NR 650 Exam 3 Questions with Correctly Solved Answers, Exams of Nursing

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NR 650 Exam 3 Questions with Correctly Solved Answers

1. When percussing the abdomen in a patient with constipation, which of the following sounds

would you expect to find in the LLQ?

A. Tympanic

B. Dull

C. Resonant

D. Hyperresonant: B

2. Which of the following represents the proper position for the NP to assess the patient's

abdomen?

A. Stand at the patient's left side and proceed in a systematic fashion.

B. Stand at the patient's left side and assess any problem areas first

C. Stand at the patient's right side and process in a systemic fashion

D. Stand at the patient's right side and assess any problem areas first: C

3. The NP will demonstrate the correct order of examination for the abdomen by using examination

techniques that follows:

1. Auscultation

2. Inspection

3. Palpation

4. Percussion

A. 1-2-3-

B. 2-3-4-

C. 3-4-1-

D. 2-1-3-4: D

4. The NP will use which of the following examination techniques to determine muscular

resistance, superficial organs and masses in the abdomen

A. inspection

B. light palpation

C. deep palpation

D. percussion: B

5. The NP will use which of the following methods to help the patient relax during the

abdominal exam?

A. ask the patient to hold their breath

B. Palpate the abdomen after inspiration

C. palpate the abdomen after expiration

D. Palpate the abdomen using quick short movements: C

6. When percussing the abdomen, you would document the normal finding of percussion over the

intestines as:

A. Tympanic

B. Dull

C. Resonant

D. Hyperresonant: A

7.The NP will use her third finger to strike or deliver a rapid tap or blow against another finger placed

against the surface of the chest or abdomen to evoke a sound wave. The striking or tapping finger is called the:: Plexor finger

8. Identify the correct examination sequence for each body system:

1. Auscultation, 2. Inspection, 3. Palpation, 4. percussion a: posterior thorax & lungs b: anterior thorax & CV system c: abdomen: a. Posterior thorax & lungs: 2-3-4- b. Anterior thorax & CV system: 2-3-4- c. Abdomen: 2-1-4-

9. A patient is seen in the office for amenorrhea, for which you obtain a urine pregnancy test in the

office that returns negative. You would document this finding in which of the following sections of the encounter?A. HPIB. CCC. Subjective DataD. Objective Data: D

10.The NP can determine higher cognitive function by asking the patient to perform which of the

following tasks?A. Explain the meaning of a proverbB. Identify the day of the week, month, season, date and yearC. Recall details of historical eventsD. Spell a five-letter word such as WORLD backward: A

11. A 36-year-old female patient is seen in the clinic for a reported fever and back pain. She

complained of pain when the NP percussed over the left CVA angle. This finding supports which of the following differential diagnosis?A. PyelonephritisB. Left lower lobe pneumoniaC. SplenomegalyD. Cholecystitis- : A

12.The liver border can be palpated normally below the costal margin at the:A. Left mid-clavicular

lineB. Right mid-axillary lineC. Right mid-calvicular lineD. Left mid-axillary line: C

13.The NP will recognize which of the following subjective or objective find- ings as worrisome for

an abdominal aortic aneurysm?A. aortic width of 2.8 cmB. 25 pack-year smoking historyC. age of 60D. Female gender: B

14.The NP will use which of the following examination techniques to deter- mine muscular

resistance, superficial organs and masses in the abdomenA. inspectionB. light palpationC. deep palpationD. percussion: B

15. The parents of a 4-month-old infant share concern about their child's umbilical hernia at a well-

child visit. The NP will correctly inform them that:A. Most umbilical hernias disappear by 12 months of ageB. The hernia can be surgically repaired before the child reaches adolescenceC. This finding indicates that their child is at high risk for other herniasD. There is a strong familial history for umbilical hernias: A

16.Which of the following abdominal exam findings would prompt the NP to consider cholecystitis

as a differential diagnosis?A. Positive psoas signB. Positive Rovsing's signC. Positive Obturator signD. Positive murphy's sign: D

17.Which of the following symptoms would you expect from a young ado- lescent in the early phase

of appendicitis?A. Abdominal pain two hours after eatingB. CVA tendernessC. Severe RLQ pain with pallor and sweatingD. Con- stipation: C

18. A 57-year-old maintenance worker comes to your office for evaluation of pain in his legs. He

has smoked two packs per day since the age of 16, but he is otherwise healthy. You are concerned that he may have peripheral vascular disease. Which of the following is part of common or concerning

symptoms for the peripheral vascular system?A) Intermittent claudicationB) Chest pressure with exertionC) Shortness of breathD) Knee pain: A

19.Which area of the arm drains to the epitrochlear nodes?A) Ulnar surface of the forearm and hand,

little and ring fingers, and ulnar middle fingerB) Radial surface of the forearm and hand, thumb and index fingers, and radial middle fingerC) Ulnar surface of the forearm and hand; second, third, and fourth fingersD) Radial surface of the forearm and hand; second, third, and fourth fingers: A

20.Mr. E complains of cramps and difficulties with walking. The cramps occur in his calves

consistently after walking about 100 yards. After a period of rest, he can start to walk again, but after 100 yards these same symptoms recur. Which of the following would suggest spinal stenosis as a cause of this pain?A) Coldness and pallor of the legsB) Relief of the pain with bending at the waistC) Color changes of the skinD) Swelling with tenderness of the skin: B

21.Which of the following pairs of ischemic symptoms versus vascular supply is correct?A) Lower

calf/superficial femoralB) Erectile dysfunction/iliac or pudendalC) Buttock/common femoralD) Upper calf/tibial or peroneal: B

22.A patient demonstrates left facial droop but can wrinkle both sides of the forehead. The examiner

should suspect a problem with:(A) Central innervation of cranial nerve VII (facial)(B) Cranial nerve V (trigeminal)(C) Peripheral inner- vation of cranial nerve VII(D) Frontalis muscle: A

23.Mr. T. is complaining of a headache. He has just awakened from a nap and states that the

headache always begins behind one eye, "feels like an icepick," and is accompanied by tearing and a runny nose. You suspect Mr. T has:(A) Migraine headache(B) Tension headache(C) Cluster headache(D) A stroke: C

24.The muscles in the neck that are innervated by cranial nerve XI are:(A) Spinal accessory and

omohyoid(B) Sternomastoid and trapezius(C) Trapezius and sternomandibular(D) Sternomandibular

and spinal accessory: B

25.During your examination you note that your client's eyes are puffy. You fur- ther assess coarse

and dry hair. You suspect:(A) Scleroderma(B) Cachexia(C) Myxedema(D) Cretinism: C

26.You have just completed your examination and you document that the patient is unable to

differentiate between sharp and dull touch bilaterally. You interpret this as:(A) Bell's palsy(B) Scleroderma of the face and cheeks(C) Damage to cranial nerve V (trigeminal nerve)(D) Paralysis: C

27.A 28-year-old housewife presents to your office for a 6-week postpartum checkup. She complains

of fatigue greater than expected and palpitations. Her hair is falling out as well. She denies sadness or depression symptoms. Before this, she had not had any medical problems. She is breastfeeding her child and is not on any birth control. She had her first period since giving birth last week. A pregnancy test done in the office is negative. What is your most likely diagnosis?(A) Thyroiditis(B) Iron-deficiency anemia(C) Addison's disease(D) Sheehan's syndrome: A

28.Which of the following percussion notes would you obtain over the gastric bubble?A)

ResonanceB) TympanyC) HyperresonanceD) Flatness: B

29.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, < 1/wk, 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?A) TensionB) MigraineC) ClusterD) Analgesic rebound: B

30. A 29-year-old computer programmer comes to your office for evaluation of a headache. The

tightening sensation is located all over the head and is of moderate intensity. It used to last minutes, but this time it has lasted for 5

days. He denies photophobia and nausea. He spends several hours each day at a computer monitor/keyboard. He has tried over-the-counter medication; it has dulled the pain but not taken it away. Based on this description, what is your most likely diagnosis?A) TensionB) MigraineC) ClusterD) Analgesic rebound: A

31. A 49-year-old administrative assistant comes to your office for eval of dizziness. You elicit the

information that the dizziness is a spinning sensation

of sudden onset, worse with head position changes. The episodes last a few seconds and then go away, and they are accompanied by intense nausea. Vomiting x1. She denies tinnitus. You perform a physical exam of the head and neck and note that the patient's hearing is intact to Weber and Rinne and that there is nystagmus. Her gait is normal. Based on this description, what is the most likely diagnosis?A) Benign positional vertigoB) Vestibular neuronitisC) Ménière's diseaseD) Acoustic neuroma: A

32.A 55-year-old bank teller comes to your office for persistent episodes of dizziness. The first

episode started suddenly and lasted 3 to 4 hours. He expe- rienced a lot of nausea with vomiting; the episode resolved spontaneously. He has had five episodes in the past 1½ weeks. He does note some tinnitus that comes and goes. Upon physical examination, you note that he has a normal gait. The Weber localizes to the right side and the air conduction is equal to the bone conduction in the right ear. Nystagmus is present. Based on this description, what is the most likely diagnosis?A) Benign positional vertigoB) Vestibular neuronitisC) Ménière's diseaseD) Acoustic neuroma: C

33.Which of the following is a "red flag" regarding patients presenting with headache?A)

Unilateral headacheB) Pain over the sinusesC) Age over 50D) Phonophobia and photophobia: C

34.Diplopia, which is present with one eye covered, can be caused by which of the following

problems?A) Weakness of CN IIIB) Weakness of CN IVC) A lesion of the brainstemD) An irregularity in the cornea or lens: D

35.On visual confrontation testing, a stroke patient is unable to see your fingers on his entire right

side with either eye covered. Which of the following terms would describe this finding?A) Bitemporal hemianopsiaB) Right tem- poral hemianopsiaC) Right homonymous hemianopsiaD) Binasal hemianop- sia: C

36.A young woman undergoes cranial nerve testing. On touching the soft palate, her uvula deviates

to the left. Which of the following is likely?A) CN IX lesion on the leftB) CN IX lesion on the rightC) CN X lesion on the leftD) CN X lesion on the right: D

37.Restrictions of internal and external hip rotation are sensitive indicators of a disease such as:

Arthritis

38.The purpose in asking a patient who complains of neck or lower back pain about bowel or

bladder dysfunction is to assess for: Associated deficit indicating neurological involvement

39. When testing for carpal tunnel syndrome, numbness or tingling in the distribution of the median

nerve (palmar surface of thumb, index, middle and medial 4th finger) when hands are pressed together in acute flexion for 60 seconds is a positive: Phalen's sign

40.Which of the following areas of musculoskeletal examination tests joint function and stability:

Range of motion

41.Which test is used to detect an injury or tear or the medial or lateral collateral ligament:

Stress test (abduction/adduction)

42.The area of the body surface innervated by a particular spinal nerve is called a: dermatome

43.Two of the most common symptoms patients with neurologic disorders describe are:

generalized weakness and pain

44.One way to test cranial nerves IX and X: assess gag reflex

45.Cranial nerves III, IV, and VI are all related to: ocular movement

46.One way to test cranial nerve XI is: Ask the patient to shrug shoulders against resistant

pressure of examiner's hands

47.One way to test cranial nerve VIII is: weber test

48.The best test to assess cranial nerve II is: snellen chart and reading newspa- per print

49.Cranial nerve VII assesses nerves associated with: the face, facial movement

50.One way to test cranial nerve XII: ask patient to stick out tongue

51.One way to test cranial nerve V is: check for facial sensation

52.The best test for assessing cranial nerve I is: Ask the patient to sniff vanilla

53.The ability to identify a number or letter written on the palm of your hand: graphesthesia

54.A test to evaluate position sense: Romberg test

55.The ability to identify an object by feeling it (tactile sensation): stereognosis

56.Mark is a 35 year old police officer who is seeing you for his annual check up. When taking his

sexual history it is important to: select all that apply.: 1. Ask about sexual partners and any history of sexually transmitted infections2. As he states he is sexually active, ask about safer sex with condoms

57.The NP is preparing to complete a vaginal examination. Best practice in- cludes: Avoid

unexpected or sudden movements, drape patient from midabdomen and depress drape between the knees to provide eye contact

58.Common scrotal swellings include: Indirect inquinal hernias

59.When discussing modifiable risk factors for breast cancer in a 57 year old female, the NP

recognizes that he/she can include discussion about which of the following?: Use of hormonal replacement treatment (HRT)

60.Normal findings of a prostate exam include which of the following: Prostate measures 2.5 cm,

rubbery, nontender

61.Which of the following is most likely benign on breast examination?: One breast larger than

the other

62.Mary is a 48 year old female who is seen today for a change in her men- strual flow. Her normal

periods are have been every 28-30 days, but in the last 6 months she only had a period twice. A pregnancy test is negative and pelvic exam is normal. You schedule a follow up visit in 2 months and encourage her to call with any questions. You discuss peri-menopausal symptoms with her. When documenting her office visit the best choice for a differential diagnosis is:: oligomenorrhea

63.Which of the following findings on a urine dipstick is indicative of an infection: Positive

leukocytes, nitrites and blood

64.Dullness noted during percussion of the abdomen could indicate all of the following Except:: air

filled intestines

65.When performing a genital exam on a 25-year-old man, the nurse notices deeply pigmented,

wrinkled scrotal skin with large sebaceous follicles. On the basis of this information, the practitioner would: Consider this a normal finding and proceed with the examination

66.A 22 year old woman is being seen at the clinic for problems with vulvar pain, dysuria, and fever.

On physical examination, the practitioner notices clusters of small shallower vesicles with surrounding erythema on the labia. There is also inguinal lymphadenopathy present. The most likely cause of these lesions is: Herpes simplex virus type 2

67.When performing the bimanual examination, the practitioner notices that the cervix feels smooth

and firm, is round, and is fixed in place (does not move). When cervical palpation is performed, the patient complains of some pain. The nurse practitioner's interpretation of these results should be which of these?: The cervix should move when palpated; an immobile cervix may indicate malignancy

68.It is important to ask your patient about their sexual history. Why? Select all that apply.: 1. To

assess their risk for potential pregnancy in females of childbearing age2. It is important to know

their sexual preferences3. So that you can provide patient centered sex education4. To learn their potential risk for sexually transmitted infection

69.Problem with balance/unsteady gait; represents a disturbance in: cerebel- lum function

70.One week old: Touch cheek lightly and head turn: rooting reflex

71.Rapid alternating movements are used to assess: balance, coordination

72.6 month old Well visit should still have this reflex present: parachute reflex

73.Normal average reflex score: 2+

74.Place a quarter in a person's hand with their eyes closed and ask them to identify it.:

Graphestesia

75.A significant sway when the client stands erect with feet together, arms at the side, and the eyes

closed: Positive rombergs sign

76.Muscle strength grade 4: Full ROM against gravity and some resistance

77.Neurologic test used to assess the sensory system: vibration and position

78.menorrhagia: excessive menstrual bleeding

79.metorrhagia: bleeding between periods

80.oligiomenorrhea: infrequent menstruation

81.polymenorrhea: less than 21-day intervals between menses

82.menopause: absence of menses for 12 consecutive months

83.Normal findings in a genital exam of a newborn male: Nonretractable of only minimally

retractable foreskin

84.coarse and curly hair spread sparsely over the pubic symphysis: Tanner stage 3 boys

85.6-year female patient; position to exam her genitalia: supine, frog-leg posi- tion

86.Normal palpitation of ovaries: They are smooth, firm, mobile, and almond shape

87.Proper order of examining the female genitalia: Speculum examination, bi- manual

examination, rectovaginal examination

88.Swelling around the inguinal ring alongside the pubic hair that is not painful and reduces

without difficulty when in the supine position: A direct inguinal hernia

89.Breast palpation that is most suggestive of cancer: Firm, nontender lump that is fixed to

underlying tissue

90.To prepare female patient for a pelvic exam and pap smear: Assure the woman that she

can stop the exam at anytime she feels discomfort

91.Associated with increased breast cancer risk: Heavy alcohol use first degree relative with

breast canceradvancing age

92.Assessment of normal prostate: It is heart shaped with a palpable grooveIt surface is

smoothIt has a elasticity, rubbery consistency

93.To determine the patient's gender identity the NP should: Incorporate open-ended,

neutral questions into the sexual history

94.Normal testicular exam: Testes that feel ovoid and mobile, and slight sensation is felt by the

patient upon compression

95.Rectal examination = firm, irregularly shaped mass: Report the finding and refer the patient to

GI for further examination.

96.Pelvic Inflammatory Disease: Cervical Motion Tenderness (CMT)