NURS 6512 FINAL EXAM
1. Costovertebral angle tenderness should be assessed whenever you suspect the patient may have: - Polynephritis
2. In older
... [Show More] adults, overflow fecal incontinence is commonly due to: -Fecal impaction
3. A 1 month old boy has been vomiting for 2 weeks. How is this symptom of GERD and pyloric stenosis further differentiated in this child’s assessment? – The infant has regurgitation with pyloric stenosis
4. Auscultation of borborygmi is associated with: - Gastroenteritis, early intestinal obstruction, or hunger
5. When auscultating the abdomen, which finding would indicate collateral circulation between the portal and systemic venous systems? – Venous hum
6. Conversion of fat-soluble wastes to water-soluble material for renal excretion is a function of the: - Liver
7. The major function of the large intestine is: -Water absorption
8. Which structure is located in the hypogastric region of the abdomen? –Ileum, bladder, and pregnant uterus
9. A 45 year old man relates a several week history of severe intermittent abdominal burning sensations. He relates that the pain is relieved with small amounts of food. Before starting the physical examination, you review his laboratory work, anticipating a (n): -Positive Helicobacter pylori result
10. You are caring for a patient with trigeminal neuralgia. During the assessment, the patient would describe the pain as: - Burning or shocklike
11. Your 85 year old patient is complaining of right knee pain. She has a history of osteoarthritis for which she is given anti-inflammatory medication. To assess her right knee pain, you should ask her if: - The pain gets better when she sits
12. A 5 year old is complaining of nondescriptive “belly pain.” Your next action should be to ask him to: - Point to the area of pain
13. The perception of pain: - Is variable and is affected by emotions, and cultural background
14. Patients presenting with ascites, jaundice, cutaneous spider veins, and nonpalpable liver exhibit signs of: - Cirrhosis
15. A patient presents to the emergency department after a motor vehicle accident. The patient sustained blunt trauma to the abdomen and complains of pain in the upper left quadrant that radiates to the left shoulder. What organ is most likely injured? – Spleen
16. Imaging studies reveal that a patient has dilation of the renal pelvis from an obstruction in the ureter, what condition will be documented in this patient’s health record? – Hydronephrosis
17. Visible intestinal peristalsis may indicate: - Intestinal obstruction
18. Infants born weighing less than 1500g are at higher risk for: - Necrotizing enterocolitis
19. Which of the following factors is not known to affect patient compliance with his or her treatment regimen? – The patient’s age and social status
20. One of the most important aspects to consider in the orthopedic screening examination is: - Symmetry
21. The sequence of the physical examination should be individualized to: - Minimize the number of times the patient has to change positions to conserve the patient’s energy
22. As you greet the patient, which examination technique is first implemented? - Inspection
23. Which of the following is most likely to enhance examiner reliability? – The examiner attempts to qualify data
24. A 7 year old boy is brought to your office with a chief complaint of possible fracture to his left third finger. He jammed it while playing basketball 2 days ago. The mother states that she really does not think it is broken because he can move it. What is your best response? – This is common misconception, and the finger may be broken. An x-ray is indicated.
25. A patient presenting for the first time with typical low back pain should receive which of the following diagnostic tests? – None of the above. X-ray is not indicated because lumbar pain is usually musculoskeletal etiology.
26. Skeletal changes in older adults are the result of: -Increased bone resorption
27. A positive straight leg raise test usually indicates: - Lumbar nerve root irritation
28. What technique is performed at every infant examination during the first year of life to detect hip dislocation? – Barlow-Ortolani maneuvers
29. Expected normal findings during inspection of spinal alignment include: - Convex lumbar curve
30. Temporalis and masseter muscles are evaluated by: - Having the patient clench his or her teeth
31. When palpating joints, crepitus may be caused when: - Irregular bony surfaces rub together
32. A 3 year old is brought to the clinic complaining of a painful right elbow. He is holding the 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: - Radial head subluxation
33. Light skin and thin body habitus are risk factors for: - Osteoporosis
34. Risk factors for sports-related injuries include: - Failure to warm up before activity
35. Injuries to long bones and joints are more likely to result in fractures than in sprains until: - Adolescence
36. Ligaments are stronger than bone until: - Adolescence
37. The family history for a patient with joint pain should include information about siblings with: -Genetic disorders
38. The Thomas test is used to detect: - Flexion contractures of the hip
39. A goniometer is used to assess: - Range of motion
40. 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. – Valgus stress
41. You note that a child has a positive Gower Sign. You know that this indicates generalized: - Muscle weakness
42. The dowager hump is: - The hallmark of osteoporosis
43. What temporary disorder may be experienced by pregnant women during the third trimester because of fluid retention? –Carpal tunnel syndrome
44. A common finding in markedly obese and pregnant women is: - Lordosis
45. A 45 year old laborer presents with low back pain, stating that the pain comes from the right buttock and shoots down and across the right anterior thigh, down the shin to the ankle. Which examination finding is considered more indicative of nerve root compression? – Positive straight leg raise result
46. Mrs. Bower is a 57 year old patient who comes in for an office visit. Which of the following disorders is known to be hereditary? – Huntington chorea
47. Testing of cranial nerve ¬¬¬¬________ is not routinely performed unless a problem is suspected. – I
48. The patient is able to rapidly touch each finger to his thumb in rapid sequence. What does this finding mean? – The patient has appropriate cerebellar function
49. Which question asked by the examiner may hellp to determine prevention strategies for seizures that a patient is experiencing? – “Are there any factors or activities that seem to start the seizures?”
50. A patient has a complaint of dizziness. The patient makes the following statement: “I sometimes feel as if the whole room is spinning.” What type of neurologic dysfunction should the examiner suspect? – Inner ear dysfunction affecting the acoustic nerve
51. The examiner asks the patient to close her eyes, then places a vibrating tuning fork on the patient’s ankle and asks her to indicate what is felt. What is being assessed? – Peripheral nerve sensory function
52. Which of the following findings should an examiner consider a normal finding if associated with pregnancy? – Acroparesthesia
52. Jack is a 52 year old obese man with a history of poorly controlled diabetes. He also smokes. Based on the above data, the examiner should recognize that Jack has several risk factors for: - Cerebrovascular accident
53. Mrs. Jones is a 24 year old patient who presents to your office 2 days postpartum. She complains that she is experiencing foot drop. Which of the following problems should the examiner consider? – Lumbosacral plexopathy
54. The examiner is assessing deep tendon reflex response in a 12 year old boy. The response is an expected reflex response. Which of the following scores should be documented? – 2+
55. A 68 year old patient presents to your office for follow-up. He tells you, “I have a hard time finding the right words when I am talking;” he also is experiencing numbness. On examination, you note postural instability. This symptom may be: - A late symptom of Parkinson’s disease
56. Motor maturation proceeds in an orderly progression from: - Head to toe
57. The thalamus is the major integration center for perception of: - Pain
58. The examiner should be concerned about neurologic competence if a social smile cannot be elicited by the time a child is ________old. – 3 months
59. Normal changes of the aging brain include: - Diminished perception of touch. -- this is by process of elimination/educated guess. I could not find direct information addressing this in Seidel
60. When interviewing a 70 year old female clinic patient, she tells you that she takes ginkgo biloba and St. John’s Wort. You make a short note to check for results of the: -Mini-mental state examination
61. The area of body surface innervated by a particular spinal nerve is called a: - Dermatome
62. If a patient cannot shrug the shoulders against resistance, which cranial nerve (CN) requires further evaluation? – CN XI, spinal accessory
63. The finger-to-nose test allows assessment of: - Coordination and fine motor function
64. You ask the patient to follow a series of short commands to assess: - Attention span
65. 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
66. When is the mental status portion of the neurologic system examination performed? – Constantly throughout the entire interaction with a client
67. An aversion to touch or being held, along with delayed or absent language development, is a characteristic of: -Autism
68. The autonomic nervous system coordinates which of the following? – Internal environment of the body
69. The major function of the sympathetic nervous system is to: - Orchestrate the stress response
70. The parasympathetic nervous system maintains the day-to-day function of: - Digestion
71. Cerebrospinal fluid serves as a: - Shock absorber
72. 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: -Finger tips
73. Which type of hallucination is most commonly associated with alcohol withdrawal? – Visual-bugs, pink elephants
74. On a scale of 0 to 4+, which deep tendon reflex score is appropriate for a finding of clonus in a patient? –3+
75. Which statement is true regarding mental status changes in older adults? – There is an increased risk of delirium with acute illness or metabolic derangement.
76. A characteristic related to syphilis or diabetic neuropathy is testicular: -Insensitivity to painful stimulation
77. When collecting personal and social history data from a woman complaining of breast discomfort, you should question her regarding: - Alcohol, tobacco, and caffeine use
78. What risk factor is associated with cervical cancer? – HPV
79. A 23 year old female presents with severe right lower quadrant tenderness. All of the following should be considered in the differential except: - Classis diverticulitis
80. What is the initial diagnostic radiology test that should be ordered if you suspect a ruptured ovarian cyst? – Abdominal and transvaginal ultrasound
81. A 17 year old male was brought into the emergency room with testicular/scrotal pain. The differential diagnosis should include all except: - Inguinal herniation
82. The nursing mother complains that her breasts are tender. You assess hard, shiny, and erythremic breasts bilaterally. You should advise the patient to: - Massage gently and continue nursing
83. A normal vas deferens should feel: - Smooth
84. In a woman complaining of a breast lump, it is most important to ask about: - Its relationship to menses
85. The finding of a painless indurated lesion on the glans penis is most consistent with: - Chancre
86. Thrombosed hemorrhoids are: - Blue, shiny, painful masses
87. Pregnancy-related cervical changes include: - Softening and bluish coloring
88. You are inspecting the genitalia of an uncircumcised adult male. The foreskin is tight and cannot be easily retracted. You should: - Inquire about previous penile infections
89. An adolescent male is being seen for acute onset of left testicular pain. The pain started 3 hours ago. He complains of nausea and denies dysuria or fever. Your prioritized assessment should be to: - Establish absent cremasteric reflex
90. A 23 year old white woman has come to the clinic because she has missed two menstrual periods. She states that her breasts have enlarged and that her nipples have turned a darker color. Your further response to this finding is: - Suggest pregnancy testing
91. What accommodations should be used in the position of a hearing-impaired woman for a pelvic examination? – The head of the table should be elevated
92. Sexual differentiation in the fetus has occurred by ¬¬¬_______weeks gestation. - 12
93. You are performing a clinical breast examination for a 55 year old woman. While palpating the supraclavicular area, you suspect that you felt a node. In order to improve your hooked technique, you should: -Ask the patient to turn her head toward that side
94. If a firm, transverse ridge of compressed tissue is felt bilaterally along the lower edge of a 40 year old patient’s breast, you should: -Record the finding in the patient’s record
95. A therapeutic technique for dealing with grieving individuals is to: - Tell them that is good to cry and to share feelings
96. The examination of the newborn should begin with: - Inspection noting skin color, flaccidity, tension, gross deformities, or distortions of facies
97. Which one of the following patient characteristics is most likely to limit patient reliability during history taking? – Patient is sleep and sensory deprived
98. In crying infants, it is often difficult to: - Auscultate heart sounds
99. Which of the following statements accurately reflects the sensitivity and specificity of laboratory tests? – No test has 100% sensitivity and specificity
100. Which medical condition would exclude one from sports participation? – Fever
101. Your 15 year old patient is athletic and thin. Radiography of an ankle injury reveals a stress fracture. You question this patient about her: - Menstrual cycles
102. Which of the following are examined with the patient in a reclining 45 degree position? –Jugular venous pulsation and pressure
103. Functional assessment is most important during the examination of a(n): -Older adult
104. The best way to ease the apprehension of a 3 year old child before a physical examination is to: - Encourage child’s participation
105. An ophthalmoscopic eye examination involves: - Lens inspection
106. When conducting a geriatric assessment, basic activities of daily living (ADLs) include: - Bathing
107. The checkout station for preparticipation physical evaluation (PPE) is critical because at this point: - The coordination of follow-ups is reviewed
108. Which of the following is true regarding the relationship between the examiner and the patient? – The patient is a full partner with the examiner
109. Which of the following factors is not known to affect patient compliance with his or her treatment regimen? – The patient’s age and social status
110. One of the most important aspects to consider in the orthopedic screening examination is: - To look for symmetry of muscle, stature, and joint movement
111. As you greet the patient, which examination technique is first implemented? – Inspection
112. Which portion of the physical examination is best done with the patient standing? –Spinal
113. Which patient position facilitates inspection of the chest and shoulders? – Sitting
114. The least reliable indicator of newborn distress is: - Color
115. Proprioception should be assessed while the patient is: - Standing
116. Part of the screening orthopedic component of the examination includes evaluating the person while: - Duck walking [Show Less]