NURS 6512 Final Exam 2 - Question and Answers

1. Examination of the patient in the lithotomy, or knee-chest, position includes: 2. To spread the breast tissue evenly over the chest wall, you should ask the woman to lie supine with: 3. An apical PMI palpated be ...

1. Examination of the patient in the lithotomy, or knee-chest, position includes: 2. To spread the breast tissue evenly over the chest wall, you should ask the woman to lie supine with: 3. An apical PMI palpated beyond the left fifth intercostal space may indicate: 4. Breath odors may clue the examiner to certain underlying metabolic conditions. The odor of ammonia on the breath may signify:ammonia-like suggests uremia, a renal condition; cinnamon- tuberculosis; musty fish or clover hepatic -failure; sweet and fruity - diabetic ketoacidosis; and foul or feculent- intestinal obstruction. 5. Which cranial nerves are usually evaluated during the examination of the eyes? 6. Loss of immediate and recent memory with retention of remote memory suggests: 7. Recent unilateral inversion of a previously everted nipple suggests: 8. A parent is advised to restrict contact or collision sports participation for their child. An example of a sport in which this child could participate is: 9. You are performing a two-point discrimination test as part of a well physical examination. The area with the ability to discern two points in the shortest distance is the: 10. A red, hot swollen joint in a 40-year-old man should lead you to suspect: 11. Normal changes of the aging brain include: 12. An examiner has rotated a brush several times into the cervical os. The brush was withdrawn and stroked lightly on a glass slide. The slide was sprayed with fixative. Which type of specimen requires this technique for collection? 13. During a routine prenatal visit, Ms. T. was noted as having dependent edema, varicosities of the legs, and hemorrhoids. She expressed concern about these symptoms. You explain to Ms. T. that her enlarged uterus is compressing her pelvic veins and her inferior vena cava. You would further explain that these findings: 14. You are examining Mr. S., a 79-year-old diabetic man complaining of claudication. Which of the following physical findings is consistent with the diagnosis of arterial occlusion? 15. The Mini-Mental State Examination should be administered for the patient who: 16. The physical assessment technique most frequently used to assess joint symmetry is: 17. Throughout the history and physical examination, the clinician should: 18. Inquiry about nocturnal muscle spasms would be most significant when taking the musculoskeletal history of: 19. The foramen ovale should close: 20. Palpation of a normal prostate in an older adult is likely to feel: 21. You are interviewing a 20-year-old patient with a new-onset psychotic disorder. The patient is apathetic and has disturbed thoughts and language patterns. The nurse recognizes this behavior pattern as consistent with a diagnosis of: 22. While collecting personal and social history data from a woman complaining of breast discomfort, you should question her regarding: 23. The Mini-Mental State Examination: 24. Postural hypotension is defined as a _____ when the patient stands, compared with sitting or supine readings. 25. You are initially evaluating the equilibrium of Ms. Q. You ask her to stand with her feet together and arms at her sides. She loses her balance. Ms. Q. has a positive: 26. The reliability of health-related findings and observations is the responsibility of the: 27. When you attempt to move a 10-month-old child from his mother's lap to the examination table, he screams loudly. Your best action is to: 28. You are inspecting the genitalia of an uncircumcised adult male. The foreskin is tight and cannot be easily retracted. 29. For purposes of examination and communication of physical findings, the breast is divided into: 30. While examining a 30-year-old woman, you note that one breast is slightly larger than the other. In response to this finding, you should: 31. When is the mental status portion of the neurologic system examination performed? 32. You are conducting a clinical breast examination for your 30-year-old patient. Her breasts are symmetrical with bilateral, multiple tender masses that are freely moveable with well-defined borders. You recognize that these symptoms and assessment findings are consistent with: 33. At your first meeting with a patient, it is usually best to say: 34. A patient you are seeing in the emergency department for chest pain is suspected of having a myocardial infarction. During the health history interview of his family history, he relates that his father had died of "heart trouble." The most important follow-up question you should pose is which of the following? 35. A 23-year-old white woman has come to the clinic because she has missed two menstrual periods. She states that her breasts have enlarged and that her nipples have turned a darker color. Your further response to this finding is to: 36. Temporalis and masseter muscles are evaluated by: 37. Your older clinic patient is being seen today as a follow-up for a 2-day history of pneumonia. The patient continues to have a productive cough, shortness of breath, and lethargy and has been spending most of the day lying in bed. You should begin the chest examination by: 38. A grade IV mitral regurgitation murmur would: radiate to the axilla (radiates from the apex to base or to left axilla). 39. To hear diastolic heart sounds, you should ask patients to: 40. Assessing orientation to person, place, and time helps determine: 41. Your patient's chief complaint is repeated pencil-like stools. Further examination should include: 42. Which one of the following is a proper technique for use of a speculum during a vaginal examination? 43. If your patient has nipple discharge, you will most likely need a: 44. Cranial nerve XII may be assessed in an infant by: 45. The difference in blood pressure readings between the right and the left arms is considered normal up to _____ mm Hg. 46. During chest assessment, you note the patient's voice quality while auscultating the lung fields. The voice sound is intensified, there is a nasal quality to the voice, and the e's sound like a’s. This sound is indicative of: 47. Kawasaki disease is suspected when assessments of a child reveal: 48. The Denver II is a tool used to determine: 49. Montgomery tubercles are most prominent in the breasts of: 50. Electrical activity recorded by the electrocardiogram (ECG) tracing that denotes the spread of the stimulus through the atria is the: 51. Which of the following statements is true regarding the examination of peripheral arteries? 52. When palpating breast tissue, the examiner should use the _____ at each site. 53. A common finding in markedly obese and pregnant women is: 54. Inspection of the scrotum should reveal: 55. When conducting a geriatric assessment, basic activities of daily living (ADLs) include: 56. A patient in the deepest coma would be scored a _____ on the Glasgow Coma Scale. 57. If pitting edema is unilateral, you would suspect occlusion of a: 58. In the adult, the apical impulse should be most visible when the patient is in what position? 59. A 12-year-old boy relates that his left scrotum has a soft swollen mass. The scrotum is not painful upon palpation. The left inguinal canal is without masses. The mass does transilluminate with a penlight. This collection of symptoms is consistent with: 60. You are conducting a preparticipation physical examination for a 10-year-old girl with Down syndrome who will be playing basketball. She has slight torticollis and mild ankle clonus. What additional diagnostic testing would be required for her? 61. Anterior cruciate ligament integrity is assessed via the_Lachmanstest. 62. The strength of the trapezius muscle is evaluated by having the patient: 63. It is especially important to test for ankle clonus if: 64. Diabetic peripheral neuropathy will likely produce: 65. To assess spinal levels L2, L3, and L4, which deep tendon reflex should be tested? 66. Breath sounds normally heard over the trachea are called: 67. Tarry black stool should make you suspect: 68. The checkout station for pre-participation physical evaluation (PPE) is critical because at this point: 69. Nancy Walker is a 16-year-old girl who presents to the clinic with complaints of severe, acute chest pain. Her mother reports that Nancy, apart from occasional colds, Nancy is not prone to respiratory problems. What potential risk factor is most important to assess with regards to Nancy's current problem? 70. The best way to ease the apprehension of a 3-year-old child before a physical examination is to: 71. To assess a cremasteric reflex, the examiner strokes the: 72. The goals of pre-participation sports evaluation include: 73. Your 15-year-old patient is athletic and thin. Radiography of an ankle injury reveals a stress fracture. You should question this patient about her: 74. One of the most important aspects to consider in the orthopedic screening examination is: 75. If a patient cannot shrug the shoulders against resistance, which cranial nerve (CN), requires further evaluation? 76. While interviewing a 70-year-old female clinic patient, she tells you that she takes ginkgo biloba and St. John's wort. You make a short note to check for results of the: 77. Part of the screening orthopedic component of the examination includes evaluating the person while he or she is: 78. Which one of the following techniques is used to detect a torn meniscus? 79. Which medical condition would exclude a person from sports participation? 80. The musculoskeletal examination should begin when: 81. The spread of the impulse through the ventricles (ventricular depolarization) is depicted on the ECG as the: 82. The examiner percusses for diaphragmatic excursion along the: 83. Functional assessment is most important during the examination of a(n): 84. You are conducting an examination of Mr. Curtis's heart and blood vessels and auscultate a grade III murmur. 85. When assessing a 17-year-old for nuchal rigidity, you gently raise his head off the examination table. He involuntarily flexes his hips and knees. To confirm your suspicions associated with this positive test, you would also perform a test for the _____ sign. 86. Bimanual examination of the uterus includes: 87. The finger-to-nose test allows assessment of: 88. A pulsation that is diminished to the point of being barely palpable would be graded as: 89. As Mr. B. enters the room, you observe that his gait is wide based and he staggers from side to side while swaying his trunk. You would document Mr. B.'s pattern as: cerebellar ataxia 90. In the most effective percussion technique of the posterior lung fields, the patient cooperates by: 91. When assessing superficial pain, touch, vibration, and position perceptions, you are testing: 92. Which portion of the physical examination is best done with the patient standing? 93. Ulnar deviation and boutonniere deformities are characteristic of: 94. The family history for a patient with joint pain should include information about siblings with: 95. When the Goodenough-Harris Drawing Test is administered to a child, the evaluator principally observes the: 96. A positive straight leg raise test usually indicates: 97. You are assessing Mr. Z.'s fluid volume status as a result of heart failure. If your finger depresses a patient's edematous ankle to a depth of 6 mm, you should record this pitting as: 98. An idiopathic spasm of arterioles in the digits is termed: 99. Nerves that arise from the brain rather than the spinal cord are called: 100. A cervical polyp usually appears as a: