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NURS-6512C-34/NURS-6512N-34-Advanced Health Assessment- 2021-Summer

Exam – Week 11 August 2021

100 out of 100 points

1. When conducting a geriatric assessment, basic activities of daily living (ADLs) include:
2. When palpating breast tissue, the examiner should use the at each site.
3. You are reviewing an ECG of a 43 year old new patient. The patient has a history of second-degree heart block. The ECG shows the PR interval is increases with each beat until a QRS is dropped. What is this type of block called?
4. Throughout the history and physical examination, the clinician should:
5. The spread of the impulse through the ventricles (ventricular depolarization) is depicted on the ECG as the:
6. You are inspecting the genitalia of an uncircumcised adult male. The foreskin is tight and cannot be easily retracted. You should:
7. Loss of immediate and recent memory with retention of remote memory suggests:
8. To hear diastolic heart sounds, you should ask patients to:
9. 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:
10. To spread the breast tissue evenly over the chest wall, you should ask the woman to lie supine with:
11. A pulsation that is diminished to the point of being barely palpable would be graded as:
12. Which of the following statements is true regarding the examination of peripheral arteries?
13. You order an ECG on a patient that c/o feeling heart palpitations, chest pain, shortness of breath. Your ECG shows irregular heart rate and you determine that you need to call EMS immediately because this rhythm can cause death. What rhythm would you suspect the ECG is showing?
14. Breath sounds normally heard over the trachea are called:
15. The checkout station for preparticipation physical evaluation (PPE) is critical because at this point:
16. Palpation of epitrochlear nodes is part of the:
17. A positive straight leg raise test usually indicates:
18. A chest radiography is performed on your patient that complains of having dyspnea, coughing productive sputum and chest pain. The image results shows consolidation and infiltrates. You compare this to your physical exam findings of distant or absent breath sounds and absent vocal fremitus. What is the most likely diagnosis?
19. The Mini-Mental State Examination:
20. A 62 year old female presents to the clinic with complains of chest pain and heart palpitations that started 3 days ago. Patient states she is healthy and only has a history of hypertension and tachycardia. Patient is currently taking Norvasc 10mg daily and Coreg 6.25 mg BID. You order an EKG and it shows heart rate above 200 beats/min and the ECG may look like a sawtooth cog.

What is the most likely diagnosis of this patient?

21. Anterior cruciate ligament integrity is assessed via the test.
22. Which one of the following techniques is used to detect a torn meniscus?
23. Recent unilateral inversion of a previously everted nipple suggests:
24. 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:
25. A common finding in markedly obese and pregnant women is:
26. A cervical polyp usually appears as a:
27. Bimanual examination of the uterus includes:
28. If your patient has nipple discharge, you will most likely need a:
29. The foramen ovale should close:
30. 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:
31. A patient in the deepest coma would be scored a on the Glasgow Coma Scale.
32. If pitting edema is unilateral, you would suspect occlusion of a:
33. A finding that is indicative of osteoarthritis is:
34. 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:
35. The reliability of health-related findings and observations is the responsibility of the:
36. Which cranial nerves are usually evaluated during the examination of the eyes?
37. An apical PMI palpated beyond the left fifth intercostal space may indicate:
38. Adrian Thompson is a 19-year-old girl who presents to the clinic with complaints of severe, acute chest pain. Her mother reports that Andrian, apart from occasional sinus infections, Andrian is not prone to respiratory problems. What potential risk factor is most important to assess with regards to Adrian’s current problem?
39. When the Goodenough-Harris Drawing Test is administered to a child, the evaluator principally observes the:
40. Inquiry about nocturnal muscle spasms would be most significant when taking the musculoskeletal history of:
41. An ophthalmoscopic eye examination involves:
42. One of the most important aspects to consider in the orthopedic screening examination is:
43. Examination of the patient in the lithotomy, or knee-chest, position includes:
44. If a patient cannot shrug the shoulders against resistance, which cranial nerve (CN) requires further evaluation?
45. The rectal past medical history of all patients should include inquiry about:
46. Tarry black stool should make you suspect:
47. Electrical activity recorded by the electrocardiogram (ECG) tracing that denotes the spread of the stimulus through the atria is the:
48. 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.
49. Darian is a 14-year-old adolescent who states his right testicle has a soft swollen mass. The testicle is not painful upon palpation. The right inguinal canal is without masses. The mass does transilluminate with a penlight. This collection of symptoms is consistent with:
50. 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:
51. The Mini-Mental State Examination should be administered for the patient who:
52. You are examining a patient in the emergency department who has recently sustained head trauma. In order to initially assess this patient’s neurologic status, you would:
53. 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:
54. 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?
55. It is especially important to test for ankle clonus if:
56. Assessing orientation to person, place, and time helps determine:
57. When assessing superficial pain, touch, vibration, and position perceptions, you are testing:
58. Kawasaki disease is suspected when assessments of a child reveal:
59. Diabetic peripheral neuropathy will likely produce:
60. The Denver II is a tool used to determine:
61. A red, hot swollen joint in a 40-year-old man should lead you to suspect:
62. Your patient’s chief complaint is repeated pencil-like stools. Further examination should include:
63. In the adult, the apical impulse should be most visible when the patient is in what position?
64. A 56-year-old male presents to the clinic to see the nurse practitioner with complaints of shortness of breath for 1 months, 15-pound weight gain and lower extremity edema. Vitals are as follows: HR: 120, Respirations 30, Blood Pressure: 138/90, BMI: 40; Oxygen saturation of 90%. On examination patient is noted to have jugular venous distention, enlarged liver, and crackles are noted on examination. A chest x-ray is completed and shows findings consistent with which diagnosis? Based on this scenario and imaging what is the most likely diagnosis?
65. 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:
66. 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:
67. When is the mental status portion of the neurologic system examination performed?
68. Which condition is considered progressive rather than reversible?
69. To assess a cremasteric reflex, the examiner strokes the:
70. An idiopathic spasm of arterioles in the digits is termed:
71. Which medical condition would exclude a person from sports participation?
72. The musculoskeletal examination should begin when:
73. While collecting personal and social history data from a woman complaining of breast discomfort, you should question her regarding:
74. When palpating joints, crepitus may occur when:
75. The presence of cervical motion tenderness may indicate:
76. Which portion of the physical examination is best done with the patient standing?
77. The goals of preparticipation sports evaluation include:
78. Facial muscle or tongue weakness may result in:
79. Ulnar deviation and boutonniere deformities are characteristic of: Selected rheumatoid
80. You are conducting an examination of Mr. Curtis’s heart and blood vessels and auscultate a grade III murmur. The intensity of this murmur is:
81. At your first meeting with a patient, it is usually best to say:
82. To assess spinal levels L2, L3, and L4, which deep tendon reflex should be tested?
83. 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:
84. Which one of the following is a proper technique for use of a speculum during a vaginal examination?
85. Breath odors may clue the examiner to certain underlying metabolic conditions. The odor of ammonia on the breath may signify:
86. 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.
87. Part of the screening orthopedic component of the examination includes evaluating the person while he or she is:
88. 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?
89. 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:
90. Palpation of a normal prostate in an older adult is likely to feel:
91. Functional assessment is most important during the examination of a(n): Selected older
92. 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:
93. Nerves that arise from the brain rather than the spinal cord are called:
94. For purposes of examination and communication of physical findings, the breast is divided into:
95. The finger-to-nose test allows assessment of:
96. The strength of the trapezius muscle is evaluated by having the patient:
97. 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:
98. The physical assessment technique most frequently used to assess joint symmetry is:
99. 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:
100. A 40 yr old female presents to the clinic with complaints of low back and buttock pain. Pt states the buttock pain radiates from one side to the other. On examination, the patient is noted to have limited ROM of the shoulders, chest wall, hips, and knees. Upon xray, you find gross postural changes and there is a severe deformity of the vertebral column. What is the most likely diagnosis for this patient?