Advanced Health Assessment Midterm Review of Quiz Questions, Exams of Nursing

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Advanced Health Assessment Midterm Review

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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 - 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 - 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 - 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 - 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 - 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 -

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 - 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 - 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 - 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 - 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? - 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 - C. Delirium Which technique is applied throughout the entire examination and interview process?

A. Inspection B. Palpation C. Percussion D. Auscultation - 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 - 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 - 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 - 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. - 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 - 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 - 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 - 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 - 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 - 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" - 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 - 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 - 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 - 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 - 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 - 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 - 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 - 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 - malignant melanoma Nail involvement characterized by painless separation of the nail plate from the nail bed is termed: Hippocratic nails

Onycholysis Koilonychia Anonychia - 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 - 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 - 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 -

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 - 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 - 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 - 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 - 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. - 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 -

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 - Myxedema Symptoms and assessment findings related to hypothyroidism include all of the following except: Palpitations Fatigue Dry, coarse skin

Cold intolerance - 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 - 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 - 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 - 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 - cushing's syndrome The test that compares air conduction and bone conduction is known as: Weber test Whispered voice test Tug tes Rinne test - 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 - 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 - Red Reflex

Small, mobile, discrete, non-tender nodes are termed: shotty fluctuant matted fixed - 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 - 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 -

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 - 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