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Seidel's physical examination Chap 1, question and answer
CAGE Questionnaire for discussing the use of alcohol, Cutting down Annoyance by criticism Guilty Eye openers Chief concern (CC) Brief statemen... [Show More] t of the reason the patient is seeking care Family history (FH) Blood relatives in the immediate or extended family with illness that have features similar to patient concerns History of present illness (HPI) Step by step evaluation of the circumstances that surround the primary reason for the patients visit Intimate partner violence (IPV) A range of abusive behaviors perpetrated by someone who is or was involved in an intimate relationship with the victim Past medical history (PMH) The patients state of overall health before the present problem Personal and social history Work, marriage, sexual, and spiritual experiences; the patients use of alcohol, tobacco, and drugs Review of systems (ROS) Identifies the presence of absence of health-related issues in each body system Symptom analysis Questions specifying onset, location, duration, intensity, characteristics, and aggravating and alleviating factors OLDCARTS Pneumonic for patient pain Onset (when it started) Location Duration Characteristics Aggravating factors (how or when it starts) Relieving factors (how it ends) Timing Severity What will best facilitate an interview with a deaf patient that can read lips? Speaking slowly approximately what percentage of patients interviewed have a sexual orientation other than heterosexual? 10% Which approach is recommended at the onset of an interview? Use an open-ened approach; let the patient explain the problem or reason for the visit repeating a patient's answer is an attempt to.. confirm an accurate understanding which of the following history types is unique to a pediatric history? developmental history when interviewing an adolescent who is reluctant to talk during an interview, it is best to..... ensure confidentiality regarding information discussed during an interview, your patient admits to feeling worthless and having a sleep disturbance for the past 3 weeks. These are clues that warrant the exploration of? risk for suicide Mrs.Carol is a 38 yr old mom who brings her 1 yr old son in for health care. which of the following requests to the child's mother would be most appropiate for the interviewer to make at the beginning of the interview? mrs.turner pls place your son on your lap Which type of questionnaire concerning drug and alcohol use is advocated? CRAFFT Jerry, a 26 yr old homosexual man, is having a health history taken. Which question regarding sexual activity would most likely hamper trust b/w jerry and the interviewer Are you married, or do you have a gf? Long periods of silence during an interview may indicate Time needed to gain courage to discuss a painful topic When questioning a patient regarding a sensitive issue, such as drug use, it is best to Be direct, firm, and to the point Direct questions are designed to Obtain or clarify specific details about an answer When taking to a patient's history, you are asked questions about your personal life. What is the best response to facilitate the interviewing process? Answer briefly and then refocus to the patient's history During an interview, a patient describes abdominal pain that often awaken him at night. Which of the following responses by the interviewer would facilitate the interviewing process? Tell me what you mean by often During an interview, the patient describes problems associated with an illness and begins to cry. The best action in this situation is to Allow the patient to cry and then resume when the patient is ready [Show Less]
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Health Assessment - Chapter 22 Muscul Seidel, 100% accurate answers
____ 1. Which joints are frequently moving articulations that are enclosed by a capsule of fibrous articular cartilage? a. Synarthroses b. Synchondroses ... [Show More] c. Amphiarthroses d. Synovial d. Synovial ____ 2. Fluid that lubricates articular cavities is called: a. blood. b. synovial fluid. c. mucus. d. cerumen. b. synovial fluid. ____ 3. Joints are held together by: a. tendons. b. ligaments. c. muscles. d. cartilage. b. ligaments. ____ 4. Bones are attached to muscles by: a. tendons. b. ligaments. c. muscles. d. cartilage. a. tendons. ____ 5. An increase in muscle tone is known as: a. crepitus. b. effusion. c. spasticity. d. atrophy. c. spasticity. ____ 6. The type of joint that has the widest range of motion in all planes is the: a. ball-and-socket. b. condyloid. c. gliding. d. saddle. a. ball-and-socket. ____ 7. Spinal vertebrae are separated from each other by: a. bursae. b. tendons. c. disks. d. ligaments. b. tendons. ____ 8. The glenohumeral joint is the other name for the: a. elbow. b. shoulder. c. wrist. d. scapula. b. shoulder. ____ 9. The joint where the humerus, radius, and ulna articulate is the: a. wrist. b. elbow. c. shoulder. d. clavicle. b. elbow. ____ 10. The articulation of the radius and carpal bones is the: a. wrist. b. elbow. c. shoulder. d. clavicle. a. wrist. ____ 11. The cruciate ligaments of the knee provide for: a. anterior and posterior stability. b. medial and lateral stability. c. movement on one plane. d. pivoting and rotation. a. anterior and posterior stability. ____ 12. Medial and lateral surfaces of the tibiotalar joint are protected by: a. bursae. b. tendons. c. muscles. d. ligaments. d. ligaments. ____ 13. The suprapatellar bursa separates the patella, quadriceps tendon, and muscle from the: a. tibia. b. fibula. c. femur. d. pelvis. c. femur. ____ 14. The tibia, fibula, and talus articulate to form the: a. ankle. b. knee. c. hip. d. pelvis. a. ankle. ____ 15. Long bones in children have growth plates known as: a. epiphyses. b. epicondyles. c. synovium. d. fossae. a. epiphyses. ____ 16. The elasticity of pelvic ligaments and softening of cartilage in a pregnant woman are the result of: a. decreased mineral deposition. b. increased hormone secretion. c. uterine enlargement. d. gait changes. b. increased hormone secretion. ____ 17. Skeletal changes in older adults are the result of: a. increased bone deposition. b. increased bone resorption. c. decreased bone deposition. d. decreased bone resorption. b. increased bone resorption. ____ 18. The family history for a patient with joint pain should include information about siblings with: a. trauma to the skeletal system. b. chronic atopic dermatitis. c. genetic disorders. d. obesity. c. genetic disorders. ____ 19. Risk factors for sports-related injuries include: a. competing in colder climates. b. previous fracture. c. history of recent weight loss. d. failure to warm up before activity. d. failure to warm up before activity. ____ 20. Light skin and thin body habitus are risk factors for: a. rheumatoid arthritis. b. osteoarthritis. c. congenital bony defects. d. osteoporosis. d. osteoporosis. ____ 21. Inquiry about nocturnal muscle spasms would be most significant when taking the musculoskeletal history of: a. adolescents. b. infants. c. older adults. d. middle-age adults. c. older adults. ____ 22. The musculoskeletal examination should begin when: a. the patient enters the examination room. b. during the collection of subjective data. c. when height is measured. d. when joint mobility is assessed. a. the patient enters the examination room. ____ 23. Pain, disease of the muscle, or damage to the motor neuron may all cause: a. bony hypertrophy. b. muscle crepitus. c. muscle hypertrophy. d. muscle wasting. d. muscle wasting ____ 24. Fasciculation occurs after injury to a muscle's: a. venous return. b. motor neuron. c. strength. d. tendon. b. motor neuron ____ 25. The physical assessment technique most frequently used to assess joint symmetry is: a. inspection. b. palpation. c. percussion. d. the use of joint calipers. a. inspection. ____ 26. A goniometer is used to assess: a. bone maturity. b. joint proportions. c. range of motion. d. muscle strength. c. range of motion. ____ 27. When palpating joints, crepitus may occur when: a. irregular bony surfaces rub together. b. supporting muscles are excessively spastic. c. joints are excessively lax. d. there is excess fluid within the synovial membrane. a. irregular bony surfaces rub together. ____ 28. The temporomandibular joint is palpated: a. under the mandible, anterior to the sternocleidomastoid muscle. b. above the mandible at midline. c. anterior to the tragus. d. at the mastoid process. c. anterior to the tragus ____ 29. The temporalis and masseter muscles are evaluated by: a. having the patient shrug their shoulders. b. having the patient clench their teeth. c. asking the patient to fully extend their neck. d. passively opening the patient's jaw. b. having the patient clench their teeth. ____ 30. The strength of the trapezius muscle is evaluated by having the patient: a. clench her or his teeth during muscle palpation. b. push her or his head against the examiner's hand. c. straighten her or his leg with examiner opposition. d. uncross her or his legs with examiner resistance. b. push her or his head against the examiner's hand. ____ 31. Expected normal findings during the inspection of spinal alignment include: a. asymmetric skin folds at the neck. b. slight right-sided scapular elevation. c. concave lumbar curve. d. the head positioned superiorly to the gluteal cleft. d. the head positioned superiorly to the gluteal cleft. ____ 32. A common finding in markedly obese patients and pregnant women is: a. kyphosis. b. lordosis. c. paraphimosis. d. scoliosis. d. the head positioned superiorly to the gluteal cleft. ____ 33. A wheelchair-dependent older woman would most likely develop skin breakdown at: a. C7. b. the iliac crests. c. L4. d. the gibbus. d. the head positioned superiorly to the gluteal cleft. ____ 34. When the patient flexes forward at the waist, which spinal observation would lead you to suspect scoliosis? a. Prominent lumbar hump b. Prominent cervical concave curve c. Lateral curvature of the spine d. Restricted ability to flex at the hips c. Lateral curvature of the spine ____ 35. When a patient abducts an arm and the ipsilateral scapula becomes more prominent (winged), this usually means that: a. there has been an injury to the nerve of the anterior serratus muscle. b. one of the clavicles has been fractured. c. there is a unilateral trapezius muscle separation. d. one shoulder is dislocated. a. there has been an injury to the nerve of the anterior serratus muscle. ____ 36. When the shoulder contour is asymmetric and one shoulder has hollows in the rounding contour, you would suspect: a. kyphosis. b. fractured scapula. c. a dislocated shoulder. d. muscle wasting. c. a dislocated shoulder. ____ 37. Ulnar deviation and swan neck deformities are characteristic of: a. rheumatoid arthritis. b. osteoarthritis. c. osteoporosis. d. congenital defects. a. rheumatoid arthritis. ____ 38. A finding that is indicative of osteoarthritis is (are): a. swan neck deformities. b. Bouchard nodes. c. ganglions. d. Heberden nodes. d. Heberden nodes. ____ 39. Carpal tunnel syndrome would result in: a. a negative Tinel sign. b. a negative Phalen test. c. reduced abduction of the thumb. d. palm tingling. c. reduced abduction of the thumb. ____ 40. Excessive hyperextension of the knee with weight bearing may indicate: a. advanced joint degeneration. b. gout. c. rotation of the Achilles tendon. d. weakness of the quadriceps muscle. d. weakness of the quadriceps muscle. ____ 41. Arm length is measured from the acromion process through the: a. olecranon joint to the carpal thumb hinge. b. olecranon process to the distal ulnar prominence. c. proximal radial prominence to the distal joint. d. proximal ulnar joint to the middle fingertip. b. olecranon process to the distal ulnar prominence. ____ 42. A positive straight leg raise test usually indicates: a. leg length discrepancy. b. improperly conditioned muscles. c. lumbar nerve root irritation. d. hip bursitis. c. lumbar nerve root irritation. ____ 43. The Thomas test is used to detect: a. hip dislocation. b. unstable sacroiliac joints. c. knee instability. d. flexion contractures of the hip. d. flexion contractures of the hip ____ 44. Which one of the following techniques is used to detect a torn meniscus? a. Drawer test b. McMurray test c. Thomas test d. Trendelenburg test b. McMurray test ____ 45. When performing the McMurray test, the examiner should place the patient in a supine position with a hand on the patient's completely flexed knee and the foot flat on the table at the buttocks, and then: a. grasp and evert the foot and extend the knee. b. grasp and invert the foot and rotate the knee. c. apply valgus stress with the foot planted. d. apply varus stress with the foot planted. a. grasp and evert the foot and extend the knee. ____ 46. Which technique is performed at every infant's examination during the first year of life to detect hip dislocation? a. Ballottement maneuver b. Barlow-Ortolani maneuver c. Range of motion d. Thomas McMurray assessment b. Barlow-Ortolani maneuver ____ 47. You note that a child has a positive Gower sign. You know that this indicates generalized: a. arthropathy. b. muscle weakness. c. bursitis. d. muscle hypertrophy. b. muscle weakness ____ 48. A 3-year-old is brought to the clinic complaining of a painful right elbow. He is holding his right arm slightly flexed and pronated and refuses to move it. The mother states that symptoms started right after his older brother had been swinging him around by his arms. This presentation supports a diagnosis of: a. radial head subluxation. b. femoral anteversion. c. carpal tunnel syndrome. d. osteomyelitis. a. radial head subluxation. ____ 49. What temporary disorder may be experienced by pregnant women during the third trimester because of fluid retention? a. Carpal tunnel syndrome b. Osteitis deformans c. Radial head subluxation d. Talipes equinovarus a. Carpal tunnel syndrome ____ 50. A red, hot, swollen joint in a 40-year-old man should lead you to suspect: a. trauma. b. bursitis. c. gout. d. cellulitis. c. gout. ____ 51. An adult with bowed tibias and a shortened thorax may have: a. ankylosing spondylitis. b. Paget disease. c. rheumatoid arthritis. d. Sprengel deformity. b. Paget disease. ____ 52. In contrast to the patient with rheumatoid arthritis (RA), the osteoarthritis patient typically exhibits: a. pain most pronounced after periods of rest. b. depression. c. sudden onset. d. less weakness and fatigue. d. less weakness and fatigue ____ 53. Your examination of an infant reveals a positive Allis sign. To confirm this finding, you would perform (or elicit) a: a. startle reflex. b. Barlow-Ortolani maneuver. c. Trendelenburg test. d. tibial torsion test. b. Barlow-Ortolani maneuver. ____ 54. Term infants normally resist: a. ankle dorsiflexion. b. McMurray test. c. forefoot adduction. d. knee extension. d. knee extension. ____ 55. A 7-year-old child who begins to limp and complains of persistent hip pain may have: a. congenital hip dislocation. b. Dupuytren contracture. c. Legg-Calvé-Perthes disease. d. osteoarthritis. c. Legg-Calvé-Perthes diseas ____ 56. Dupuytren contracture affects the: a. hip flexor muscle. b. rotator cuff. c. carpal tunnel. d. palmar fascia. d. palmar fascia. ____ 57. A dowager hump is: a. the hallmark of osteoporosis. b. pathognomic of scoliosis. c. indicative of tendonitis. d. characteristic of rickets. a. the hallmark of osteoporosis. Completion Complete each statement. 1. A tingling sensation radiating from the wrist to the hand on striking the median nerve is a positive _____ sign. 2. Anterior cruciate ligament integrity is assessed via the _________ test. 3. During a football game, a player was struck on the lateral side of the left leg while his feet were firmly planted. He is complaining of left knee pain. To examine the left knee, you should initially perform the __________ test. 4. The elbow joint that allows for flexion and extension in one plane represents a type of _____ joint. 5. The most mobile vertebrae are the _______________ vertebrae. 1. Tinel 2. Lachman 3. valgus stress 4. hinge 5. cervical Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 1. Cardinal signs for rheumatoid disorders include which of the following? (Select all that apply.) a. Gradual onset b. Weakness that is usually localized and not severe c. Coarse crepitus on motion d. Joint tenderness e. Sleep disturbance A, D, E a. Gradual onset d. Joint tenderness e. Sleep disturbance ____ 2. The wrist moves in: (Select all that apply.) a. eversion and inversion. b. proximal radius and ulna articulation. c. flexion and extension d. adduction and abduction. C, D c. flexion and extension d. adduction and abduction. [Show Less]
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Walden week 6 Seidel's test bank CH 15, questions and answer
The structure that carries oxygenated blood to the body from the left ventricle is the: aorta Induration, edema and hyperpigmentation are common as... [Show More] sociated findings with which of the following? Venous ulcer In which location would carotid bruits be heard best? Anterior margin of the sternocleidomastoid muscle The characteristics of arterial pulses are directly affected by all the following except: venous valvular competence. The most prominent component of the jugular venous pulse is the: a wave. In newborn infants, closure of the ductus arteriosus usually occurs: 12 to 14 hours after birth. Mrs. Carrol is a 33-year-old patient who is pregnant and presents for a routine checkup. On examination, you note that her blood pressure has decreased. Blood pressure normally decreases during which period? Second trimester of pregnancy During a routine prenatal visit, Ms. T was noted as having dependent edema, varicosities of the legs, and hemorrhoids. She expressed concern about these symptoms. You explain to Ms. T that her enlarged uterus is compressing her pelvic veins and her inferior vena cava. You would further explain that these findings: are usual conditions during pregnancy. Vascular changes expected in the older adult include: loss of vessel elasticity. Persons of Irish or German descent and genetically predisposed women who take birth control pills are at risk for developing varicose veins. The amplitude of pulses is recorded on a(n): numeric scale of 0 to 4. Which of the following statements is true regarding the examination of peripheral arteries? The pulses are most readily felt over bony prominences. Which arterial pulse is most useful for evaluating heart activity? Carotid A pulsation that is diminished to the point of being barely palpable would be graded as: 1. The term claudication refers to: pain from muscle ischemia. Conduction system impairment should be suspected if an irregular heartbeat is: paradoxical. An idiopathic spasm of arterioles in the digits is termed: Raynaud disease. A major risk factor for arterial embolic disease is: atrial fibrillation. You are examining Mr. S, a 79-year-old diabetic man complaining of claudication. Which of the following physical findings is consistent with the diagnosis of peripheral arterial disease? Loss of hair over the extremities You are performing a physical examination on a 46-year-old male patient. His examination findings include the following: positive peripheral edema, holosystolic murmur in the tricuspid region, and a pulsatile liver. His diagnosis is: tricuspid regurgitation. A sound similar to a murmur that is heard over arteries is a: bruit. A characteristic distinguishing primary Raynaud phenomenon from secondary Raynaud phenomenon includes which of the following? Digital ischemia with pain. In children, coarctation of the aorta should be suspected if you detect: a delay between the radial and femoral pulses Kawasaki disease is suspected when assessment of a child reveals conjunctival injection, strawberry tongue, and edema of the hands and feet. Which of the following statements is true regarding the development of venous ulcers in older adults? Diabetes, peripheral neuropathy, and nutritional deficiencies are causative factors. When examining arterial pulses the thumb may be used: especially if vessels have a tendency to move. In differentiating between an occluded artery and occluded vein, a distinguishing sign (present in venous but not arterial occlusion) is: edema. To assess a patient's jugular veins, the patient should first be placed in which position? Supine Observation of hand veins can facilitate assessment of: right heart pressure. You are assessing Mr. Z's fluid volume status as a result of heart failure. If your finger depresses a patient's edematous ankle to a depth of 6 mm, you should record this pitting as: 3+ If pitting edema is unilateral, you would suspect occlusion of a: major vein. Thrombosis of a leg vein should be suspected if the patient feels calf pain: on dorsiflexion of the foot. Which of the following statements is most accurate in describing hepatojugular reflux? It is exaggerated in patients with right heart failure. You are performing jugular venous pressure measurement for your patient in heart failure. You see a pulse wave with the patient's head elevated at a 45-degree angle. Your action as a result of this assessment is to: confirm that the pulsations decrease with inspirations. A bounding pulse in an infant may be associated with: patent ductus arteriosus. In infants or small children, a capillary refill time of 4 seconds: indicates dehydration or hypovolemic shock A venous hum heard over the internal jugular vein of a child: usually has no pathologic significance. In pregnancy, blood pressure is at its lowest at: 16 to 20 weeks. You are palpating bilateral pedal pulses and cannot feel one of the pulses. The feet are equally warm. You find that both great toes are pink, with a capillary refill within 2 seconds. Which of the following statements is correct? Pedal pulses are not always palpable. The arterial pulse is produced by ____________________. ventricular systole The level at which the jugular venous pulse is visible gives an indication of _________________________. right atrial pressure When palpating the carotid artery, which of the following is most important? (Select all that apply.) a. Rotate the patient's head to the side being examined to relax the sternocleidomastoid. b. Excessive carotid sinus massage can compromise blood flow to the brain. c. Excessive carotid sinus massage can cause slowing of the pulse. Which of the following are risk factors for varicose veins? (Select all that apply.) a. Gender c. Lower extremity trauma d. Increased body mass [Show Less]
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Seidel Ch 19 Female Genitalia, question and answer with complete top solution
Posteriorly, the labia minora meet as two ridges that fuse to form the: a. fourchette. b. vulva. c. clitoris. d. perineum. a. fourchette. The labia m... [Show More] inora join posteriorly at a junction called the fourchette. What structures are located at the 5 o'clock and the 7 o'clock positions of the vaginal orifice and open onto the sides of the vestibule in the groove between the labia minora and the hymen? a. Skene glands b. Perineal bodies c. Labia majora d. Bartholin glands e. Labia minora D. Bartholin glands Bartholin glands are found posteriorly on each side of the vaginal orifice and open onto the sides of the vestibule. A cervical polyp usually appears as a: a. grainy area at the ectocervical junction. b. bright red, soft protrusion from the endocervical canal. c. transverse or stellate scar. d. hard granular surface at or near the os. b. bright red, soft protrusion from the endocervical canal. Cervical polyps are bright red, soft, and fragile. They usually protrude from the endocervical canal. Which structure is located posteriorly on each side of the vaginal orifice? a. Skene glands b. Clitoris c. Perineum d. Bartholin glands d. Bartholin glands Bartholin glands are found posteriorly on each side of the vaginal orifice. During sexual excitement, how is the vaginal introitus lubricated? a. The Bartholin glands secrete mucus. b. The clitoris produces moisture. c. The Skene glands drain fluid. d. The urethral surfaces secrete water. a. The Bartholin glands secrete mucus into the introitus for lubrication during sexual stimulation. The vaginal mucosa of a woman of childbearing years should appear: a. smooth and pink. b. moist and excoriated. c. dry and papular. d. transversely rugated. d. transversely rugated. Between puberty and menopause, the vagina is transversely rugated; after menopause, it loses its rugation. The adnexa of the uterus are composed of the: a. corpus and cervix. b. fallopian tubes and ovaries. c. uterosacral and broad ligaments. d. vagina and fundus. b. fallopian tubes and ovaries. A bluish color to the cervix during pregnancy is called (the): a. McDonald sign. b. Spinnbarkeit. c. Goodell sign. d. Chadwick sign. d. Chadwick sign. The Chadwick sign is a bluish color to the cervix during pregnancy. The Goodell sign is an increase in vascularity and softening of the cervix. Spinnbarkeit refers to the quality of elastic mucus during mittelschmerz, and the McDonald sign is fundal flexing on the cervix. Mittelschmerz may occur in which phase of the menstrual cycle? a. Menstrualb. b. Postmenstrual c. Ovulation d. Secretory e. Luteal Ans: C. Ovulation Mittelschmerz, lower abdominal pain associated with ovulation, may also be accompanied by tenderness on the side where ovulation took place that month. The pelvic joint that separates most appreciably during late pregnancy is the: a. sacroiliac. b. symphysis pubis. c. sacrococcygeal. d. iliofemoral. b. symphysis pubis. Of the four pelvic joints, the one that moves appreciably later in pregnancy is the symphysis pubis. Pregnancy-related cervical changes include: a. flattening and lengthening. b. thinning and reddening. c. hardening and pallor. d. softening and bluish coloring. d. softening (Goodell sign) and bluish coloring(Chadwick sign). Mrs. Robinson, a 49-year-old patient, presents to the office complaining of missing her menstrual period. She asks about menopause. You explain to her that the conventional definition of menopause is: a. the first day of the last menstrual period. b. 1 year with no menses. c. the last day of the last menstrual period. d. the cessation of ovulation. b. 1 year with no menses. Which systemic feature is related to the effects of menopause? a. Increased abdominal fat distribution b. Decreased LDL levels c. Cold intolerance d. Decreased cholesterol levels a. Increased abdominal fat distribution Systemic effects of menopause include increased intraabdominal body fat, increased LDL and cholesterol levels, and hot flashes. Ms. A, age 32, states that she has a recent history of itchy vaginal discharge. Ms. A has never been pregnant. Her partner uses condoms and she uses spermicide for birth control. Which of the following data are most relevant to Ms. A's problem? a. Bowel habits b. Douching routines c. Menstrual flow d. Nutritional factors b. Douching routines When obtaining history of present illness information for the woman with a vaginal discharge, you should inquire about her douching habits. Douching is not only medically unnecessary but it can also mask, or even worsen, conditions such as bacterial vaginosis or a yeast infection. Which risk factor is associated with cervical cancer? a. Endometriosis b. Low parity c. Multiple sex partners d. Obesity c. Multiple sex partners Cervical cancer is associated with certain HPV strains. Multiple sex partners increase the risk of HPV infection. Which of the following cancers is not associated with human papillomavirus (HPV) infection? a. Cervical b. Vaginal c. Vulvar d. Ovarian e. Penile ANS: C. Vulvar HPV infection can cause cervical, vaginal, and vulvar cancers in women; penile cancer in men; anal and oropharyngeal cancer and genital warts in both men and women. Vaccination against HPV before exposure to the virus through sexual contact is recommended for preadolescent and adolescent girls and boys The risk of ovarian cancer is increased by: a. the use of oral contraceptives. b. cigarette smoking. c. age between 35 and 50 years. d. early age at first intercourse. a. the use of oral contraceptives. There is a relationship between the number of menstrual cycles and risk of ovarian cancer. Early menarche and menopause after 50 years of age increase the risk. The form of gynecologic cancer that is increased in obese women is: a. vaginal. b. cervical. c. ovarian. d. endometrial. d. endometrial. Obesity increases a woman's chance of developing endometrial cancer by twofold to fivefold. When performing a gynecologic examination, the examiner should change gloves after touching the patient's: a. anal area. b. Bartholin glands. c. Skene glands. d. cervix. e. urethra. ANS: A. anal area Whenever the anal surface is touched, the examiner should change gloves to prevent bacterial cross-contamination to other genital areas. The mother of an 8-year-old child reports that she has recently noticed a discharge stain on her daughter's underwear. Both the mother and daughter appear nervous and concerned. You would need to ask questions to assess the child's: a. drug ingestion. b. fluid intake. c. risk for sexual abuse. d. hormone responsiveness. c. risk for sexual abuse. Vaginal discharge in a child could be related to a chemical irritation from soaps, lotions, or powders or to urinary tract infections. Concerned parents and children should be assessed for the risk of sexual abuse. The female patient should ideally be in which position for the pelvic examination? a. Fowler b. Prone c. Lateral supine d. Lithotomy d. Lithotomy Ideally, the woman should be in a lithotomy position for a pelvic examination. When you plan to obtain cytologic studies, speculum introduction may be facilitated by: a. lubrication with gel. b. lubrication with warm water. c. use of a plastic speculum. d. opening the blades completely. b. lubrication with warm water. It is generally thought that gel lubrication may interfere with cytologic studies; therefore, most clinicians lubricate the speculum with warm water. Although gel lubrication would facilitate speculum introduction, the gel could interfere with cytologic studies. Use of a plastic speculum or opening the blades completely would not facilitate speculum introduction. Which of the following findings indicates a possible gonococcal infection? a. Bulging of the anterior or posterior vaginal wall b. Discharge from urethra or Skene glands c. Irregular urethral orifice in midline d. Irregular vaginal edges at introitus b. Discharge from urethra or Skene glands Use two fingers of one hand to push the introitus down to relax the pubococcygeal muscle. Then hold the closed speculum with the other hand, and insert the speculum past your fingers obliquely. The examiner should change gloves after touching the patient's: a. anal area. b. Bartholin glands. c. Skene glands. d. urethra. a. anal area. During a digital examination of the vagina, the cervix is noted to be positioned posteriorly. On bimanual examination of this woman, you would expect to palpate a(n) ___________ uterus. a. retroverted b. anteverted c. midline d. laterally deviated b. anteverted The presence of cervical motion tenderness may indicate: a. pregnancy. b. nulliparity. c. pelvic inflammatory disease. d. vulvovaginitis. c. pelvic inflammatory disease. Which one of the following is a proper technique for the use of a speculum during a vaginal examination? a. Allow the labia to spread, and insert the speculum slightly open. b. Insert one finger, and insert the opened speculum. c. Press the introitus downward, and insert the closed speculum obliquely. d. Spread the labia, and insert the closed speculum horizontally. c. Press the introitus downward, and insert the closed speculum obliquely. Gently insert a finger of one hand to push the introitus down to relax the pubococcygeal muscle. Then hold the closed speculum with the other hand and insert the speculum past your finger obliquely. Small, pale yellow, raised, and rounded areas are visualized on the surface of the cervix. You should: a. chart this as nabothian cysts. b. chart this as a friable cervix. c. obtain a viral culture. d. test the pH of the cervical os. a. chart this as nabothian cysts. This describes nabothian cysts, which are retention cysts of the endocervical glands and are considered a normal variant. No further testing is warranted. An examiner has rotated a brush several times into the cervical os. The brush was withdrawn and stroked lightly on a glass slide. The slide was sprayed with fixative. Which type of specimen requires this technique for collection? a. Gonococcal culture b. Cytology smear c. Haemophilus smear d. Trichomonas smear b. Cytology smear When collecting specimens, which sample should be obtained first? a. Chlamydial swab b. Gonococcal culture c. Pap smear d. Wet mount c. Pap smear A Pap smear is obtained first and then other samples to test for gonorrhea, chlamydia, Trichomonas, bacterial vaginosis, or candidiasis are obtained. Pap smear results are affected by the presence of blood, and vaginal infections result in more friable tissues; therefore, the Pap smear should be obtained first. Dacron swabs are necessary when testing for which condition? a. Gonorrhea b. Pregnancy c. Trichomoniasis d. Chlamydia d. Chlamydia The visualization of a large proportion of "clue cells" on your wet mount slide examination suggests: a. trichomonal infection. b. bacterial vaginosis. c. candidiasis. d. gonorrhea. b. bacterial vaginosis. Clue cells are present in bacterial vaginosis. Hyphae are present in candidiasis, and flagella are present in trichomonal infection. Gonorrhea and cervical cancer cannot be identified on a wet mount The presence of a fishy odor after adding potassium hydroxide to a wet mount slide containing vaginal mucus suggests: a. bacterial vaginosis. b. yeast infection. c. chlamydial infection. d. pregnancy. a. bacterial vaginosis. A positive whiff test suggests bacterial vaginosis. Bimanual examination of the uterus includes: a. grasping the cervix between the examining fingers. b. grasping the vaginal wall and pulling it downward. c. inserting one finger into the fundus. d. placing the thumb on the clitoris and the forefinger on the cervix. a. grasping the cervix between the examining fingers. The assessment of which structure is not part of the bimanual examination? a. Cervix b. Bladder c. Uterus d. Ovaries b. Bladder The bimanual examination consists of assessing the cervix, uterus, adnexa, and ovaries. The rectovaginal examination is an important component of the total pelvic examination because it: a. is the most direct cervical examination route. b. is a more comfortable examination for the posthysterectomy patient. c. is an alternate source for cytology specimens. d. allows the examiner to reach almost 2.5 cm higher into the pelvis. d. allows the examiner to reach almost 2.5 cm higher into the pelvis The rectovaginal examination allows you to reach almost 2.5 cm higher into the pelvis to examine structures not reached with the bimanual examination. It is more uncomfortable for the patient and is not the source for cytology specimens or more complete evaluation of the bladder. Prominent labia minora are a normal finding in: a. adolescents. b. menopausal women. c. newborns. d. pregnant women. c. newborns. Newborn genitalia findings are the result of maternal hormones. Both the labia majora and minora are swollen, with the minora often being more prominent. [Show Less]
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Seidel Chapter 13 - Ears, Nose, and Throat, question and answer| A+ content
Mr. Harris is a 67-year-old patient who presents to your office with a complaint of hearing loss. On examination, you perform the Weber test. Which of the ... [Show More] following is considered a normal finding? The patient hears the tone equally in both ears. Which finding is most likely to cause an examiner to suspect a foreign object in the nose of a young child? There is a purulent discharge from the child's nose. Mrs. Jones is a 45-year-old patient who presents to your office with a complaint of fatigue. On examination, you observe a blackish area on the top surface of the tongue. Mrs. Jones tells you that her tongue is painful. Which question by the examiner would be helpful in explaining this finding? "Have you been taking antibiotics lately?" Which of the following situations is an indication for transillumination he patient complains of pain over the sinuses with palpation For which assessment would you use an otoscope with a pneumatic attachment? Mobility of the tympanic membrane Mr. Torres brings his 8-year-old son in with a complaint of sore throat. On examination, you note that the patient's tonsils are enlarged and nearly touch the uvula. This is documented as 3+. Mr. Jones presents to your office following a fistfight. On examination of the tympanic membrane, you notice a blue color. This indicates the patient has: blood in the middle ear. When examining a patient's ear, you hear a cracking sound when you ask the patient to yawn. This finding is indicative of otitis media with effusion Which statement made by a 75-year-old patient indicates a normal process of aging? Food does not taste the same as it used to." Mrs. Lineman brings her 6-week-old infant in for a follow-up examination. On examination, you observe a tympanic membrane lacking conical appearance and with a diffuse light reflex. These findings: are normal for an infant of this age Which behavior described by a parent indicates that an infant or young child may have a hearing problem? "My 2-month-old baby does not seem to respond to loud noises." What is your conclusion when you find gingival enlargement in a pregnant patient? It is a normal finding. Mr. Fitzgerald is a 26-year-old patient who complains of chronic sniffling, nasal congestion, nosebleeds, mucosal scabs, and septum perforation. You would suspect: cocaine abuse A function of cerumen in the ear canal is to provide: lubrication The middle ear is an air-filled cavity in which of the following bones? Temporal The external ear is separated from the middle ear by the tympanic membrane Saliva, which is secreted by the salivary glands, is responsible for moisturizing the mucosa and initiating digestion The function of the turbinates in the nose is to increase the surface area of the nose Mrs. Lukin is a 46-year-old patient who complains of seasonal allergies. During her examination, which of the following pairs of sinuses are accessible for physical examination? Maxillary and frontal The tongue is anchored to the floor of the mouth by the: frenulum. 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? Hearing loss To which problem are older individuals more prone? Decreased salivation The set of the ears is determined by an imaginary line that originates at the inner canthus On examination, the auditory canal of a 13 year old is found to be obstructed with cerumen. Which tool would you use to clean out an obstructed auditory canal? Body temperature water irrigation Mrs. Vellok is a 38-year-old patient who presents with a complaint of hearing loss. On examination, pulling Mrs. Vellok's auricle upward and back facilitates visualization of the tympanic membrane by: straightening the auditory canal A tympanic membrane that is retracted is also more concave The pneumatic attachment to the otoscope is used to evaluate which characteristic of the tympanic membrane? Mobility Screening for auditory function in an individual begins when the patient responds to your questions and directions Mr. Kooler is a 38-year-old patient who, during the Weber test, indicates that sound is heard better in one ear. This is described as: lateralization. A sensorineural hearing loss is the result of: a defect in the inner ear that leads to distortion of sound and misrepresentation of speech. Mr. Scottman is a 55-year-old patient who complains of a bilateral watery discharge from the nose that is associated with sneezing and nasal congestion. This is indicative of a(n): allergy. Mrs. Wheeler is a 64-year-old patient who presents to your office. She tells you that she has a vitamin B12 deficiency. The examiner can easily detect this by observing: a smooth tongue Gingivitis is characterized by redness and swelling of the margins of the gums. The color of the nasal mucosa should appear deep pink. Mr. Davids is a 67-year-old patient who presents to your office with a complaint of thickened white plaques on the tongue. These are most likely: leukoplakia A bony protuberance at the midline of the hard palate that is of no clinical significance is called: torus palatinus On examination of a 15-year-old patient, you find scabs on the nasal mucosa and a decrease in taste and smell. Which problem do you suspect? Cocaine use When the patient sticks out his tongue as part of the oral examination, you note that it deviates to the right. How do you interpret this finding? The hypoglossal nerve is impaired When you ask the patient to clench the teeth and then to smile, which cranial nerve are you testing? Facial [Show Less]
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Seidel Chapter 7 Mental Status, question and answer | latest updated
1. Ms. Pammy is a 36-year-old woman who presents to your office with a complaint of depression. She is experiencing anger, fear, and sorrow. Which of the f... [Show More] ollowing regulates feelings of anger, fear, and sorrow? A. Limbic system B. Corpus callosum C. Temporal lobes D. Caudate nucleus A. Limbic system The limbic system mediates certain patterns of behavior that determine survival (e.g., mating, aggression, fear, and affection). Reactions to emotions such as anger, love, hostility, and envy originate here, but the expression of emotion and behavior is mediated by connections between the limbic system and the frontal lobe. Answers b, c, and d are incorrect because they are responsible for other functions. Mrs. Hilliard brings her 9-year-old daughter to your office. She has been diagnosed with autistic disorder. Which of the following statements best describes this disorder? A. Pervasive neurodevelopmental disorder B. Global intellectual deficit C. Social impairment syndrome D. Right brain dysfunction A. Pervasive neurodevelopmental disorder Autism is a pervasive neurodevelopmental disorder of unknown etiology that includes a wide spectrum of disorders typically identified before 3 years of age and is more common in boys than girls. Mr. Edwards presents to the emergency department after an auto accident. Which of the following scales would be used to evaluate the mental status of a patient after head trauma? A. Mini-Mental State Examination B. Perceptual distortion assessment C. Glasgow Coma Scale D. Functional assessment C. Glasgow Coma Scale The Glasgow Coma Scale is used to quantify level of consciousness after an acute brain injury or medical condition. The Mini-Mental State Examination (MMSE) is a standardized tool to assess cognitive function changes over time. Perceptual distortion assessment evaluates the variation between a reported perception of a stimulus and the normal response. Functional assessment is an objective measure of a person's ability to perform the activities of daily living. Disordered perceptions, decreased attention span, suspiciousness, and fear with motor and sensory excitement are characteristics of which disorder? A. Delirium B. Dementia C. Schizophrenia D. Depression A. Delirium Delirium is impaired cognition and consciousness and mood and behavioral dysfunction of acute onset. Disordered perceptions, decreased attention span, suspiciousness, and fear with motor and sensory excitement are objective characteristics found in delirium. Mr. Yates is a 67-year-old patient who presents to your office with his son. Which of the following would best test Mr. Yates's comprehension? A. Ask him to count backward by 7s from 100. B. Ask him to follow one- and two-step commands. C. Ask him the meaning of "a stitch in time saves nine." D. Ask him his name, the date, and the season. B. Ask him to follow one- and two-step commands. Asking simple one- and two-step directions measures a patient's comprehension. Patients should be able to follow instructions of this type. Answers a, c, and d measure other cognitive abilities, like abstract reasoning. Mrs. Tucker presents to your office today for a follow-up appointment. She appears to fidget in her seat and with her hands. Which of the following would assess her attention span? A. Are you usually this anxious? B. I am going to ask you to name four items; do the best you can. C. What does this phrase mean: "A stitch in time saves nine?" D. Could you take this paper, fold it in half, and put it on the counter? D. Could you take this paper, fold it in half, and put it on the counter? Answer d is an example of asking the patient a set of short commands that measures attention span. Answer a is a form of validation. Asking answer c measures cognitive abilities, whereas answer b does not provide enough information to determine what the examiner is trying to measure. A mother brings her child, an 18-month-old boy, to the clinic. She states that the child rarely talks or smiles. She has also noticed that he does not like to be held. She states that his motor development seems to be normal. With what condition are these symptoms consistent? A. Dementia B. Autistic disorder C. Attention deficit D. Delirium B. Autistic disorder Symptoms such as delayed or underdeveloped language skills and resisting being held or touched are signs of autism, a pervasive neurodevelopmental disorder of unknown etiology that includes a wide spectrum of disorders typically identified before 3 years of age and is more common in boys than girls. Mr. Johnson presents to your office with a complaint of anxiety. Which area of the mental assessment corresponds to his complaint? A. Cognitive abilities B. Speech/language C. Emotional stability D. Appearance and behavior C. Emotional stability Emotional stability is evaluated when the patient does not seem to be coping well or does not have resources to meet his or her personal needs. Anxiety may be present in other components of the mental assessment, but it is a measure of the patient's emotional stability. Mrs. Karon is a 46-year-old female patient who presents to your office for a physical. When you enter the room, her arms are folded tight and she will not look up to address you. Into which category of examination findings do these observations belong? A. Cognitive abilities B. Speech/language C. Emotional stability D. Appearance and behavior D. Appearance and behavior Body language, grooming, and emotional status comprise the patient's appearance and behavior. A lack of concern with appearance, or inappropriate dress for season or occasion in a previously well-groomed individual may indicate depression, a psychiatric disorder, or dementia, which are indicative of the patient's emotional status. Answer b is inappropriate becauase the patient did not verbalize anything. Mrs. Horter brings her 14-year-old son in with a complaint that he has a poor attention span. Which of the following examination categories is most reflective of attention span? A. Cognitive abilities B. Speech/language C. Emotional stability D. Appearance and behavior A. Cognitive abilities Attention span, state of consciousness, responses to analogies, abstract reasoning, arithmetic calculation, and memory are assessed to evaluate cognitive abiliites. Signs of possible cognitive impairment are poor attention span, significant memory loss, confusion (impaired cognitive function with disorientation, attention and memory deficits, and difficulty answering questions or following commands), impaired communication, inappropriate affect, personal care difficulties, hazardous behavior, agitation, and suspiciousness. Which is a major difference between Alzheimer disease and vascular dementia? A. Etiology B. Degree of memory loss C. Functional ability D. Extent of personality disintegration A. Etiology Dementia is a chronic, slowly progressive disorder of failing memory, cognitive impairment, behavioral abnormalities, and personality changes that often begins after age 60 years and is usually related to structural diseases. Vascular dementia is a type of dementia related to acute or embolic strokes or cerebral hemorrhages caused by hypertension. Up to 70% of Alzheimer dementia is caused by the presence of senile plaques and neurofibrillary tangles with abnormal amyloid processing or deposits. Which of the following actions would best evaluate the patient's judgment? A. Ask the patient the meaning of the statement "A stitch in time saves nine." B. Provide the patient with four unrelated words and ask the patient to remember them. C. Ask the patient, "What do you plan to do after you are discharged from the hospital?" D. Give the patient pencil and paper and ask him to write a paragraph about judgment. C. Ask the patient, "What do you plan to do after you are discharged from the hospital?" Questions that focus on the patient's plan for the future are used to assess the patient's judgment, as well as questions to illicit how the patient meets his or her social and familial obligations and those based on hypothetical situations. Answers a, b, and d measure other categories of mental functioning Mr. Gates is a 68-year-old man who is brought to your office by his daughter. Which of the following would demonstrate an evaluation of thought process and content? A. Observing the person's patterns of thinking, especially the appropriateness of sequence, logic, coherence, and relevance to the topics discussed B. Observing congruence of affect and speech C. Inquiring about visual, auditory, or tactile hallucinations D. Asking the patient a question such as "What would you do if you were in a theater and saw a fire starting?" A. Observing the person's patterns of thinking, especially the appropriateness of sequence, logic, coherence, and relevance to the topics discussed Thought process and content are evaluated by observing the patient's thought patterns, especially the appropriateness of sequence, logic, coherence, and relevance to the topics discussed. The patient's thought process should be easy to follow, with logical and goal-directed ideas expressed. Illogical, disorganized, or unrealistic thought processes, flight of ideas (rapid disconnected thoughts), blocking (i.e., an inappropriate pause in the middle of a thought, phrase, or sentence), or impaired stream of thinking (e.g., repetition of a word, phrase, or behavior) indicates an emotional disturbance or a psychiatric disorder. Answers b, c, and d evaluate other components of mental function. Mr. Brooks is a 65-year-old patient who presents to your office with his daughter. The daughter states that her father has intact reading comprehension, impaired writing skills, and uses only nouns and verbs in speech. Which of the following best identifies this condition? A. Wernicke aphasia B. Broca aphasia C. Dementia aphasia D. Global aphasia B. Broca aphasia Broca aphasia is an expressive type of aphasia characterized by intact reading comprehension, impaired writing skills, and using only nouns and verbs in speech. Wernicke and Broca aphasias display different symptoms, and the patient's speech with dementia aphasia may be rambled, incoherent and disordered or the patient may struggle to find the right words. Mr. Santos is a 78-year-old patient who presents to your office with his daughter. The daughter describes difficulties that include a sudden onset of cognitive impairment, illogical flow of ideas, and hallucinations. Which of the following best describes this condition? A. Delirium B. Alzheimer-type dementia C. Vascular-type dementia D. Anxiety disorder A. Delirium Characteristics of delirium include a sudden onset of cognitive impairment, illogical flow of ideas, and hallucinations that fluctuates during the day and last hours or days. Patients with answers b, c, and d display different characteristics. Mr. Green returns to your office with his son 3 months after his CVA. The son questions when his father's speech will improve. Which of the following areas of the brain are integral to motor speech? A. Broca area (frontal lobe) B. Reticular activating system C. Limbic system D. Insula A. Broca area (frontal lobe) Broca area (frontal lobe) contains the motor cortex, which is associated with speech formation, as well as decision making, problem solving, the ability to concentrate, and short-term memory. Answers b, c, and d are associated with different areas of the brain and other characteristics. Mr. Reasoner brings his son in for a routine physical examination. On examination, you note impaired attention for his age, impulsivity, and hyperactivity. Your impression is attention-deficit/hyperactivity disorder. You know that this occurs in children before they are: A. 5 years old. B. 7 years old. C. 9 years old. D. 11 years old. B. 7 years old. Attention-deficit/hyperactivity disorder is a neurobehavioral problem of impaired attention and hyperactive behavior affecting 5% to 10% of school-age children, with an onset before 7 years of age. A review of related history includes detailed inquiry about: A. disorientation and confusion. B. depression. C. medication use. D. all of the above. D. all of the above. Responses to questions about these topics provide clues for focusing the physical examination and the development of an appropriate diagnostic evaluation. Questions regarding medication use (prescription and over-the-counter preparations) as well as complementary/alternative therapies are relevant for each area. Schizophrenia affects which of the following? A. A person's perceptions B. A person's mood C. Attention span D. Only older adults A. A person's perceptions Schizophrenia is a severe, persistent, psychotic syndrome with impaired reality that relapses throughout life. Other disorders may affect a person's mood, attention span, and the older adult. Mr. Jared is a 68-year-old patient who presents to your office with his daughter. During the interview, you note that he has a slumped posture in the chair and lack of facial expression. These observations are most suggestive of which of the following conditions? A. Endocrine disorder B. Concussion C. Parkinson disease D. Vascular dementia C. Parkinson disease Slumped posture and a lack of facial expression may indicate depression or a neurologic condition such as Parkinson disease. The limbic system mediates: A. vomiting. B. emotions. C. speech. D. balance. B. emotions. The limbic system mediates certain patterns of behavior that determine survival (e.g., mating, aggression, fear, and affection). Reactions to emotions such as anger, love, hostility, and envy originate here, but the expression of emotion and behavior is mediated by connections between the limbic system and the frontal lobe. Answers a, c, and d are not a part of the anatomy and physiology of the brain. Mrs. Gerrard is a 72-year-old patient who presents to your office. After your examination, you suspect she is depressed. Which of the following findings could indicate depression in an adult patient? A. Unable to demonstrate abstract reasoning B. Unable to correctly write his or her name C. Unable to comb his or her hair D. Demonstrates impaired math skills D. Demonstrates impaired math skills Impairment of arithmetic skills may be associated with depression and diffuse brain disease. The patient's inability to demonstrate abstract reasoning, correctly write his or her name, or comb his or her hair are associated with other impaired cognitive abilities. Anger or rage reactions, impulsive behavior, and hyperarousal persisting for more than a month are characteristic signs of which problem? A. Schizophrenia B. Attention-deficit/hyperactivity disorder C. Posttraumatic stress disorder D. Vascular dementia C. Posttraumatic stress disorder Anger or rage reactions, impulsive behavior, hyperarousal, condition persists for more than 4 weeks are objective data of posttraumatic stress disorder. Mrs. Bates is a 56-year-old patient who presents to your office with her son. He states she has had a change in mental status. On examination, you note that her judgment is poor. With which problem is poor judgment most closely associated? A. Drug toxicity B. Dementia C. Temporal lobe injury D. Limbic system dysfunction B. Dementia Impaired judgment may indicate intellectual disability, emotional disturbance, frontal lobe injury, dementia, or psychosis. The examiner asks the patient to complete this statement: "A bird is to air as a fish is to _________." This is an example of what type of testing? A. Calculation B. Analogies C. Judgment D. Mood and feelings B. Analogies An analogy is a comparison of two things based on their being alike in some way. Analogies are used to investigate cognitive abilities. An inability to describe similarities or differences between common objects such as carrots and green beans is suggestive of which problem? A. A left cerebral hemisphere lesion B. Depression C. An eating disorder D. Aphasia A. A left cerebral hemisphere lesion Patients with average intelligence should be able to describe the similarities and differences between common objects. An inability to describe similarities or differences may indicate a lesion of the left or dominant cerebral hemisphere. A 65-year-old woman is brought to the clinic by her family, who report that they have noticed a change in her mental abilities over the past 2 weeks. Normally she is independent, intelligent, and socially oriented. Her medical history is unremarkable except for congestive heart failure, which is controlled with digoxin. She has had no major changes in her health. What question would be the most important for the examiner to ask the family? A. "Is there a family history of Alzheimer disease?" B. "How much alcohol does she drink in an average week?" C. "When was her digoxin blood level last checked?" D. "Did you know that mental function begins to decline after the age of 60?" C. "When was her digoxin blood level last checked?" Digoxin may cause disorientation and confusion. Responses to questions regarding medication use are important for evaluating present illness. A patient who has difficulty writing or drawing is most likely to have which condition? A. Temporal lobe damage B. Peripheral neuropathy C. Wernicke paralysis D. Psychiatric hallucinations B. Peripheral neuropathy Uncoordinated writing or drawing may indicate dementia, parietal lobe damage, a cerebellar lesion, or peripheral neuropathy. Which is a classical indication of Alzheimer disease? A. Use of clang associations B. Occurrence of visual hallucinations C. Disintegration of personality D. Flat affect and mood C. Disintegration of personality Eventual profound disintegration of personality and complete disorientation occur in a majority of Alzheimer cases (dementia). In babies, babbling and cooing usually occur around: A. 2 to 3 months. B. 3 to 4 months. C. 4 to 6 months. D. 6 to 8 months. B. 3 to 4 months. Cooing and babbling are expected after 3 and 4 months of age, respectively. At what age do babies usually say one or two words, such as "Mama" and "Dada"? A. 4 to 6 months B. 6 to 8 months C. 8 to 10 months D. 10 to 12 months D. 10 to 12 months Expressive language milestones for this age include words such as "Mama," "Dada," and "Bye-Bye." Social smiling usually occurs around: A. 2 to 3 months. B. 3 to 4 months. C. 4 to 6 months. D. 6 to 8 months. A. 2 to 3 months. Social smiling occurs in the 2- to 3-month-old infant. The examiner should be concerned when it is difficult or impossible to elicit a social smile in an infant who appears ill. This may be indicative of a neurologic condition or infection, such as meningitis. Typical changes in mental functioning that occur with aging include distinctive personality changes. A. True B. False B. False Verbal skills and general knowledge continue to increase into the 60s and often remain stable into the 80s. Recent memory for important events and conversations is usually not impaired. The older adult may complain about memory loss but this is not predictive of cognitive decline. Older adults are expected to maintain the same level of interpersonal skills and have no personality changes. Which part of the brain mediates certain patterns of behavior that determine survival, such as mating, aggression, fear, and affection? A. Frontal lobe B. Parietal lobe C. Temporal lobe D. Limbic system D. Limbic system The limbic system mediates certain patterns of behavior that determine survival (e.g., mating, aggression, fear, and affection), whereas the frontal, parietal, and temporal lobes do not. The Mini-Mental Status examination is designed to track cognitive changes over time. A. True B. False A. True The MMSE is a standardized tool to assess cognitive function changes over time. There are 11 items measuring orientation, registration, attention and calculation, recall, and language, and it takes approximately 5 to 10 minutes to administer. Screening for depression should be a routine part of care for all new mothers. A. True B. False A. True An estimated 39% of women who have depression during pregnancy have postpartum depression. An estimated 13% of women have postpartum depression (Underwood, Waldie, D'Souza, et al., 2016). Postpartum psychosis occurs in 0.1% to 0.2% of women (Berrisford, Lambert, and Heron, 2015). Because depression may interfere with the mother's health, ability to work, and attachment to the newborn and the infant's subsequent development, all new mothers should be screened for depressive symptoms. Problem solving and short-term recall memory are associated with which section of the brain? A. Frontal lobe B. Parietal lobe C. Temporal lobe D. Limbic system A. Frontal lobe The frontal lobe, containing the motor cortex, is associated with speech formation, decision making, problem solving, the ability to concentrate, and short-term memory. The parietal lobe is primary responsible for receiving and processing sensory data. The temporal lobe is responsible for perception and interpretation of sounds as well as localizing their source. The limbic system is responsible for emotions. Which area in the brain regulates the level of arousal? A. Limbic system B. Reticular activating system C. Temporal lobe D. Occipital lobe B. Reticular activating system The reticular activating system (RAS) in the brainstem regulates awareness and arousal. Answers a, c, and d regulate other areas of the brain. Which part of the brain contains the Wernicke speech area, which permits speech and comprehension of written language? A. Frontal lobe B. Parietal lobe C. Temporal lobe D. Limbic system C. Temporal lobe The temporal lobe is responsible for perception and interpretation of sounds as well as localizing their source. It contains the Wernicke speech area, which allows a person to understand spoken and written language. It is also involved in the integration of behavior, emotion, and personality, as well as long-term memory. Answers a, b, and d regulate other characterisitics. Long-term memory is associated with which area of the brain? A. Frontal lobe B. Parietal lobe C. Temporal lobe D. Limbic system C. Temporal lobe The temporal lobe not only contains the Wernicke speech area, it is also involved in the integration of behavior, emotion, and personality, as well as long-term memory. Answers a, b, and d regulate other characterisitics. Distorted Thinking Unrealistic sense of persecution, jealousy, grandiose ideas, or ideas of reference - neutral things in the environment have a special meaning to the person. MoCA verses MMSE The MoCA has more cognitively demanding task related to memory recall and executive functioning than the MMSE. The MoCA was found to better discriminate patients with mild cogative impairment at risk for dementia than the MMSE, as well as those patients with multiple domain verses single domain mild cognitive impairment. Assessing orientation to person, place, and time helps determine: Ability to understand analogies Abstract reasoning Attention span State of consciousness ANS: D Rationale: Orientation to person, place, and time are measures of states of consciousness and awareness, not degrees of attention span. Analogies and abstract reasoning are higher functions than orientation. Emotional status can be better evaluated by observing behaviors. One method to evaluate mental status, cognitive function, and assess for dementia is: Mini-Cog Glasgow Coma Scale Geriatric depression inventory Coherence testing scale ANS: A Rationale: The Mini-Cog is a brief screening tool for measuring cognitive function; it takes 5 minutes to administer Testing the patient's arithmetic calculation will assist in determining: Dementia and Parkinson disease Depression and diffuse brain disease Schizophrenia and brain damage Intellectual disability ANS: B Rationale: Arithmetic calculations should be completed with few errors and within 1 minute. When the patient has average intelligence, impairment of arithmetic skills may be associated with depression and diffuse brain disease. Glasgow Coma Scale Used to quantify consciousness in person with head trauma or hypoxic event Versions are available for adult, infant, and young child Assesses the function of the cerebral cortex and brainstem through the patient's verbal, motor, and eye opening responses to specific stimuli Scores range from 3 to 15, with 15 being the optimal level of consciousness. THIS IS PERTINENT IN EMERGENT/INPATIENT SITUATIONS. Refresh your memory so that you are ready for the HESI final. Delirium Impaired cognition, arousal, consciousness, mood and behavioral dysfunction of acute onset Dementia A chronic, slowly progressive disorder of failing memory, cognitive impairment, behavioral abnormalities, and personality changes that often begins after age 60 years Brocha Aphasia (Expressive) Word Comprehension - fair to good Spontaneous speech - impaired speech flow; laborious effort to peak; know what they want to say but cannot articulate properly; telegraphic speech (mostly nouns and verbs) Reading Comp - Intact Writing - Impaired Wernicke Aphasia (Receptive) Word Comprehension - Can hear words but cannot relate them to previous experience Spontaneous speech - Fluent speech but uses words inappropriatly, such as neologisms or word substitutions; may be totally incomprehensible. Reading Comp - Impaired Writing - Impaired Global Aphasia (Expressive and Receptive) Word Comprehension - Absent or reduced to person's own name, few select words Spontaneous speech - Absent or reduced to only a few words or sounds Reading Comp - Severely impaired Writing - Severely impaired Cerebrum Area of the brain responsible for all voluntary activities of the body frontal lobe Motor cortex, speech formation, decision making, problem solving, ability to concentrate, short term memory. Associated areas that relate to strong emotions and reactions to them originate here. parietal lobe receiving and processing sensory data Temporal lobe Perception and integration of sounds/source; Wernicke speech area ~ ability to understand spoken and written language; integration of behavior, emotion, and personality; long term memory Limbic System mediates behaviors that determine survival ~ mating, aggression, fear, and affection Reactions to emotions like anger, love, hostility, and envy originate here, BUT the expression of emotion and behavior is mediated by connections between the limbic system and the frontal lobe Reticular System the part of the brain that is involved in attention, sleep, and arousal. Regulates vital reflexes such as heart and respiratory functioning. Disruption of ascending reticular activating system can lead to AMS ~ confusion or delirium [Show Less]
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Seidel Chapter 22 test 9, question and answer | A+ content
The autonomic nervous system coordinates which of the following? Internal organs of the body The major function of the sympathetic nervous system i... [Show More] s to orchestrate the stress response. The parasympathetic nervous system maintains the day-to-day function of digestion. Cerebrospinal fluid serves as a: shock absorber. Diabetic peripheral neuropathy will likely produce diminished pain sensation. The thalamus is the major integration center for the perception of pain. The awareness of body position is known as: proprioception Which area of the brain is responsible for perceiving sounds and determining their source? Temporal lobe Peripheral nerves that arise from the brain rather than the spinal cord are called ___________ nerves. cranial Which area of the brain maintains temperature control? hypothalamus If a patient cannot shrug his or her shoulders against resistance, which cranial nerve (CN) requires further evaluation? CN XI, spinal accessory Motor maturation proceeds in an orderly progression from head to toe. Normal changes of the aging brain include: diminished perception of touch. The area of body surface innervated by a particular spinal nerve is called a dermatome. A neurologic past medical history should include data about: circulatory problems. Which of the following is the technique most often used for evaluating the neurologic system? Inspection When assessing superficial pain, touch, vibration, and position perceptions, you are testing sensory function. You are initially evaluating the equilibrium of Ms. Q. You ask her to stand, with her feet together and arms at her sides. She loses her balance. Ms. Q has a positive: Romberg sign. The finger to nose test allows assessment of coordination and fine motor function. You are performing a two-point discrimination test as part of a well physical examination. The area with the ability to discern two points in the shortest distance is the fingertips As Mr. B enters the room, you observe that his gait is wide-based and he staggers from side to side while swaying his trunk. You would document Mr. B's pattern as: cerebellar ataxia Deep pressure tests are used mostly for patients who are experiencing: absent superficial pain sensation Vibratory sensory testing should be routinely done for the patient with: diabetes. To assess a cremasteric reflex, the nurse strokes the: inner thigh and observes whether the testicle and scrotum rise on the stroked side When you ask a patient to close her or his eyes and identify an object placed in the hand, you are evaluating stereognosis. The ability to recognize a number traced on the skin is called: graphesthesia. Which one of the following conditions is consistent with Brown-Séquard syndrome? Motor paralysis on the lesion side of the body To assess spinal levels L2, L3, and L4, which deep tendon reflex should be tested Patellar When using a monofilament to assess sensory function, the nurse: applies pressure to the monofilament until the filament bends. Visible or palpable extension of the elbow is caused by reflex contraction of which muscle? Triceps It is especially important to test for ankle clonus if: deep tendon reflexes are hyperactive. Which sign is associated with meningitis and intracranial hemorrhage? Nuchal rigidity When assessing a 17-year-old for nuchal rigidity, you gently raise his head off the examination table. He involuntarily flexes his hips and knees. To confirm your suspicions associated with this positive test, you would also perform a test for the __________ sign Kernig On a scale of 1+ to 4+, which deep tendon reflex score is appropriate for a finding of clonus in a patient? 4+ Cranial nerve XII may be assessed in an infant by: observing the infant suck and swallow. You are most concerned for the infant who has a: strong tonic neck at 6 months At what age should the infant begin to transfer objects from hand to hand? 7 months An acute polyneuropathy that commonly follows a nonspecific infection occurring 10 to 14 days earlier and that primarily affects the motor and autonomic peripheral nerves in an ascending pattern is: Guillain-Barré syndrome. Which of the following is a concern, rather than an expected finding, in older adults? Bilateral pill-rolling of the fingers Which of the following conditions is potentially life-threatening if not treated expeditiously with antibiotics? Bacterial meningitis Ipsilateral Horner syndrome indicates a cerebrovascular accident (CVA) occurring in the posterior inferior cerebellar artery The immune system attacks the synaptic junction between the nerve and muscle fibers, blocking acetylcholine receptor sites in: myasthenia gravis. Persons with Parkinson disease have an altered gait characterized by short shuffling steps. You are assessing the deep tendon reflexes of a 28-year-old man. Your examination reveals that the patient's reflexes are normal. You would document this finding as _____. 2+ The motor cortex of the brain is in the _______________. frontal lobe The major portion of brain growth and myelinization occurs between ____ and ____ year(s) old. birth, 1 The tests for cortical sensory function include which of the following? (Select all that apply 2 point, extinction phenom, stereognosis [Show Less]
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