears in the medial menis
53. Which nerve runs from the spine through the neck, the axilla, and into the arm?
Brachial plexus
Explanation:
The brachial plexus is a network of nerve fibers that runs from the spine through the neck, the
axilla, and into the arm. This network of nerves passes through the cervico-axillary canal to reach
the axilla and innervates brachium (upper arm), antebrachium (forearm), and hand. The radial
nerve originates in the axilla and travels down the arm in a shallow depression (radial groove) on
the surface of the humerus. The median nerve is located on the ventral forearm and is just medial
to the brachial artery in the antecubital fossa. The ulnar nerve runs posteriorly in the ulnar groove
between the medial epicondyle and the olecranon process.
54. When upper motor neuron systems are damaged below the crossover of its tracts in the
medulla, motor impairment develops on the same side. This term is:
ipsilateral
Explanation:
When upper motor neuron systems are damaged above the crossover of its tracts in the medulla,
motor impairment develops on the opposite side. This term is contralateral. In damage below the
crossover, motor impairment would occur on the same side or ipsilateral side. Superficial refers
to the outer surface of something. Intermediate is a term used to denote something between two
other structures.
55. Symptoms of orthostatic hypotension include all of the following except:
syncope: unsteadiness: visual blurring: respiratory rate greater than 30.
Explanation:
Orthostatic hypotension occurs in 20% of older adults and in up to 50% of frail nursing home
residents, especially when they first arise in the morning. Symptoms include lightheadedness,
weakness, unsteadiness, visual blurring, and in 20% to 30% of patients, syncope.
56. What is the earliest recognizable clinical manifestation(s) of cystic fibrosis in a child?
Clubbing, frequent respiratory infections, and rectal prolapse
Explanation:
Cystic fibrosis is one of the most common genetic disorders in Caucasian children in the United
States and is usually diagnosed at an early age. However, if it is not diagnosed in infancy, some
of the symptoms seen in children include: not growing or gaining weight appropriately, frequent
lung infections, persistent cough, and wheezing. Other symptoms may also develop in childhood
such as: clubbing, rectal prolapse, and polyps in the nose or sinuses. The other choices are not
seen in cystic fibrosis.
57. The most effective method to use when assessing visual acuity in young children, is the:
E chart.
Explanation:
The E chart and Snellen charts assess visual acuity but for the young child, but the E chart is
more appropriate. The child can tell the examiner which direction the E is pointing. The Snellen
test requires that the child be able to identify letters of the alphabet. The most effective method to
use when assessing conjugate gaze in young children, is the use of the cover-uncover test and the
corneal light reflex test. The Ishihara chart assesses color blindness.
58. An adolescent visits the nurse practitioner for a sports participation physical. The nurse
practitioner instructs the adolescent to hold his arms against his lateral upper legs against
resistance. This maneuver assesses for:
strength of the deltoid muscle
Explanation:
This maneuver assesses strength of the deltoid muscle.
59. Ptosis of the left eye would be suggestive of damage to which cranial nerve?
Cranial Nerve III (CN III)
Explanation:
Ptosis of the left eye would be suggestive of 3rd nerve palsy (CN III)-Oculomotor nerve.
60. When performing the first Leopold maneuver on a pregnant woman, if the fetal buttocks
and head are not easily palpated at the fundus, the fetus is said to be in:
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