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CPM Final Exam 2024: Questions and Answers, Exams of Nursing

A comprehensive set of questions and answers for a cpm final exam. It covers various topics related to cardiovascular and pulmonary medicine, including heart sounds, lung auscultation, patient communication, and obstetric history. Designed to help students prepare for their final exam by providing a detailed overview of key concepts and clinical scenarios.

Typology: Exams

2024/2025

Available from 01/08/2025

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Download CPM Final Exam 2024: Questions and Answers and more Exams Nursing in PDF only on Docsity!

CPM FINAL EXAM 2024 ACTUAL

EXAM COMPLETE EXAM

QUESTIONS WITH DETAILED

VERIFIED ANSWERS (100%

CORRECT ANSWERS) /ALREADY

GRADED A+

1- A 62 year old patient with a history of hypertension reports to you that they feel their heart "jumping around" in their chest and "skipping beats". Which condition would present with an irregular heart RHYTHM?

-Sinus bradycardia

-Ventricular tachycardia

-Normal sinus rhythm

-Atrial fibrillation - ....ANSWER...Atrial fibrillation

2- Which corresponds to the first heart sound ("S1" or "lubb")?

-The closing of the aortic and pulmonic valves during diastole

-The opening of the mitral and tricuspid valves during systole

-The opening of the aortic and pulmonic valves during diastole

-The closing of the mitral and tricuspid valves during systole - ....ANSWER...The closing of the mitral and tricuspid valves during systole

3- From a medical-legal perspective, which statement is most correct?

-If you didn't document in the medical record that you did or said something regarding a patient encounter, then it will later be assumed that you didn't do or say it ("If you didn't document it, you didn't do it")

-Since there are so many details involved in patient care, you can't be expected to write down everything you did, so, at a later date, when your actions are brought into question, your recollection of the encounter is as acceptable as your documentation of the encounter.

-Since you are a medical student, and will have access to the electronic medical record in various offices and institutions, it will be acceptable for you to look up test results for your family and friends.

-Since most medical records are now electronic, it is acceptable to send personal medical information using commercial e-mail services like Gmail. - ....ANSWER...-If you didn't document in the medical record that you did or said something regarding a patient encounter, then it will later be assumed that you didn't do or say it ("If you didn't document it, you didn't do it")

3- The systolic blood pressure is recorded as:

-The disappearance of the Korotkoff sounds upon deflation of the cuff

-The disappearance of a palpable brachial pulse of the inflation of the BP cuff

-The initial muffling of the Korotkoff sounds upon deflation of the cuff

-The appearance of 2 consecutive beats upon deflation of the cuff - ....ANSWER...The appearance of 2 consecutive beats upon deflation of the cuff

3- A patient with a history of congestive heart failure presents to you for evaluation of leg swelling. According to Seidel, In which grade of pitting edema does the "pit" usually disappear in 10-15 seconds?

-4+ - ....ANSWER...2+

3- Match the heart valve with the proper area for auscultating that valve:

Aortic Valve - ....ANSWER...Second right intercostal space at the right sternal border

3- Match the heart valve with the proper area for auscultating that valve:

Pulmonic Valve - ....ANSWER...Second and third intercostal space at the left sternal border

3- Match the heart valve with the proper area for auscultating that valve:

Tricuspid valve - ....ANSWER...Fourth left intercostal space along the lower left sternal border

3- Match the heart valve with the proper area for auscultating that valve:

Mitral Valve - ....ANSWER...Apex of the heart in the fifth left intercostal space at the midclavicular line

3- Which is the preferred way to communicate with a patient whose language you do not speak?

-Use a professional interpreter, either in person or via a translator phone.

-Use the patients child as an interpreter.

-Use hand gestures and whatever limited English the patient understands in order to obtain the history.

-Use a friend or neighbor to interpret. - ....ANSWER...Use a professional interpreter, either in person or via a translator phone.

4- Asking the patient to say "ninety-nine" is used to check for:

-Wheezing

-Tactile fremitus

-Crepitus

-Dyspnea - ....ANSWER...Tactile fremitus

4- Dyspnea refers to

-Rapid breathing

-Difficult, labored breathing

-Slow breathing

-Shallow breathing - ....ANSWER...Difficult, labored breathing

4- Egophony is best described as:

-A dullness is heard to percussion

-A vibration is palpated when the patient breath

-A crackly sound is heard outside the respiratory tree

-When the patient says "ee", it sounds like "aa" due to a lung consolidation - ....ANSWER...When the patient says "ee", it sounds like "aa" due to a lung consolidation

4- Match the lung finding the best fits the condition;

Pneumonia - ....ANSWER...Dullness to percussion with crackles and rhonchi

4- Match the lung finding the best fits the condition;

Pneumothorax - ....ANSWER...Hyperresonance to percussion, diminished to absent breath sounds

4- Match the lung finding the best fits the condition;

Asthma - ....ANSWER...Prolonged expiratory wheeze with diminished lung sounds

4- Match the lung finding the best fits the condition;

Pleural effusion - ....ANSWER...Dullness to percussion with absent breath sounds over the effected area

4- What is generally the preferred sequence for examining the lungs?

-Inspection, palpation, percussion, auscultation

-Auscultation, percussion, palpation, inpection

-Inspection, auscultation, palpation, percussion

-Percussion, auscultation, inspection, palpation - ....ANSWER...Inspection, palpation, percussion, auscultation

4- Three of these lung sounds are considered abnormal ("adventitious"). Only one is considered a normal, expected finding. Which lung sound is considered a normal, expected finding?

-Vesicular

-Crackle

-Wheeze

-Rhonchi - ....ANSWER...Vesicular

4- Which represents a normal healthy adult?

-Anteroposterior chest diameter is greater than transverse diameter

-Anteroposterior chest diameter is equal to transverse diameter

-Anteroposterior chest diameter is less than transverse diameter

-There is no relationship between anteroposterior and transverse chest diameter - ....ANSWER...Anteroposterior chest diameter is less than transverse diameter

4- "Retractions" are evidence of;

-Low oxygen level

-Pneumonia

-Anxiety

-Airway obstruction - ....ANSWER...Airway obstruction

4- During an interview with a patient, the patient begins to cry. What would be an appropriate response

-provide a tissue, offer support, allow the moment to pass, and resume once the patient is ready

-tell the patient that since he is so upset, you will leave the room and bring the preceptor

-Tell the patient that things are really not so bad, so they don't need to cry

-change the subject so the patient will stop thinking about whatever made them upset - ....ANSWER...provide a tissue, offer support, allow the moment to pass, and resume once the patient is ready

4- A patient is angry at you because they have seen you 3 times for their back pain, and still are not better. Which would be the most appropriate immediate response?

-"It's not my fault your back pain isn't better. These things take time."

-"If you don't like the care I am giving you, why don't you find another doctor?"

-"If you would have listened to my advice to lose weight, you wouldn't be having this problem".

-"I understand that having continued pain in your back has made you upset. Tell me how the pain is still affecting you". - ....ANSWER..."I understand that having continued pain in your back has made you upset. Tell me how the pain is still affecting you".

4- During a discussion with a patient, which level of personal disclosure on the part of the physician would be most appropriate?

-"You think your diarrhea is bad? Let me tell you about what happened to me last time my wife and I travelled to Mexico."

-"I know you think that your heart problems are bad, but my mother is about to have a heart valve replacement, so look at things in perspective."

-"I realize that having your first baby can be very nerve-racking. I was nervous too when I had my first child"

-"I wish I could help you with your itchy rash, but I have been on call and haven't slept for 3 days. I am really tired." - ....ANSWER..."I realize that having your

first baby can be very nerve-racking. I was nervous too when I had my first child"

5- Which initial approach would most likely lead to an open and informative discussion about an adult patient's sexuality?

-Ask "are you married?"

-Ask "do you have a boyfriend ?"

-Ask "are you involved in a sexual relationship, and if so would you please tell me about the relationship?" - ....ANSWER...Ask "are you involved in a sexual relationship, and if so would you please tell me about the relationship?"

5- A patient comes to your preceptor's office for a gynecological exam. The patient is currently not pregnant. Your preceptor's note indicates that this is a 28 year old female who is G3P2012. Using your White Book as your guide, match the element of this patient's obstetric history with the proper number.

full-term births - ....ANSWER...

5- A patient comes to your preceptor's office for a gynecological exam. The patient is currently not pregnant. Your preceptor's note indicates that this is a 28 year old female who is G3P2012. Using your White Book as your guide, match the element of this patient's obstetric history with the proper number.

living children - ....ANSWER...

5- A patient comes to your preceptor's office for a gynecological exam. The patient is currently not pregnant. Your preceptor's note indicates that this is a 28 year old female who is G3P2012. Using your White Book as your guide, match the element of this patient's obstetric history with the proper number.

premature births - ....ANSWER...

5- A patient comes to your preceptor's office for a gynecological exam. The patient is currently not pregnant. Your preceptor's note indicates that this is a 28 year old female who is G3P2012. Using your White Book as your guide, match the element of this patient's obstetric history with the proper number.

miscarriages or abortions - ....ANSWER...

5- A patient comes to your preceptor's office for a gynecological exam. The patient is currently not pregnant. Your preceptor's note indicates that this is a 28 year old female who is G3P2012. Using your White Book as your guide, match the element of this patient's obstetric history with the proper number.

total number of times pregnant - ....ANSWER...

6- When examining the thyroid from behind, the thyroid isthmus can palpated

-beneath the cricoid cartilage

-in the posterior triangle

-above the cricoid cartilage

-in the sternal notch - ....ANSWER...beneath the cricoid cartilage

6- Which best describes a normal thyroid?

-Firm, pliable, fixed, nodular

-Firm, woody, free-moving, smooth

-Firm, pliable, free-moving, nodular

-firm, pliable, free moving, smooth - ....ANSWER...firm, pliable, free moving, smooth

6- Palpating which structure on the infant can give a clue as to infection or increased intracranial pressure?

-anterior fontanel

-posterior fontanel

-frontal sinuses

-tempromandibular joint - ....ANSWER...anterior fontanel

6- Which feature of sinusitis is most suggestive of acute bacterial rhinosinusitis, and hence appropriate for consideration for antibiotics, as opposed to a viral upper respiratory infection?

-nasal congestion

-symptoms lasting more than 10 days

-Cough

-watery eyes - ....ANSWER...symptoms lasting more than 10 days

  1. You have your full set of teeth including wisdom teeth. You have a toothache in the upper left most posterior molar. What number tooth is this?

-32 - ....ANSWER...

6- What is the description of a normal tympanic membrane?

-Opaque, yellow, visible light reflex, mobile

-Translucent, pearly gray, bulging, mobile

-Opaque, red, visible light reflex, immobile

-translucent, pearly gray, visible light reflex, mobile

  • ....ANSWER...translucent, pearly gray, visible light reflex, mobile

6- Which appearance of TM may indicate pus in the middle ear (otitis media)?

-Bulging, red, cloudy with no mobility

-Red, translucent, mobile

-Retracted, translucent, amber/yellow

-Pearly grey, mobile, translucent - ....ANSWER...Bulging, red, cloudy with no mobility

6- Which is a normal Rhinne test?

-air conduction heard longer than

bone conduction by ratio of 2:

-bone conduction heard longer than air conduction by ratio of 2:

-equal bone and air conduction

-The Rhinne test doesn't test bone and air conduction - ....ANSWER...air conduction heard longer than

bone conduction by ratio of 2:

6- Tonsils which are nearly touching the uvula are graded as

-4+ - ....ANSWER...3+

6- Pain when pulling the pinna as well as a swollen auditory canal with discharge is suggestive of

-otitis externa ("swimmer's ear")

-otitis media

-Inner ear infection

-Perforated tympanic membrane - ....ANSWER...otitis externa ("swimmer's ear")

6- Which is least indicative of "strep throat"?

-Exudates on the tonsils

-Cough

-cervical adenopathy

-fever - ....ANSWER...Cough

6- When palpating lymph nodes, it is best to use;

-The tips of all 5 fingers

-The palms of your hands

-The pads of the 3 middle fingers

-The back of your hand - ....ANSWER...The pads of the 3 middle fingers

6- Which element of the head, ears, nose and throat exam is usually saved for the end of the physical exam in small children and why?

-The fontanel exam because the fontanel is usually bulging at first when children are first undressed

-The otoscopic exam because this part of the exam often makes children cry, making subsequent parts of the exam difficult

-The thyroid exam because, once the child cries, the thyroid is more easily palpated

-The mouth because parents usually feed their children just before an exam, and you need to allow time for the saliva to clear the milk from the oral cavity - ....ANSWER...The otoscopic exam because

this part of the exam often makes children cry, making subsequent parts of the exam difficult

6- In looking at the tongue and palate, and posterior pharynx, you assign a Mallampati score. A patient with which score is more likely to have sleep apnea, or be a challenge to intubate?

-The Mallampati score has no bearing on ease of intubating or sleep apnea - ....ANSWER...

7- As part of their annual health maintenance visit, a patient screens positive for depression when the nurse administered the PHQ-2. Your preceptor asks you to interview the patient regarding the possible diagnosis of major depressive disorder. You choose to use the SIG-E-CAPS mnemonic to guide your interview. Match the letter of "SIG E CAPS" to the proper symptom of depression. For the two S's, you must use the order as indicated in the white book. - ....ANSWER...S-Increased or decreased sleep

I- Decreased interest or pleasure in almost all activities

G- Increased (inappropriate ) guilt or increased feelings of worthlessness. hopelessness

E- Decreased energy

C- Decreased concentration

A- Increased or decreased appetite

P- psychomotor agitation or retardation

S- Suicidal ideation, plan or attempt

8- The "A" in the CAGE questions stands for

-Do you feel you consume Alcohol in excess?

-Have you physically Abused someone when drinking alcohol?

-Are you Annoyed when people criticize your drinking?

-Are you Able to arrive at work despite your drinking? - ....ANSWER...Are you Annoyed when people criticize your drinking?

8- Which of the following most closely represents a standard alcoholic drink?

-a 16 oz draft beer

-A Martini with 2 shots (3 oz) of gin

-A 5 oz. glass of wine

-A 40 oz bottle of malt liquor - ....ANSWER...A 5 oz. glass of wine

8- Which practice may help address the opioid use disorder problem faced in our community?

-Prescribe opioids only for chronic pain.

-Limit opioid prescriptions to only 3 tablets per day

-Screen patients for substance use disorder prior to considering them for opioid therapy

-Recommend that patients travel to Canada to buy legal marijuana to treat their pain instead of taking opioids. - ....ANSWER...Screen patients for substance use disorder prior to considering them for opioid therapy

8- Your patient likes having wine with dinner. They want to know if that is a "problem". You decide to use the Audit-C tool to characterize their drinking pattern. What is you patient's AUDIT-C score if they:

Have an alcoholic drink 3 times a week

Drink one or two 5 oz glasses of wine each time they drink

Consume 6 or more drinks in an occasion less than monthly (maybe at a Superbowl party or on New Years)

-5 - ....ANSWER...4

8- Your patient agrees that smoking is a problem, and would like to consider quitting, but they have no plan to quit within the next month. In which stage of readiness to change is your patient?

-precontemplation

-contemplation

-preparation

-action

-maintenance - ....ANSWER...contemplation

9- As we grow older, which of the following is inevitable?

-We will all suffer major depression

-We will all experience dementia

-We will all suffer debilitating pain

-We will all need care in a nursing home.

-We will all die. - ....ANSWER...We will all die

9- In the Functional Assessment, which is NOT considered a "Basic Activity of Daily Living (ADL)"?

-Gardening

-Dressing

-Bathing (Hygiene)

-Toileting

-Eating

-Ambulating - ....ANSWER...Gardening

9- There are several tools for screening for cognitive defecits in the elderly. One is called the Folstein Mini-Mental State Examination (White Book). Another screening tool, which is brief and easy to administer, is called the "Mini-Cog". With this tool, the patient is asked to repeat three items, recall those three items a feww minutes later, and draw something. Which of the following are they asked to draw?

-A dog or cat

-A human face with nose, eyes, and ears

-A house