Advanced Health Assessment Midterm Review Questions With Answers 2024 Updated And Graded A, Exams of Nursing

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Advanced Health Assessment Midterm

Review Questions With Answers 2024

Updated And 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 - Answ 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 - Answ 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 - Answ 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 - Answ 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 - Answ 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 - Answ 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 - Answ C. arthritis A healthy BMI can best be described as: A. 18.5-24. B. 30.0-34. C. 25.0-29. D. 35.0-39.9 - Answ A. 18.5-24.

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 - Answ 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 - Answ 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 C How long have you been here? D. What's your mother's maiden name? - Answ A. What does a rolling stone gathers no moss mean? Dave, age 76, is brought in by his wife, who states that within the last 2 days Dave has become agitated and restless, has had few lucid moments, slept very poorly last night and can remember only recent events. Of the following differential diagnoses, which best fits the symptoms from this brief history? A. Depression B. Dementia C. Delirium D. Schizophrenia - Answ C. Delirium

Which technique is applied throughout the entire examination and interview process? A. Inspection B. Palpation C. Percussion D. Auscultation - Answ A. Inspection During a patient's pain assessment, the most important element is the patient's: A. Sleep hygiene B. Perception of his/her own pain C. Vital signs D. Fear of addiction - Answ B. Perception of his/her own pain The general survey of the patient includes all of the following except: A. appearance B. tanner stage C. height D. weight - Answ B. tanner stage One of the main differences between a comprehensive and focused assessment is: A. for the comprehensive assessment you will select the methods relevant to thorough assessment of the targeted problem B. for the focused assessment you will select the methods relevant to thorough assessment of the targeted problem C. for the focused assessment you perform a thorough head to toe examination D. for the comprehensive assessment you always refer the patient to a specialist at the end of the examination - Answ B. for the focused

assessment you will select the methods relevant to thorough assessment of the targeted problem Which of the following is an example of subjective data: A. Mr. D's vital signs are BP 138/66 P 107 T 99.9 SPO2 92% RR 20 B. Mr. D has inspiratory and expiratory wheezes noted during auscultation of the lungs C. Mr D's CXR shows an infiltrate in the left lower lobe consistent with pneumonia D. Mr D is a 53 year old male who presents to the clinic complaining of shortness of breath and says "it hurts to take deep breaths." He reports this started 2 days ago and says he's been having fever and chills. - Answ D. Mr D is a 53 year old male who presents to the clinic complaining of shortness of breath and says "it hurts to take deep breaths." He reports this started 2 days ago and says he's been having fever and chills. All of the following are included in the Review of Systems except: A. general B. Cardiovascular C. Psychiatric D. All of the above - Answ D. All of the above Which of the following is not a goal when developing a systematic sequence of examination: A. maximize the patients' comfort B. perform invasive imaging first C. avoid unnecessary changes in position D. enhance clinical efficiency - Answ B. perform invasive imaging first All of the following are examples of health promotion except: A. using USPSTF guidelines for practice during the exam

B. using American College of Chest Physicians grading criteria during the exam C. removing baby aspirin 81 mg from the medication list of a patient with know coronary artery disease during the exam D. using CDC recommendations for exercise during the exam - Answ C. removing baby aspirin 81 mg from the medication list of a patient with know coronary artery disease during the exam The initial moments of your encounter with a patient lay the foundation for your ongoing relationship. Which of the following best helps lay that foundation: A. ensure there is more than adequate lighting in the exam room 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 - Answ 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 - Answ 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" - Answ 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 - Answ 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 - Answ 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 - Answ 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 - Answ 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 - Answ 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 - Answ 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 - Answ 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 - Answ malignant melanoma Nail involvement characterized by painless separation of the nail plate from the nail bed is termed: Hippocratic nails Onycholysis Koilonychia Anonychia - Answ Onycholysis A 72-year-old teacher comes to a skilled nursing facility for rehabilitation after being in the hospital for 6 weeks. She was treated for sepsis and respiratory failure and had to be on the ventilator for 3 weeks. You are completing your initial assessment and are evaluating her skin condition. On her sacrum there is full-thickness skin loss that is 5 cm in diameter, with damage to the subcutaneous tissue. The underlying muscle is not affected. You diagnose this as a pressure ulcer. What is the stage of this ulcer? Stage 1 Stage 2 Stage 3 Stage 4 - Answ Stage 3 Sammy, age 12, presents with claerly demarcated round or oval patches of hair loss without visible scaling or inflammation. What do you suspect?

Psoriasis Erythema multiforme Alopecia Areata Syphilis - Answ Alopecia Areata A basal cell carcinoma is: an epithelial tumor that originates from either the basal layer of the epidermis or cells in the surrounding dermal structures and are usually found in sun-exposed areas a malignant tumor of the squamous epithelium of the skin or mucous membranes an overgrowth and thickening of the cornified epithelium lined with epithelium and contains a fluid or semisolid material - Answ an epithelial tumor that originates from either the basal layer of the epidermis or cells in the surrounding dermal structures and are usually found in sun- exposed areas You ask a patient to follow your finger laterally when evaluating extraocular movements. Which cranial nerves are you testing? IV, VII III, VI III, X

II, III - Answ III, VI The mental status examination enables the nurse practitioner to identify: Intelligence quotient and reasoning Abstract thinking and memory functioning Reasoning and psychomotor skills Memory functioning and intelligence - Answ Abstract thinking and memory functioning An assessment of a client experiencing hallucinations would most likely reveal all of the following except: experiences that seem real but lack actual external stimulation may be auditory may be visual only occurs in the setting of schizophrenia - Answ 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 - Answ 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. - Answ 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 - Answ 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 - Answ Myxedema Symptoms and assessment findings related to hypothyroidism include all of the following except: Palpitations Fatigue Dry, coarse skin Cold intolerance - Answ 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 - Answ 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 - Answ 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 - Answ 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 - Answ cushing's syndrome The test that compares air conduction and bone conduction is known as: Weber test Whispered voice test Tug tes Rinne test - Answ Rinne test A 12-year-old presents to the clinic with his father for evaluation of a painful lump in the left eye. It started this morning. He denies any trauma or injury. There is no visual disturbance. Upon physical examination, there is a red raised area at the margin of the eyelid that is tender to palpation; no tearing occurs with palpation of the lesion. Based on this description, what is the most likely diagnosis? Dacryocystitis Chalazion Hordeolum Xanthelasma - Answ Hordeolum When performing an examination using the opthalmoscope, place yourself about 15 inches away from the patient and at a 15 degree angle from the patient's line of vision. The first thing that should come into view is called:

physiologic cup Red Reflex optic disc papilledema - Answ Red Reflex Small, mobile, discrete, non-tender nodes are termed: shotty fluctuant matted fixed - Answ shotty A 29-year-old physical therapist presents for evaluation of an eyelid problem. On observation, the right eyeball appears to be protruding forward. Based on this description, what is the most likely diagnosis? Ptosis Ectropion Epicanthus Exophthalmos - Answ Exophthalmos

The thyroid gland is best assessed: above the hyoid bone behind the cricoid below the suprasternal notch The thyroid gland is best assessed: above the hyoid bone behind the cricoid below the suprasternal notch Correct Response above the suprasternal notch - Answ 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 - Answ 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 - Answ 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 - Answ 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 - Answ 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 - Answ 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 - Answ thick, white plaques adhering to the underllying mucosa Which of the following are associated causes of epistaxis:

anticoagulants nsaids coagulopathies all of the above - Answ 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 - Answ 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 - Answ 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 - Answ Skin between the ribs moves inward with inspiration Which lung sound possesses the characteristics of being louder and higher in pitch, with a short silence between inspiration and expiration and with expiration being longer than inspiration? Bronchial Bronchovesicular Vesicular Tracheal - Answ Bronchial A patient complains of shortness of breath for the past few days. On examination, you note late inspiratory crackles in the lower third of the chest that were not present a week ago. What is the most likely explanation for these? Heart failure

Asthma COPD Bronchiectasis - Answ Heart failure A 21-year-old college senior presents to your clinic, complaining of shortness of breath and a nonproductive nocturnal cough. She states she used to feel this way with extreme exercise a few years ago and used to have to use some kind of inhaler 20 minutes before exercise. She denies any other upper respiratory symptoms, chest pain, gastrointestinal symptoms, or urinary tract symptoms. Her past medical history is significant only for seasonal allergies, for which she takes a nasal steroid spray but is otherwise on no other medications. She has had no surgeries. Her mother has allergies and eczema and her father has high blood pressure. She is an only child. She denies smoking and illegal drug use but drinks three to four alcoholic beverages per weekend. She is a junior in finance at a local university and she has recently started a job as a bartender in town. On examination she is in no acute distress and her tempera - Answ Asthma A 62-year-old construction worker presents to your clinic, complaining of almost a year of chronic cough and occasional shortness of breath. He denies any chest pain. He has had no weight gain, weight loss, fever, or night sweats. His past medical history is significant for high blood pressure and arthritis. He has smoked two packs a day for the past 45 years. He drinks occasionally but denies any illegal drug use. He is married and has two children. He denies any foreign travel. His father died of a heart attack and his mother died of Alzheimer's disease. On examination you see a man looking slightly older than his stated age. His blood pressure is 130/80 and his pulse is 88. His head, eyes, ears, nose, and throat examinations are unremarkable. His cardiac examination is normal. On examination of his chest, the diameter seems enlarged. Breath sounds are decreased throughout all lobes. Rhonchi are heard over all lung - Answ Chronic obstructive pulmonary disease (COPD) Which of the following is consistent with good percussion technique?

Allow all of the fingers to touch the chest while performing percussion. Maintain a stiff wrist and hand. Leave the plexor finger on the pleximeter after each strike. Strike the pleximeter over the distal interphalangeal joint. - Answ Strike the pleximeter over the distal interphalangeal joint. The following are examples of transmitted voice sounds except: ask the patient to say their name and then repeat it again backwards ask the patient to say "ninety-nine" ask the patient to whisper "one-two-three" as the patient to say "ee" - Answ ask the patient to say their name and then repeat it again backwards A client is complaining of dyspnea. During your subjective assessment, you are able to best assess the degree the patient's dyspnea by asking about: age severity based on the patient's daily activities body weight

height - Answ 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 - Answ 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 - Answ pneumothorax A classic assesment of patient with angina pectoris would include the following: exertional pain chest pressure