Advanced Health Assessment Midterm Questions GRADED A., Exams of Nursing

Download Advanced Health Assessment Midterm Questions GRADED A. and more Exams Nursing in PDF only on Docsity! Advanced Health Assessment Midterm Questions GRADED A. The following information belongs in which section of the Comprehensive Heath History (H&P)? "3 day history of rash and swelling" A. History of Present Illness B. Review of Systems C. Allergies D. Chief Complaint - CORRECT ANSWER --D. Chief Complaint A patient with abdominal pain describes "what" the pain feels like and "how long" it lasts. In which part of the H&P would you place this information? A. History of Present Illness B. Past Medical History C. Sexual History D. Review of Systems - CORRECT ANSWER --A. History of present illness Which of the following best describes the patient record? A. describes the approach to a problem B. serves a dual purpose as it reflects your anaylsis of the patient's health status and documents examination findings C. shows your clinical thought process D. reflects you interpersonal skills with the patient - CORRECT ANSWER --B. serves a dual purpose as it reflects your anaylsis of the patient's health status and documents examination findings The consideration of culture and ethnicity during the interview process are important because: A. similar cultures always provide similar responses B. some cultures consider certain questions and gestures offensive C. it is politically correct D. none of the above - CORRECT ANSWER --B. some cultures consider certain questions and gestures offensive During an interview, your patient admits to feeling worthless and having a sleep disturbance for the last 3 weeks. These are clues that warrant exploration of: A. risk for suicide B. split personality C. cognitive function D. functional assessment - CORRECT ANSWER --A. risk for suicide Worries persisting for =>6 months most likely reflects one of the most prevalent psychiatric conditions in the United States known as: A. posttraumatic stress disorder B. generalized anxiety disorder C. fatigue D. social phobia - CORRECT ANSWER --B. generalized anxiety disorder Risk factors for fatal overdose of pain medications include all of the following except: A. age 65 or older B. depression C. arthritis D. concurrent benzodiazepine use - CORRECT ANSWER --C. arthritis A healthy BMI can best be described as: A. 18.5-24.9 B. 30.0-34.9 C. 25.0-29.9 D. 35.0-39.9 - CORRECT ANSWER --A. 18.5-24.9 The comprehensive health history: A. has a completely different format that varies with each institution B. varies from country to country C. follows the same general format regardless of the institution or geographical location D. follows the exact same format across the world, except Europe - CORRECT ANSWER --C. follows the same general format regardless of the institution or geographical location Which of the following is not a common symptom of depression? A. Anhedonia B. Dry lips C. Appetite disturbance D. Worthlessness - CORRECT ANSWER --B. Dry lips During a mental status exam, which question might you ask to assess abstraction ability? A. What does a rolling stone gathers no moss mean? B. Start with 100 and keep subtracting by 7 B. explain your role, your status as a student provider and how you will be involved in the patient's care C. check the light source in the otoscope D. check the light source in the opthalmascope - CORRECT ANSWER --B. explain your role, your status as a student provider and how you will be involved in the patient's care Which of the following is not one of the seven attributes of a symptom: A. location B. quality C. timing D. immunization status - CORRECT ANSWER --D. immunization status All of the following are examples of empathic responses except: A. "I cannot imagine how hard this must be for you" B. "I think you need a psych consult immediately" C. "You must be feeling sad" D. "That sounds upsetting" - CORRECT ANSWER --B. "I think you need a psych consult immediately" Which of the following are components of the three dimensions of cultural humility: A. self-awareness B. respectful communication C. collaborative partnership D. all of the above - CORRECT ANSWER --D. all of the above When performing the general survey which of the following is not considered a sign of distress: A. pain B. labored breathing C. large mole on forehead D. anxiety - CORRECT ANSWER --C. large mole on forehead You are speaking to an 8th grade class about health prevention and are preparing to discuss the ABCDEs of melanoma. Which of the following descriptions correctly defines the ABCDEs? A = asymmetry; B = irregular borders; C = color changes, especially blue; D = diameter >6 mm; E = evolution A = actinic; B = basal cell; C = color changes, especially blue; D = diameter >6 mm; E = evolution A = actinic; B = irregular borders; C = keratoses; D = dystrophic nails; E = evolution A = asymmetry; B = regular borders; C = color changes, especially orange; D = diameter >6 mm; E = evolution - CORRECT ANSWER --A = asymmetry; B = irregular borders; C = color changes, especially blue; D = diameter >6 mm; E = evolution A 28-year-old patient comes to the office for evaluation of a rash. At first there was only one large patch, but then more lesions erupted suddenly on the back and torso; the lesions itch. On physical examination, you note that the pattern of eruption is like a Christmas tree and that there are a variety of erythematous papules and macules on the cleavage lines of the back. Based on this description, what is the most likely diagnosis? Tinea versicolor Pityriasis rosea Psoriasis Atopic eczema - CORRECT ANSWER --Pityriasis rosea A 19-year-old construction worker presents for evaluation of a rash. He notes that it started on his back with a multitude of spots and is also on his arms, chest, and neck. It itches a lot. He does sweat more than before because being outdoors is part of his job. On physical examination, you note dark tan patches with a reddish cast that has sharp borders and fine scales, scattered more prominently around the upper back, chest, neck, and upper arms as well as under the arms. Based on this description, what is your most likely diagnosis? Tinea versicolor Pityriasis rosea Psoriasis Atopic eczema - CORRECT ANSWER --Tinea versicolor Which skin lesions are most commonly found on sun-exposed skin of older, fair- skinned people? Skin tags Seborrheic keratoses Actinic keratoses Angiomas - CORRECT ANSWER --Actinic keratoses A 68-year-old retired farmer comes to your office for evaluation of a skin lesion. On the right temporal area of the forehead, you see a flattened papule the same color as his skin, covered by a dry scale that is round and feels hard. He has several more of these scattered on the forehead, arms, and legs. Based on this description, what is your most likely diagnosis? Seborrheic keratosis Actinic keratosis Basal cell carcinoma Squamous cell carcinoma - CORRECT ANSWER --Actinic keratosis Which type of lesion often grows out of already present nevi that are changing or atypical, especially if the patient is over 50 years old: malignant melanoma basal cell carcinoma squamous cell carcinoma karposi sarcoma - CORRECT ANSWER --malignant melanoma may be auditory may be visual only occurs in the setting of schizophrenia - CORRECT ANSWER --only occurs in the setting of schizophrenia The nurse practitioner is examining an adolescent who has been a long-term IV cocaine user. What other findings would alert the nurse practitioner to a frequent complication. Epistaxis and chronic rhinorrhea Cardiac arrhythmias and hypertension Chest congestion and wheezing Hepatitis and cellulitis - CORRECT ANSWER --Hepatitis and cellulitis The nurse practitioner is completing a history and physical on a child who she suspects may be autistic. Findings associated with autism include: Delay in language development Delay in physical growth Overprotective parents who provide minimal social interaction for the child Warm, cuddling child with excessive need for interaction. - CORRECT ANSWER -- Delay in language development A 38-year-old accountant comes to your clinic for evaluation of a headache. The throbbing sensation is located in the right temporal region and is an 8 on a scale of 1 to 10. It started a few hours ago, and she has noted nausea with sensitivity to light; she has had headaches like this in the past, usually less than one per week, but not as severe. She does not know of any inciting factors. There has been no change in the frequency of her headaches. She usually takes an over-the-counter analgesic and this results in resolution of the headache. Based on this description, what is the most likely diagnosis of the type of headache? Tension Cluster Migraine Analgesic rebound - CORRECT ANSWER --Migraine A middle aged pateint presents with diffuse facial swelling. Upon further assessment of the face you note hair is dry, course and sparse; thinning of lateral eyebrows; periorbital edema. This represents a finding of: Cishing's syndrome Myxedema Nephrotic syndrome Angioedema - CORRECT ANSWER --Myxedema Symptoms and assessment findings related to hypothyroidism include all of the following except: Palpitations Fatigue Dry, coarse skin Cold intolerance - CORRECT ANSWER --Palpitations Enlarged or tender lymphnodes, if unexplained, call for: Immediate biopsy Re-examination of the regions they drain Immediate soft-tissue CT Stat referral to ENT - CORRECT ANSWER --Re-examination of the regions they drain Jaxson is a 10 year-old male patient that presents to the clinic today complaining of a headache. His mother reports that he has just not been acting himself for the past two days. All of the following would be pertinent in your examination, except: Assessing for cranial trauma or deformity Incorrect Response Assessing for nuchal rigidity Assessing for cervical spine tenderness or deformity Assessing for Jugular Vein Distension - CORRECT ANSWER --Assessing for Jugular Vein Distension Tonsillar lymphnodes are located: at the angle of the mandible in the midline, a few centimeters behind the tip of the mandible behind the tonsilis in the oropharynx superficial to the sternomastoid - CORRECT ANSWER --at the angle of the mandible A skin and tissue disorder usually caused by increased adrenal cortisol production; characterized by round or "moon" face appearance is: myxedema acromegaly cushing's syndrome nephrotic syndrome - CORRECT ANSWER --cushing's syndrome The test that compares air conduction and bone conduction is known as: above the suprasternal notch - CORRECT ANSWER --above the suprasternal notch All of the following are considered bony landmarks of the eardrum except: cone of light short process of the malleus handle of the malleus umbo - CORRECT ANSWER --cone of light What is the correct procedure for palpation of a client's thyroid gland? stand behind the client, hyperextend th head and palpate both sides simultaneoulsy stand behind the client, have the client flex the neck slightly forward to relax the sternomastoid muscles stand in front of the client, hyperextend the head and have the client lean away from the side being evaluated stand next to the client and have the cliient lean away from the side being examined and take a swallow of water - CORRECT ANSWER --stand behind the client, have the client flex the neck slightly forward to relax the sternomastoid muscles When a client sips water and swallows, the thyroid isthmus: moves down and slightly posterior and feels smooth on palpation elongates and enlarges during the swallow and immediately returns to a resting position moves slightly out during the sipping and backward during the swallowing moves upward during the swallow and feels symmetric and smooth to palpation - CORRECT ANSWER --moves upward during the swallow and feels symmetric and smooth to palpation Types of ocular discharge found in the setting of conjunctivitis include all of the following except: hemorrhagic mucoid mucoidpurulent watery - CORRECT ANSWER --hemorrhagic Which of the following are common characteristics of acute otitis media: gray, retracted TM chalky, white patches with irregular margins on the surface of the TM erythema of the external ear canal erythema, bulging TM with loss of bony landmarks - CORRECT ANSWER -- erythema, bulging TM with loss of bony landmarks Thrush is most often characterized as: white exudate on the tonsils thick, white plaques adhering to the underllying mucosa white specks found only on the buccal mucosa fissures on the tongue - CORRECT ANSWER --thick, white plaques adhering to the underllying mucosa Which of the following are associated causes of epistaxis: anticoagulants nsaids coagulopathies all of the above - CORRECT ANSWER --all of the above A 19-year-old college student, Todd, is brought to your clinic by his mother. She is concerned that there is something seriously wrong with him. She states for the past 6 months his behavior has become peculiar and he has flunked out of college. Todd denies any recent illness or injuries. His past medical history is remarkable only for a broken foot. His parents are both healthy. He has a paternal uncle who had similar symptoms in college. The patient admits to smoking cigarettes and drinking alcohol. He also admits to marijuana use but none in the last week. He denies using any other substances. He denies any feelings of depression or anxiety. While speaking with Todd and his mother you do a complete physical examination, which is essentially normal. When you question him on how he is feeling, he says that he is very worried that Microsoft has stolen his software for creating a better browser. He tells you he has se - CORRECT ANSWER --Schizophrenia A 32-year-old white female comes to your clinic, complaining of overwhelming sadness. She says for the past 2 months she has had crying episodes, difficulty sleeping, and problems with overeating. She says she used to go out with her friends from work but now she just wants to go home and be by herself. She also thinks that her work productivity has been dropping because she just is too tired to care or concentrate. She denies any feelings of guilt or any suicidal ideation. She states that she has never felt this way in the past. She denies any recent illness or injuries. Her past medical history consists of an appendectomy when she was a teenager; otherwise, she has been healthy. She is single and works as a clerk in a medical office. She denies tobacco, alcohol, or illegal drug use. Her mother has high blood pressure and her father has had a history of mental illness. On examination you see a woman appearing her st - CORRECT ANSWER --Major depressive episode Which of the following occurs in respiratory distress? Speaking in sentences of 10-20 words Skin between the ribs moves inward with inspiration Neck muscles are relaxed Patient torso leans laterally - CORRECT ANSWER --Skin between the ribs moves inward with inspiration height - CORRECT ANSWER --severity based on the patient's daily activities CDC guidelines recommend smoking prevention and cessation should begin when a patient is: A middle-aged female A geriatric male A teenager Of legal drinking age - CORRECT ANSWER --A teenager While performing percussion you identify an area of dullness in the left lower lobe. This could represent all of the following except: lobar pneumonia pneumothorax pleural effusion empyema - CORRECT ANSWER --pneumothorax A classic assesment of patient with angina pectoris would include the following: exertional pain chest pressure discomfort in the shoulder, back, neck or arm all of the above - CORRECT ANSWER --all of the above Orthopnea is differentiated from other forms of dyspnea as it: occurs when the patient is lying down and improves when the patient sits up occurs when the patient is lying down and improves when the rolls over occurs when the patient is sitting up and improves when the patient lays down is always accompanied by heart palpitations - CORRECT ANSWER --occurs when the patient is lying down and improves when the patient sits up When assessing a patient for cardiovascular disease, you are aware that it strikes a disproportionate number of: hispanics and women native americans and men african americans and women african americans and men - CORRECT ANSWER --african americans and women A 25-year-old optical technician comes to your clinic for evaluation of fatigue. As part of your physical examination, you listen to her heart and hear a murmur only at the cardiac apex. Which valve is most likely to be involved, based on the location of the murmur? Mitral Tricuspid Aortic Pulmonic - CORRECT ANSWER --Mitral Where is the point of maximal impulse (PMI) normally located? In the left 5th intercostal space, 7 to 9 cm lateral to the sternum In the left 5th intercostal space, 10 to 12 cm lateral to the sternum In the left 5th intercostal space, in the anterior axillary line In the left 5th intercostal space, in the midaxillary line - CORRECT ANSWER --In the left 5th intercostal space, 7 to 9 cm lateral to the sternum To hear a soft murmur or bruit, which of the following may be necessary? Ask the patient to hold their breath Ask the patient to silence their cell phone Check the tubing of your stethescope for any cracks that could cause an air leak All of the above - CORRECT ANSWER --All of the above How should you determine whether a murmur is systolic or diastolic? Palpate the carotid pulse. Palpate the radial pulse Judge the relative length of systole and diastole by auscultation. Correlate the murmur with a bedside heart monitor. - CORRECT ANSWER --Palpate the carotid pulse. Which of the following best describes a grade 4-intensity murmur? It is moderately loud. It can be heard with the stethoscope off the chest. It can be heard with the stethoscope partially off the chest. It is associated with a "thrill." - CORRECT ANSWER --It is associated with a "thrill." You suspect that a patient has actue cholecystitis, you would expect to find which of the following to be positive upon exam: murphy sign grey-turner sign mcmurray sign kehr sign - CORRECT ANSWER --murphy sign To differentiate among the different diagnoses of imflammatory bowel diseases, you look at the client's histological, culture and physical features. Mary has transmural inflammation, granulomas, focal involvement of the colon with some skipped areas, involving the terminal ileum and proximal colon. What do you suspect: crohn's disease ulcerative colitis infectious colitis ischemic colitis - CORRECT ANSWER --crohn's disease Visceral pain is best described as: pain that originates from the parietal peritoneum pain that occurs when organs contract unusually and forcefully or are distended and stretched pain that is felt in distant sites pain that is felt after a loose bowel movement - CORRECT ANSWER --pain that occurs when organs contract unusually and forcefully or are distended and stretched A 52-year-old secretary comes to your office, complaining about accidentally leaking urine when she coughs or sneezes. She says this has been going on for about a year now. She relates that she has not had a period for 2 years. She denies any recent illness or injuries. Her past medical history is significant for four spontaneous vaginal deliveries. She is married and has four children. She denies alcohol, tobacco, or drug use. During her pelvic examination you note some atrophic vaginal tissue, but the remainder of her pelvic, abdominal, and rectal examinations are unremarkable. Which type of urinary incontinence does she have? stress urge overflow neurologic - CORRECT ANSWER --stress What is the most common origination of melena: esophagus stomach duodenum all of the above - CORRECT ANSWER --all of the above You are assessing a patient who reports a history of a positive Helicobacter Pylori test. You interpret this finding as an infection associated with: GERD irritable bowel syndrome duodenal or stomach ulcer esophageal dysphagia - CORRECT ANSWER --duodenal or stomach ulcer A careful history of a client with a chief complaint of diarrhea reveals that this adult has recurrent abdominal pain and diarrhea that alternates with constipation. The symptoms have been present >6 months and the client also reports change in stool frequency and appearance. This most likely represents: drug-induced diarrhea inflammatory bowel disease giardiasis irritable bowel syndrome - CORRECT ANSWER --irritable bowel syndrome An elderly client presents with fever, leukocytosis and cramps. Upon physical exam you find lower left quadrant tenderness. The most likely diagnosis is: appendicitis diverticulitis irritable bowel syndrome pancreatitis - CORRECT ANSWER --diverticulitis Mr. Patel is a 64-year-old man who was told by another care provider that his liver is enlarged. Although he is a life-long smoker, he has never used drugs or alcohol and has no knowledge of liver disease. Indeed, on examination, a liver edge is palpable 4 centimeters below the costal arch. Which of the following would you do next? order a liver ultrasound order a hepatitis panel determine liver span by percussion oder a stat GI referral - CORRECT ANSWER --determine liver span by percussion