Bundle
Package Deal For Advanced Health Assessment HESI Exam Questions and Answers( Well Researched Questions and Answers)
10 Items
ADVANCED HEALTH ASSESSMENT EXAM 1
What is suggested when touch and position sense are normal or only slightly impaired, and there is a disproportionate decrease in, or loss of, discriminati... [Show More] ve sensations? - correct answer suggests disease of the sensory cortex. Stereognosis, number identification, and two-point discrimination are impaired in? - correct answer posterior column disease. What does primary headaches include? - correct answer migraine, tension, cluster, and chronic daily headaches Where does secondary headaches arise? - correct answer secondary headaches arise from underlying structural, systemic, or infectious causes and may be life threatening What is a symptom of a subarachnoid hemorrhage? - correct answer "the worst headache of my life." What are the signs/symptoms of meningitis? - correct answer Severe headache and stiff neck Dull headache increased by coughing and sneezing, especially in the same location, occurs in? - correct answer mass lesions from brain tumors or abscess Migraine headaches - correct answer *often preceded by an aura or prodrome. *is highly likely if three of the five "POUND" features are present: -Pulsatile or throbbing; -One-day duration, or lasts 4 to 72 hours if untreated -Unilateral -Nausea or vomiting -Disabling or intensity causing interruption of daily activity. Optic discs that are bulging with blurred margins is indicative of? - correct answer papilledema Pallor optic discs is indicative of? - correct answer optic atrophy cup enlargement is indicative of? - correct answer glaucoma Rinne Test assesses? - correct answer air and bone conduction AC>BC Weber Test assesses? - correct answer lateralization Sensorineural testing assess? - correct answer cochlear branch of CN VIII What might cause conductive hearing loss? - correct answer Excess cerumen, otosclerosis, and otitis media What might cause sensorineural hearing loss? - correct answer presbyacusis from aging Vertigo with hearing loss and nystagmus typifies? - correct answer Ménière's disease The palate would fail to rise with a bilateral lesion of which CN? - correct answer CN X An absence of the gag reflex with unilateral absence of an elevation of the tounge and palate suggests a lesion of which CNs? - correct answer CN IX, and perhaps CN X If the protruded tongue deviates transiently in a direction away from the side of the cortical lesion, toward the side of weakness, this is indicative of? - correct answer a unilateral cortical lesion what is a sign of carpal tunnel syndrome? - correct answer weak opposition of the thumb Look for ___ in cerebellar disease - correct answer nystagmus, dysarthria, hypotonia, ataxia. A gait that lacks coordination, with reeling and instability, is called? - correct answer ataxia Hyperactive reflexes (hyperreflexia) - correct answer are seen in central nervous system lesions along the descending corticospinal tract. Look for associated upper motor neuron findings of weakness, spasticity, or a positive Babinski sign. Hypoactive or absent re exes (hyporeflexia) - correct answer are seen in diseases of spinal nerve roots, spinal nerves, plexuses, or peripheral nerves. Look for associated findings of lower motor unit disease, namely weakness, atrophy, and fasciculations. How would a lethargic patient look? - correct answer A lethargic patient appears drowsy but opens the eyes and looks at you, responds to questions, and then falls asleep. How would an obtunded patient look? - correct answer An obtunded patient opens the eyes and looks at you but responds slowly and is somewhat confused. Alertness and interest in the environment are decreased. How would a stuporous patient look? - correct answer A stuporous patient arouses from sleep only after painful stimuli. Verbal responses are slow or even absent. The patient lapses into an unresponsive state when the stimu- lus ceases. There is minimal aware- ness of self or the environment. How would a comatose patient look? - correct answer A comatose patient remains unarousable with eyes closed. There is no evident response to inner need or external stimuli Aphonia - correct answer refers to a loss of voice that accompanies disease affecting the larynx or its nerve supply. Dysphonia - correct answer 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. Causes include laryngitis, laryngeal tumors, and a unilateral vocal cord paralysis (CN X). Dysarthria - correct answer refers to a defect in the muscular control of the speech apparatus (lips, tongue, palate, or pharynx). Words may be nasal, slurred, or indistinct, but the central symbolic aspect of language remains intact. Causes include motor lesions of the central or peripheral nervous system, parkinsonism, and cerebellar disease. Aphasia - correct answer refers to a disorder in producing or understanding language. It is often caused by lesions in the dominant cerebral hemisphere, usually the left. Nystagmus - correct answer is a rhythmic oscillation of the eyes, analogous to a tremor in other parts of the body. It has multiple causes, including impairment of vision in early life, disorders of the labyrinth and the cerebellar system, and drug toxicity. Nystagmus occurs normally when a person watches a rapidly moving object (e.g., a passing train). Thunderclap headaches - correct answer reaching maximal intensity over several minutes occur in 70% of patients with subarachnoid hemorrhage, and are often preceded by a sentinel leak headache from a vascular leak into the subarachnoid space. If headache is severe and of sudden onset, consider? - correct answer subarachnoid hemorrhage or meningitis. Characteristics of migraine and tension headaches - correct answer Migraine and tension headaches are episodic and tend to peak over several hours. *New and persisting, progres- sively severe headaches raise concerns of tumor, abscess, or mass lesion. Unilateral headache occurs in? - correct answer migraine and cluster headaches Where do tension headaches often arise? - correct answer in the temporal areas cluster headaches - correct answer may be retro-orbital (situated or occurring behind the orbit of the eye). Medication for overuse headache is indicated if? - correct answer is indicated if present ≥15 days a month for three months and reverts to <15 days a month when the medication is discontinued bilateral visual loss that is gradual can indicate - correct answer cataracts or macular degeneration Slow central visual loss can occur in - correct answer -macular degeneration, nuclear cataract peripheral visual loss can occur in - correct answer advanced open-angle glaucoma Has the patient seen lights flashing across the field of vision? - correct answer Flashing lights or new vitreous floaters suggest detachment of vitreous from retina. **Prompt eye consultation is indicated. [Show Less]
- Exam
- $13.95
- 0
- 111
HEALTH ASSESSMENT PRACTICE QUESTIONS
Which is not a skills requisite? A: Inspection B: Palpation C: Vital signs D: Percussion - correct answer C: Vital Signs What are some things you ar... [Show More] e looking for during palpation? - correct answer Temperature, Moisture, Texture, Lumps Over what tissue would you expect to hear resonance? A: Stomach B: Lungs C: Brain D: Bones - correct answer B: Lungs Over what tissue would you expect to hear tympany? A: Lungs B: Bone C: Brain D: Stomach - correct answer D: Stomach Over what tissue would you expect to hear a dull sound? A: Stomach B: Bone C: Liver D: Lungs - correct answer C: Liver Over what tissue would you expect to hear a flat sound? A: Lung B: Bone C: Muscle D: Stomach E: B&C - correct answer E: Bone & Muscle When is NOT best to use the diaphragm of the stethoscope? A: Heart murmur B: Breathing C: Bowl sounds D: High-pitched - correct answer A: Heart murmer How should you listen to heart and lung sounds? A: Over a gown B: Touching the skin - correct answer B: Touching the skin What position is correct for inserting a rectal suppository? A: Lithotomy B: Sims C: Dorsal Recumbent D: Supine - correct answer B: Sims Taking an axillary temperature on an adult will result in a temperature reading that is: A: One degree lower B: Accurate C: One degree higher D: Same as Oral - correct answer A: One degree lower What is a full & bounding pulse force? A: 3+ B: 2+ C: 1+ D: 0 - correct answer A: 3+ What is inversely related to blood pressure? A: Cardiac output B: Viscosity C: Elasticity D: Peripheral vascular resistance - correct answer C: Elasticity What category of blood pressure is 142/95? A: Normal B: Prehypertension C: Hypertension I D: Hypertension II - correct answer C: Hypertension I Which describes orthostatic blood pressure? A: A rise in systolic pressure by 10 mmHg B: A drop in Diastolic pressure by 10 mmHg C: A drop in systolic pressure by 10 mmHg D: A drop in diastolic pressure by 5 mmHg - correct answer B: A drop in diastolic pressure by 10 mmHg My blood pressure is 116/62. What is my pulse pressure? A: 20 B: 32 C: 63 D: 54 - correct answer D: 54 What is my cardiac output if my heart rate is 60bpm and my blood pressure is 120/72? A: 5.7L B: 6.1L C: 4.8L D: 5.0L - correct answer A: 5.7L At what phase would you hear muffling in Korotkoffs? A: Phase I B: Phase II C: Phase III D: Phase IV - correct answer D: Phase IV Which would not higher blood pressure? A: Anxiety B: Small cuff size C: Large cuff size D: Thigh blood pressure - correct answer C: Large cuff size What causes an auscultatory gap? A: Hypertension B: Arterial wall stiffness C: Both A&B D: Neither - correct answer C: Both A&B How should you take an infants temperature? A: Rectal B: Oral C: Axillary D: Temporal - correct answer C: Axillary What things should you look for during a health history? A: Physical Appearance B: Body Structure C: Mobility D: Behavior E: all of the above - correct answer E: ALl What percent of your diet should carbohydrates be? A: 40% B: 50% C: 60% D: 20% - correct answer B: 50% When does general survey begin? A: When you first look at the patient B: When you are looking through the patients chart C: After the meeting D: None of these - correct answer A: When you first look at the patient Which is not a primary lesion? A: Macule B: Papule C: Pustule D: Keloid - correct answer D: Keloid Which of the following do not go together? A: Macule & Patch B: Vesicle & Bulla C: Wheal & Cyst D: Nodule & Tumor - correct answer C: Wheal & Cyst What is a freckle an example of? A: Macule B: Papule C: Cyst D: Vesicle - correct answer A: Macule Which is related to shingles? A: Macule B: Vesicle C: Nodule D: Plaque - correct answer B: Vesicle Which is related to psoriasis? A: Plaque B: Patch C: Wheal D: Bulla - correct answer A: Plaque A patient comes in a has a crack in on his big toe. He tells you that he spends a lot of time doing yard work outside and is very sweaty. When you look at the crack it appears to travel into the dermis. It is most likely a: A: Scar B: Papule C: Keloid D: Fissure - correct answer D: Fissure A patient comes in with a spider angioma spot. This could indicate the patient has: A: Liver disease B: Diabetes C: Vitamin A Deficiency D: COPD - correct answer A: Liver disease A patient comes in with worry of edema. While assessing, you notice they show deep pitting that indents for a short time. This is: A: 1+ B: 2+ C: 3+ D: 4+ - correct answer C: 3+ A patient with edema would show what kind of turgor? A: Delayed B: Fast - correct answer B: Fast Which of the following is not a benign lesion? A: Freckles B: Cherry angioma C: Mongolian spot D: Malignant melanoma - correct answer D: Malignant melanoma A 56-year-old patient comes in with worry about her skin color change. She has noticed her hands have become a purple color. This would most likely be: A: Senile prupura B: Cherry angioma C: Spider angioma D: Bulla - correct answer A: Senile prupura What disease is associated with clubbing of the nails? A: Diabetes B: Hypothyroidism C: Pulmonary Disease D: Vitamin D deficiency - correct answer C: Pulmonary Disease ** Also cyanotic heart disease & lung cancer What would a capillary refill of more than 3 seconds indicated? A: Edema B: poor circulation C: inflammation D: Anxiety - correct answer B: poor circulation A patient with hyperthyroidism would have what type of hair? A: Dry B: Alopecia C: Blond D: Fine - correct answer D: Fine **Dry is hypo A patient is being assessed for their level of consciousness. When assessing their eyes, the patient only reacts to pain. What rating would this be? A: 4 B: 3 C: 2 D: 1 - correct answer C: 2 A patient is being assessed for their level of consciousness. When testing their motor responses, it is found the patient presents a Add to decerebrate pose. This is: A: Side lying B: Prone with elbows flexed C: Prone with elbows extended D: Supine - correct answer C: Prone with elbows extended What would the mini-mental state exam most likely test for? A: Substance abuse B: Anxiety C: Cognition D: Depression - correct answer C: Cognition What are things you would look for with Behavior & Physical Cues? A: Mood & affect B: Body Language C: Facial Expressions D: Speech patterns E: all of the above - correct answer E: All of the above What would you not look for with speech and language? A: Pace B: Articulation C: Word choice D: Accent - correct answer D: Accent What does ABCT stand for? - correct answer Appearance, Behavior, Cognitive function, Thought process What is ABCT used for? A: Mental Health Assessment B: Glascows Coma Scale C: Substance abuse D: Interpersonal Violence - correct answer A: Mental Heaht Assessment What does AUDIT test for? A: Alcohol problems B: Bullying C: Speech development D: Danger - correct answer A: Alcohol problems What does CAGE test for? A: Bullying B: Lifetime alcohol abuse C: Domestic violence D: Cognitive impairment - correct answer B: Lifetime alcohol abuse How many drinks per day can a male have for it to be considered moderate? A: 2 B: 3 C: 4 D: 5 - correct answer A: 2 Is it safe to consume alcohol while pregnant? A: Yes B: In the first trimester C: In the third trimester D: No - correct answer D: No Where does the apex of the lungs start? A: Clavicle B: C7 C: T1 D: Anterior Scapula - correct answer B: C7 A patient comes in and claims they smoke 3 packs a day. The patients states this started 20 years ago. What is their pack year? A: 30 B: 45 C: 50 D: 60 - correct answer D: 60 There is negative pressure in the pleural space during: A: Expiration B: Wheezing C: Inspiration D: Syncope - correct answer C: Inspiration There is greater lung pressure than atmospheric pressure during: A: Expiration B: Inhalation C: Vertigo D: COPD - correct answer A: Expiration Which is not a sign of difficulty breathing? A: Abdominal breathing B: Nasal Flaring C: Eupneic breaths D: Anxiety E: Retractions - correct answer C: Eupneic Breaths A patient comes in and shows periods of increased depth interspersed with apnea. This is most likely related to: A: Bradypnea B: Biot C: Cheyne-Stokes D: Ataxic - correct answer C: Cheyne-Stokes A patient comes in and shows a breathing pattern that is deep and greate than 20 breaths per [Show Less]
- Exam
- $13.95
- 0
- 88
N5220 ADVANCED HEALTH ASSESSMENT
In which age group are milia an expected finding? A. Newborns B. Young children C. Adolescents D. Older adults - correct answer A On palpation... [Show More] of an older individual's skin, you observe "tenting." Which of the following would be most appropriate for you to do in regard to this condition? A. Have the individual further evaluated for dehydration. B. Refer the client for punch biopsy of the skin. C. Inform the individual to be especially vigilant in self-screening for skin cancer. D.Observe the skin carefully for other manifestations of loss of skin integrity. - correct answer A Skin color is dependent on which of the following cells? A. Carotenocytes B. Melanocytes C. Dermatocytes D. Keratinocytes - correct answer B Wrinkling of the skin is less marked in individuals who: A. are obese. B. demonstrate premature graying. C. are white. D. have overactive sebaceous and sweat gland activity. - correct answer A Molding of the infant's head is caused by: A. premature closure of the fontanels. B. shifting and overlapping of the skull bones during birth. C. subperiosteal edema. D. increased cerebrospinal fluid. - correct answer B In addition to the head, neck, axilla, and inguinal areas, the examiner may also assess lymph nodes: A. on the palmar aspect of the hands. B. in the popliteal region. C. in the patellar region. D. on the dorsum of the foot. - correct answer B When you ask the patient to clench the teeth and then to smile, which cranial nerve are you testing? A. Trochlear B. Abducens C. Facial D. Vagus - correct answer C The color of the nasal mucosa should appear: A. deep pink. B. red. C. bluish gray. D. pale pink. - correct answer A The pneumatic attachment to the otoscope is used to evaluate which characteristic of the tympanic membrane? A.Vibrations B.Mobility C.Tension D.Strength - correct answer B A tympanic membrane that is retracted is also more: A. concave. B. convex. C. impacted. D. dilated. - correct answer A To which problem are older individuals more prone? A. Increased sensitivity to tastes B. Hyperactivity of the salivary glands C. Decreased salivation D. Edema of the tongue - correct answer C During the course of the interview, a patient indicates that he has been given the drug gentamicin (an aminoglycoside antibiotic) for an upper respiratory infection. Based on this information, you would check for which type of problem? A. Dizziness and vertigo B. Recurrent nosebleeds C. Hearing loss D. Oral lesions - correct answer C A function of cerumen in the ear canal is to provide: A. vibration. B. lubrication. C. sound transmission. D. adhesiveness. - correct answer B Which of the following situations is an indication for transillumination? A. The patient complains of epistaxis. B. The patient has crepitus with jaw movement. C. The parotid gland is palpable and tender. D. The patient complains of pain over the sinuses with palpation - correct answer D Which finding is most likely to cause an examiner to suspect a foreign object in the nose of a young child? A. There is a purulent discharge from the child's nose. B. The turbinates appear bluish gray and boggy. C. The child cries when the soft tissue of the nose is palpated. D. Unilateral nasal flaring is present. - correct answer A In the older adult patient, stature begins to decline at: A. 40 years of age. 50 years of age. 60 years of age. 70 years of age. - correct answer Present problem - correct answer Step-by-step evaluation of circumstances Focused history - correct answer Taken during an acute situation requiring immediate attention Interim history - correct answer A chronicle of events since last meeting with the patient Chief complaint - correct answer Brief description of the perceived problem Medical history - correct answer Previous childhood and adult illness Social history - correct answer Education, home environment, hobbies Inventory history - correct answer Touches on major points of concern without detail Systems review - correct answer Organized physiologic data Family history - correct answer Pedigree diagram or genogram Complete history - correct answer A history completed the first time a patient is seen A 4x3cm rough, elevated area of psoriasis is an example of - correct answer plaque A musical squeaking noise heard b auscultation of the lungs is called - correct answer wheezing An apical PMI palpated beyond the left fifth intercostal space indicated - correct answer left ventricular enlargement Behavior approved by the group standards is - correct answer the norm Blood pressure - correct answer is a peripheral measurement of cardiovascular function Coarse, dry, brittle hair is associated with which metabolic disorder - correct answer hypothyroidism Contraction of the ventricles causes - correct answer closure of the mitral and tricuspid valves If the apical pulse is more vigorous than expected to the chest wall, it is called - correct answer heave or lift In barrel chest, the ratio of the AP diameter to the transverse is - correct answer equals 1.0:1.0 or greater Mr. Harris is a 42-year-old patient who is evaluated in the clinic. Currently he is on disability and his diet is poor. You are concerned that he has a vitamin C deficiency. Which of the following foods would increase his vitamin C intake? - correct answer Raw green vegetables Painful vesicles are associated with - correct answer herpes zoster Skin turgor checks are performed in order to determine - correct answer hydration To palpate inguinal nodules, you should have the patient - correct answer lie supine with the knee slightly flexed When examining a infant's middle ear the practitioner should use one hand to stabilize the otoscope against the head while using the other hand to - correct answer pull the auricle down Where would the nurse palpate when assessing the submental lymph nodes? - correct answer Midline behind the tip of the mandible When hearing is being tested what cranial nerve is being tested? - correct answer VIII Which is a function of Vitamin D? - correct answer Helps enzymes that aid in calcium absorption Which statement best describes the role of Vitamin E in the human body? - correct answer Protects cell membranes from oxidation Which statement best describes the chief complaint? A. General health and illness B. The reason the individual is seeking care C. Information to make the diagnosis D. Concerns about confidentiality and trust - correct answer B A conversation with a parent concerning a 5-year-old child: A. violates the child's need for privacy. B. is inappropriate because the child is able to talk with you. C. provides significant information about family dynamics. D. causes distrust in the child toward the examiner. - correct answer C J.F. shares with you that he has an uncle and a brother with sickle cell disease. Where would this information best be documented? A. Chief complaint B. Medical history C. Social history D. Family history - correct answer D A mother runs into the emergency department with her 6-year-old son. She says that her son fell 15 feet from a tree. The child is screaming and has an open fracture of the left forearm. You would conduct a(n): A. complete history. B. focused history. C. problem-oriented history. D. interim history. - correct answer B Some older adults may have sensory losses that make communication more difficult. Some degree of hearing loss is common in older adults. One action that tends to worsen hearing or communication problems is: A. positioning yourself so the patient is looking at your face. B. speaking clearly and slowly. C. using a high-pitched voice. D. avoiding noisy interviewing rooms. - correct answer C A health care provider develops a cultural knowledge base to: A. anticipate the patient's adherence to a treatment plan. B. predict behaviors and attitudes. C. understand the behaviors, practices, and problems observed. D. change undesirable behavior or practices to conform to health care practice. - correct answer C A common mistake made by health care professionals is to: A. acknowledge the practice of folk or herbal remedies. B. adapt health care concepts to meet the needs of individuals of other cultures. C. stereotype individuals based on their color or ethnic group. D. overestimate the ability of individuals from diverse cultures to understand health care concepts. - correct answer C Cultural beliefs and behaviors that will have an effect on your assessment of the patient include which of the following? A. Diet and nutritional practices. B. The nature of relationships within a family C. Modes of communication: the uses of speech, body language, and space D. All of the above - correct answer D What part of the hand is best for the examiner to use to palpate a superficial mass detected in the skin? A. Finger pads B. Heel of the hand C. Dorsal surface of the hand D. Ulnar surface of the hand - correct answer A According to the Centers for Disease Control and Prevention, the health care provider should apply infection control measures to which group of patients? A. Patients with a known infectious disease B. Patients with a possible infectious disease C. Patients who appear ill D. All patients regardless of their infectious status - correct answer D In which of the following situations is transillumination an appropriate examination technique? A. Assessment of vesicles on the skin B. Detection of fluid within the sinuses C. Measurement of bone density in the skull D. Determination of a mass in the abdomen - correct answer B Temperature changes are best assessed by: A. the ulnar surface of the hand. B. the dorsal aspect of the hand. C. the tips of the fingers. D. the ventral aspect of the fingers. - correct answer B During auscultation of a patient's heart, the sounds from the TV are interfering with adequate hearing of the heart sounds. Which of the following options would be best in this situation? A. Ask the patient to turn off/mute the TV for a couple of minutes. B. Turn up the sound on the stethoscope. C. Come back when the TV is off. D. Skip the auscultation examination for this time. - correct answer A How is a blood pressure reading affected if a wide adult cuff is used on a small child? A. Blood pressure readings will be lower. B. Blood pressure readings will be higher. C. Systolic readings will be falsely high and diastolic falsely low. D. Blood pressure readings will be variable because correct cuff size is a matter of comfort. - correct answer A Pain has been referred to as the fifth vital sign. Which statement is true of pain and its management? A. Pain is exclusively a physiologic response. B. The patient determines what is an unacceptable pain level. C. Tolerance and addiction to pain medication are universal phenomena. D. There is a single cause of pain for each patient. - correct answer B In the older adult patient, stature begins to decline at: A. 40 years of age. B. 50 years of age. C. 60 years of age. D. 70 years of age. - correct answer B Which occurrence marks the completion of skeletal growth? A. Fused epiphyses of long bones B Eighteenth birthday C. Fused epiphyses of all bones D. Fifteenth birthday - correct answer A A baby's height, until 2 years of age, is measured by: A. the recumbent length. B. stadiometer. C. height weight parameters. D. skinfold thickness. - correct answer A Which factor accounts for the decline in stature of an older adult? A. Increased trifold skin thickness B. Decreased weight compared with height C. Kyphosis D. Decreased muscle mass - correct answer C The tool that uses physical and neuromuscular findings to confirm the gestational age of a newborn is: A. the Keating Fetal Assessment. B. the Ballard Clinical Assessment. C. the Winslow Fetal Growth Assessment. D. all of the above. - correct answer B A history of an individual's food intake is important because it: A. allows estimation of the adequacy of the diet. B. identifies foods from the food pyramid. C. compares the recommended dietary allowances to the US Department of Agriculture food pyramid. D. compares diet and exercise. - correct answer A A skin lesion that may be associated with neurofibromatosis or pulmonary stenosis is: A. café au lait spots. B. nevus vasculosus. C. port wine limb stain. D. spider angioma. - correct answer A Which of the following techniques helps the examiner determine whether a palpable skin mass is filled with fluid? A. Using a Wood's lamp B. Biopsy C Transillumination D. Noting the odor of the lesion - correct answer C Which of the following findings suggests that a patient has a fungal infection of the nail beds? A. The nail bed is wide and thick. B The nail plate has a central depression, causing a spoon appearance. C. Superficial white spots are present in the nail plate. D. The nail plate is yellow and crumbling. - correct answer D Skin color is dependent on which of the following cells? A. Carotenocytes B. Melanocytes C. Dermatocytes D. Keratinocytes - correct answer B Wrinkling of the skin is less marked in individuals who: A. are obese. B. demonstrate premature graying. C. are white. D. have overactive sebaceous and sweat gland activity. - correct answer A On palpation of an older individual's skin, you observe "tenting." Which of the following would be most appropriate for you to do in regard to this condition? A. Have the individual further evaluated for dehydration. B. Refer the client for punch biopsy of the skin. C. Inform the individual to be especially vigilant in self-screening for skin cancer. D. Observe the skin carefully for other manifestations of loss of skin integrity. - correct answer A Mr. Jones is a 55-year-old gentleman with diabetes. To visualize his macula, the examiner should ask Mr. Jones to: A. blink the eye several times quickly. B. lie in a supine position. C. look directly into the light of the ophthalmoscope. D. direct eye gaze on an object to the left and then to the right. - correct answer C Which is the correct technique for performing a fundoscopic examination with a traditional ophthalmoscope? Examine the patient's: A. right eye with your right eye, and the left eye with your left eye. B. right eye with your left eye, and the left eye with your right eye. C. right and left eyes with your dominant eye. D. right and left eyes with your nondominant eye. - correct answer A Which of the following cranial nerves directly connects the eye to the brain? A. Abducens B. Trochlear C. Optic D. Oculomotor - correct answer C Which finding is most likely to cause an examiner to suspect a foreign object in the nose of a young child? A. There is a purulent discharge from the child's nose. B. The turbinates appear bluish gray and boggy. C. The child cries when the soft tissue of the nose is palpated. D. Unilateral nasal flaring is present. - correct answer A A function of cerumen in the ear canal is to provide: A. vibration. B. lubrication. C. sound transmission. D. adhesiveness. - correct answer B To which problem are older individuals more prone? A. Increased sensitivity to tastes B. Hyperactivity of the salivary glands C. Decreased salivation D. Edema of the tongue - correct answer C A tympanic membrane that is retracted is also more: A. concave. B. convex. C. impacted. D. dilated. - correct answer A Which type of breath sounds are normally auscultated over most of the lung fields? A. Vesicular B. Bronchovesicular C. Bronchial D. Tubular - correct answer A Breath sounds normally heard over the trachea are called: [Show Less]
- Exam
- $13.95
- 0
- 87
EXAM 1 - ADVANCED HEALTH ASSESSMENT FALL 2013 AGMSN
Identify essential components of the health history - correct answer a. Identifying data and source of the history b. Chief complaint - use "quotes" from ... [Show More] patient c. Present illness - chronological order! • Medications, allergies, tobacco use, alcohol and drug use • 7 attributes (OLD CARTS) d. Past illness • Medical, surgical, Obstetric/gynecological, psychiatric • Health maintenance e. Family history f. Personal and social history g. Review of systems - Go through each one! Discuss scope of nursing assessment - correct answer Can be either: 1. Comprehensive Assessment 2. Focused Assessment What are the indications for and what is included in a Comprehensive Assessment? - correct answer a. Comprehensive assessment - a complete assessment. • Includes all elements of the health history and a complete physical assessment. • This is useful for new patients. • Gives a good baseline for future assessments. • Opportunity for health promotion. • Gives you a lot of information about the patient and also gives you time to build a relationship. What are the indications for and what is included in a Focused Assessment? - correct answer b. Focused assessment - is focused on the concern or the problem the patient presents with • Restricted to a specific body system or two • May be useful for an ongoing relationship once you established a baseline if there are no new concerns. Components of the Health History: Identifying Data and Source of the History; Reliability - correct answer a. Identifying data and source of the history: age, gender, occupation, marital status. Who is giving the information? How reliable is it? • Name/Age/Gender • Occupation • Marital status • Source of data (family member, parent) Gives you indication of reliability of the data Child vs. parent confused adult vs. the adult child or family member Components of the Health History: Chief Complaint(s) - correct answer b. Chief complaint: Symptoms that cause the patient to seek care • One or more symptoms causing them to seek care. • Use quotes from patient • Just a phrase Components of the Health History: Present Illness - correct answer c. Present illness: More details about the chief complaint. How long? What does it affect? How does the person feel? Have they done anything about it? • Amplifies the complaint • Symptoms—OLD CARTS Onset—when did it start Location Duration—how long Characteristics—what is it like? (burning, stabbing, etc.) Aggravating factors and Relieving factors Timing—when does it occur Severity—pain from 1-10? • Expands on the chief complaint • Describes how the symptoms develop • Thoughts and feelings about the illness • The "story" of the chief complaint • Medications • Allergies • Tobacco, alcohol and drug use Components of the Health History: Past History - correct answer d. Past illness: childhood illness, health practices. Medical, surgical, obstetrical/gynecological, psychiatric illnesses? Dates. • Childhood illnesses • Medical • Surgical • Obstetrical/gynecological • Psychiatric • Health maintenance practices Lifestyle Home safety Immunizations Screenings Components of the Health History: Family History - correct answer e. Family history: Genogram with health, illnesses, death, etc. Document the absence or presence of illnesses. Specifically ask about diabetes, cancers, HTN, CAD, heart disease, mental illness (especially things that are familial) • Genogram • Causes of death • Ages of death • Illnesses and health • Presence or absence of diseases - ask about key ones: Diabetes HTN CAD Genetics Components of the Health History: Personal and Social History - correct answer f. Personal and social history: educational level, family origin, current household, personal interests, lifestyle—alcohol, drugs? • Educational level • Family of origin, cultural influences • Who is in the household • Personal interests • Lifestyle • Sexual history-partners, frequency • Habits—drugs and alcohol • Nutrition, sleep, exercise • Religious preference • Military Components of the Health History: Review of Systems - correct answer g. Review of systems: go through each body system and document the presence and/or absence to each major body system. People forget things...so you will have to ask about each one and then examples of important illnesses or symptoms in each system. • Series of questions from head to toe: General (may include psychiatric) Skin HEENT (may include neurological) Neck Breasts Respiratory Cardiovascular Gastrointestinal Peripheral Vascular Urinary Genital Musculoskeletal Psychiatric Neurologic Hematologic Endocrine • Prepare the patient for the questions • Start general and then focus questions if there is a concern • Helps uncover problems the patient has overlooked • Be organized. Describe the steps of the process of gathering information - correct answer a. Prepare by considering your approach to the patient b. Professional dress and behavior c. Good lighting; Have all equipment ready d. Be organized, Taking notes? • Respect the patient - privacy, comfort e. Use a chronological and sequential approach f. Greet, establish rapport - Establish an agenda for the interview g. What is the patient's story? h. Respond to cues - Expand and clarify points Discuss interviewing techniques including ways to expand on client information. - correct answer a. Start with open ended questions to get the story of the symptoms b. Go to more specific questions related to the symptom c. End with yes/no questions about the symptoms d. Chronological! e. Techniques for interviewing: • Active listening • Empathetic responses • Guided questioning • Nonverbal communication • Validation • Reassurance • Partnering • Summarizing • Transitions • Empowering the patient Recognize ethical considerations in patient-examiner relationships - correct answer a. Cultural humility - self-awareness, respectful communication, collaborative relationships b. Sexuality - clinician and patient relationships c. Ethics and professionalism • Confidentiality • Non-maleficence or "first, do no harm" • Autonomy—patient's right to determine their care • Beneficence—provider needs to do good for the patient. d. Issues • Seduction • Anxiety • Excessive flattery • Financial concerns The "silent" patient - correct answer • Some issues may be painful to discuss • Tearful, unable to speak • Be attentive • Look for nonverbal cues • Are your questions too quick or offensive? "Altered" capacity - correct answer • Delirium, dementia or other health conditions • What is the decision making capacity? • Durable power of attorney or health care proxy? • Allow them to be fully involved to the limit of his/her ability. "Talkative" patient - correct answer • Let talk for 5-10 minutes and listen closely • Focus on what seems to be most important to the patient • Learn how to set limits when needed • Interrupt only if necessary "Crying" patient - correct answer • "I can see that you are not feeling well, it is alright to cry" • Silence or pausing • Gentle probing and respond empathetically • Be supportive • Give them a tissue Permission to cry "Confused" Patient - correct answer • Multiple symptoms • Neurological disorder? • Mental illness? • Dementia? • Intoxication? • Mental status exam • Family member help? "Angry" patient - correct answer • Face it • It may be displacement on to the HCP because of frustration, illness, or pain • Be calm • Avoid confrontation • No one is happy to be sick.... Describe the components of the clinical reasoning process - correct answer a. Clinical Reasoning - • This is what makes you a nurse - nursing is intellectual • Nurses make nursing diagnoses and use disease process to help with that b. Identify abnormal findings c. Localize findings anatomically d. Interpret findings in terms of a probable cause e. Make a hypothesis about the nature of the finding f. Test the hypothesis g. Develop a plan that is agreeable with the patient h. Use Evidence-based practice! 1. Identify the components of the general survey - correct answer a. Height and weight b. General appearance—by general inspection 2. Formulate health history questions for the general survey - correct answer a. Health history related to general survey • Changes in weight? • Fatigue and/or weakness? • Exercise, sleep, nutritional/diet history • Fever, chills, night sweats? • Pain? (use OLD CARTS) 3. Apply concepts of the general survey to patient situations: Height and Weight - correct answer a. Height and weight: • Height Measure in stocking feet Short or tall? Build (muscular? Slender?) Body symmetry and proportions/deformities • Weight Remove excess clothing and shoes Emaciated, slender, plump, obese? If obese, is fat distributed evenly or concentrated over trunk, upper torso, around the hips? Any rapid change in weight? (fluid retention?) • Calculating the body mass index (BMI) Normal BMI is 19-25. Obesity increases risk for HTN, DM, heart disease, stroke, sleep apnea, depression 3. Apply concepts of the general survey to patient situations: General Appearance - correct answer b. General appearance: • Apparent state of health Acute or chronically ill, frail Age appropriate? • Level of consciousness Awake, alert, responsive or lethargic, obtunded, comatose • Signs of distress Cardiac or respiratory; pain; anxiety/depression • Skin Lesions, turgor, color Sun exposure • Dress, grooming, and personal hygiene Appropriate to weather and temperature Clean, properly buttoned/zipped • Facial expression Eye contact, appropriate changes in facial expression Mood • Odors of body and breath • Posture, gait, and motor activity Blood Pressure (normal and abnormal) - correct answer • Normal < 120/80 • Pre- HTN 120-139/ 80-89 • HTN > 140/90 Stage I 140-159/ 90-99 Stage II >160/ >100 Heart Rate (normal and abnormal) - correct answer • Normal 60-100 Bradycardia < 60 Tachycardia >100 Respiratory Rate (normal and abnormal) - correct answer • Normal rate: 12-20 breaths/minute Tachypnea >20 Bradypnea < 12 Temperature (normal and abnormal) - correct answer • Average oral temperature:37°C or 98.6°F • Fever: 100.4°F or 38°C • Diurnal variation: 35.8°C - 37.3°C (96.4°F - 99.1°F) Pain (normal and ways to assess) - correct answer • Normal - No pain: 0 out of 10 • Ways to assess: Numeric Rating Scale - Rate pain from 0 - 10 Wong-Baker FACES Scale - used by children or patients with language barriers or cognitive impairment FLACC Pain Scale - for newborns or babies Level of consciousness (LOC) - correct answer how aware the person is of his environment Attention - correct answer the ability to focus or concentrate alert - correct answer patient is awake and aware lethargic - correct answer you must speak to the patient in a loud forceful manner to get a response obtunded - correct answer you must shake a patient to get a response stuporous - correct answer the patient is unarousable except by painful stimuli (sternal rub) coma - correct answer the patient is completely unarousable short-term memory - correct answer covers events or memories that occurred minutes to days before long-term memory - correct answer covers events or memories that occurred months to years before orientation - correct answer requires memory and attention - aware of person (who they are) - place (where they are) - time (when is it) perceptions - correct answer awareness of the objects in the environment to the five senses and their interrelationships (hallucinations?) thought processes - correct answer the logic, coherence, and relevance of a patient's thoughts as they lead to thoughts and goals; HOW people think insight - correct answer awareness that thought, symptoms, or behaviors are normal or abnormal; e.g. distinguishing that a daydream or hallucination is not real judgment - correct answer process of comparing and evaluating different possible courses of action affect - correct answer the observable mood of a person expressed through facial expression, body movements, and voice mood - correct answer the sustained emotion of the patient - euthymic: normal - dysthymic: depressed - manic: elated language - correct answer the complex symbolic system for expressing written and verbal thoughts, emotion, attention, and memory higher cognitive functions - correct answer level of intelligence assessed by vocabulary, knowledge base, calculations, and abstract thinking Mental Status Examination - correct answer • Consists of the following components: Appearance and behavior Speech and language Mood Thoughts and perceptions Cognitive function: memory, attention, information and vocabulary, calculations, abstract thinking, and constructional ability Assessing Cognitive Functions - correct answer • Assess orientation to person, place, and time • Assess attention Digital span: give the patient a string of numbers to recite back to you Serial 7s: ask the patient to subtract serial "7s" from 100 Spelling backward: ask the patient to spell W-O-R-L-D backwards • Assess remote memory by asking about past historical events • Assess recent memory by asking about something recent (weather, national event, etc.) • Assess new learning ability by giving the patient three or four words to remember; then ask him to repeat the words after several minutes Assessing Higher Cognitive Functions - correct answer • Through your conversation, you can often assess the patient's higher cognitive functions • Information and vocabulary • Calculating ability: ask the patient to perform more difficult calculations such as making change (e.g., if you had a dollar's worth of nickels and someone needed 65 cents how many nickels would you have left?) • Abstract thinking Interpreting proverbs: "A stitch in time saves nine" Similarity exercises: What do a ball and an orange have in common? [Show Less]
- Exam
- $13.95
- 0
- 93
ADVANCED HEALTH ASSESSMENT - EXAM -2
Holosystolic murmur heard best at Apex, may transmit to axilla and sternum. - correct answer Mitral Regurgitation Symptoms of Mitral regurgitation - cor... [Show More] rect answer may be asymptomatic for decades, then SOB, Fatigue, HF What increases the murmur of Mitral regurgitation, what decreases the murmur? - correct answer Decrease murmur = stand up Increase murmur = clench fist Common causes of mitral regurgitation - correct answer Congenital abnormality, Rheumatic Heart disease, acute endocarditis, Chordae tendinae dysfunction... Mid-systolic grade II-III/VI, best heard between L. sternal border and apex. - correct answer physiologic murmur - specifically "Still's Murmur" (usually ages 3-6) Harsh, crescendo-decrescendo systolic murmur best heard at right sternal border. Can radiate to the neck - correct answer Aortic Stenosis What are the common symptoms of Aortic Stenosis - correct answer Chest pain, syncope, exercise intolerance, dyspnea, CHF. May have a long latent period before sx. what are patients at risk for with severe aortic stenosis - correct answer Sudden Death! What am I associated with .... Medium pitched CONTINUOUS murmur in both systole/diastole. Usually harsh, machinery like noise. Loud, sometimes a thrill is present. (heard best L infraclavicular fossa and pulmonic area) - correct answer patent ductus arteriosus Mid-to late systolic murmur, may have a mid-systolic click best heard over the lower left sternal border. - correct answer Mitral Valve Prolapse what are the symptoms associated with MVP? - correct answer Most people are asymptomatic. May have chest pain, palpitation, mild dyspnea, fatigue, anxiety. Loud, blowing, high pitched diastolic murmur best heard Lower Left Sternal Border.. - correct answer Aortic insufficiency / Aortic regurgitation What are symptoms associated with severe aortic regurgitation? - correct answer Dyspnea, fatigue, CHF, widened pulse pressure. Water-hammer pulse Low pitched, mid-diastolic rumble best heard at the apex in the Left Lateral position. May also hear an "opening Snap" - correct answer Mitral Stenosis What is the most common cause for mitral stenosis - correct answer Rheumatic Heart Disease What are the sx associated with Mitral stenosis? - correct answer DYSPNEA, fatigue, palpitations, hemoptysis, angina-like chest pain. A-fib is common What are patients with Mitral Stenosis at risk for? (2 things) - correct answer Thromboembolization & pulmonary hypertension Which murmurs are louder during inspiration? (left or right) - correct answer Right Which murmurs are louder during expiration? (left or right) - correct answer Left Early, mid, or late systolic OR pansystolic Medium pitched murmur best heard at the lower left sternal border. Can radiate to the right sternal border? - correct answer Tricuspid Regurgitation/Insufficiency What is associated with a Pansystolic, louder in midsystole. best heard at LSB with radiation to the RSB. May have systolic THRILL at LLSB. Increased murmur with Valsalva. - correct answer Ventricular Septal Defect In a fetus, blood flows from the right atrium to the left atrium through the __________. - correct answer Foramen ovale In a fetus, the connection between the pulmonary artery and aorta is the ___________. - correct answer Ductus arteriosus _________ brings blood back from the fetus to the placenta - correct answer umbilical artery ________ brings blood from the placenta to the fetus - correct answer umbilical vein Which 3 CHD are associated with INCREASED pulmonary blood flow - correct answer PDA, ASD, VSD What are symptoms associated with Patent Ductus arteriosus? - correct answer may be asymptomatic, or CHF, bounding peripheral pulses, WIDE pulse pressure, II-V Harsh machinery like CONTINUOUS murmur best heard left clavicle, 1st/2nd L ICS. What is the treatment for PDA? - correct answer Indomethacin to effect closure Blood flows from Left to Right Atrium through an opening. Can result in R atrium and ventricle distention, and increased pulmonary blood flow. - correct answer Atrial Septal Defect Symptoms of ASD? - correct answer fatigue, exertional dyspnea, RARELY CHF.. may see pulmonary symptoms later in life if unrepaired. Shunt between the Left and Right Ventricle - correct answer Ventricular Septal defect What are the 4 associated defects of Tetralogy of Fallot? - correct answer 1. Pulmonic stenosis 2. Large VSD 3. Overriding aorta 4. Right Ventricular hypertrophy 2 CHD with DECREASED Pulmonary blood flow (CYANOTIC) - correct answer Tetrology of fallot and tricuspid atresia Symptoms of Tetralogy of Fallot? - correct answer cyanosis with feeding, hypercyanotic spells, squatting improves pulmonary blood flow. Grade III-VI harsh systolic ejection murmur. chest xray of tetralogy of Fallot - correct answer boot shaped heart lack of connection between right atrium and right ventricle - correct answer Tricuspid atresia (TA) Symptoms of Tricuspid atresia? - correct answer cyanosis at birth or a fews days after, difficulty feeding, week suck, clubbing, tachycardia, tachypnea, crackles.. Treatment for Tricuspid atresia? - correct answer IV PGE1 (prostoglandin) to keep the PDA open. then surgery. Position for Tet spell to help relieve cyanotic episode - correct answer cradled in knee position Obstructive blood flow disorders (three) - correct answer 1. coarctation of the aorta 2. Aortic stenosis 3. pulm stenosis Narrowing/constriction of the aorta is ____________. symptoms include: __________ - correct answer Coartication of the aorta. BP is increased in heart and upper portions of the body, decreased BP in lower portions of the body. Sx: tachypnea, poor feeding, cool lower extremities, older children> leg pain, dizziness, syncope. *BOUNDING pulses in upper extremities, weak pulses in lower extremities. Coartication of aorta are at high risk for - correct answer hypertension, rupture aorta, AA, Stroke Narrowing of the aortic valve is ____________. Sx associated with it include __________ in pediatrics. - correct answer Aortic stenosis. SX: dif. feeding, fatigue, CP with activity, faint pulses, CHF, shock in AS newborns (severe), sudden death r/t dysrhythmias. Are there activity restrictions for children/adolescents with aortic stenosis? - correct answer Must have cardiac exam often (at least annually).. for mod/severe AS. avoid competitive intense sports - b/c of risk for sudden death from V. dysrhythmias. Narrowing of the subpulmonic, valvular, or supravaluvular area. sx assoc with it include _______ in pediatrics - correct answer pulmonary stenosis sx: asymptomatic until murmur is hear. exertional dyspnea, fatigue. Newborn > cyanosis, right sided CHF CHD where the aorta and pulmonary vessels are switched - correct answer Transposition of the Great vessels. Underdevelopment of the Left side of the heart. (CHD) - correct answer Hypoplastic Left Heart Syndrome - often a very small L. ventricle and very narrow aortic valve. -usually fatal in first few months if not surgically treated. TX: prostaglandin to maintain ductal patency. then surgery or transplant. NORMALLY, the ________ side of the heart has higher pressure than the _________ side of the heart - correct answer Left side has higher pressure than the Right side Left to Right sided CHD are (ASD, VSD, PDA) are ______________. (cyanotic or acyanotic) - correct answer Acyanotic Right to Left disorders are acyanotic or cyanotic? - correct answer Cyanotic (blue) Leading ACQUIRED caused of heart disease in children? - correct answer Kawasaki Disease Criteria for diagnosis of Kawasaki disease - correct answer 1. fever >5 days unresponsive to Abt. 2. bilateral conjunctival injection (no exudate) 3. inflammatory changes to oral mucosa (erythema of lips or oropharynx, STRAWBERRY TONGUE, fissuring of lips 4. peripheral extremity edema, erythema, periungual desquamation 5. polymorphous rash (urticarial or pruritic) 6. cervical lymphadenopathy (unilateral, anterior cervical) heart sound that represents increase force of ATRIAL contraction and ventricular distention. - correct answer s4 - always pathologic "TENNESSEE" heart sound associated with rapid ventricular filling. best heard in lateral decubitus position. -Can be normal ages <40 - correct answer s3 - "kentucky" condition where fungal or bacteria invade traumatized endocardial surfaces, most common the valves. most commonly occurs with underlying structural defects - correct answer Infective endocarditis 80% of all IE in children is Staph (gram+) 3 Gram postive organisms - correct answer Staph, Strep, Enterococcus flat nontender lesion on palms and soles - associated with IE - correct answer Janeway lesions painful raised lesions on pads of fingers and toes - associated with IE - correct answer Osler Nodes retinal hemmorhags with a central white spot associated with IE - correct answer Roth Spots covers most of the anterior eyeball surface - correct answer balbar conjunctiva lines the eyelids - correct answer palpebral conjunctiva clear liquid that fills the anterior and posterior chambers of the eye. it is produced by the ciliary body - correct answer Aqueous humor visual receptive layer where light waves changed into nerve impulses - correct answer Retina Creamy yellow, sharply demarcated structure in funduscopic exam - correct answer optic disk A:V ratio - normal - correct answer 2:3 or 3:4 ophthalmoscope question. which color do you use to see near objects; and to use for farsighted eyes - correct answer Black opthalmoscope question: which color diopter would you use to see far/distant objects and to use with nearsighted eyes - correct answer Red What does 20/200 mean? - correct answer At 20 ft a patient can read what a person with normal vision can reat at 200 ft. the larger the second number the worse the vision.. 20/200 is also considered legally blind. myopia - correct answer impaired far vision "nearsightedness" Presbyopia - correct answer impaired near vision symptoms associated with ACUTE angle closure glaucoma - correct answer severe pain, N/V, halos around lights, photophobia, cornea cloudy. pupil mid dilated and fixed. Tx: Urgent referral Lateral rectus muscle of the eye is controlled by which Cranial nerve? - correct answer VI Inferior oblique (up/out), superior rectus (up/in), medial rectus is controlled by which cranial nerve? - correct answer III The superior oblique (down/out)muscle is controlled by which cranial nerve? - correct answer IV edema of the bulbar conjunctiva. - correct answer Chemosis microscopic or visible blood layering in the anterior chamber of the eye. usually after blunt trauma. Urgent referral necessary - correct answer Hyphema eye pain, conjunctival hyperemia, corneal cloudiness with stomal involvement. Urgent referral. - correct answer Keratitis normal intraocular pressure - correct answer 10-20mmHg opacification of the lens of the eye - correct answer Cataracts inflammation of the eyelids - correct answer blepharitis chronic sterile inflammation of the meibomian gland. it is self limited. - correct answer Chalazion an acute infection of one of the glands in the eyelid, painful. - correct answer Hordeolum obstruction that occurs at any point along the lacrimal drainage pathway. - correct answer dacryocystitis acute onset of floaters - correct answer retinal detachment blindspot around area of normal vision or decreased vision - correct answer scotoma - associated with glaucoma, optic nerve disorder, or visual pathway disorder. deviation in the anteroposterior axis of the eye - correct answer Strabismus an involuntary, rapid and repetitive movement of the eyes. Usually the movement is side-to-side - correct answer nystagmus double vision - correct answer diplopia leading cause of IRREVERSIBLE vision loss in the industrialized world - correct answer Macular degeneration which part of vision is lost in macular degeneration? - correct answer primarily central vision Eye exam findings of a pt with Hypertension - correct answer Copper wiring, silver wiring, AV nicking, tapering, banking, cotton wool (soft exudates), hard exudates, superficial retinal "flame shaped" hemorrhages Eye exam findings of a pt with diabetic retinopathy - correct answer microaneurysms (first sign), dot blot hemorrhages, , retinal edema and hard exudate, neovascularization (proliferative retinopathy). enlargement of the globe of the eye - correct answer bupthalmos what can bupthalmos be a sign of in infants - correct answer glaucoma, increased IOP OU means ____ - correct answer both eyes OD means _____ - correct answer right eye OS means_______ - correct answer left eye common organisms that cause otitis externa "swimmers ear" - correct answer pseudomonas aeriginosa, Staph epidermimidis, Staph Aureus Treatment for otitis externa - correct answer antibiotic ear gtts - Neomycin/polymyxin/hydrocortisone. Quinolones are the only non-ototoxic med that is safe for perforated TM Common organism for acute otitis media - correct answer Strep pneumoniae, H. influenzae, Moraxella catarrhalis, Strep pyogenes Treatment for Acute otitis media if bacterial is suspected... - correct answer First line - Amoxicillin 40-90mg/kg/day divided BID x10 #2 : --cephalosporin for nontype 1 hypersensitivity to pen. --Azithro, ceftriaxone, clindamycin for type 1 hypersens. #3. if failure - step up to augmentin decreased TM mobility, fluid level or bubbles. Often asymptomatic and afebrile.. what am I? - correct answer otitis media with EFFUSION What is the risk of otitis media with effusion - correct answer hearing loss Treatment for effusion - correct answer document each visit presence and duration of effusion. watchful waiting.. usually resolves in about 3 months. Referral if at high risk for having dev. delays. most common pathogen for acute bacterial sinusitis? - correct answer #1 Strep pneumoniae. other causes include: H. influenza, Moraxella catarrhalis. clamydia pneum. and strep pyogenes Antiobiotic treatment for acute BACTERIAL rhinosinusitis? - correct answer ---mild/mod ABRS with no risk of resistance is Amoxicillin/clavulanate 45mg/kg/day divided BID. ---with increased risk of resistance Amox/clavulanate 90mg/kg/day divided BID. Why is Augmentin given for ABRS rather than just Amoxicillin? - correct answer cluvulanate is used to treat H. flu and M. cattarrhalis - common causes of ABRS. Amoxillicin covers strep pneumo What are alternative treatments for ABRS if there is a penicillin allergy? - correct answer Doxycycline OR Clindamycin + 3rd gen cephalosporin OR respiratory quinolone First line treatment for acute strep Pharyngitis (GABHS) - correct answer Penicillin Penicillin V = oral x10 dyas Penicillin G = IM single dose Treatment of Group A Strep pharyngitis for a pt with penicillin allergy. - correct answer Clindamycin, azithromycin, clarithromycin characteristic symptom is a barking cough. what am I - correct answer Laryngotracheitis "croup" what is the treatment for croup with stridor at rest - correct answer Hospitilization. racemic epi nebulizer, steroids, mist with oxygen sudden onset sore throat, difficulty swallowing, fever, drooling, muffled voice, tripod position... Diagnosis? - correct answer Epiglottis - send to ED! which cranial nerve is responsible for taste in the posterior third of the tongue? - correct answer CN IX - glossopharyngeal which cranial nerve facilitates facial movement? - correct answer CN VII - facial which CN is responsible for visual acuity? - correct answer II- optic which CN is responsible for swallowing - correct answer X - vagus [Show Less]
- Exam
- $13.95
- 0
- 83
ADVANCED HEALTH ASSESSMENT FINAL
Select the correct sequence of techniques used during an examination of a child's abdomen: a. Percussion, inspection, palpation, auscultation b. Inspecti... [Show More] on, palpation, percussion, auscultation c. Inspection, auscultation, percussion, palpation d. Auscultation, inspection, palpation, percussion - correct answer c. Inspection, auscultation, percussion, palpation When percussing a child's abdomen, you note tympany. This is indicative of the presence of: a. Fluid b. Air c. Feces d. Hepatomegaly - correct answer b. Air When inspecting the child's abdomen, the examiner notes a midline muscular separation with bulging at the child cries. This finding is a(n): a. Umbilical hernia b. Inguinal hernia c. Omphalocele d. Diastasis recti - correct answer d. Diastasis recti A 10-month-old infant is brought to the clinic with complaints of cough and rhinorrhea. When auscultating the child's lungs, you note a large, bulging umbilical mass. The mass is easily reducible but increases when the child cries. This assessment finding is a(n): a. Inguinal hernia b. Umbilical hernia c. Gastroschisis d. Omphalocele - correct answer b. Umbilical hernia The iliopsoas (psoas sign) test is used to identify: a. Splenic enlargement b. Costovertebral tenderness c. Intra-abdominal inflammation d. Decreased peristalsis or intestinal activity - correct answer c. Intra-abdominal inflammation When auscultating bowel sounds in an infant or a young child, it is essential to use a pediatric stethoscope because: a. A stethoscope diaphragm that is too large may also encompass lung sounds, confusing the clinical picture b. A stethoscope diaphragm that is too large may also encompass vascular sounds, confusing the clinical picture c. A stethoscope diaphragm that is too large may cause pain in a small infant if pressure is applied during auscultation d. A stethoscope diaphragm that is too large may decrease the child's cooperation - correct answer a. A stethoscope diaphragm that is too large may also encompass lung sounds, confusing the clinical picture Decreased hepatic enzyme function in children from birth until age 3 to 4 years causes: a. Short drug half-lives b. Long drug half-lives c. Physiologic jaundice d. Hypoglycemia - correct answer b. Long drug half-lives The stomach capacity in a neonate is approximately: a. 30 mL b. 60 mL c. 90 mL d. 120 mL - correct answer b. 60 mL A dull percussion note at or beyond the anterior axillary line on the left indicates: a. Hepatomegaly b. Splenomegaly c. A normal finding d. A fibrotic spleen - correct answer b. Splenomegaly Assessment for renal tenderness should be performed with the child: a. Lying supine b. Lying prone c. In a side-lying position d. Sitting upright - correct answer d. Sitting upright Indirect percussion can be used to detect: a. Costovertebral tenderness b. Abdominal masses c. Rebound tenderness d. Hepatomegaly - correct answer a. Costovertebral tenderness The lower left quadrant (LLQ) contains the: a. Left ureter b. Pancreas (body) c. Stomach d. Liver (left lobe) - correct answer a. Left ureter The percussion note that is normally heard over a child's stomach is: a. Dull b. Tympany c. Resonance d. Hyperactive - correct answer b. Tympany A firm, olive-like mass palpable in the RUQ of a 3-week-old infant is likely a(n): a. Fecal mass b. Pyloric stenosis c. Umbilical hernia d. Inguinal hernia - correct answer b. Pyloric Stenosis Infants and toddlers have a protuberant abdomen due to: a. Increased pancreatic enzyme activity b. Weak abdominal musculature c. More abdominal subcutaneous tissue d. Decreased hepatic enzyme function - correct answer b. Weak abdominal musculature A young child's kidney is more susceptible to trauma because: a. Until age 5 years, kidneys rupture more easily b. More of the kidney is exposed because of the thin abdominal wall c. There is a proportionately larger abdomen in young children d. The urinary bladder capacity varies - correct answer b. More of the kidney is exposed because of the thin abdominal wall Which of the following is an appropriate response by the provider to a 30-month-old child who is resistant to the abdominal exam? a. Inspect only; auscultate and palpate only if necessary b. Ask the child to describe the symptoms in more detail c. Ask the child if he or she would like to listen to the stomach through the stethoscope and press on the stomach with his or her own hands d. Defer the exam - correct answer c. Ask the child if he or she would like to listen to the stomach through the stethoscope and press on the stomach with his or her own hands Which of the following findings in the child's prenatal history is relevant when conducting the abdominal assessment? a. Maternal oligohydramnios b. Amount of maternal weight gain c. Perinatal asphyxia d. Timing of the first meconium stool - correct answer a. Maternal oligohydramnios The RLQ contains the: a. Liver (right lobe) b. Pancreas c. Ascending colon d. Cecum - correct answer d. Cecum The provider palpates the child's abdomen slowly and deeply away from an area of tenderness, then quickly removes the palpating hand. The child experiences pain when the palpating hand is removed quickly. This describes: a. Light palpation b. Rebound tenderness c. Deep palpation d. Costovertebral tenderness - correct answer b. Rebound tenderness Deep palpation is used to assess: a. Areas of abdominal tenderness b. Underlying abdominal structures c. Areas of abdominal rigidity d. Abdominal tympany - correct answer b. Underlying abdominal structures Deep tenderness at McBurney's point is a sign of: a. Acute appendicitis b. Peritonitis c. Peptic ulcer disease d. Pelvic inflammatory disease - correct answer a. Acute appendicitis A 10-year-old child presents to the clinic with acute RLQ abdominal pain and fever. The examiner positions the child supine, then flexes each leg at the hip and rotates the hip internally and externally. The child complains of pain when this maneuver is conducted on the right leg. This is an elicitation of: a. The iliopsoas sign b. The obturator sign c. Murphy's sign d. Rebound tenderness - correct answer b. The obturator sign Which of the following terms defines movement away from the midline? a. Abduction b. Adduction c. Flexion d. Extension - correct answer a. Abduction Physical findings associated with talipes equinovarus are: a. Medial deviation of the forefoot that is flexible and can be abducted beyond the midline b. Laxity of ligaments supporting the foot's longitudinal arch, causing the feet to be positioned in abduction c. Internal rotation of the foot with forefoot adduction involving muscles, tendons and bone d. Marked inward deviation of the hand and an extremely short forearm - correct answer c. Internal rotation of the foot with forefoot adduction involving muscles, tendons and bone Assessment findings in an infant with developmental dysplasia of the hip can include: a. Negative Ortolani sign b. Positive Galeazzi sign c. Positive Trendelenburg sign d. Negative Barlow sign - correct answer b. Positive Galeazzi sign Sustained clonus that extends beyond six to eight beats or clonus that continues past the neonatal period may indicate: a. Cerebral palsy b. Increased intracranial pressure c. Talipes equinovarus d. Dystonia - correct answer a. Cerebral palsy Which of the following assessment findings is within normal limits for the child's age? a. A toddler with lordosis b. A 3-year-old with genu varum c. A 12-year-old with genu valgum A 2-day-old with syndactyly - correct answer a. A toddler with lordosis An antalgic gait indicates: a. Pain b. Infection c. Clubfoot d. Developmental dysplasia of the hip - correct answer a. Pain A visible lateral curvature of the spine when the child is standing indicates: a. Lordosis b. Spina bifida c. Kyphosis d. Scoliosis - correct answer d. Scoliosis Assessment of the hips to detect developmental dysplasia of the hip is done at every well-child exam until age: a. 6 months b. 1 year c. 18 months d. 2 years - correct answer b. 1 year Tibial torsion can be caused by: a. Birth injury b. Trauma c. Viral illness d. Sickle cell disease - correct answer b. Trauma A 15-month-old boy is in the clinic for a well-child visit. You note increased muscle tone. This is a red flag for: a. Adam syndrome b. Cerebral palsy c. Down syndrome d. Muscular dystrophy - correct answer b. Cerebral palsy Until approximately what age is slight genu valgum (knock-knee) within normal limits? a. 7-8 years b. 8-9 years c. 9-10 years d. 10-11 years - correct answer a. 7-8 years A child who exhibits a positive Gower sign likely has a: a. Fracture b. Myopathy c. Hip infection d. Seizure disorder - correct answer b. Myopathy Uneven knee height with knees flexed in a supine infant indicates: a. Genu varum b. Tibial torsion c. Developmental dysplasia of the hip d. Metatarsus adductus - correct answer c. Developmental dysplasia of the hip A rapid and rhythmic, jerking movement of the foot caused by the sudden stretching of a tendon is termed: a. Tremor b. Clonus c. Nystagmus d. Myoclonus - correct answer b. Clonus Muscle strength in the lower extremities can be assessed in a 6-month-old infant by: a. Pulling the infant from the sitting to the standing position b. Placing the infant prone and observing whether the infant can crawl c. Performing the Ortolani maneuver d. Observing the infant try to pull to stand - correct answer a. Pulling the infant from the sitting to the standing position The most common presenting symptom of neuromuscular disease in children is: a. Fatigue b. Muscle weakness c. Myoclonus d. Tremors - correct answer b. Muscle weakness Genu varum (bow legs) is normal until age: a. 3-4 years b. 4-5 years c. 5-6 years d. 6-7 years - correct answer a. 3-4 years The varus deformity of both tibias caused by chronic obesity is: a. Osgood-Schlatter disease b. McMurray disease c. Blount's disease d. Werdnig-Hoffmann disease - correct answer c. Blount's disease A marked limp or refusal to walk accompanied by fever, point tenderness, or limited range of motion in the hip suggests: a. Juvenile rheumatoid arthritis b. Osteomyelitis c. Cerebral palsy d. Sacroiliac inflammation - correct answer b. Osteomyelitis The forward bending test is an essential screening tool for: a. Lordosis in preschool children b. Kyphosis in school-aged children c. Torticollis in all age groups d. Scoliosis in school-aged children and adolescents - correct answer d. Scoliosis in school-aged children and adolescents A normal healthy full-term infant should be able to walk independently by age: a. 9-12 months b. 12-15 months c. 15-18 months d. 18-21 months - correct answer b. 12-15 months A 7-year-old child is asked to stand straight and then raise the right leg off the ground. When bearing weight on the left hip, the pelvis will drop on the right side. This finding is the: a. Trendelenburg sign b. Barlow sign c. Ortolani sign d. Galeazzi sign - correct answer a. Trendelenburg sign Which of the following statements regarding pes planus (flat feet) is true? a. A normal variation, beginning at 2 to 3 years and resolving by approximately 7 to 8 years b. A normal variation in infants as they first begin to walk, then slowly resolving as the child grows c. A normal variation in infants until approximately age 3 to 4 months d. A normal variation, beginning at 2 to 3 years, resolving by adolescence - correct answer b. A normal variation in infants as they first begin to walk, then slowly resolving as the child grows The most sensitive indicator of a child's neurologic status is: a. Mood and affect b. Gait and balance c. Cranial nerve assessment d. Level of consciousness - correct answer d. Level of consciousness Which of the following assessments indicates potential cerebellar dysfunction? a. Ataxia b. Graphesthesia c. Hearing deficits d. Stereognosis - correct answer a. Ataxia To assess vestibular function of the acoustic nerve in a child, the examiner would: a. Perform the whisper test b. Perform the Romberg test c. Perform the Weber test d. Perform the Rinne test - correct answer b. Perform the Romberg test To examine for the function of the hypoglossal nerve in a child, the examiner would: a. Ask the child to identify tastes b. Ask the child to stick out his or her tongue c. Test the child's ability to swallow d. Ask the child to nod his or her head from side to side - correct answer b. Ask the child to stick out his or her tongue Which of the following is the most appropriate method of evaluating cerebellar function in a preschool-age child? a. Perform the Romberg test b. Conduct a cranial nerve examination c. Observe heel-to-toe walking d. Ask the child to perform the finger-to-nose test - correct answer a. Perform the Romberg test Injury to Wernicke's area of the cerebral cortex results in: a. Executive function deficits b. Expressive aphasia c. Receptive aphasia d. Memory loss - correct answer c. Receptive aphasia The presence of Brudzinski's sign indicates: a. Increased intracranial pressure b. Meningeal irritation c. Cerebellar dysfunction d. Spinal cord injury - correct answer B. Meningeal irritation A 3-year-old child suffered a severe traumatic brain injury. The examiner would expect this child's Babinski reflex to be: a. Negative b. Positive c. Fluctuating, depending on intracranial pressure d. Unable to be assessed - correct answer b. Positive A 5-year-old boy is new to the clinical practice and presents for a kindergarten physical. During the examination, his gait is assessed. No limp or ataxia is noted, but he is toe walking. The provider asks his parents if this is how he normally walks and they say yes. Which of the following parts of the child's past medical history are important to assess? a. Previous history of hyperactive deep tendon reflexes b. Previous history of lower extremity injury c. History of perinatal or neonatal hypoxia or asphyxia d. History of high fever in infancy - correct answer c. History of perinatal or neonatal hypoxia or asphyxia Which of the following developmental assessment findings requires an in-depth neurologic assessment? a. Delayed expressive language milestone achievement b. Poor school performance c. Loss of developmental skills d. Poor social skills with peers - correct answer c. Loss of developmental skills Which of the following assessment findings indicates increased intracranial pressure? a. Papilledema on fundoscopic examination b. Nuchal rigidity c. Numbness and tingling d. Hyperactive deep tendon reflexes - correct answer a. Papilledema on fundoscopic examination A normal response to the elicitation of the Achilles tendon reflex is: a. Flexion of the toes b. Plantar flexion c. Extension of the great toe with fanning of the remaining toes d. Extension of the toes - correct answer b. Plantar flexion To test the sensory function of the trigeminal nerve in an infant, the examiner would: a. Elicit the startle reflex b. Elicit the gag reflex c. Assess direct and consensual pupillary response to light d. Elicit the corneal (blink) reflex - correct answer d. Elicit the corneal (blink) reflex To elicit the plantar reflex: a. Ask the child to slide the heel of the foot along the opposite shin b. Place a vibrating tuning fork on the child's ankle and ask the child when the vibration stops c. Strike the lateral aspect of the sole of the foot with the end of the reflex hammer d. Ask the child to perform a heel-to-toe walk - correct answer c. Strike the lateral aspect of the sole of the foot with the end of the reflex hammer A child has been hit by a car while riding her bicycle. The Glasgow Coma Scale assessment reveals a total score of 10. This is considered indicative of a: a. Mild head injury b. Moderate head injury c. Severe head injury d. Normal finding - correct answer b. Moderate head injury Which of the following postural reflexes should disappear between age 12 and 24 months? a. Positive support b. Landau c. Parachute d. Protective extension sitting position - correct answer b. Landau The Glasgow Coma Scale includes all of the following assessment areas except: a. Eye opening b. Thought processes c. Motor response d. Verbal response - correct answer b. Thought processes Because of the need for the child's cooperation during assessment, the sensory examination is not typically conducted until age: a. 2 years b. 3 years c. 4 years d. 5 years - correct answer b. 3 years Neurologic soft signs, when found on neurologic examination, indicate: a. A likely history of severe asphyxia and a poor neurologic outcome b. A sign of a moderate cerebral ischemic injury and likely motor and cognitive delays c. A minor abnormality and often are resolved by late school age to adolescence d. A lingering effect of traumatic brain injury - correct answer c. A minor abnormality and often are resolved by late school age to adolescence Which of the following neurologic assessments test proprioception? a. Assessment of the child's ability to identify direction of movement b. Assessment of pain c. Assessment of the child's ability to identify hot and cold temperature d. Assessment of ability to hop in place - correct answer a. Assessment of the child's ability to identify direction of movement Which of the following assessments is a function of the parasympathetic nervous system? a. Pupillary constriction b. Pupillary dilation c. Bronchial muscle relaxation d. Urinary bladder relaxation - correct answer a. Pupillary constriction Which of the following assessments is a function of the sympathetic nervous system? a. Increased salivation b. Bronchial muscle constriction c. Stomach peristalsis d. Adrenaline secretion - correct answer d. Adrenaline secretion A mental health assessment is being conducted on 16-year-old Melissa. Which of the following statements should not be kept confidential? a. "I have been sexually active with three boys." b. "I sometimes smoke pot." c. "I sometimes drink wine from my parent's alcohol cabinet." d. "Sometimes I feel like ending my life." - correct answer d. "Sometimes I feel like ending my life." Which of the following somatic complaints often accompanies anxiety disorders in children? a. Headache b. Somnolence c. Bradycardia d. Seizures - correct answer a. Headache Which of the following assessment findings is indicative of anxiety that is outside normal limits? a. a 15-month-old who cries intensely when she sees her mother gather her car keys and purse b. A 4-year-old who is afraid to take a bath because he is afraid of being sucked down the drain c. An 8-year-old who wakes up every night, seeking parental reassurance regarding fears and concerns about what will happen the next day d. An adolescent who is worried and preoccupied about social acceptance and social competence at school - correct answer c. An 8-year-old who wakes up every night, seeking parental reassurance regarding fears and concerns about what will happen the next day During a health maintenance visit, the mother of an 8-year-old boy says that he has received several warnings at school regarding his behavior. His teacher and the school social worker have documented that he loses his temper easily, repeatedly defies the teacher and school rules, argues with adults at school, and deliberately annoys his classmates. The healthcare provider should do a full screening for: a. Social phobias b. Depression c. Attention deficit hyperactivity disorder d. Oppositional defiant disorder - correct answer d. Oppositional defiant disorder Signs of nonsuicidal self-injury may include all of the following except: a. Emaciated appearance b. Wearing long-sleeved clothing in warm weather c. Overt suicidal ideation d. Scarring on visible skin - correct answer c. Overt suicidal ideation Common fears among school-aged children include: a. Loud noises b. Separation c. Peer rejection [Show Less]
- Exam
- $13.95
- 0
- 104
ADVANCED HEALTH ASSESSMENT MIDTERM REVIEW OF QUIZ QUESTIONS
The following information belongs in which section of the Comprehensive Heath History (H&P)? "3 day history of rash and swelling" A. History of Pres... [Show More] ent Illness B. Review of Systems C. Allergies D. Chief Complaint - correct answer D. Chief Complaint A patient with abdominal pain describes "what" the pain feels like and "how long" it lasts. In which part of the H&P would you place this information? A. History of Present Illness B. Past Medical History C. Sexual History D. Review of Systems - correct answer A. History of present illness Which of the following best describes the patient record? A. describes the approach to a problem B. serves a dual purpose as it reflects your anaylsis of the patient's health status and documents examination findings C. shows your clinical thought process D. reflects you interpersonal skills with the patient - correct answer B. serves a dual purpose as it reflects your anaylsis of the patient's health status and documents examination findings The consideration of culture and ethnicity during the interview process are important because: A. similar cultures always provide similar responses B. some cultures consider certain questions and gestures offensive C. it is politically correct D. none of the above - correct answer B. some cultures consider certain questions and gestures offensive During an interview, your patient admits to feeling worthless and having a sleep disturbance for the last 3 weeks. These are clues that warrant exploration of: A. risk for suicide B. split personality C. cognitive function D. functional assessment - correct answer A. risk for suicide Worries persisting for =>6 months most likely reflects one of the most prevalent psychiatric conditions in the United States known as: A. posttraumatic stress disorder B. generalized anxiety disorder C. fatigue D. social phobia - correct answer B. generalized anxiety disorder Risk factors for fatal overdose of pain medications include all of the following except: A. age 65 or older B. depression C. arthritis D. concurrent benzodiazepine use - correct answer C. arthritis A healthy BMI can best be described as: A. 18.5-24.9 B. 30.0-34.9 C. 25.0-29.9 D. 35.0-39.9 - correct answer A. 18.5-24.9 The comprehensive health history: A. has a completely different format that varies with each institution B. varies from country to country C. follows the same general format regardless of the institution or geographical location D. follows the exact same format across the world, except Europe - correct answer C. follows the same general format regardless of the institution or geographical location Which of the following is not a common symptom of depression? A. Anhedonia B. Dry lips C. Appetite disturbance D. Worthlessness - correct answer B. Dry lips During a mental status exam, which question might you ask to assess abstraction ability? A. What does a rolling stone gathers no moss mean? B. Start with 100 and keep subtracting by 7 C How long have you been here? D. What's your mother's maiden name? - correct answer A. What does a rolling stone gathers no moss mean? Dave, age 76, is brought in by his wife, who states that within the last 2 days Dave has become agitated and restless, has had few lucid moments, slept very poorly last night and can remember only recent events. Of the following differential diagnoses, which best fits the symptoms from this brief history? A. Depression B. Dementia C. Delirium D. Schizophrenia - correct answer C. Delirium Which technique is applied throughout the entire examination and interview process? A. Inspection B. Palpation C. Percussion D. Auscultation - correct answer A. Inspection During a patient's pain assessment, the most important element is the patient's: A. Sleep hygiene B. Perception of his/her own pain C. Vital signs D. Fear of addiction - correct answer B. Perception of his/her own pain The general survey of the patient includes all of the following except: A. appearance B. tanner stage C. height D. weight - correct answer B. tanner stage One of the main differences between a comprehensive and focused assessment is: A. for the comprehensive assessment you will select the methods relevant to thorough assessment of the targeted problem B. for the focused assessment you will select the methods relevant to thorough assessment of the targeted problem C. for the focused assessment you perform a thorough head to toe examination D. for the comprehensive assessment you always refer the patient to a specialist at the end of the examination - correct answer B. for the focused assessment you will select the methods relevant to thorough assessment of the targeted problem Which of the following is an example of subjective data: A. Mr. D's vital signs are BP 138/66 P 107 T 99.9 SPO2 92% RR 20 B. Mr. D has inspiratory and expiratory wheezes noted during auscultation of the lungs C. Mr D's CXR shows an infiltrate in the left lower lobe consistent with pneumonia D. Mr D is a 53 year old male who presents to the clinic complaining of shortness of breath and says "it hurts to take deep breaths." He reports this started 2 days ago and says he's been having fever and chills. - correct answer D. Mr D is a 53 year old male who presents to the clinic complaining of shortness of breath and says "it hurts to take deep breaths." He reports this started 2 days ago and says he's been having fever and chills. All of the following are included in the Review of Systems except: A. general B. Cardiovascular C. Psychiatric D. All of the above - correct answer D. All of the above Which of the following is not a goal when developing a systematic sequence of examination: A. maximize the patients' comfort B. perform invasive imaging first C. avoid unnecessary changes in position D. enhance clinical efficiency - correct answer B. perform invasive imaging first All of the following are examples of health promotion except: A. using USPSTF guidelines for practice during the exam B. using American College of Chest Physicians grading criteria during the exam C. removing baby aspirin 81 mg from the medication list of a patient with know coronary artery disease during the exam D. using CDC recommendations for exercise during the exam - correct answer C. removing baby aspirin 81 mg from the medication list of a patient with know coronary artery disease during the exam The initial moments of your encounter with a patient lay the foundation for your ongoing relationship. Which of the following best helps lay that foundation: A. ensure there is more than adequate lighting in the exam room B. explain your role, your status as a student provider and how you will be involved in the patient's care C. check the light source in the otoscope D. check the light source in the opthalmascope - correct answer B. explain your role, your status as a student provider and how you will be involved in the patient's care Which of the following is not one of the seven attributes of a symptom: A. location B. quality C. timing D. immunization status - correct answer D. immunization status All of the following are examples of empathic responses except: A. "I cannot imagine how hard this must be for you" B. "I think you need a psych consult immediately" C. "You must be feeling sad" D. "That sounds upsetting" - correct answer B. "I think you need a psych consult immediately" Which of the following are components of the three dimensions of cultural humility: A. self-awareness B. respectful communication C. collaborative partnership D. all of the above - correct answer D. all of the above When performing the general survey which of the following is not considered a sign of distress: A. pain B. labored breathing C. large mole on forehead D. anxiety - correct answer C. large mole on forehead You are speaking to an 8th grade class about health prevention and are preparing to discuss the ABCDEs of melanoma. Which of the following descriptions correctly defines the ABCDEs? A = asymmetry; B = irregular borders; C = color changes, especially blue; D = diameter >6 mm; E = evolution A = actinic; B = basal cell; C = color changes, especially blue; D = diameter >6 mm; E = evolution A = actinic; B = irregular borders; C = keratoses; D = dystrophic nails; E = evolution A = asymmetry; B = regular borders; C = color changes, especially orange; D = diameter >6 mm; E = evolution - correct answer A = asymmetry; B = irregular borders; C = color changes, especially blue; D = diameter >6 mm; E = evolution A 28-year-old patient comes to the office for evaluation of a rash. At first there was only one large patch, but then more lesions erupted suddenly on the back and torso; the lesions itch. On physical examination, you note that the pattern of eruption is like a Christmas tree and that there are a variety of erythematous papules and macules on the cleavage lines of the back. Based on this description, what is the most likely diagnosis? Tinea versicolor Pityriasis rosea Psoriasis Atopic eczema - correct answer Pityriasis rosea A 19-year-old construction worker presents for evaluation of a rash. He notes that it started on his back with a multitude of spots and is also on his arms, chest, and neck. It itches a lot. He does sweat more than before because being outdoors is part of his job. On physical examination, you note dark tan patches with a reddish cast that has sharp borders and fine scales, scattered more prominently around the upper back, chest, neck, and upper arms as well as under the arms. Based on this description, what is your most likely diagnosis? Tinea versicolor Pityriasis rosea Psoriasis Atopic eczema - correct answer Tinea versicolor Which skin lesions are most commonly found on sun-exposed skin of older, fair-skinned people? Skin tags Seborrheic keratoses Actinic keratoses Angiomas - correct answer Actinic keratoses A 68-year-old retired farmer comes to your office for evaluation of a skin lesion. On the right temporal area of the forehead, you see a flattened papule the same color as his skin, covered by a dry scale that is round and feels hard. He has several more of these scattered on the forehead, arms, and legs. Based on this description, what is your most likely diagnosis? Seborrheic keratosis Actinic keratosis Basal cell carcinoma Squamous cell carcinoma - correct answer Actinic keratosis Which type of lesion often grows out of already present nevi that are changing or atypical, especially if the patient is over 50 years old: malignant melanoma basal cell carcinoma squamous cell carcinoma karposi sarcoma - correct answer malignant melanoma Nail involvement characterized by painless separation of the nail plate from the nail bed is termed: Hippocratic nails Onycholysis Koilonychia Anonychia - correct answer Onycholysis A 72-year-old teacher comes to a skilled nursing facility for rehabilitation after being in the hospital for 6 weeks. She was treated for sepsis and respiratory failure and had to be on the ventilator for 3 weeks. You are completing your initial assessment and are evaluating her skin condition. On her sacrum there is full-thickness skin loss that is 5 cm in diameter, with damage to the subcutaneous tissue. The underlying muscle is not affected. You diagnose this as a pressure ulcer. What is the stage of this ulcer? Stage 1 Stage 2 Stage 3 Stage 4 - correct answer Stage 3 Sammy, age 12, presents with claerly demarcated round or oval patches of hair loss without visible scaling or inflammation. What do you suspect? Psoriasis Erythema multiforme Alopecia Areata Syphilis - correct answer Alopecia Areata A basal cell carcinoma is: an epithelial tumor that originates from either the basal layer of the epidermis or cells in the surrounding dermal structures and are usually found in sun-exposed areas a malignant tumor of the squamous epithelium of the skin or mucous membranes an overgrowth and thickening of the cornified epithelium lined with epithelium and contains a fluid or semisolid material - correct answer an epithelial tumor that originates from either the basal layer of the epidermis or cells in the surrounding dermal structures and are usually found in sun-exposed areas You ask a patient to follow your finger laterally when evaluating extraocular movements. Which cranial nerves are you testing? IV, VII III, VI III, X II, III - correct answer III, VI The mental status examination enables the nurse practitioner to identify: Intelligence quotient and reasoning Abstract thinking and memory functioning Reasoning and psychomotor skills Memory functioning and intelligence - correct answer Abstract thinking and memory functioning An assessment of a client experiencing hallucinations would most likely reveal all of the following except: experiences that seem real but lack actual external stimulation may be auditory may be visual only occurs in the setting of schizophrenia - correct answer only occurs in the setting of schizophrenia The nurse practitioner is examining an adolescent who has been a long-term IV cocaine user. What other findings would alert the nurse practitioner to a frequent complication. Epistaxis and chronic rhinorrhea Cardiac arrhythmias and hypertension Chest congestion and wheezing Hepatitis and cellulitis - correct answer Hepatitis and cellulitis The nurse practitioner is completing a history and physical on a child who she suspects may be autistic. Findings associated with autism include: Delay in language development Delay in physical growth Overprotective parents who provide minimal social interaction for the child Warm, cuddling child with excessive need for interaction. - correct answer Delay in language development A 38-year-old accountant comes to your clinic for evaluation of a headache. The throbbing sensation is located in the right temporal region and is an 8 on a scale of 1 to 10. It started a few hours ago, and she has noted nausea with sensitivity to light; she has had headaches like this in the past, usually less than one per week, but not as severe. She does not know of any inciting factors. There has been no change in the frequency of her headaches. She usually takes an over-the-counter analgesic and this results in resolution of the headache. Based on this description, what is the most likely diagnosis of the type of headache? Tension Cluster Migraine Analgesic rebound - correct answer Migraine A middle aged pateint presents with diffuse facial swelling. Upon further assessment of the face you note hair is dry, course and sparse; thinning of lateral eyebrows; periorbital edema. This represents a finding of: [Show Less]
- Exam
- $13.95
- 0
- 78
ADVANCED HEALTH ASSESSMENT FINAL
patient tells you they are taking ASA everyday. What do you ask next? - correct answer Why are you taking ASA daily? what is the most important rule as ... [Show More] an APN regarding sensitive topics - correct answer be nonjudgmental still have to be succinct, focused, and direct too cultural competence is best enhanced when the HCP? - correct answer uses self-awareness and reflection you assess a patients broken arm and you suspect she may be a victim of violence. which statement triggers your concern? - correct answer I hurt it about 4 days ago=delay of treatment you are going to organize a BP screening fair at the mall. you are involved in what type of prevention? - correct answer secondary prevention secondary prevention - correct answer screening means you are looking for a disease thats already there patients presents with RLQ pain, as you document his HPI you note his c/o nausea. In your symptom analysis this would be considered: - correct answer associated symptom Pt's daughter is explaining why her mother is at the office. This is an example of: - correct answer subjective information Pt has a BMI of 27. Is this normal, underweight, or overweight? - correct answer overweight You administered the CAGE questionnaire as part of a screening policy and the patient answers yes to 2 and 4. what is the significance of this if any? - correct answer he has physical dependence and needs intervention what does question 4 on the CAGE questionnaire ask? what is the significance of it? - correct answer do they need an eye opener? it indicates physical dependence you are meeting for the first time a 14 y/o female patient. you would want to include the what in her exam? - correct answer HEADS & RAFFT what does HEADS & RAFFT assess - correct answer behavior of the teenager patient scores a 29 on the mini-mental exam. what do you document this as? - correct answer a normal finding what are the components of the adult health history? - correct answer 1. identifying data 2. history of present illness 3. review of systems NOT physical exam what does the CAGE questionnaire look for - correct answer alcoholism coronary artery disease risk factors (4) - correct answer 1. smoking 2. HTN 3. family history 4. age you have a new patient and in order to get reimbursed at a higher level for education you provide, you must document the time spent on this education at least what percentage of the visit - correct answer at least 55% of the visit how do you define an established patient - correct answer patient presents for a checkup in your office. you have not seen her before but she was last seen by the MD in your group 2 years ago how long would it be since a patient has been seen in the same practice for them to be considered a new patient - correct answer 3 years ago as you review your note for your patient you realize that the keys to select the right level of billing include what 3 things - correct answer history exam decision making when performing a history & physical on a pediatric patient, which important factor affects the outcome the most: - correct answer child's development level the key element for all levels of CPT code documentation is: - correct answer chief complaint when obtaining a health history from an older client, which characteristics of the older client must be taken into consideration? - correct answer auditory acuity is the most common sensory loss in the aged population and may hinder the interview what's the most important question to ask as you build your HPI - correct answer have you ever had this before? the development of screening and prevention guidelines is based on? - correct answer increase in average life expectancy limiting public smoking is what type of prevention? - correct answer primary prevention-trying to prevent disease what is the leading cause of mortality in teenagers - correct answer motor vehicle accidents according to the ABCDE approach to preventive cardiology, the items to assess for the "A" include: (3 Things) - correct answer 1. assessment of risk 2. antiplatelet therapy 3. anticoagulation therapy NOT apple shape patients presents to have a TB test read. how is this billed? - correct answer 99211 b/c it doesn't have to be seen as a provider teenager moved to the community and doesn't have any immunization records. what do you do - correct answer repeat vaccines learning how to drive with a therapist after a stroke is considered what type of prevention - correct answer tertiary prevention already have the disease and the manifestation of the disease adding a community youth center to an area with a history of gangs is what type of prevention - correct answer primary prevention trying to prevent more gangs the SCOFF screening too is used to diagnose eating disorders: true or false - correct answer False no screening tool diagnoses affects of aging on our body - correct answer 1. fat replaces muscle 2. decrease in lean body mass 3. lowered protein reserves slow the body's response 4. total caloric needs decrease you do a physical exam of a healthy 58 y/o patient and you hear a moderately loud murmur and there is no palpable thrill. what is the appropriate grade of this murmur? - correct answer grade 3 what's the difference between a grade 3 and grade 4 murmur? - correct answer grade 4 has a thrill you exam a patient in the ER who presents with SOB. Her JVP at 45 degrees is 7cm above the clavicle. Understanding the formula for determining JVP in relation to the right atria, this finding is most consistent with what diagnosis? - correct answer right-sided heart failure where can you best auscultate the 2nd heart sound? - correct answer place the diaphragm of the stethoscope at the 2nd ICS at the base of the heart you hear a split S2 on auscultation of a 25 y/o client. what is your best action? - correct answer ask the client to hold their breath and repeat physiology S2 is related to respirations where would you expect to hear best an abnormal heart sound when the client has mitral valve insufficiency? - correct answer 5th ICS, left MCL what does an S3 heart sound indicate - correct answer volume what does an S4 heart sound indicate - correct answer stiffness you hear an S4 on a 72 y/o client with a history of HTN. What could this finding indicate? - correct answer an increased resistance to ventricular filling which result for an ABI would be consistent with physical symptoms? patient c/o of pain in his leg when walking that is relieved with rest - correct answer ABI of 0.6 what is the normal ABI - correct answer 1.0 what could oslers nodes be a sign of - correct answer endocarditis During the physical exam of a 72 y/o you note a BP of 140/90. According to the JNC 8, what would you do first? - correct answer calculate cardiac risk pulsus paradoxus is more likely to be associated with: - correct answer status asthmaticus what is arcus senilis - correct answer bilateral gray ring around the irises of older patients. pt will deny visual changes bilateraly gray ring around the iris NOT in an elderly patient - correct answer hyperlipidemia to r/o middle lobe pneumoia where would you auscultate? - correct answer under the right axillae 30 y/o patient c/o palpitations and some light-headedness for past 6 months. NP notices a mid-systolic click with a late systolic murmur heard best in the apical area. what would you suspect? - correct answer mitral valve prolapse what is acute bronchitis characterized by - correct answer paroxysms of coughing that is dry or productive of mucoid sputum a positive clinical sign on physical exam indicating pneumonia is: - correct answer dullness on percussion when auscultating for vocal resonance in a client with possible consolidation of lung tissue, the NP hears "a" when the client says "e". this is called: - correct answer positive egophony what does hyperresonance in percussion of the lungs indicate? - correct answer an expected finding with emphysema b/c of air trapping as you assess a client you understand that their dyspnea is basically a dysfunction with external respiratory physiology due to her: - correct answer emphysema happens at the lung where does external respiration happen - correct answer at the lung where does internal respiration happen - correct answer at the tissue level assess a 55 y/o smoker with a thick sputum producing cough. on exam you notice a positive tactile fremitus, resonant percussion, and normal voice sounds. you suspect: - correct answer bronchitis you review a chart of a patient with positive whispered pectoriloquy. you understand this to be: - correct answer abnormal-loud and clear finding what does the presence of increased tactile fremitus indicate - correct answer fluid or solid mass within the lungs what are 3 risk factors for breast cancer? - correct answer 1.history of maternal breast cancer (premenopausal onset) 2. first pregnancy after age 35 3. late menopause after 54 is asymmetric breast development a risk factor for breast cancer - correct answer no what is a good description of a breast cancer lump - correct answer single, firm, non-tender, ill-defined what is the classic description of a fibroadenoma? - correct answer single, firm, rubbery lump what types of tissues compose the internal structures of the breast - correct answer fibrous, glandular, and adipose tissue in an older man, gynecomastia may be secondary to: - correct answer a change in testosterone what would you expect to find on physical exam in a patient with Paget's disease? (3 things) - correct answer 1. c/o itching and crusting 2. scaly appearance of nipple 3. redness & thickening of areola NOT an inverted nipple in assessing a patient with a positive cardiac history you utilize the CHADS scoring. what are the elements that this scoring system is based on to determine risk? - correct answer 1. HTN 2. DM 3. CHF you noticed a thrill at the apex during systole. this could indicate: - correct answer mitral regurg patient c/o excessive daytime sleepiness, flushed fash. SOB ambulating to the room, BMI>30, +JVD, +HJR, HTN. what are 3 possible list of diagnoses: - correct answer 1. Pickwician syndrome 2. CHF 3. metabolic syndrome not AFib! what would you expect to find with tactile fremitus in a patient with pneumonia - correct answer increased tactile fremitus would symmetric expansion be normal or abnormal in pneumonia - correct answer abnormal how would you interpret this murmur: 5th ICS, timing of diastole with radiation to axilla - correct answer mitral stenosis 3 risk factors for men to get breast cancer - correct answer 1. testosterone level 2. low levels of physical activity 3. h/o bone fracture after 45 NOT 45-55 y/o a circumscribed, elevated lesion >1 cm in diameter and containing clear serous fluid is best described as what: - correct answer bulla the history and physical of a client indicates past occurrences of lichenification. The NP identifies the characteristics of this lesion as: - correct answer rough, thickened epidermis; accentuated skin markings the NP finds a lesion that is about 0.75 cm in diameter, brown, circumscribed, flat and nonpalpable. the correct term for this lesion is: - correct answer macule description of a possible melanoma - correct answer a new 2-mm mole that is brown with a red, irregular border, and is occasionally pruritic an annular skin lesion is usually arranged in what kind of shape - correct answer a circle or ring shape when educating patients about the risk factors for skin cancer you list 3 risk factors - correct answer 1. genetic predisposition 2. high mole count 3. high altitude NOT dark eyes elderly retired farmer presents with a rolled border, pearly, firm nodule with telangiectasia on his nose. what would you list in his differential diagnosis? - correct answer basal cell carcinoma an adult female presents with an irregular variegated nevus on her lower left back that has doubled in size. what should the NP do? - correct answer refer immediately to a dermatologist sounds like a possible melanoma and DO NOT want to do a punch biopsy your patient is 2 weeks old and has pinhead size, smooth, white raised areas across the nose and forehead. How do you document this? - correct answer milia what type of skin lesion is directly related to chronic sun exposure and photo damage - correct answer actinic keratoses what labs do you order if your patient has white nail syndrome - correct answer BUN & Creatinine sign of renal insufficiency what term would you use to describe an elderly patient with multiple solar lentingos <1cm. These are not uncommon for their age. - correct answer macules flat against the skin, like very large freckles what is tinea capitis caused by? - correct answer dermatophyte how would you document a patient with dependent edema with <1" indentation up to the mid-tibia bilaterally - correct answer 4+ what is the most common type of melanoma - correct answer superficial assessment of a patients skin reveals a positive Auspitzs sign. What diagnosis does this help you with? - correct answer psoriasis you note a history of atophic dermatitis in a patient. what other items in the personal or family history would you look for? - correct answer asthma what do the A's stand for in the triad of A's? - correct answer 1. atopic dermatitis 2. asthma 3. allergic rhinitis how would you best describe squamous cell carcinoma? - correct answer often has a keratinous horn how long should it take for jaundice to resolve in a newborn in order for it to be normal? - correct answer 1 week what are the 4 major components to be documented for a skin lesion? - correct answer 1. distribution 2. configuration 3. palpable features 4. pattern what is the most common cutaneous malignancy - correct answer basal cell carcinoma where do you most commonly find basal cell carcinoma - correct answer in sun exposure areas a bruit above and to the left of the umbilicus is most consistent with: - correct answer history of HTN as you palpate the abdomen, +rebound tenderness at McBurney's point would alert you to what? - correct answer appendicitis what sign would you see in a patient with cholecystitis - correct answer + Murphy's sign what do you typically see in later disease presentation of colorectal cancer - correct answer often includes iron deficiency anemia A cullen's sign after surgery may indicate: - correct answer intra-abdominal bleeding what does hyperresonance while percussing the abdomen most likely represent? - correct answer gaseous distention what 3 conditions might you see a positive fluid wave test - correct answer 1. congestive heart failure 2. portal hypertension 3. cirrhosis NOT inflammation of the spleen a liver span of 3.0 cm MCL would indicate: - correct answer liver atrophy small liver span for a male how would you test for a positive obturator sign in a client with abdominal pain? - correct answer passively rotate the right hip from the 90 degree hip/knee flexion position a client complains of extreme pain in his abdomen and points to the RLQ. In examining the acute abdominal pain the NP would: - correct answer palpate the left side of the abdomen, then gently palpate the right side, noting guarding and tenderness what is the most important goal of assessing a client with abdominal pain - correct answer rule out emergent conditions what could purple striae on an abdominal assessment imply - correct answer Cushing's disease ask about heat/cold intolerance how long after a diagnosis of ulcerative colitis do you need a colonoscopy? how frequent - correct answer every 10 years is the spleen easily palpable in an infant - correct answer yes what do you suspect if you elicit let costo-vertebral angle tenderness - correct answer pyelonephritis when listening to a patients abdomen you hear a systolic bruit in the epigastric area. It occurs at a fixed interval after the apical impulse. what do you suspect is the most likely source of the bruit - correct answer the abdominal aorta patient presents with abdominal pain. You note +AWT (abdominal wall tenderness). This leads you to what possible diagnosis - correct answer muscle strain abdominal disorders in the older patient are more difficult to diagnose because they usually present with: - correct answer vague symptoms & often little or no abdominal pain female patient with a history of ETOH abuse. your abdominal exam should include what test? - correct answer scratch test-looks at liver size pupils change in size when the client focuses from a close object to a distant object. this is interpreted as: - correct answer normal visual accomodation on ophthalmic exam, there appears to be a narrowing or blocking of the vessels. the significant of this finding is: - correct answer the client needs to be evaluated for chronic hypertension positive bruit on exam of the thyroid most likely indicates: - correct answer hyperthyroidism you notice patients history shows a bilateral lid lag of the eye. you should ask the patient about what other problems? - correct answer thyroid client is older (70 y/o) c/o blurred vision that has been getting increasingly worse over past 2 years and has a problem with glare but no pain. What would you first check for? - correct answer cataract what age do children approximate adult vision - correct answer 4 y/o how would you describe a normal Rinne test - correct answer air conduction twice as long as bone conduction which sinus is most likely affected if patient presents with pain and pressure over her cheeks and discolored nasal discharge. you cannot transilluminate the sinuses - correct answer maxillary 72 y/o retired factory worker has hearing loss in his right ear due to excessive cerumen (means theres no air conduction). what would you expect when performing a Weber test - correct answer sound lateralizes to the right ear how do you correctly palpate the thyroid gland - correct answer have the client lower their chin and lean head slightly toward the side being evaluated patient has dipped tobacco for past 35 years. when examining the tongue there is an area of white painless plaques that he cannot get off with brushing. what is the most likely diagnosis - correct answer leukoplakia which lymph nodes would you expect to find enlarged with conjunctivitis - correct answer pre-auricular & anterior cervical patient has chronic hypertension. what would you expect to visualize on funduscopic exam - correct answer cotton wool patches & flame hemorrhages patient presents with eye pain. when you examine the external eye you note a red, tender, swollen, raised area pointing upward from along the lower lash border. what would you document this as? - correct answer hordeolum what two things are important when getting your history involving an injury - correct answer 1. how the injury occurred (activity, trauma) 2. if and how the patient has self treated [Show Less]
- Exam
- $13.95
- 0
- 83
ADVANCED HEALTH ASSESSMENT - COMPREHENSIVE FINAL EXAM
COMPONENTS OF MENTAL STATUS EXAM INCLUDE: - correct answer A-B-C-T APPEARANCE; posture, body movements, dress, grooming and hygiene BEHAVIOR; LOC, Facial... [Show More] expression, speech, mood and affect COGNITION; address, phone#, etc. date?, attention span, recent and remote memory, new learning THOUGHT PROCESS; perceptions, should be logical and consistent this person make sense? how do people treat you?, do you feel you are being watched, followed or controlled? have you heard your name when alone? ___________________ screens for Anxiety - correct answer GAD- 7 questions to ask for depression or suicidal ideations: - correct answer Depression: Over the past two weeks, have you fell down, depressed or hopeless? Over the past 2 weeks, have you felt little interest or pleasure in doing things? Suicidal: Have you ever felt so blue you thought of hurting yourself? Do you have a plan to hurt yourself? How would you do it? ***Must not ignore any talk of suicide*** When is a full mental status exam necessary? - correct answer * Patients whose initial screening suggests an anxiety disorder or depression * Behavioral changes: such as memory loss, inappropriate social interaction * Brain lesions: trauma, tumor, cerebrovascular accident or stroke * Aphasia: impairment of language ability secondary to brain damage * Symptoms- of psychiatric mental illness especially with acute onset ________________ Screens for Alcoholism. - correct answer CAGE: Score 2 or greater highly significant * Have you ever felt you should CUT down on your drinking? * Have people ANNOYED you by criticizing your drinking? * Have you ever felt bad or GUILTY about your drinking? * Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover? (EYE OPENER) Things to Consider When Assessing Older Adults mental status include: - correct answer Ask about chronic illness and how they are managing? Sensory impairments? Polypharmacy (med list again!) Social isolation Physiological issue - Delirium vs. Dementia - UTI - Sundowners Delirium VS Dementia VS Depression: Onset course duration consciousness attention psychomotor changes reversibility - correct answer Delirium ** Dementia ** Depression: ========================================== O: Acute insidious Acute or insidious C: Fluctuating Progressive May be chronic D: Hrs to wks Mos to yrs Mos to yrs C: Altered Usually clear clear A: Impaired Normal unless May be decreased severe dementia P: increased often normal may be slowed in decreased severe cases R: usually irreversible usually Delirium Causes: - correct answer D- Dementia E- Electrolyte disorders L - Lung, liver, heart, kidney, brain dysfunction I- Infection R- Rx Drugs I- Injury, pain, stress U- Unfamiliar environment M- Metabolic Adolescent: heeadsss psychosocial interview: - correct answer - Home - Education & Employment - Eating - Activities - Drugs - Sexuality - Suicide & Depression - Safety (injury/violence) When assessing children for mental heath disorders, things to consider: - correct answer Does the child seem sad, tired, restless? Does the child spend a lot of time alone? Frequent outbursts of shouting, complaining, or crying? Lost interest in hobbies like music/sports? Talks about death or suicide? Sleep too much or not enough? Other questions... ____________________ is the test for Proprioception. - correct answer Romberg's Test: - Stand with feet together - Arms out with palms up - Shut eyes - If pt sways or looses balance = Positive Romberg's Risks Related to Undiagnosed Ear Disorders: - correct answer - Poor language development - Delayed learning - Social isolation - Hearing loss - Risk for falls - Missed diagnoses of respiratory and oral infections Major symptoms of ear disease include: - correct answer Hearing loss Vertigo Tinnitus Otorrhea Otalgia Itching Questions to ask if acute hearing loss occurs: - correct answer - Is the hearing loss in one ear? - For how long have you been aware of the hearing loss? - Was the loss sudden? - Is there a family history of hearing loss? - What type of work do you do (or have you done)? - What types of hobbies do you have? - Have you noticed you can hear better when it's noisy? - What kind of medications are you currently taking? - Do you know if you have been given an antibiotic called streptomycin or gentamicin? Types and Causes of Hearing Loss: - correct answer Conductive: - Poor transmission of sound waves through the external and/or middle ear - Tend to speak softer Sensorineural - Diseases of the cochlea and/or poor conduction of sound-generated impulses along the eighth cranial nerve to the brain stem - Tend to speak louder Mixed - Combination of both conductive and sensorineural hearing loss in the same ear Questions to ask if acute vertigo occurs: - correct answer - How long have you had this sensation? - Have you had repeated attacks? - How long does an attack last? Seconds? Minutes? Hours? Days? - Is the onset of an attack abrupt? - Was the sensation brought on by, or worsened by, changes in position? - Does the spinning sensation get worse during an attack? - Are there positions that make you feel better? During an attack have you had double vision? Loss of strength? Decreased hearing? A disturbance of gait? Nausea? Vomiting? Ringing in your ears? - What medications are you currently taking? - Do you know if you have been given an antibiotic called streptomycin or gentamicin? Tinnitus is defined as ___________________. - correct answer Buzzing or ringing in the ears without environmental input Causes of Tinnitus can include: - correct answer - Meniere's disease - Noise trauma - Ototoxic drugs - Otosclerosis Pulsatile tinnitus is ____________________ and can be caused by _______________________. - correct answer - Beats at the same rate as the heart - vascular tumor of head or neck Characteristics of Tinnitus include: - correct answer - Originates in the central auditory system - Affects approximately 10% of the population - Can be transient or continuous - Can be mild, moderate, or severe - Can be subjective (audible only to patient) or objective (sound also audible to examiner as a bruit) - Incidence increases with age Otorrhea is _________________. - correct answer discharge from the ear. Usually indicates acute or chronic infection. Questions to ask a patient with Otorrhea include: - correct answer - Can you describe the discharge? - Have you had similar episodes? - Do you experience dizziness? - Do you have ear pain? - Have you had a recent ear or throat infection? - Have you had any change in your hearing? - Have you used ear drops? - Have you been swimming recently? - Have you had any recent head or ear injuries? Otalgia is _______________ , and may be related to ________________. - correct answer - an earache or ear pain. - inflammatory conditions in or around the ear, or it may be referred from distant anatomic sites in the head and neck. Whats the difference between Primary and Secondary Otalgia? - correct answer - Primary (originating within ear structures) * Infections and inflammations of middle and external ear structures and mastoid tissues. - Secondary (referred to the ear from other regions) * TMJ problems, dental and periodontal problems * Infections in the sinuses and nasopharyngeal areas * Lesions of the tongue * Cervical musculoskeletal problems * Neuralgias Itching in the Ear can be caused by _____________ . - correct answer - Yeast infection of ear - Systemic * Diabetes * Hepatitis * Lymphoma The presence of a tophi is __________________ and is defined as_________________________. - correct answer - a highly specific but nonsensitive sign of gout. - Tophi are deposits of uric acid crystals. They appear as hard nodules in the helix or antihelix. Cauliflower ear is a ______________________. - correct answer pinna that is gnarled as a result of repeated trauma. If discharge is present in the ear you should __________________. - correct answer note its characteristics, such as color, consistency, and clarity. Test for Auditory Acuity include: - correct answer - Whisper test - Finger rub test - Tuning Fork Tests 512-Hz fork ideal * Test the ability of the patients to hear pure tones - Weber Test * Tests for adequacy of bone conduction > Conductive loss - Lateralized to affected hear > Sensorineural - lateralized to unaffected ear > Normal - no lateralization - Rinne Test * Tests for comparison of air conduction to bone conduction in each ear separately > AC in compared to BC > AC > BC = Positive Rinne Questions to ask if obstruction in the nose is suspected: - correct answer - Is the obstruction on one side? - Have you ever had an injury to your nose? - How long has the obstruction been present? - Do you have any allergies? - Does the obstruction worsen with stress? - Is there a history of nasal polyps? - Is the obstruction associated with other symptoms? - Is there a seasonal change in your symptoms? * Which season is worse? Types of dIscharge from nose include: - correct answer - Thin and watery - Thick and purulent - Bloody - Foul smelling Sinus Disease Symptoms include: - correct answer - Fever - Malaise - Cough - Nasal congestion - Maxillary toothache - Purulent nasal drainage - Headache - Decongestants ineffective - Pain worse when bending over Three Major Salivary Glands in mouth include __________________ . - correct answer - Parotid glands *Located in the cheek area below and in front of the ears; secrete saliva via Stensen's ducts (AKA parotid duct) - Sublingual glands *Found under the tongue; provide saliva via several ducts - Submandibular glands * Located in the floor of the oral cavity; secrete saliva into the mouth Review of specific symptoms questions for oral cavity should include: - correct answer - When did you last see a dentist? - What did the dentist do? - Do your gums bleed? - Have you any pain, sores, or masses on your lips or in your mouth that do not heal? - Have you had any problems after extraction of a tooth? - Do you wear dentures? - Have you noticed any change in the way your dentures fit? Common Symptoms Related to the Oral Cavity include: - correct answer - Pain - Ulceration - Bleeding - Mass - Halitosis - Xerostomia Questions related to pain in oral cavity should include: OLDCARTS - correct answer - Where is the pain? - Describe the pain? - Do you feel the pain anywhere else? - How long has the pain been present? - What brings the pain on? - What makes it better? Worse? - When you have the pain, do you have any other symptoms? If there is an ulcer in the oral cavity, questions to ask should include: - correct answer - Have you had a lesion like this before? - Are there multiple lesions? - How long have the lesions been present? - Are there lesions anywhere else on the body, such as in the vagina? Urethra? Anus? - Are the lesions painful? - Do you smoke? - How much? - Do you drink alcohol? - Do you have a history of venereal disease? If a patient snores or if suspected sleep apnea, questions you should include: - correct answer - Have you been told you snore? - How often do you snore? - Does your snoring bother other people? - Have breathing pauses been noticed? - Are you tired after sleeping? - Are you tired during the daytime? - Have you ever fallen asleep while driving? - Do you have high blood pressure? - Is your BMI greater than 28? - Are you 50 years or older? - Are you a man with a neck circumference greater than 17 inches or a woman with a neck circumference greater than 16 inches? - During usual sleep, have you noticed or been told that you toss and turn frequently? - Have you noticed or been told that you kick or jerk your legs repeatedly? - During the time you are usually awake, how often do you become irresistibly sleepy or fall asleep in the following situations: * After a meal * Reading or watching TV * Sitting and talking to someone * At work * While a passenger in a vehicle * While driving a vehicle - About how many times per night do you wake up? - Do you have difficulty falling asleep at night? - How many hours do you sleep? Dysphonia is ______________________. - correct answer hoarseness; the major symptom of laryngeal disease is a change in voice. Four Chambers of the Heart include: - correct answer Upper two chambers: (right and left atria) - Thin-walled, low-pressure chambers - Receive blood from the venae cava and pulmonary arteries - Pump blood into the respective ventricle Lower two chambers (right and left ventricles) - Thick muscular-walled chambers - Pump blood from the atria to the lungs and throughout the body via the aorta - Animation of cardiac cycle: https://www.youtube.com/watch?v=SwxA3L55yqs Epicardium is ____________________. - correct answer the thin, outmost protective layer of the heart. Myocardium is ____________________. - correct answer - Thick muscular middle layer - Pumps blood through the heart Endocardium is ____________________. - correct answer - Lines the inner cavities; covers the heart valves - Limits heart motion; provides a barrier to infection What are the different Valves of the Heart and where are these Heart Sounds heard? - correct answer Aortic region - the 2nd intercostal space, right sternal border. Pulmonic region - the 2nd intercostal space, left sternal border. Erb's points - 3rd intercostal space, left sternal border. Tricuspid region - the 5th intercostal space, left sternal border. Mitral region - the 5th intercostal space, left mid-clavicular line. Phases of the Cardiac Cycle include: - correct answer Systole ; The contraction of the ventricles as blood is ejected from the right ventricle into the pulmonary arteries and from the left ventricle into the aorta * Heard best at the apex of the heart * S1 - closure of AV valves (M1 T1) Diastole ; The passive filling of the ventricles followed by contraction of the atria, thereby moving blood from the atria to the ventricles < Heard best at the base of the heart * Pt: deep breath, exhale, hold breath & lean forward < S2 - closure of semilunar valves (A2 P2) Extra Heart Sounds - correct answer - S3 and S4 * Sometimes classified as extra cardiac sounds * Presence is not necessarily indicative of a pathologic condition * Best heard at/near apex of heart * If over 30 years old or symptomatic, evaluate further S3 - "ventricular gallop" - Volume overload to the ventricles - Regurgitant valvular lesion - CHF S4 - "atrial gallop" - Ventricular hypertrophy - Myocardial ischemia - "Summation gallop" - all 4 heart sounds present simultaneously Most common murmurs - systolic vs diastolic: MS.ARD & MR.ASS = - correct answer M S A R D Mitral Stenosis (5ICS-MCL but can radiate laterally) Aortic Regurg (Erb's point) Diastolic murmurs M R A S S Mitral Regurg (5ICS-MCL) Aortic Stenosis (2ICS-RSB & clavicle) Systolic murmurs Audible mid-systolic click is indicative of _________________. - correct answer MVP (mitral valve prolapse) Erb's point auscultate especially for __________________ . - correct answer - opening snap of MVP - Aortic valve regurgitation - Patent VSD How do you describe any murmurs heard in heart? - correct answer - Timing in the cardiac cycle - Location - Radiation - Duration - Intensity - Pitch - Quality - Relationship to respiration - Relationship to body position WHAT ARE THE 6 LEVELS OF THE LEVINE SCALE FOR GRADING MURMURS? - correct answer I/VI. The murmur can only be heard if one listens carefully for some time. II/VI. The murmur is faint but can be heard straightaway with a stethoscope. III/VI. The murmur is moderately loud and can be heard immediately but there is no palpable thrill (vibration that can be felt). IV/VI. The murmur is loud and accompanies a palpable thrill. V/VI. The murmur accompanies a palpable thrill and is loud enough to be heard with just a slight touch of a stethoscope's rim. VI/VI. The murmur accompanies a palpable thrill and is so loud that it can be heard before a stethoscope even makes contact with skin. Resource: http://mvpresource.com/what-is-the-levine-grading-scale/ What are the Symptoms Associated with Chest Pain? - correct answer - Anxiety - Dyspnea - Nausea - Vomiting - Diaphoresis - Faintness - Clamminess - Pallor What are the Types of Chest Pain? - correct answer - Angina * Stable and unstable * Atypical presentations - Vascular - Pulmonary - Musculoskeletal - Neural - Gastrointestinal Common Cardiac CC's include: - correct answer - Palpitations - Dyspnea * PND vs DOE - Syncope - Fatigue - Edema (dependent?) - Hemoptysis - Cyanosis * Differential cyanosis What should you inspect for in a Cardiovascular assessment? - correct answer - General - Skin * Color * Xanthomata -Nails * Splinter hemorrhages - Lichstein's sign (beware false + or -) - Eyes *Arcus senilis *Xanthelasma *Hypertelorism - Mouth * Palatal petechiae - Neck * Webbing - Chest configuration - Extremities When inspecting the Skin, with suspected cardiovascular issues, you should assess for ___________. - correct answer - Color- is cyanosis present? Does it appear central or peripheral? Is Pallor present? - Temp Xanthomata are __________. - correct answer stony- hard, slightly yellowish masses that are commonly found on the extensor tendons of the fingers- indicative of extremely high serum cholesterol >450mg/dL Eruptive Xanthomata result from ______________. - correct answer elevations in plasma triglyceride concentrations, >1500mg/dL When assessing the Nails, with suspected cardiovascular issues, you should assess for ___________. - correct answer Splinter hemorrhages: visible, small reddish-brown lines in the nail bed. classically associated with infective endocarditis. - Lichstein's sign is ____________. - correct answer (not reliable -beware false + or -): Earlobe crease; is an oblique crease, often bilateral, seen frequently in patients older than 50 yrs with significant CHD Arcus senilis, if found in patients younger than 40 years old may be due to - correct answer -hypercholesterolemia What does Arcus senilis look like? - correct answer a whitish ring at the perimeter of the cornea. Xanthelasma is __________ and is due to possible _______________. - correct answer - the presence of yellowish plaques on the eyelids. - hyperlipoproteinemia Hypertelorism is ___________ and is often associated with ____________. - correct answer - widely set eyes - congenital heart problems such as mitral valve prolapse. When cardiovascular issues are suspected, a high-arched palate may be associated with ________________. - correct answer congenital heart problems such as mitral valve prolapse. Palatal petechiae is often associated with ___________________. - correct answer infective endocarditis. Webbing of neck, as seen in individuals with Turners syndrome and in patients with Noonan's syndrome, may be due to _______________. - correct answer coarctation of the aorta. Pectus excavatum is ______________ . - correct answer caved in chest Pectus carinatum is _______________. - correct answer pigeon breast Questions to assess during General Appearance assessment for cardiac patient should include: - correct answer is the patient in acute distress? What is the patients breathing like? Is it labored? Are accessory muscles being used? Common symptoms associated with DVT are ______________. - correct answer - Swelling in one or both legs - Pain or tenderness in one or both legs, may occur only --when standing or walking - Warmth of skin of the affected leg - Red or discolored skin of the affected leg - Visible surface veins - Leg fatigue How do you elicit a Homan's sign? - correct answer First support patients die with one hand in his foot with the other. Bend his leg slightly at the knee; then firmly and abruptly dorsiflex the ankle. Resulting deep calf pain indicates a positive Homan's sign. The patient may also resist ankle dorsiflexion or flex the knee involuntarily if Homan's sign is positive. Name the Extra Cardiac Sounds one may hear. - correct answer - Systolic Ejection Clicks < Early systolic: * Aortic ejection click * Pulmonic ejection click < Midsystolic: * Single or multiple; associated with prolapse of mitral or tricuspid valves - Diastolic Sounds * Opening snap of the mitral valve or tricuspid valves if pathologically deformed - Other sounds * Pericardial friction rub * Mediastinal crunch What diagnostic tests are for Chest Pain? - correct answer - Electrocardiogram (ECG) - Chest X-ray - Hematologic studies - Cardiac catheterization What diagnostic test is for murmurs? - correct answer Echocardiogram What are the main symptoms of pulmonary disease? - correct answer - Cough - Sputum production - Hemoptysis - Dyspnea - Wheezing - Cyanosis - Chest Pain - Snoring What components of the physical assessment for pulmonary disease should you include? - correct answer - Inspection (anterior and posterior) * Should include general assessment of patient's overall "attitude" - Distress - Posture - Chest configuration - Inspect hands for clubbing - Respiratory rate/pattern Barrel Chest is seen in patients with ________________. - correct answer COPD The use of accessory muscles during breathing is indicative of __________________. - correct answer respiratory distress Palpation of chest is used to assess _______________. - correct answer - Areas of tenderness - Symmetry - Tactile fremitus Increased tactile fremitus can be a result of ___________. - correct answer - Pulmonary consolidation - Pneumonia - Pulmonary edema - Alveolar fibrosis - Alveolar tumor Decreased tactile fremitus can be a result of ___________. - correct answer - Decreased tactile fremitus - Separation between lung and chest wall - Pleural effusion - Pneumothorax - Obesity - Atelectasis - Airway obstruction - Tumor or foreign body - Bronchopneumonia - Pulmonary hyperinflation - Emphysema (COPD) Tracheal Shifts toward side of what diseases? - correct answer Atelectasis Lung cancer pulling on a bronchus Tracheal Shifts away from side of what diseases? - correct answer Pneumothorax Large pleural effusion What does asymmetrical chest excursion indicate? - correct answer Localized pulmonary disease may cause one side of the chest to move less than the opposite side. Name the Percussion notes in the lung and what they are indicative of. - correct answer - Tympany > Large pneumothorax - Hyperresonance > Emphysema - Resonance > Normal lung [Show Less]
- Exam
- $13.95
- 0
- 81
ADVANCED HEALTH ASSESSMENT QUIZZES 1-4
When writing a SOAP note, the nurse practitioner is aware that "A" represents - correct answer The diagnosis When reading a healthcare record you see th... [Show More] e following notation: Patient states "I have had a runny nose and a cough for 1 week now" This is an example of: - correct answer Chief complaint Which of the following is an appropriate recording of the subjective information provided by a patient? - correct answer "grabbing" chest pain for 2 hours You receive results from the laboratory, a metabolic panel and a CBC. Where should that information appear in the SOAP note? - correct answer Objective The nurse asks "Mr. S. tell me what you do when your headaches occur," with this question you are seeking information about: - correct answer Aggravating and relieving factors What is the best terminology to describe significant symptoms associated with each area of the patient's body? - correct answer Review of systems Mrs. Ellis is being seen for a routine physical examination. She is a college graduate and president of a research firm. She attends the local Methodist church weekly. She has adequate health insurance. Most of this information belongs in her: - correct answer Personal and social history Mr. S complains of a headache. During the history, he mentions his use of alcohol and street drugs. Where is the most appropriate place for this information? - correct answer Social history You are a nurse practitioner in a busy primary care practice, when should you ask your patient about substance use? A) when prescribing medication B) At an episodic visit C) At the patient's annual health assessment D) All of the above - correct answer All of the above It is important to ask your patient about their sexual history. Why? Select all that apply. - correct answer 1. To assess their risk for potential pregnancy in females of childbearing age 2. It is important to know their sexual preferences 3. So that you can provide patient centered sex education 4. To learn their potential risk for sexually transmitted infection Documentation of the general survey includes - correct answer Posture, gait, motor activity and personal hygiene The normal appearance of the tympanic membrane is - correct answer Pearly grey with a visible cone of light shining downward & forward from center While undergoing the Rinne test for air conduction (AC) and bone conduction (BC), normal findings would reveal that - correct answer AC is greater than BC Which of the following describes a normal thyroid examination finding? Select all that apply. - correct answer 1. nonpalpable 2. Slightly palpable, smooth, symmetrical Macule - correct answer Flat, non-palpable <1cm lesion Common mole (nevi) - correct answer Hyperpigmented papule 0.75 cm Patch - correct answer flat >1cm lesion Bullae - correct answer fluid-filled, well circumscribed lesion >1com Fissure - correct answer narrow linear crack into epidermis, exposing dermis Vesicle - correct answer fluid-filled, well circumscribed lesion <5mm The most lethal skin cancer is - correct answer melanoma A 4 by 3 cm, well circumscribed, rough, elevated area of skin is an example of a - correct answer plaque The mental status exam consists of assessment of a patient's appearance and behavior, speech and language, mood, thoughts and perceptions and cognitive function. By questioning orientation to time, person, and place, recent and remote memory, you are assessing - correct answer Cognitive function You are seeing a 37 year old female that you suspect is suffering from depression and you are concerned about her risk of suicide. Which of the following findings is of greatest concern that would cause you to recommend immediate hospitalization or referral to the emergency room or crisis for further evaluation - correct answer History of previous suicide attempt with current intent and means What is responsible for the inspiratory splitting of S2 - correct answer Closure of the aortic, then pulmonic valves When recording results of heart murmurs, it is important to include - correct answer quality, pitch, location, grade A grade 2 murmur is best described as - correct answer Quiet, heard immediately after placing stethoscope on the chest A 23-year old optical assistant comes to your office for evaluation of fatigue. As part of your physical examination, you listen to her heart and hear a Grade 2 murmur only at the cardiac apex. Which valve is most likely to be involved, based on the location of the murmur? - correct answer Mitral You listen to the chest and hear a murmur that falls between S1 and S2. This murmur is identified as - correct answer a systolic murmur Jugular venous pressure is considered elevated when: - correct answer It is >3-4 cm above the sternal angle Restrictions of internal and external hip rotation are sensitive indicators of a disease such as - correct answer Arthritis The purpose in asking a patient who complains of neck or lower back pain about bowel or bladder dysfunction is to assess for - correct answer Associated deficit indicating neurological involvement When testing for carpal tunnel syndrome, numbness or tingling in the distribution of the median nerve (palmar surface of thumb, index, middle and medial 4th finger) when hands are pressed together in acute flexion for 60 seconds is a positive - correct answer Phalen's sign Which of the following areas of musculoskeletal examination tests joint function and stability - correct answer Range of Motion Which test is used to detect an injury or tear or the medial or lateral collateral ligament - correct answer Stress test (Abduction/ Adduction) The area of the body surface innervated by a particular spinal nerve is called a - correct answer Dermatome Two of the most common symptoms patients with neurologic disorders describe are - correct answer generalized weakness and pain One way to test cranial nerves IX and X - correct answer Assess gag reflex Cranial nerves III, IV, and VI are all related to - correct answer Ocular movement One way to test cranial nerve XI is - correct answer Ask the patient to shrug shoulders against resistant pressure of examiner's hands One way to test cranial nerve VIII is - correct answer Weber test The best test to assess cranial nerve II is - correct answer Perform snellen chart and reading newspaper print Cranial nerve VII assesses nerves associated with - correct answer The face, facial movement One way to test cranial nerve XII - correct answer Ask the patient to stick out tongue One way to test cranial nerve V is - correct answer Check for facial sensation The best test for assessing cranial nerve I is - correct answer Ask the patient to sniff vanilla The ability to identify a number or letter written on the palm of your hand - correct answer Graphesthesia A test to evaluate position sense - correct answer Romberg test The ability to identify an object by feeling it (tactile sensation) - correct answer Stereognosis Components of cultural humility include all of the following except - correct answer discussing "cinco de mayo" with your patient of Mexican background Key components of peripheral arterial examination include - correct answer Measurement of blood pressure and assessment for aortic, renal, and femoral bruits A patient presents with claudication symptoms and diminished pulses. Which of the following is consistent with chronic arterial insufficiency? - correct answer Pallor of the foot when raised to 60 degrees for one minute Normal pulses are - correct answer +2 Risk factors for lower extremity peripheral vascular disease iclude - correct answer Age 70+, obesity, and smoking Mark is a 35 year old police officer who is seeing you for his annual check up. When taking his sexual history it is important to: select all that apply. - correct answer 1. Ask about sexual partners and any history of sexually transmitted infections 2. As he states he is sexually active, ask about safer sex with condoms The NP is preparing to complete a vaginal examination. Best practice includes - correct answer Avoid unexpected or sudden movements, drape patient from midabdomen and depress drape between the knees to provide eye contact Common scrotal swellings include - correct answer Indirect inquinal hernias When discussing modifiable risk factors for breast cancer in a 57 year old female, the NP recognizes that he/she can include discussion about which of the following? - correct answer Use of hormonal replacement treatment (HRT) Normal findings of a prostate exam include which of the following - correct answer Prostate measures 2.5 cm, rubbery, nontender Which of the following is most likely benign on breast examination? - correct answer One breast larger than the other Mary is a 48 year old female who is seen today for a change in her menstrual flow. Her normal periods are have been every 28-30 days, but in the last 6 months she only had a period twice. A pregnancy test is negative and pelvic exam is normal. You schedule a follow up visit in 2 months and encourage her to call with any questions. You discuss peri-menopausal symptoms with her. When documenting her office visit the best choice for a differential diagnosis is: - correct answer Oligomenorrhea What does a high level of thyroid stimulating hormone (TSH) indicate? - correct answer Hypothyroidism Which of the following findings on a urine dipstick is indicative of an infection - correct answer Positive leukocytes, nitrites and blood Iron deficiency anemia causes which of the following changes in RBC indices - correct answer Microcytic, hypochromic The preferred order for examination of the abdomen is - correct answer Inspection, auscultation, percussion, palpation To identify the lower border of the liver, the NP would: - correct answer Percuss starting at the level of the umbilicus in the right lower quadrant, percussing up toward the liver at the midclavicular line There are 3 main types of abdominal pain including visceral, parietal, and referred pain. Which type of pain is described as gnawing, burning, cramping, or aching and may be difficult to localize? - correct answer Visceral pain Which of the following will help to optimize yield from a pediatric examination? - correct answer Doing the examination out of order if necessary to take advantage of quiet periods for auscultation When interviewing children or adolescents, it is important to - correct answer Always interview adolescents separately after inquiring about concerns from the parent or guardian Dullness noted during percussion of the abdomen could indicate all of the following Except: - correct answer Air filled intestines When performing a genital exam on a 25-year-old man, the nurse notices deeply pigmented, wrinkled scrotal skin with large sebaceous follicles. On the basis of this information, the practitioner would - correct answer Consider this a normal finding and proceed with the examination A 22 year old woman is being seen at the clinic for problems with vulvar pain, dysuria, and fever. On physical examination, the practitioner notices clusters of small shallower vesicles with surrounding erythema on the labia. There is also inguinal lymphadenopathy present. The most likely cause of these lesions is - correct answer Herpes simplex virus type 2 When performing the bimanual examination, the practitioner notices that the cervix feels smooth and firm, is round, and is fixed in place (does not move). When cervical palpation is performed, the patient complains of some pain. The nurse practitioner's interpretation of these results should be which of these? - correct answer The cervix should move when palpated; an immobile cervix may indicate malignancy When assessing for symptoms of diarrhea, it is most important to assess the patient for - correct answer Current prescription and non-prescription medications After completing an assessment of a 60 year old man with a family history of colon cancer, the nurse discusses with him early detection measures for colon cancer. The nurse should mention the need for a - correct answer Colonoscopy every 10 years [Show Less]
- Exam
- $13.95
- 0
- 101
Purchase the bundle to get the full access instantly
- 3 Million+ Study Documents
- 100% Money Back Guarantee
- Immediate Download Access
Add To Cart
Reviews 0
Bundle Details
$14.00
- Trusted by 800,000+ Students
- 24/7 Money Back Guarantee
- Download is directly available
143
0
Seller Details
Beginner
Reviews received
