Walden health assessment final exam

NURS 6512 FINAL EXAM

1. Costovertebral angle tenderness should be assessed whenever you suspect the patient may have: -

2. In older adults, overflow fecal incontinence is commonly due to:

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?

4. Auscultation of borborygmi is associated with: -

5. When auscultating the abdomen, which finding would indicate collateral circulation between the portal and systemic venous systems? –

6. Conversion of fat-soluble wastes to water-soluble material for renal excretion is a function of the: -

7. The major function of the large intestine is: -

8. Which structure is located in the hypogastric region of the abdomen? –

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): -

10. You are caring for a patient with trigeminal neuralgia. During the assessment, the patient would describe the pain as: -

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: -

12. A 5 year old is complaining of nondescriptive “belly pain.” Your next action should be to ask him to: -

13. The perception of pain: - 14. Patients presenting with ascites, jaundice, cutaneous spider veins, and nonpalpable liver exhibit signs of: -

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?

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?

17. Visible intestinal peristalsis may indicate:

18. Infants born weighing less than 1500g are at higher risk for:

19. Which of the following factors is not known to affect patient compliance with his or her treatment regimen? –

20. One of the most important aspects to consider in the orthopedic screening examination is: -

21. The sequence of the physical examination should be individualized to: -

22. As you greet the patient, which examination technique is first implemented? -

23. Which of the following is most likely to enhance examiner reliability? –

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? –

25. A patient presenting for the first time with typical low back pain should receive which of the following diagnostic tests?

26. Skeletal changes in older adults are the result of: -

27. A positive straight leg raise test usually indicates: -

28. What technique is performed at every infant examination during the first year of life to detect hipdislocation?

29. Expected normal findings during inspection of spinal alignment include:

30. Temporalis and masseter muscles are evaluated by:-

31. When palpating joints, crepitus may be caused when: -

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: -

33. Light skin and thin body habitus are risk factors for: -

34. Risk factors for sports-related injuries include: -

35. Injuries to long bones and joints are more likely to result in fractures than in sprains until: -

36. Ligaments are stronger than bone until: -

37. The family history for a patient with joint pain should include information about siblings with: -

38. The Thomas test is used to detect: -

39. A goniometer is used to assess: -

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. –

41. You note that a child has a positive Gower Sign. You know that this indicates generalized: -

42. The dowager hump is: -

43. What temporary disorder may be experienced by pregnant women during the third trimester because of fluid retention?–

44. A common finding in markedly obese and pregnant women is: -

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?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? –

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? –

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? –

49. Which question asked by the examiner may hellp to determine prevention strategies for seizures that a patient is experiencing? – “

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? –

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? –

52. Which of the following findings should an examiner consider a normal finding if associated with pregnancy? –

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: -

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? –

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? –

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: -

56. Motor maturation proceeds in an orderly progression from: -

57. The thalamus is the major integration center for perception of: -

58. The examiner should be concerned about neurologic competence if a social smile cannot be elicited by the time a child is ________old. –

59. Normal changes of the aging brain include: -

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: -

61. The area of body surface innervated by a particular spinal nerve is called a: -

62. If a patient cannot shrug the shoulders against resistance, which cranial nerve (CN) requires further evaluation? –

63. The finger-to-nose test allows assessment of: -

64. You ask the patient to follow a series of short commands to assess: -

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: -

66. When is the mental status portion of the neurologic system examination performed? –

67. An aversion to touch or being held, along with delayed or absent language development, is a characteristic of: -

68. The autonomic nervous system coordinates which of the following? –

69. The major function of the sympathetic nervous system is to: -

70. The parasympathetic nervous system maintains the day-to-day function of: -

71. Cerebrospinal fluid serves as a: -

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: -

73. Which type of hallucination is most commonly associated with alcohol withdrawal? –

74. On a scale of 0 to 4+, which deep tendon reflex score is appropriate for a finding of clonus in a patient? –

75. Which statement is true regarding mental status changes in older adults? –

76. A characteristic related to syphilis or diabetic neuropathy is testicular: -

77. When collecting personal and social history data from a woman complaining of breast discomfort, you should question her regarding: -

78. What risk factor is associated with cervical cancer? –

79. A 23 year old female presents with severe right lower quadrant tenderness. All of the following should be considered in the differential except: -

80. What is the initial diagnostic radiology test that should be ordered if you suspect a ruptured ovarian cyst? –

81. A 17 year old male was brought into the emergency room with testicular/scrotal pain. The differential diagnosis should include all except: -

82. The nursing mother complains that her breasts are tender. You assess hard, shiny, and erythremicbreasts bilaterally. You should advise the patient to: -

83. A normal vas deferens should feel: -

84. In a woman complaining of a breast lump, it is most important to ask about: -

85. The finding of a painless indurated lesion on the glans penis is most consistent with: -

86. Thrombosed hemorrhoids are: -

87. Pregnancy-related cervical changes include: -

88. You are inspecting the genitalia of an uncircumcised adult male. The foreskin is tight and cannot be easily retracted. You should: -

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: -

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: -

91. What accommodations should be used in the position of a hearing-impaired woman for a pelvic examination? –

92. Sexual differentiation in the fetus has occurred by ­­­_______weeks gestation. -

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: -

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: -

95. A therapeutic technique for dealing with grieving individuals is to: - \

96. The examination of the newborn should begin with: -

97. Which one of the following patient characteristics is most likely to limit patient reliability during history taking? –

98. In crying infants, it is often difficult to: -

99. Which of the following statements accurately reflects the sensitivity and specificity of laboratory tests? –

100. Which medical condition would exclude one from sports participation? –

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: -

102. Which of the following are examined with the patient in a reclining 45 degree position? –

103. Functional assessment is most important during the examination of a(n): -

104. The best way to ease the apprehension of a 3 year old child before a physical examination is to: -

105. An ophthalmoscopic eye examination involves: -

106. When conducting a geriatric assessment, basic activities of daily living (ADLs) include: -

107. The checkout station for preparticipation physical evaluation (PPE) is critical because at this point: - 108. Which of the following is true regarding the relationship between the examiner and the patient? –

109. Which of the following factors is not known to affect patient compliance with his or her treatment regimen? –

110. One of the most important aspects to consider in the orthopedic screening examination is:

111. As you greet the patient, which examination technique is first implemented? –

112. Which portion of the physical examination is best done with the patient standing? –

113. Which patient position facilitates inspection of the chest and shoulders? –

114. The least reliable indicator of newborn distress is: -

115. Proprioception should be assessed while the patient is: -

116. Part of the screening orthopedic component of the examination includes evaluating the person while: -

Part of the screening orthopedic component of the examination includes evaluating the person while he or she is:

Question 3

1 out of 1 points

The difference in blood pressure readings between the right and the left arms is considered normal up to _____ mm Hg.

Question 4

1 out of 1 points

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:

Question 5

1 out of 1 points

Kawasaki disease is suspected when assessments of a child reveal:

Question 6

1 out of 1 points

The finger-to-nose test allows assessment of:

Question 7

1 out of 1 points

In the adult, the apical impulse should be most visible when the patient is in what position?

Question 8

1 out of 1 points

The strength of the trapezius muscle is evaluated by having the patient:

Question 9

1 out of 1 points

When palpating joints, crepitus may occur when:

Question 10

1 out of 1 points

Palpation of a normal prostate in an older adult is likely to feel:

Question 11

1 out of 1 points

You are conducting a preparticipation physical examination for a 10-year-old girl with Down syndrome who will be playing basketball. She has slight torticollis and mild ankle clonus. What additional diagnostic testing would be required for her?

Question 12

1 out of 1 points

Which one of the following techniques is used to detect a torn meniscus?

Question 13

1 out of 1 points

The reliability of health-related findings and observations is the responsibility of the:

Question 14

1 out of 1 points

Loss of immediate and recent memory with retention of remote memory suggests:

Question 15

1 out of 1 points

Which condition is considered progressive rather than reversible?

Question 16

1 out of 1 points

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.

Question 17

1 out of 1 points

An idiopathic spasm of arterioles in the digits is termed:

Question 18

1 out of 1 points

Which portion of the physical examination is best done with the patient standing?

Question 19

1 out of 1 points

While collecting personal and social history data from a woman complaining of breast discomfort, you should question her regarding:

Question 20

1 out of 1 points

A finding that is indicative of osteoarthritis is:

Question 21

1 out of 1 points

One of the most important aspects to consider in the orthopedic screening examination is:

Question 22

1 out of 1 points

When is the mental status portion of the neurologic system examination performed?

Question 23

1 out of 1 points

Breath odors may clue the examiner to certain underlying metabolic conditions. The odor of ammonia on the breath may signify:

Question 24

1 out of 1 points

If pitting edema is unilateral, you would suspect occlusion of a:

Question 25

1 out of 1 points

When the Goodenough-Harris Drawing Test is administered to a child, the evaluator principally observes the:

Question 26

1 out of 1 points

A grade IV mitral regurgitation murmur would:

Question 27

1 out of 1 points

A pulsation that is diminished to the point of being barely palpable would be graded as:

Question 28

1 out of 1 points

Postural hypotension is defined as a _____ when the patient stands, compared with sitting or supine readings.

Question 29

1 out of 1 points

In the most effective percussion technique of the posterior lung fields, the patient cooperates by:

Question 30

0 out of 1 points

Bimanual examination of the uterus includes:

Question 31

1 out of 1 points

A cervical polyp usually appears as a:

Question 32

1 out of 1 points

The physical assessment technique most frequently used to assess joint symmetry is:

Question 33

1 out of 1 points

Inspection of the scrotum should reveal:

Question 34

1 out of 1 points

A patient you are seeing in the emergency department for chest pain is suspected of having a myocardial infarction. During the health history interview of his family history, he relates that his father had died of "heart trouble." The most important follow-up question you should pose is which of the following?

Question 35

1 out of 1 points

The adnexa of the uterus are composed of the:

Question 36

1 out of 1 points

The musculoskeletal examination should begin when:

Question 37

1 out of 1 points

The family history for a patient with joint pain should include information about siblings with:

Question 38

1 out of 1 points

Which medical condition would exclude a person from sports participation?

Question 39

1 out of 1 points

The examiner percusses for diaphragmatic excursion along the:

Question 40

1 out of 1 points

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:

Question 41

1 out of 1 points

The Denver II is a tool used to determine:

Question 42

1 out of 1 points

Tarry black stool should make you suspect:

Question 43

1 out of 1 points

Palpation of epitrochlear nodes is part of the:

Question 44

1 out of 1 points

To hear diastolic heart sounds, you should ask patients to:

Question 45

1 out of 1 points

Assessing orientation to person, place, and time helps determine:

Question 46

1 out of 1 points

Montgomery tubercles are most prominent in the breasts of:

Question 47

1 out of 1 points

Temporalis and masseter muscles are evaluated by:

Question 48

1 out of 1 points

A red, hot swollen joint in a 40-year-old man should lead you to suspect:

Question 49

1 out of 1 points

You are examining a patient in the emergency department who has recently sustained head trauma. In order to initially assess this patient's neurologic status, you would:

Question 50

0 out of 1 points

Which cranial nerves are usually evaluated during the examination of the eyes?

Question 51

1 out of 1 points

An ophthalmoscopic eye examination involves:

Question 52

1 out of 1 points

While interviewing a 70-year-old female clinic patient, she tells you that she takes ginkgo biloba and St. John's wort. You make a short note to check for results of the:

Question 53

1 out of 1 points

For purposes of examination and communication of physical findings, the breast is divided into:

Question 54

1 out of 1 points

Ulnar deviation and boutonniere deformities are characteristic of:

Question 55

1 out of 1 points

You are conducting an examination of Mr. Curtis's heart and blood vessels and auscultate a grade III murmur. The intensity of this murmur is:

Question 56

1 out of 1 points

At your first meeting with a patient, it is usually best to say:

Question 57

1 out of 1 points

The best way to ease the apprehension of a 3-year-old child before a physical examination is to:

Question 58

1 out of 1 points

Breath sounds normally heard over the trachea are called:

Question 59

1 out of 1 points

The goals of preparticipation sports evaluation include:

Question 60

1 out of 1 points

Throughout the history and physical examination, the clinician should:

Question 61

1 out of 1 points

When assessing superficial pain, touch, vibration, and position perceptions, you are testing:

Question 62

1 out of 1 points

The foramen ovale should close:

Question 63

1 out of 1 points

A parent is advised to restrict contact or collision sports participation for their child. An example of a sport in which this child could participate is:

Question 64

1 out of 1 points

The checkout station for preparticipation physical evaluation (PPE) is critical because at this point:

Question 65

1 out of 1 points

An apical PMI palpated beyond the left fifth intercostal space may indicate:

Question 66

1 out of 1 points

The spread of the impulse through the ventricles (ventricular depolarization) is depicted on the ECG as the:

Question 67

1 out of 1 points

Your older clinic patient is being seen today as a follow-up for a 2-day history of pneumonia. The patient continues to have a productive cough, shortness of breath, and lethargy and has been spending most of the day lying in bed. You should begin the chest examination by:

Question 68

1 out of 1 points

Your patient's chief complaint is repeated pencil-like stools. Further examination should include:

Question 69

1 out of 1 points

When palpating breast tissue, the examiner should use the _____ at each site.

Question 70

1 out of 1 points

Normal changes of the aging brain include:

Question 71

1 out of 1 points

You are inspecting the genitalia of an uncircumcised adult male. The foreskin is tight and cannot be easily retracted. You should:

Question 72

0 out of 1 points

You are examining Mr. S., a 79-year-old diabetic man complaining of claudication. Which of the following physical findings is consistent with the diagnosis of arterial occlusion?

Question 73

0 out of 1 points

Which one of the following is a proper technique for use of a speculum during a vaginal examination?

Question 74

1 out of 1 points

A positive straight leg raise test usually indicates:

Question 75

1 out of 1 points

Examination of the patient in the lithotomy, or knee-chest, position includes:

Question 76

1 out of 1 points

A common finding in markedly obese and pregnant women is:

Question 77

1 out of 1 points

To assess a cremasteric reflex, the examiner strokes the:

Question 78

1 out of 1 points

When conducting a geriatric assessment, basic activities of daily living (ADLs) include:

Question 79

1 out of 1 points

You are interviewing a 20-year-old patient with a new-onset psychotic disorder. The patient is apathetic and has disturbed thoughts and language patterns. The nurse recognizes this behavior pattern as consistent with a diagnosis of:

Question 80

1 out of 1 points

Nerves that arise from the brain rather than the spinal cord are called:

Question 81

1 out of 1 points

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:

Question 82

1 out of 1 points

The Mini-Mental State Examination:

Question 83

1 out of 1 points

Facial muscle or tongue weakness may result in:

Question 84

1 out of 1 points

To assess spinal levels L2, L3, and L4, which deep tendon reflex should be tested?

Question 85

0 out of 1 points

Which of the following statements is true regarding the examination of peripheral arteries?

Question 86

1 out of 1 points

Recent unilateral inversion of a previously everted nipple suggests:

Question 87

1 out of 1 points

A 12-year-old boy relates that his left scrotum has a soft swollen mass. The scrotum is not painful upon palpation. The left inguinal canal is without masses. The mass does transilluminate with a penlight. This collection of symptoms is consistent with:

Question 88

1 out of 1 points

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 to:

Question 89

1 out of 1 points

The presence of cervical motion tenderness may indicate:

Question 90

1 out of 1 points

Nancy Walker is a 16-year-old girl who presents to the clinic with complaints of severe, acute chest pain. Her mother reports that Nancy, apart from occasional colds, Nancy is not prone to respiratory problems. What potential risk factor is most important to assess with regards to Nancy's current problem?

Question 91

1 out of 1 points

Cranial nerve XII may be assessed in an infant by:

Question 92

1 out of 1 points

When you attempt to move a 10-month-old child from his mother's lap to the examination table, he screams loudly. Your best action is to:

Question 93

1 out of 1 points

It is especially important to test for ankle clonus if:

Question 94

1 out of 1 points

To spread the breast tissue evenly over the chest wall, you should ask the woman to lie supine with:

Question 95

1 out of 1 points

Diabetic peripheral neuropathy will likely produce:

Question 96

1 out of 1 points

Your 15-year-old patient is athletic and thin. Radiography of an ankle injury reveals a stress fracture. You should question this patient about her:

Question 97

1 out of 1 points

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:

Question 98

1 out of 1 points

While examining a 30-year-old woman, you note that one breast is slightly larger than the other. In response to this finding, you should:

Question 99

1 out of 1 points

A patient in the deepest coma would be scored a _____ on the Glasgow Coma Scale.

Question 100

1 out of 1 points

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:

Question 101

1 out of 1 points

Functional assessment is most important during the examination of a(n):