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state of consciousness. d. five to eight b. showing the patient four items and asking him or her to list the items about 10 minut c. Dementia b. dementia. e. Dementia b. b.^ delirium. gets lost in her or his neighborhood. a. a.^ may^ be^ used^ to^ estimate^ cognitive^ changes^ quantitatively. Mini-Mental State Examination. b.
Health Assessment Final Review Exam
- Assessing orientation to person, place, and time helps determine
- Under most conditions, adult patients should be able to repeat a series of numbers.
- Recent memory may be tested by
- Which condition is considered progressive rather than reversible?
- An older adult is administered the Set Test and scores a 14. The nurse interprets this score as indicative of
- Which of the following is usually related to structural diseases of the brain?
- A state of impaired cognition, consciousness, mood and behavioral dysfunction of acute onset refers to
- The Mini-Mental State Examination should be administered for a patient who
- The Mini-Mental State Examination (MMSE)
- While interviewing a 70-year-old female clinic patient, she tells you that she takes ginkgo biloba and St. John’s wort. You make a short note to check for results of the
- For purposes of examination and communication of physical findings, the breast is divided into
four quadrants plus a tail. c. inspect both breasts simultaneously. d. a.^ Thickening^ of^ the^ inframammary^ ridge its relationship to menses. a. Nulliparity c. sit with his arms hanging at his sides. b. b.^ Sitting Skin dimpling or retraction b. unilateral. c. on or around the nipple. c. b.^ cancer. fibrocystic changes. e.
- When conducting a clinical breast examination, the examiner should
- Which breast change is typical after menopause?
- In a woman complaining of a breast lump, it is most important to ask about
- A 50-year-old woman presents as a new patient. Which finding in her personal and social history would increase her risk profile for developing breast cancer?
- To begin the clinical breast examination (CBE) for a man, ask him to:
- Inspection of the breasts usually begins with the patient in which position?
- Which finding, found on inspection, is related to fibrotic tissue changes that occur with breast carcinoma?
- Venous patterns on breasts are suggestive of pathology when they are
- In patients with breast cancer, peau d’orange skin is often first evident
- Recent unilateral inversion of a previously everted nipple suggests 22.You are conducting a clinical breast examination for a 30-year-old patient. Her breasts are symmetrical with bilateral, multiple tender masses that are freely moveable with well-defined borders. You recognize that these symptoms and assessment findings are consistent with
finger pads b. upper outer quadrant. d. into the axillae. d. flexed at the elbow. e. c.^ radially. d.^ supraclavicular ask the patient to turn her head toward that side. e. fibrocystic changes. e. Bartholin glands d. Early parity e.
- When palpating breast tissue, the examiner should use the at each site. 24.The largest amount of glandular breast tissue lies in the
- The tail of Spence extends
- When examining axillary lymph nodes, the patient’s arm is
- Lymphatic flow of the breast primarily drains
- The greatest concern for breast cancer is when you palpate nodes.
- You are performing a clinical breast examination for a 55-year-old woman. While palpating the supraclavicular area, you suspect that you felt a node. To improve your hooked technique, you should
- You are conducting a clinical breast examination for a 30-year-old patient. Her breasts are symmetrical with bilateral, multiple tender masses that are freely moveable with well-defined borders. You recognize that these symptoms and assessment findings are consistent with
- What structures are located at the 5 o’clock and the 7 o’clock positions of the vaginal orifice and open onto the sides of the vestibule in the groove between the labia minora and the hymen?
- Which factor is associated with an increased risk of cervical cancer?
- The risk of ovarian cancer is increased by a history of
nulliparity. e. anteverted b. pelvic inflammatory disease. c. d.^ deviated^ to^ the^ left or^ right. chart this as nabothian cysts. a. Bladder b. by age 21 years. d. absence of vaginal wall rugation. b. Cryptorchidism c. testicular. a. should be performed while bathing. b.
- During digital examination of the vagina, the cervix is noted to be positioned posteriorly. Upon bimanual examination of this woman, you would expect to palpate a(n) uterus.
- The presence of cervical motion tenderness may indicate
- During a routine vaginal examination, you insert the speculum and visualize the cervix. The cervix projection into the vaginal vault is approximately 5 cm. Upon bimanual examination, you would expect to find the uterus
- Small, pale yellow, raised, and rounded areas are visualized on the surface of the cervix. You should
- The assessment of which structure is not part of the bimanual examination?
- When a woman is not sexually active, cervical cancer screening should begin
- During a pelvic examination for a postmenopausal woman, you would expect to assess
- Which of the following is a risk factor for testicular cancer?
- The most common cancer in young men age 15 to 30 years is .
- Self-examination of the male genitalia
indication of general fluid retention. b. a tumor. c. transilluminate the mass. d. establish absent cremasteric reflex. c. hydrocele. b. testicle and scrotal rise on the stroked side. e. Move your finger upward along the vas deferens. e. Indirect c. Vas deferens d. smooth. b. establish absent cremasteric reflex. c.
- Mr. L. has an unusually thick scrotum with edema and pitting. He has a history of cardiac problems. The appearance of his scrotum is more likely a(n)
- An enlarged, painless testicle in an adolescent or adult may indicate
- You palpate a soft, slightly tender mass in the right scrotum of a man. You attempt to reduce the size of the mass, and there is no change in the mass size. Your next assessment maneuver is to
- An adolescent male is being seen for acute onset of left testicular pain. The pain started 3 hours ago. He complains of nausea and denies dysuria and fever. Your prioritized assessment should be to
- A 12-year-old boy says that his left scrotum has a soft swollen mass. The scrotum is not painful upon palpation. The left inguinal canal is without masses. The mass does transilluminate with a penlight. This collection of symptoms is consistent with
- A cremasteric reflex should result in
- Which technique is appropriate to detect an inguinal hernia?
- Which type of hernia lies within the inguinal canal?
- What structure of the male genitalia travels through the inguinal canal and unites with the seminal vesicle to form the ejaculatory duct?
- A normal vas deferens should feel
- An adolescent male is being seen for acute onset of left testicular pain. The pain started 3 hours ago. He complains of nausea and denies dysuria and fever. Your prioritized assessment should be to
testicular torsion. e. indirect inguinal. c.
- The most emergent cause of testicular pain in a young male is
- The most common type of hernia occurring in young males is
- Percussion of the abdomen begins with establishing d. overall dullness and tympany in all quadrants.
- Before performing an abdominal examination, the examiner should b. have the patient empty his or her bladder.
- When examining a patient with tense abdominal musculature, a helpful technique is to have the patient c. flex his or her knees.
- After thorough inspection of the abdomen, the next assessment step is to c. auscultate.
- How long do you auscultate for BS? (pg380) d. 5 minutes.
- What is the technique for percussing the liver border? Where to start, how you move, what are you listening for?(pg381) c. auscultate using the scratch technique.
- Percussion at the right midclavicular line, below the umbilicus, and continuing upward is the correct technique for locating the b. lower liver border.
- When palpating the abdomen, you should note whether the liver is enlarged in the d. right upper quadrant.
- An examiner can recognize a friction rub in the liver by a sound that is b. high pitched and associated with respirations.
- Costovertebral angle tenderness should be assessed whenever you suspect the patient may have c. pyelonephritis.
- The autonomic nervous system coordinates which of the following? c. Internal organs of the body
- The major function of the sympathetic nervous system is to a. orchestrate the stress response.
- The parasympathetic nervous system maintains the day-to-day function of a. digestion. 70.The motor cortex of the brain is in the b. frontal lobe.
- The thalamus is the major integration center for perception of c. pain.
- Which area of the brain is responsible for perceiving sounds and for determining their source? d. Temporal lobe
- Nerves that arise from the brain rather than the spinal cord are called c. cranial.
- If a patient cannot shrug the shoulders against resistance, which cranial nerve (CN) requires further evaluation? d. CN XI, spinal accessory
- Normal changes of the aging brain include b. diminished perception of touch. 76 .The area of body surface innervated by a particular spinal nerve is called a a. dermatome.
- A neurologic past medical history should include data about b. circulatory problems.
- When assessing superficial pain, touch, vibration, and position perceptions, you are testing c. sensory function.
- You are examining a patient in the emergency department who has recently sustained head trauma. To initially assess this patient’s neurologic status, you would b. test the six cardinal points of gaze.
- You are initially evaluating the equilibrium of Ms. Q You ask her to stand with her feet together and arms at her sides. She loses her balance. Ms. Q has a positive
d. Romberg sign.
- The finger-to-nose test allows assessment of a. coordination and fine motor function.
- You are performing a two-point discrimination test as part of a well physical examination. The area with the ability to discern two points in the shortest distance is the c. fingertips.
- As Mr. B enters the room, you observe that his gait is wide based and he staggers from side to side while swaying his trunk. You would document Mr. B’s pattern as b. cerebellar ataxia.
- Deep pressure tests are used mostly for patients who are experiencing a. absent superficial pain sensation.
- To assess a cremasteric reflex, the examiner strokes the c. inner thigh and observes whether the testicle and scrotum rise on the stroked side. 86.You have asked a patient to close his eyes and identify an object placed in his hand. You are evaluating a. stereognosis.
- The ability to recognize a number traced on the skin is called b. graphesthesia.
- To assess spinal levels L2, L3, and L4, which deep tendon reflex should be tested? b. Patellar
- It is especially important to test for ankle clonus if a. deep tendon reflexes are hyperactive. 90.Which sign is associated with meningitis and intracranial hemorrhage? d. Nuchal rigidity
- When assessing a 17-year-old patient for nuchal rigidity, you gently raise his head off the examination table. He involuntarily flexes his hips and knees. To confirm your suspicions associated with this positive test result, you would also perform a test for the sign. a. Kernig
- On a scale of 0 to 4+, which deep tendon reflex score is appropriate for a finding of clonus in a patient? e. 4+
- Cranial nerve XII may be assessed in an infant by b. observing the infant suck and swallow.
- A positive Babinski sign is normal until what age? c. 16 to 24 months 95.Which of the following is a concern, rather than an expected finding, in older adults? b. Bilateral pillrolling of the fingers
- Ipsilateral Horner syndrome indicates a cerebrovascular accident (CVA) occurring in the c. posterior inferior cerebellar artery.
- An acute polyneuropathy that commonly follows a nonspecific infection occurring 10 to 14 days earlier and that primarily affects the motor and autonomic peripheral nerves in an ascending pattern is c. Guillain-Barré syndrome.
- The immune system attacks the synaptic junction between the nerve and muscle fibers blocking acetylcholine receptor sites in a. myasthenia gravis.
- Diabetic peripheral neuropathy will likely produce b. diminished pain sensation.
- Persons with Parkinson disease have an altered gait that is characterized by a. short shuffling steps.
- A clinical syndrome of intracranial hypertension that mimics brain tumors is d. pseudotumor cerebri.
- Classic carpal tunnel syndrome would result in c. reduced abduction of the thumb.
- You note that a child has a positive Gower sign. You know that this indicates generalized b. muscle weakness.
- A tingling sensation radiating from the wrist to the hand on striking the median nerve is a positive sign. d. Tinel
- Thrombosis of a leg vein should be suspected if the patient feels calf pain b. on dorsiflexion of the foot.
- Your patient presents with symptoms that lead you to suspect acute appendicitis. Which assessment finding is least likely to be associated with this condition? c. Consistent right lower quadrant (RLQ) pain
- A patient presents with symptoms that lead you to suspect acute appendicitis. Which assessment finding is least likely to be associated with this condition early in its course? e. Obturator muscle test 108. Your patient returns to the office with multiple complaints regarding her abdomen. Which of the following are objective findings? (Select all that apply.) b. dullness on percussion c. rebound tenderness e. Diarrhea f. burning pain in epigastrium 110. Your patient is a 48-year-old woman with complaints of severe cramping pain in the abdomen and right flank. Her past medical history includes a history of bladder calculi. You diagnose her with renal calculi at this time. Which of the following symptoms would you expect with her diagnosis? (Select all that apply.) a. Abdominal pain on palpation d. CVA tenderness e. Fever g. Hematuria
- A 45-year-old laborer presents with low back pain, stating that the pain comes from the right buttock and shoots down and across the right anterior thigh, down the shin to the ankle. Which examination finding is considered more indicative of nerve root compression? d. Contralateral straight leg raise result
- A positive straight leg raise test usually indicates c. lumbar nerve root irritation.
- The Thomas test is used to detect d. flexion contractures of the hip.
- When performing the drawer test, the examiner would place the patient in a supine position and flex the knee 45 to 90 degrees, placing the foot flat on the table, and then c. grasp the lower leg with both hands and draw the tibia forward and then backward.
- Which one of the following techniques is used to detect a torn meniscus? b. McMurray test
- During a football game, a player was struck on the lateral side of the left leg while his feet were firmly planted. He is complaining of left knee pain. To examine the left knee, you should initially perform the test. b. valgus stress
- Anterior cruciate ligament integrity is assessed via the test. a. Lachman
- You are initially evaluating the equilibrium of Ms. Q You ask her to stand with her feet together and arms at her sides. She loses her balance. Ms. Q has a positive d. Romberg sign.
- When assessing a 17-year-old patient for nuchal rigidity, you gently raise his head off the examination table. He involuntarily flexes his hips and knees. To confirm your suspicions associated with this positive test result, you would also perform a test for the sign. a. Kernig