Comprehensive Nursing Exam Preparation, Exams of Nursing

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CURRENTLY TESTING SOLUTIONS OF NUR 634 FINAL EXAM

QUESTIONS WITH ACTUAL CORRECT DETAILED ANSWERS

72 - year-old M pt complains of bilateral knee pain. the NP assess stumbling during heel strike suggestive of? - ANSWER-quadracep weakness or abnormal patellar tracking 14 y/o student comes to clinical for a 3-month hx of dyspnea when playing basketball. the dyspnea resolves shortly after resting. There is no fever, chills, cough sputum, chest pain, or serious illness. Asthma is suspected. Which of the following sounds heard on exhalation would suggest asthma? - ANSWER-wheezing 75 y/o F in good health presents to a NP. she takes no medications but has been told in the past her BP is high. which one of the following findings is consistent with normal aging process and is not a sign of CV disease? - ANSWER-murmur, stiffened ventricles (valvular changes) An older adult M complains of feeling something in his L scrotum. On palpitation, soft, and moveable blood vessels that feel like a bag of warms are noted underneath the scrotal skin. the testicles are not swollen or red; what is likely the diagnosis? - ANSWER-varicocele-varicose vein of spermatic cord Kyphosis is a late sign of? - ANSWER-? Parents generally bring children for health. At what age should the provider begin to question the child him or herself regarding presenting symptoms? - ANSWER->6? The bulge sign and the balloon sign may be present where there is a/an? - ANSWER-Patellar effusion- fluid in the knee. Swelling in suprapatellar pouch, bulge confirms presence of fluid as you move join from side to side. The cremasteric reflex is elicited by: - ANSWER-Cremasteric reflex is a superficial reflex seen in males, light stroking or poking the medical part of thigh regardless of the direction of the stroke.

Stimulation of moro reflex? - ANSWER-Scare in baby. Spread of arms (abduct), fingers spread, legs extend. Gently lift head and release babv so that they feel like they are falling. Absence of this suggest damage to brain or spinal cord. one side absent-brachial plexus injury. The two most important components of the eye exam for young child? - ANSWER-I think: motility, hirschberg light reflex. use toys and make it fun. Indication of crepitus - ANSWER-common sign of bone fx or RA. in lungs-subcutaneous emphysema (trapped air under skin) Retention Cysts - ANSWER-tumor like accumulation of secretions formed when the outlet of secreting gland is obstructed. can develop in breast, pancreas, kidney, mucus membrane. Small sac of mucus that forms when mucus duct becomes blocked. yellowish blge and should be drained GCS - ANSWER-measures LOC, eye opening, motor response, verbal response. 3- 15 Assessment of CN XI - ANSWER-Spinal accessory nerve, shrug shoulders Assessment of egophony? - ANSWER-Say "e" and sounds like "a"= egophony. Suggests consolidation, pleural effusion, pneumonia. The FNP will be able to assess the splitting of s2 in which location? - ANSWER-2nd ICS L sternal boarder A 42 y/o healthy F requests an MRI rather than mammogram. no hx of family ca. which of the following is true about MRI as a screening modality for breast ca in the general population? - ANSWER-accurate by high false positive rate Assessment of PAD - ANSWER-pain with walking but better at rest Evaluation of corneal abrasion - ANSWER-Slit lamp exam= stain in eye.

Assessment of urine analysis of UTI - ANSWER-there would NOT be proteins assessment of stereognosis and graphesthesia - ANSWER-stereognosis: identify object without seeing or hearing but by touch graphesthesia: draw figure 8 on hand and can identify what was written Assessment of risk factors for melanoma - ANSWER-ABCDE A 35 y/o soccer player presents to urgent care with complain of swelling and pain on medial aspect of right knee. on exam the knee is swollen and tender on the joint. to assess for possible injury to meniscus, which maneuver will yield the best information for the NP. - ANSWER-mcMurrarys test, fully bend leg and pull outward bow legged while externally rotating as you extend knee. Click or pain=+ The NP begins the exam of a 29 y/o female presenting for cough. noted is depression of the lower part of the sternum. Which of the following best describes the appearance of the chest. - ANSWER-Pectus excavatum "sunken in appearance". birth defect, cup shaped. When examining the cervix of a 20 y/o female you note that most of the cervix is pink but there is a small ring of dark red tissue surrounding the os. This is most likely? - ANSWER-Strawberry cervix- not linked to Ca. Causes: hormones, pregnancy, PO birth control, and age (young,puberty) Testing CN IX and X for a child - ANSWER-swallow and gag say "ah" and stick tongue out to observe uvula and soft palate. Describe McMurray's test - ANSWER-Assess for meniscus tear. Lateral: pt supine w. knee completely flexed, old joint with one hand and foot in the other. rotate foot internally while extending knee. click/pain=positive medial: hold knee and fully bend leg and pull outward bow legged while externally rotating and extending knee. Bell's Palsy (facial nerve paralysis) - ANSWER-lesion on CN VII

cannot move eyebrows. R side facial paralysis facial drooping, drooling, pain behind ear, loss of taste Fibromyalgia - ANSWER-Femal patient w tiredness, fatigue, pain and tender points. caused by stress no swelling Asthma and breath sounds - ANSWER-wheezing cannot hear clear lungs sounds in patient with asthma--> wheezing Pneumonia - ANSWER-increased tactile fremitus. egophony percussion sounds would be dull bronchophony=pneumonia Patient with pain down butt and with lifting - ANSWER-sciatica pressure on sciatica nerve causes radiating pain runs down one or both legs from lower back

• SLR (straight leg raise) - ANSWER-=herniated disc also pain like sciatica lumbo-sacral radiculopath. Cluster headaches - ANSWER-severe unilateral pain behind eye (redness) Resting tremors - ANSWER-Parkinsons #1 cause of stroke - ANSWER-HTN Romberg Test - ANSWER-tests cerebellar ataxia

proprioception-have hard time balancing. measures sense of balance (dorsal column of spinal cord) stand and close eyes with arms crossed-do they stand still? Not a fidning of a rotator cuff tear? - ANSWER-painless because rotator cuffs are very painful Whisper test-how to do it? - ANSWER-whisper 3 words into ear and repeat them back. cover ear that you are not whispering into hordeum - ANSWER-pustule on eyelid in BPH - ANSWER-prostate is firm, uniform, and enlarged. Strep pharyngitis symptoms - ANSWER-sore throat, painful swallowing, fever, rash NOT cough SLE lupus - ANSWER-butterfly rash malar rash +ANA (anti-nuclear antibody) scleroderma Sjogren syndrome Bag of warms, scrotum - ANSWER-varicocele (varicose veins of spermatic cord) Hip circumduction - ANSWER-Lack of knee flexion Candida test - ANSWER-ANA everything but dry! Questions to ask for remote memory - ANSWER-mothers maiden name, childhood, school, historical events

Thenar Atrophy - ANSWER-carpel tunnel syndrome, distal muscle weakness, base of thumb Bulging or ballooning of knee - ANSWER-patellar effusion (fluid in knee) s&s: sswelling, stiffness, dull/mild ache restricted mvmnt. what ligament does abducting knee test - ANSWER-MCL Moro reflex - ANSWER-scare baby. hold infant supine, support head, abruptly lower entire body and baby's arms with abduct and extend, hands will open, legs flex, baby may cry. Yellow of skin is problem with - ANSWER-bilirubin Purpose of MMSE - ANSWER-dementia PAD - ANSWER-pain with walking and better with rest Where is S2 split heard - ANSWER-2nd ICS and L sternal border where is mitral regurg best heard - ANSWER-apex and S1 L sternal border What does CN XI assess - ANSWER-shoulder shrug otitis media - ANSWER-erythema, landmarks not visible, bulging, negative mobility. corneal abrasion - ANSWER-slit lamp exam; dye fluroxene in eye. Melenoma - ANSWER-ABCDE

expressive aphasia-not affected part - ANSWER-reading comprehension CN3 oculomotor - ANSWER-pupils constricts on near vision smoking but not ready to quit - ANSWER-contemplation Mental health Q - ANSWER-all of the above depression - ANSWER-decrease in desire to do things delirium - ANSWER-onset in about 2 days inserting/removing vaginal speculum for pelvic exam - ANSWER-posterior, down MRI breast - ANSWER-accurate but high false positive What do you not use for yeast infection test - ANSWER-dry menopausal bleeding - ANSWER-endometrial biopsy achilles tendon reflex - ANSWER-when tapped, foot will dorsiflex decrease in s CVA tenderness - ANSWER-kidney mitral regurg - ANSWER-at apex S1 (5th ics mid nipple) extraocularmotor - ANSWER-not CN

rotator cuff tear - ANSWER-painful UTI - ANSWER-no proteins strep pharyngitis - ANSWER-no cough torsion of spermatic cord - ANSWER-pain and decreased reflex murphy sign - ANSWER-cholecystitis polymyalgia rheumatica - ANSWER-joint pain shotty lymph nodes - ANSWER-small mobile lymph nodes in the neck that are palpable and represent benign change-viral illness, Child does not care about peer pressure - ANSWER- baby responds to clapping hands - ANSWER- Heberden nodes - ANSWER-dip joints common in OA, small boney growths at tip of finger joint Bouchard nodes - ANSWER-pain at base of thumb, in carpel ometacarpal arthritis "dont cry over spilled milk" assesses what - ANSWER-abstract thinking what is it called when youre unable to ID a pen as an ojbect - ANSWER-agnosia Which is a component of assessing cognition - ANSWER-memory

to assess spinal levels L2-L4, which DTR would be tested - ANSWER-patellar pt with t4 spinal injury, you move f.c and patient becomes flushed and diaphoretic above the nipple line - ANSWER-autonomic dysreflexia what is NOT a common symptom of parkinsons - ANSWER-intention tremors Way to assess cerebellar function - ANSWER-finger to finger, heel to shin, finger to nose what is kernigs sign - ANSWER-flex knee while pt is supine making R angle with leg and straighten it--- resistance or pain in lower back is + Kernig's sign suggesting meningeal irritation pupils are reactive to in both to light direct and consensual but unequal in size; what do you expect - ANSWER-anisocoria large left supraclavicular lymph node is indicative of what - ANSWER-serious pathology- virchow node- malignancy AV nicking during retinal exam; what would you have seen - ANSWER-atrial stiffening- vein stops on either side of the artery clicking in TMJ - ANSWER-crepitus, displacement of joint new onset ear pain, suggestive of otitis media - ANSWER-lack of mobility in tympanic membrane during insuffiation touching tonsisls is grade __ - ANSWER-4+ To determine s1 - ANSWER-palpate carotid artery for carotid upstroke Assessment of jvp correlates with - ANSWER-CVP

where on the body and when in cardiac cycle would you ascultate a murmur - ANSWER-mitral valv prolapse-late systolic. mid systolic click at apex and left lower sternal border what do you do prior to ABG - ANSWER-allens test when percussing PNA pt youll hear - ANSWER-dullness Pulse oximeter reads 97% what does that mean - ANSWER-arterial hgb 97% you hear bronchial breath sounds in left lower lung what do you expect - ANSWER-fluid filled-increased breath sounds suggest consolidation. scattered expiratory wheezing - ANSWER-chronic asthma assessing ROM in healthy 28 year old women with no joint issues which would indicate limited ankle ROM - ANSWER-30 degree plantar flexion Crepitus while palpating joints indicates - ANSWER-Roughened articular cartilages. painless bumps on dorsolateral aspects of distal interphalangeal joints with limited flexion during ROM - ANSWER-Heberden's nodes Suspect lumbar radiculopathy.. - ANSWER-compression of nerve, numbness, weakness along nerve. Do a straight leg raise, bragard stretch test, or femoral stretch test Sprain - ANSWER-stretch ligament strain - ANSWER-stretch or tear of muscle

what test do you do if you suspect choleocystitis - ANSWER-Murphys sign- palpate inferior liver border while pt deep breathes How do you assess for enlarged spleen - ANSWER-percuss L anterior axillary line how to assess for peritonitis - ANSWER-rebound tenderness (+ Blumberg) markle sign increased WBC how to assess CN IX and X in child - ANSWER-stick tongue out and say "ahh" What does increased tactile fermitus suggest - ANSWER-PNA patient with pain down butt and with lifting suggests - ANSWER-sciatica what is not a sign of fibromyalgia - ANSWER-swelling signs of fibromyalgia and what causes - ANSWER-stress induced. tired, fatigue, pain, and tender points lesion on CVII facial nerve is a sign of - ANSWER-Bells palsy Signs of bells palsy - ANSWER-dropping, drooling, pain behind ear, loss of taste how to assess medial meniscus tear - ANSWER-hold knee, fully bend knee and pull outward like bowlegged while externally rotating knee out- click or pain is positive for tear how to assess for lateral meniscus tear - ANSWER-rotate leg inward while extending knee out and if click or pain then yes has tear

bronchophony is a sign of - ANSWER-PNA positive straight leg raise test is.. - ANSWER-herniated disc and pain like sciatica (lumbo-sacral radiculopathy) Urge incontinence is from - ANSWER-detrusor muscle How do you do a whisper test - ANSWER-close opposite ear and whisper three words and have pt repeat what is not a sign of pharyngitis symptoms - ANSWER-cough Romber tests for - ANSWER-cerebellar ataxia-balance assessment findings of patient with BPH - ANSWER-prostate is firm, uniform, enlarged assessment findings of patient with SLE lupus - ANSWER-malar rash-butterfly rash A + ANA (antinuclear antibody) test suggests - ANSWER-scheloderma sjogen syndrome what is hip circumduction - ANSWER-lack of knee flexion What do you NOT use for Candida Test - ANSWER-everything but the one that mentions dry,. NOT dry prep What to ask to test remote memory - ANSWER-mothers maiden name What is thenar atrophy - ANSWER-carpel tunnel syndrome, distal muscle weakness buldging at base of thumb What ligament does abducting knee test - ANSWER-MCL

what is the purpose of a MMSE - ANSWER-assess dementia sign of PAD - ANSWER-walking and better with rest where is an S2 split hear - ANSWER-2nd ICS L sternal border (pulmonic) where is mitral regurg best heard - ANSWER-apex, L sternal border What do you use to examine corneal abrasion - ANSWER-slit lamp exam what does expressive aphasia NOT affect - ANSWER-reading comprehension If a patient smokes and is not ready to quit what is this - ANSWER-contemplation what is true about breast MRI - ANSWER-2x more false positive what do you not use for yeast infection test - ANSWER-DRY angle when inserting or removing vaginal speculum - ANSWER-posterior-down what does CN2 NOT test - ANSWER-extraocular motor Assessment of torsion of spermatic cord - ANSWER-pain and decrease reflexes a positive murphys sign suggests - ANSWER-cholecystitis finding for polymyalgia rheumatica - ANSWER-joint pain

A skin condition seen in older fair skinned adults that may lead to squamous cell ca - ANSWER-Actinic keratosis Palpate frontal sinus tenderness by.. - ANSWER-Thumbs press up under bony brows Visualize ear on infant by.. - ANSWER-Pull auricle down When you shine light on pupil of r and l eye and they constrict this is called - ANSWER-Consensual rxn Pt has low TSH and high T4 you would expect.. - ANSWER-Lid lag What is echoing used for - ANSWER-Elaborate details and feelings Pupils unequal but reactive - ANSWER-Anisocoria Nasal turbinates appear pale, swollen, boggy, clear drainage. This is - ANSWER-Allergies Ear pain exacerbated by touching tregus.. is.. - ANSWER-Otitis externa 66/F USPSTF for cervical screening - ANSWER-Don't need one at that age Parental presence developmental considerations when obtaining health hx on toddler - ANSWER-Use toys Painful bump under eyelid - ANSWER-Stye Expected finding for otitis media - ANSWER-Bulging tympanic membrane Painful teary eye with rope like discharge and clear drainage - ANSWER-Allergen

Patient unable to identify an object is - ANSWER-Agnosia Provider complains about non-compliant pt - ANSWER-Bias Appropriate information to include on ROS - ANSWER-Pt has occasional loss of urine when coughing What is not a sign of dementia - ANSWER-Increase in abstract thinking What to do to rule out etoh abuse - ANSWER-CAGE What is not a characteristic of delirium - ANSWER-The patient is coherent An 8 mo old has strawberry tongue, white tonsils, uvula erythmatous, palatial petechiae, temp 100.9 HR 90 and RR 20 - ANSWER-Rapid strep test Assessing mouth patient has 1cm ulceration that is crusted with elevated border - what should you ask - ANSWER-When'd you first notice it Pregnant women at clinic with 3 days of small bleeding and swelling of gum, you'd tell them - ANSWER- This is likely from hormonal imbalance Location of post auricular lymph - ANSWER-Behind ear Elderly may self report but symptoms may not match actual findings, what do you do - ANSWER-Verify hx with family Temp 101.5 wbc 16 tonsilar exudate..this info is____ - ANSWER-Objective

Black infant 1 mo assessment, parents are concerned with rash since birth-pustular Melanosis. You'd tell them this is.. - ANSWER-Normal and no treatment, may last for a few months New patient at clinic with ear and throat pain, what kind of assessment would you do - ANSWER- Comprehensive bc they are new.