NURS 6512 Midterm Exam. Questions & Answers
NURS 6512 Questions & Answers
NURS 6512
Walden University NURS 6512 Midterm Exam. Questions & Answers
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1. Before performing an abdominal examination, the examiner should:
Have the patient empty their bladder
2. During an interview, tears appear in the patient’s eyes and his voice becomes shaky. Initially, you should:
Keep the interview moving to distract the patient
3. Which of the following is the most accurate reflection of an individual’s food intake?
Food Diary
4. Percussing at the right midclavicular line, below the umbilicus, and continuing upward is the correct technique for locating the:
Lower liver border
5. A fixed image of any group that rejects its potential for originality or individuality is known as a:
Stereotype
6. Peritonitis produces bowel sounds that are
Decreased/Hypoactive
7. Brittle nails are typical findings in:
Older adults
8. Which of the following is an expected change in the assessment of the thyroid during pregnancy?
A Bruit is auscultated d/t increased vascularity
9. You are planning to palpate the abdomen of your patient. Which part of the examiner's hand is best for palpating vibration?
Ulnar Surface
10. A 5-year-old child presents with nasal congestion and a headache to assess for sinus tenderness you should palpate over the:
Maxillary sinuses only
11. During physical examination of a 30-year-old Chinese man you notice a slight asymmetry of his face. the cranial nerve examination is normal. Your best action is to
Ask the patient if this characteristic runs in his family
12. Unusual white areas on the skin may be due to
Vitiligo
13. You are using an ophthalmoscope to examine a patient’s inner eye. You rotate the lens selector clockwise, then counterclockwise to compensate for:
Myopia
14. Mrs. Webb is a 38-year old patient who has been changing her lifestyle to eat in a healthy way and lose weight: during your health promotion education regarding her nutritional status, you explain the function of dietary protein as:
Building and maintaining tissues
15. Mr. Akins is a 78-y/o patient who presents to the clinic with complaints of hearing loss. Which of the following are changes in hearing that occur in the elderly? Select all that apply.
c. Loss of high frequency
e. Sounds may be garbled, difficult to localize
f. Unable to hear in a crowded room
16. The most superior part of the stomach is the
Fundus
17. Mrs. Grace is a 58-year-old patient who has a diagnosis of pernicious anemia. Which B vitamin is deficient in patients with pernicious anemia?
B12
18. A 51-y/o woman calls with complaints of weight loss and constipation. She reports enlarged hemorrhoids and rectal bleeding. You advise her to:
Come to the laboratory for a stool guaiac test.
19. Placing the base of a vibrating tuning fork on the midline vertex of the patient’s head is a test for:
Lateralization of Sound
20. Which technique is most likely to result in the patients understanding of questions?
Use the patient's own terms if possible.
21. Mr. Williams, age 25, has recovered recently from an upper and lower respiratory infection. He describes a long-standing nasal dripping. He is seeking treatment for a mild hearing loss that has not gone away. Information concerning his chronic postnasal drip should be documented within which section of the history?
Past medical data
22. Nasal symptoms that imply an allergic response include:
Bluish gray turbinates. ("Turbinates that appear bluish gray or pale pink with a swollen, boggy consistency may indicate allergies"-Seidel p.243)
23. Mr. Franklin is speaking with you the health care provider, about his respiratory problem. Mr. Franklin says, “I’ve had this cough for 3 days and it’s getting worse.” You reply, “Tell me more about your cough.” Mr. Franklin states, “I wish I could tell you more, that’s why I am here! You tell me what’s wrong.” Which caregiver response would be the most appropriate for enhancing communication?
After 3 days, you're tired of coughing. Have you had a fever?"
24. When taking a history, you should:
Use a chronologic and sequential framework.
25. Which of the following formats would be used for visits that address problems not yet identified in the problem-oriented medical record (POMR)?
Brief SOAP note
26. Mr. and Mrs. Johnson have presented to the office with their infant son with complaints of ear drainage. When examining an infant’s middle ear, the nurse should use one hand to stabilize the otoscope against the head while using the other hand to:
Pull the auricle down and back in an effort to straighten the upward curvature of the canal
27. Which question would be considered a leading question?
You don't get headaches often, do you?"
28. Mr. Black is a 44y/o patient who presents to the clinic with complaints of neck pain that he thinks is from his job involving computer data entry. As the examiner, you are checking the range of motion in his neck and note the greatest degree of cervical mobility is at?
C 4 to C 5: C4 and C5 or C5 and C 6 provide the greatest horizontal mobility in adults
29. The term denoting the caregiver’s need to do no harm to the patient is:
Deontologic imperatives.
30. A tool used to screen adolescents for alcoholism is the:
CRAFFT
31. Under normal circumstances, how much water is lost daily by the body?
Under normal circumstances, approximately 2 to 2.5 liters of water is lost daily
32. You have just completed a skin assessment on Mr. Baker. During your assessment, you have transilluminated a skin lesion. During the physical examination, you know that skin lesions are transilluminated to distinguish:
Transillumination is used to determine the presence of fluid in cysts and masses. Fluid-filled lesions will transilluminate with a red glow, and solid masses will not transilluminate.
33. Mr. Mills is a 55/y/o patient who presents to the office for an initial visit for health promotion. A survey of mobility and activities of activities of daily living is part of a(n):
Functional assessment.
34. Sweat glands, hair, and nails are all formed from?
Invagination of epidermis into dermis
35. A brief statement of the reason the patient is seeking health care is called the?
Chief concern
36. Which part of the information contained in the patient’s record may be used in court?
Anything that is entered into a patient’s record in paper or electronic form, is a legal document and can be used
37. Which cranial nerves innervate the face?
5 and 7
38. In counseling a client regarding nutrition education, you explain that linoleic acid, a major fatty acid, is thought to be essential for?
Linoleic acid, found abundantly in milk and dairy fat, is required for normal growth and development, it has been suggested that it can reduce body fat in overweight patient
39. When are open-ended questions generally most useful?
During the initial part of the interview
40. Knowledge of the culture or cultures represented by the patient should be used to?
Help make interview questions more pertinent
41. Mrs. Berger is a 39-year-old woman who presents with a complaint of epigastric abdominal pain. You have completed the inspection of the abdomen. What is your next step in the assessment process?
Auscultation
42. A guideline for history taking is for caregivers to?
Make notes sparingly so that patients can be observed during the history taking
43. Which type of speculum should be used to examine a patient’s tympanic membrane?
The largest speculum that will fit comfortably in ear
44. You are palpating a patient’s thyroid and find that its broadest dimension measures 4cm. the right lobe is 25% larger than the left. These data would indicate?
The description is most likely a normal finding
45. Mr. L. presents to the clinic with severe groin pain and a history of kidney stones. Mr. L.’s son tells you that, for religious reasons, his father wishes to keep any stone that is passed into the urine filter that he has been using. What is your most appropriate response?
Healthcare provider should be willing to modify delivery and respectful of wishes/culture background
46. Before performing an abdominal examination, the examiner should?
Have the patient empty his or her bladder
47. You are examining a pregnant patient and have noted a vascular lesion. When you blanche over the vascular lesion, the site blanches and refills evenly from the center outward. The nurse documents this lesion as a?
Telangiectasia
48. As you explain your patient’s condition to her husband, you notice that he is leaning toward you and pointedly blinking his eyes. Knowing that he is from England, your most appropriate response to this behavior is to?
The English worry about being overheard and tend to speak in a modulated voice, so when they lean toward you, they probably have a question
49. When palpating the abdomen, you should note whether the liver is enlarged in the?
The liver is located in the right upper quadrant of the abdomen
50. Expected normal percussion tones include?
Normal lings produce renaissance percussion tones
51. Mr. Abdul is a 40-year-old Middle Eastern man who presents to the office for a first visit with the complaint of new abdominal pain. You ate concerned about violating a cultural prohibition when you prepare to do his rectal examination. The best tactic would be to?
Inform the patient of the reason for the exam and ask if it is acceptable to him
52. Fluorescing lesions are best distinguished using a(n)?
Wood’s lamp
53. Mrs. Hartzell is a 34-year-old patient who has presented for nutritional counseling because she is a vegetarian. Deficiency of which of the following is a concern in the vegetarian diet?
Proteins, calcium, iron, B12, and vitamin D
54. Underestimation of blood pressure will occur if the blood pressure cuff’s width covers?
Cuff that are too wide will underestimate blood pressure, which would happen with a cuff that is more than one third of the upper arm
55. Mrs. Britton is a 34-year-old patient who presents to the office with complaints of skin rashes. You have noted a 4’3cm, rough, elevated area of psoriasis. This is an example of a?
Plaque
56. Penicillin is considered a?
Miracle drug for all the reasons except. It was not the first antibiotic.
57. Small, minute bruises are called?
Petechiae
58. After thorough inspection of the abdomen, the next assessment step is?
Auscultation
59. When you are questioning a patient regarding alcohol intake, she tells you that she is only a social drinker. Which initial response is appropriate?
What amount and what kind of alcohol do you drink in a week?
60. Regardless of the origin, discharge is described by noting?
Color and consistency
61. Recommended carbohydrate content of total dietary intake (% total calories) is?
50%
62. Tuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure?
Hearing range of normal speech
63. Auscultation should be carried out last, except when examining the?
The abdomen
64. Mr. Kevin Marks is a new health care provider. What is the best method to develop cultural competence?
Realize the cultural values are difficult to change and must be respected
65. Which of the following is an “ABCD” characteristic of malignant melanoma?
Asymmetric borders
66. Tracheal tug suggests the presence of a(n)?
Aortic aneurysm
67. Your patient presents with symptoms that lead you to suspect acute appendicitis. Which assessment finding is least likely to be associated with this condition early in its course?
Consistent right lower quadrant pain
68. The review of systems is a component of the:
Personal and social history
69. Cherry angiomas are a common finding in:
Adults older than 30 years
70. Mr. Donalds is a 45-year-old roofer. Your inspection to determine color variations of the skin is best conducted:
with illumination provided by daylight.
71. To correctly document absent bowel sounds, one must listen continuously for:
5 minutes
72. The adult recommended dietary fat intake should be ____g/day.
20 to 35
73. Mr. Jones is a 45-year-old patient who presents for a physical examination. On examination, you note costochondral beading, enlarged skull, and bowed legs and diagnose him with rickets. A deficiency of which fat-soluble micronutrient can result in rickets?
Vitamin D
74. A flat, nonplapable lesion is described as a macule if the diameter is:
Less than 1 cm
75. Mrs. Raymonds is a 24-year-old patient who has presented for a routine concern over her current weight. In your patient teaching with her, you explain the importance of macronutrients. Which of the following is a macronutrient?
Fat
76. Which of the following organs is part of the alimentary tract?
continuous tract from the mouth to the esophagus, stomach, small intestine, large intestine, and anus
77. Mr. Sanchez is a 45-year-old gentleman who has presented to the office for a physical examination to establish a new primary care health care provider. Which of the following describes a physical, not a cultural, differentiator?
Race
78. To approximate vocal frequencies, which tuning fork should be used to assess hearing?
500 to 1000 Hz
79. During percussion, a dull tone is expected to be heard over:
The liver
80. The attitudes of the health care professional:
Culturally derived/are largely irrelevant to the success of relationships with the patient
81. When recording physical findings, which data are recorded first for all systems?
Inspection
82. Spasmodic muscular contractions of the head, face, or neck are called:
tics
83. Which of the following occurs when firm pressure is used to apply the stethoscope’s bell end-piece to the skin?
It functionally converts to a diaphragm end-piece.
84. Differential diagnoses belong in the:
Assessment
85. Pigmented, raised, warty lesions over the face and trunk should be assessed by an experienced practitioner who can distinguish:
seborrheic keratoses from actinic keratoses.
86. Mr. Walter’s, a 32-year-old patient, tells you that his ears are “stopped up.” An objective assessment of this complaint is achieved by using the:
tympanometer
87. Mrs. Leonard brings her newborn infant into the pediatrician’s office for a first well-baby visit. As the health care provider, you teach her that newborns are more vulnerable to hypothermia due to:
a poorly developed subcutaneous fat layer.
88. Tympanic thermometers measure body temperature when a probe is placed:
Eardrum (in the ear)
89. A serous membrane that lines the abdominal cavity and forms a protective cover for many abdominal structures is the:
peritoneum
90. White, rounded, or oval ulcerations surrounded by a red halo and found on the oral mucosa are:
aphthous ulcers (canker sores)
91. When assessing abdominal pain in a college-age woman, one must include:
the first day of the last menstrual period.
92. Your patient is complaining of acute, intense sharp epigastric pain that radiates to the back and left scapula with nausea and vomiting. Based on this history, your prioritized physical examination should be to:
inspect for ecchymosis of the flank.
93. The infant should be placed in which position to have his or her height or length measured?
Supine on a measuring board
94. Mr. Marks is a 66-year-old patient who presents for a physical examination to the clinic. Which question has the most potential for exploring a patient’s cultural beliefs related to a health problem?
"Why do you think you are having these symptoms?"
95. Which of the following is the most vital nutrient?
water
96. What finding is unique to the documentation of a physical examination of an infant?
Fontanel size
97. Mrs. G. reports an increase in her alcohol intake over the past 5 years. To screen her for problem drinking, you would use the:
CAGE questionnaire
98. Mr. D. complains of a headache. During the history he mentions his use of alcohol and illicit drugs. This information would most likely belong in the:
personal and social history
99. You are completing a general physical examination on Mr. Rock, a 39-year-old man with complaints of constipation. When examining a patient with tense abdominal musculature, a helpful technique is to have the patient:
flex his or her knees
100. When communicating with older children and teenagers, you should be sensitive to their:
typical reluctance to talk
101. Periods of silence during the interview can serve important purposes, such as:
Providing time for reflection. [Show Less]