NR 509 Advanced Health Assessment Final Exam Q&A with Complete Solution (Latest 2021/2022)100% Verified

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NR 509 Advanced Health Assessment Final Exam Q&A with Complete Solution (Latest 2021/2022)100% Verified A circumscribed, elevated lesion, >1 cm I diameter and containing clear serous fluid is best d... escribed as Correct Answer- Bulla The history and physical of a client indicates paste occurrences of lichenification. The NP identifies this as: Correct Answer- Rough, thickened epidermis, accentuated skin markings On examination of a client's skin, the nurse practitioner finds a lesion that is about 0.75 cm in diameter, brown, and circumscribed. Correct term for this lesion is: Correct Answer- Macule In performing a skin assessment, the NP understands that the following characteristic of a mole would need intervention: Correct Answer- A new 2mm mole that is brown with a red, irregular border, and occasionally pruritic The NP describes an annular skin lesion as usually arranged in Correct Answer- A circle or ring shape An NP educating patients realizes that risk factors for skin cancer include all except: Correct AnswerDark eyes Which of the following in a client's history would place the patient most at risk for melanoma? Correct Answer- Intense, intermittent sun exposure An elderly retired farmer presents with a rolled border, pearly, firm nodule with telangiectasia on his nose. This is: Correct Answer- Basal cell carcinoma An adult female presents with an irregular, variegated nevus on her left lower back that has doubled in size the past ?. The NP should: Correct Answer- Refer immediately to a dermatologist The ABCDs of melanoma identification include all of the following EXCEPT: Correct Answer- B (bridging): connection across sidesYour patient is 2 weeks old. During your assessment, you note that she has pinhead sized, smooth, white, raised areas. You document this as: Correct Answer- Milia Which skin lesions are directly related to chronic sun exposure and photo damage? Correct AnswerActinic keratosis In your assessment you note Ms. Angel has white nail syndrome, you order: Correct Answer- BUN & Creatinine Mary D. an 84 y.o F has multiple solar lentils <1 cm. These are not uncommon for her age. You would describe these as: Correct Answer- Macules Lou, a 50 yo homeless man is diagnosed with tinea capitis. You realize this is cause by a(n): Correct Answer- Dermatophyte Ron R presents with dependent edema. You assess he has a >1 inch indentation up to mid-tibia bilaterally. You document this as: Correct Answer- +4 edema The most common type of melanoma is the: Correct Answer- Superficial You are assessing Arlene C's skin complaint. You get a +Auspitz sign. This aides you in the diagnosis of: Correct Answer- Psoriasis As you gather you history from a patient with atopic dermatitis what other items in the personal or family history would you expect with this patient? Correct Answer- Asthma Which of the following statements best describes squamous cell carcinoma? Correct Answer- Often has a keratinous horn You are assessing a newborn and note the baby is jaundiced. He is 3 days old. You realize that for this to be a normal finding it must be gone within: Correct Answer- 1 weekWhat are the major components to be documented for a skin lesion? Correct Answer- -Distribution -Configuration -Palpable features -Pattern -All of the above Which of the following presentations suggests a diagnosis of a malignant melanoma? Correct AnswerLesion with border irregularity All of the following statements concerning basal cell carcinoma are true EXCEPT? Correct Answer- It is most often found on abdomen or trunk The NP denotes a bruit above and to the left of the umbilicus. This finding is consistent with: Correct Answer- History of HTN As you palpate the abdomen, + rebound tenderness at McBurney's point would alert you to: Correct Answer- Appendicitis Which of the following is true regarding colorectal cancer? Correct Answer- Later disease presentation often includes iron deficiency anemia You assess for Cullen sign in Dan, age 62, after surgery. Cullen sign may indicate: Correct Answer- Intraabdominal bleeding When percussing the abdomen, you document hyper-resonance. This most likely represents: Correct Answer- Gaseous distention A positive fluid wave test may occur with all of the following conditions EXCEPT Correct AnswerInflammation of the spleenHarold Williams abdominal exam includes a liver span of 3.0 MCL. Your assessment reveals: Correct Answer- Liver atrophy To test for a positive obturator sign in a client with abdominal pain, the NP: Correct Answer- Passively rotates the right hip from the 90 degree hip/knee flexion position A middle-aged woman who is overweight had RUQ pain that radiates to her R subscapular area. If there is a positive ______, the patient has _____ Correct Answer- Murphy's sign, cholecystitis A clients complains of extreme pain in his abdomen and points to the RLQ. In examining the acute abdomen, the NP would: Correct Answer- Palpate the left side of the abdomen, then the right side, noting guarding and tenderness The most important goal of assessing a client with abdominal pain is Correct Answer- Rule out emergent conditions While examining the abdomen of a post-op patient, you note that the bowel sounds are noted within 20 seconds. You. document that this is: Correct Answer- a normal finding During your abdominal assessment you note purple striae. Your next step would be to: Correct AnswerAsk about cold/heat intolerance Ruay Smith is a 27 yo M diagnosed with ulcerative colitis at age 18. He needs a colonoscopy by age Correct Answer- 30 When palpating the abdomen of an infant, the NP realizes that the spleen is easily palpable: Correct Answer- True In your examination of Gordon, age 29, you elicit L costa-vertebral angle tenderness. What do you expect? Correct Answer- Pyelonephritis When auscultating a patient's abdomen, the NP hears a systolic bruit in the epigastric area. It occurs at a fixed interval, most likely source of this bruit is: Correct Answer- abdominal aortaJay Smith presents with abdominal pain. As you assess him you chat +AWT. This leads you to what possible diagnosis Correct Answer- Muscle strain Mr Java is an 85 yo M, you realize that abdominal disorders in the older patient are more difficult to diagnose because Correct Answer- Vague symptoms and often little to no pain Mrs Jones is a female patient with history of ETOH abuse. Your abdominal exam should include: Correct Answer- The scratch test When examining the eyes, the NP realizes that the pupils change in size when the client focuses from a close object to a far object. This is: Correct Answer- Normal visual accommodation On ophthalmic examination, there appears to be narrowing or blocking of the vessels. Significance of this finding is: Correct Answer- The client should be evaluated for chronic hypertension Mr Smith has a +bruit upon examination of the thyroid. This most likely indicates: Correct AnswerHyperthyroidism As you are getting your patients history you notice bilateral lid lag of the eye. You make a note to yourself to assess for problems with: Correct Answer- thyroid 70 yo comes to clinic c/o blurred vision, problems w glare, no pain. NP should check first for ___ Correct Answer- cataract At what age do you approximate adult vision? Correct Answer- 4 years old The purpose of conducting the Rinne test is to determine the conduction of sound through bone and auditory canal to determine that: Correct Answer- Air conduction is twice as long as bone conduction Sally, age 19, presents with pain and pressure over her cheeks and discolored nasal discharge. You cannot transilluminate. Which sinus is affected? Correct Answer- MaxillaryZeke Gilbert, age 72, retired factory worker, has hearing loss in the right ear due to excessive cerumen. The NP would expect to find____ during the weber test Correct Answer- Sound materializes to the Right ear What is the correct procedure for palpation of a client's thyroid gland? Correct Answer- Have a client lower chin and lean slightly toward the side being evaluated you are giving an 85 yo nursing home resident her annual physical exam. History of HTN. Margin of lower lid is turned outward and conjuctiva is exposed Correct Answer- Ectropion 56 yo salesman evaluated area on the tongue that has been present for 3 ___, unable to scrape off. White painless plaques. What is the likely diagnosis? Correct Answer- Leukoplakia Client presents with conjunctivitis. Which lymph nodes would you expect to find enlarged? Correct Answer- Pre-auricular and anterior cervical Conducting an ophthalmic exam on a patient with chronic hypertension. What would you expect to see? Correct Answer- cotton wool patches and flame hemorrhages When Judy, age 15, asks you to explain what 20/50 vision means you respond: Correct Answer- You can see at 20 feet what normal people can see at 50 feet Ms Ins presents with eye pain. The external eye is red, tender, swollen, raised area, pointing outward on the lash border. This is: Correct Answer- Hordeolum firm, painless, relatively fixed submandibular node would most likely be seen in the diagnosis of : Correct Answer- oral caner As an APN, you believe strongly in anticipatory guidance and prevention education. You explain this to your patient that the development of screening and prevention guidelines is based on: Correct Answerincreased in average life expectancyted who is 15 yo just moved into the community and is staying in a foster home temporality without any record of immunizations. Which immunizations does he need? Correct Answer- -meningococcal -mmr -tdap -all of the above*** the client tells you that he takes aspirin daily. What question should you ask next? Correct Answer- Why do you take aspirin daily? Mr. Bill presents to your office for a physical. You note that his BMI is 27. You inform him that this is considered Correct Answer- overweight You are evaluating an elderly man who was brought by his distraught daughter. You explain that many physical changes occur as we age that affect nutrition. Including all of the following except? Correct Answer- total caloric needs increase Mr P complains of a "pain in his stomach". In your note you document that he is c/o pain in the LLQ, radiating with worsening intensity towards the umbilicus. Pain is 6/10. Denies n/v/d. HPI should includeCorrect Answer- When did it begin? During a routine physical exam of a 44 yo woman you note she has an inverted left nipple. You decide to investigate because: Correct Answer- The inversion may be a recent change A 30 yo F is in the office c/o palpiations and some lightheadedness for the past ?, random episodes, no detectable pattern. NP notes a mid systolic click with a late systolic murmur heard best in the apical area. You suspect Correct Answer- Mitral valve prolapse (MVP) All of the following tests require the patient's voice to perform correctly except: Correct Answer- - egophany -tactile fremitus -whispered pectoriloquy *auscultation*59 yo M with history of COPD presents with worsening dyspnea. Patient is afebrile, breath sounds are decreased bilaterally, noted to have JVD and pitting edema of lower extremities. What is the most likely cause of his dyspnea? Correct Answer- CHF James Jones 55 yo M smoker presents with thick sputum producing cough. Exam: +tactile fremitus, resonant percussion, and normal voice transmission. You suspect: Correct Answer- bronchitis During the breast exam of a 30 year old nulliparous female. The NP palpates several rubbery areas of the breast tissue. They are slightly tender to palpation and present in both breasts. Expecting menses in 5 days. Which intervention is best? Correct Answer- Tell her to recheck 1 week after her menses All of the following symptoms associated with chest pain are likely to represent CAD except? Correct Answer- pain with inspiration 60 yo landscaper presents to your office to establish care, history of CHF controlled with medications. Denies cp, edema. Early diastolic ? with opening snap ___. You suspect? Correct Answer- Mitral stenosis When performing a H&P on a pediatric patient. Which important factor affects the outcome the most: Correct Answer- Child's developmental level The most important question to ask as you build your HPI is Correct Answer- Have you ever had this before? Which of the following patients is least likely to become an alcohol abuser? Correct Answer- 50 yo construction worker who drinks 1 beer nightly You are describing a lesion noted on Mr Smith a 55 yo M. It is flat, nonpalpable, <1cm. You describe this as a Correct Answer- macule A patient states that she has had a rash on her breast for about 2 weeks. In order to determine if it is pagets disease you would expect to have all of the following on physical exam EXCEPT Correct Answerinverted nippleYou notice a medium-pitched harsh systolic murmur during a routine exam or R upper border of the sternum. Which of the following is most likely? Correct Answer- Aortic stenosis Which of the following statements in NOT typical of the murmur it is describing? Correct Answer- Grade II/Grade VI murmur is associated with a thrill? you realize that as an APN you must ask sensitive questions, the most important thing is to be: Correct Answer- nonjudgemental cultural competence is best enhanced when the healthcare provider Correct Answer- uses self awareness and reflection [Show More]

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