Download PHARMACOLOGY EXAM 2 RASMUSSEN NEWEST 2024 ACTUAL EXAM 150 QUESTIONS AND CORRECT DETAILED A and more Study notes Nursing in PDF only on Docsity! NURS 612 EXAM 1 MARYVILLE UNIVERSITY ADVANCED HEALTH ASSESSMENT EXAM 1 NEWEST 2024 ACTUAL EXAM 170 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ Which of the following statements is true regarding use of abbreviations? - ...ANSWER...Use only universally accepted abbreviations for documentation You are taking a health history on your patient. When you are asking about problems in other body systems, your patient reports constipation over the past 5 or 6 months. This would be documented in - ...ANSWER...Review of symptoms Your patient presents to the office with a chief complaint of shoulder pain that he reports as stabbing. In using the mnemonic OLDCARTS, this is noted as - ...ANSWER...characteristic Before instilling a mydriatic eyedrop, the examiner should - ...ANSWER...observe the eye with focused light tangentially The examiner screens a 5-year-old child for nystagmus by - ...ANSWER...inspecting movement of the eyes to the six cardinal fields of gaze Which of the following correctly describes the method to assess accommodation? - ...ANSWER...Constriction should be noted as gaze shifts from across the room to an object 6 inches away. Which of the following should be used to test for near vision? - ...ANSWER...Rosenbaum chart To visualize the macula, the examiner should ask the patient to - ...ANSWER...look directly into the light of the ophthalmoscope. muscle that elevated the upper eyelid? - ...ANSWER...CN III Mr. Kasey is a 57-year-old patient who presents to your office. During the eye examination, you note that his pupils are not equal in size; however, they react to light and accommodation. This is called - ...ANSWER...anisocoria When performing a Weber test, which of the following is considered a normal finding? - ...ANSWER...The patient hears the tone equally in both ears. The examiner observes a blackish lesion on the top surface of the tongue of an adult patient. The patient indicates that his tongue is painful. Which question by the examiner would be helpful in explaining this finding? - ...ANSWER..."Have you been taking antibiotics lately?" Which of the following situations is an indication for transillumination? - ...ANSWER...The patient complains of pain over sinuses with palpation. The examiner notes that a patient's tonsils are enlarged and that they touch the uvula. This is documented as - ...ANSWER...3+ Which of the following statements made by a 72-year- old patient would indicate a normal process of aging? - ...ANSWER..."Food does not taste the same as it used to." Chronic sniffling, nasal congestion, nosebleeds, mucosal scabs, and septum perforation are signs of - ...ANSWER...cocaine abuse Mrs. Williams presents to the office for a follow-up visit. On examination, you note deep fissures at the corners of her mouth and identify this as cheilosis. You know this is a result of - ...ANSWER...riboflavin deficiency Mr. Cruz presents for a physical examination. On examination, you note that the lower molars are distally positioned in relation to the upper molars. How would you classify this malocclusion? - ...ANSWER...Class II malocclusion The most important clinical signs for sinusitis in adults includes which of the following? - ...ANSWER...Maxillary toothache, purulent nasal drainage, poor response to decongestants Normal findings in elderly mouth/pharynx - ...ANSWER...Oral tissues may be dryer (xerostomia) General findings in elderly mouth/pharynx - ...ANSWER...xerostomia, Periodontal disease, Oral cancer, Aspiration pneumonia, fully edentulous Glaucoma What is disease that progressively destroys the macula, impairing central vision - ...ANSWER...Age related macular degeneration (AMD): gradual blurring of central vision, and increased difficulty reading fine print, recognizing faces or seeing street signs - ...ANSWER...Dry AMD progression... rapid loss of central vision, with metamorphopsia (images that appear distorted - ...ANSWER...Wet AMD What is Glaucoma? - ...ANSWER...progressive, chronic optic neuropathy in which intraocular pressure (IOP), disease of optic nerve where the nerve cells die characterized by a progressive series of abnormal changes in the retinal microvasculature, proliferative retinopathy, dilated fundoscopy - ...ANSWER...Diabetic retinopathy Subjective Data for Open-angle glaucoma - ...ANSWER...symptoms are absent except for a gradual loss of peripheral vision over a period of years what you might see in Acute glaucoma - ...ANSWER...intense ocular pain, blurred vision, halos around lights, a red eye, and a dilated pupilo Occasionally: stomach pain, nausea, & vomiting presbyopia, decrease in dim light sight, decreased ability to adjust to change in lighting - ...ANSWER...Normal findings with elderly Conjunctiva What is being looked at with ophthalmoscope - ...ANSWER...Red reflex, vascular supply of the retina, optic disc and macula if someone of a different culture comes in with pain how would you address that? - ...ANSWER...ask if they any cultural beliefs that will affect how you need to treat the pain, does the pain frighten you, how do you cope with pain, what ways do you usually treat pain How would you like to be addressed?; How are you feeling today?; What would you like for us to do today?; What do you think is causing your symptoms?; What is your understanding of your diagnosis? - ...ANSWER...examples of patient-centered questions If language is a barrier how should it be handled - ...ANSWER...professional interpreter, rather than a family member, should be used What do open-ended questions allow? - ...ANSWER...gives the patient discretion about the extent of an answer What do direct questions allow? - ...ANSWER...to seeks specific information If you look at the outside of the ear and you see drainage, is this normal or abnormal? - ...ANSWER...Abnormal What is your differential diagnoses if you see drainage outside of the ear? - ...ANSWER...Otitis Externa, Otitis Media, Ear effusion, or foreign body in the ear What kind of patients get Otitis Externa? - ...ANSWER...Swimmers, breast/ bottle fed children When you exam the ear what things are you looking for? - ...ANSWER...TM (whether it is perforated or not), cone of light, look at the canal (whether it is swollen or red, look for cerumen impaction) what is palpated while examining external ear? - ...ANSWER...the preauricular and post auricular lymph nodes and mastoid area What is the worst differential diagnosis for a patient that comes in with an ear infection? - ...ANSWER...Mastoid infection or meningitis Which of the following will best facilitate the interview when obtaining a history for a deaf patient who can read lips? - ...ANSWER...speaking slowly During a history, the patient indicates he has an uncle and a brother with sickle cell disease. Which of the following is an appropriate method to document this information? - ...ANSWER...Include it in the family history. Which approach is recommended at the onset of an interview? - ...ANSWER...Use an open-ended approach; let the patient explain the problem or reason for the visit. Which of the following questions may lead to an inaccurate patient response? - ...ANSWER..."That was a horrible experience, wasn't it?" Repeating a patient's answer is an attempt to - ...ANSWER...confirm an accurate understanding. During an interview, your patient admits to feeling worthless and having a sleep disturbance for the past 3 weeks. These are clues that warrant the exploration of - ...ANSWER...risk for suicide Jerry, a 26-year-old homosexual man, is having a health history taken. Which question regarding sexual activity would most likely hamper trust between Jerry and the interviewer? - ...ANSWER...Are you married or do you have a girlfriend When questioning a patient regarding a sensitive issue, such as drug use, it is best to - ...ANSWER...be direct, firm, and to the point All of the following are cultural considerations that affect health care except - ...ANSWER...eye color, temperature, and visual acuity Which of the following is an example of a physical, as opposed to a cultural, characteristic? - ...ANSWER...Skin color Despite repeated instruction over a period of 3 years, the mother of three young children has still not had her children immunized. Which of the following questions would help the health care provider understand this situation? - ...ANSWER...What are your beliefs about immunizations Which mode of communication may be offensive to a patient whose cultural perspective differs from that of the practitioner - ...ANSWER...maintaining firm and direct eye contact Which of the following infection control guidelines are currently recommended by the Centers for Disease Control and Prevention (CDC)? - ...ANSWER...standard precautions A patient presents with multiple raised lesions on her skin. Which instrument should be used to examine these lesions - ...ANSWER...ruler In an outpatient setting such as a clinic, how should infection control practice differ from that in the acute care setting? - ...ANSWER...Infection control practice is applicable in all healthcare settings. In which of the following situations is transillumination an appropriate examination technique - ...ANSWER...Detection of fluid within the sinuses Which of the following instruments is used in conjunction with a simple nasal speculum to visualize the lower and middle turbines of the nose? - ...ANSWER...penlight On first meeting, the examiner notices that the patient has an obvious odor. Which examination technique is the examiner using in this scenario? - ...ANSWER...Inspection Focused visual attention obtains data from - ...ANSWER...inspection Which technique is applied throughout the entire examination and interview process - ...ANSWER...inspection As a component of palpation, which surface is most sensitive to vibration - ...ANSWER...ulnar surface of the hand How deep should the examiner's hands press while group of patients? - ...ANSWER...All patients regardless of their infectious status Unless a life-threatening situation exists, the best guide to determining the priority for the patient's condition should be based on - ...ANSWER...intuition When determining a need for additional examination, testing, or procedures, the examiner knows that these should be done - ...ANSWER...if they relate to the examiner's hypothesis After an examiner has identified and confirmed a problem, the next step is to - ...ANSWER...determine the managment plan The use of a computer could potentially be detrimental to the examiner because - ...ANSWER...it may become a substitute for critical thinking. To identify problems based on clinical examination, the examiner should organize the data - ...ANSWER...by body systems Each of the following could become a barrier to the critical thinking process, except for the examiner's - ...ANSWER...objectivity (feelings, attitudes, and values could be barriers) Which statement best characterizes a belief that supports a sound decision-making process? - ...ANSWER...Common problems occur commonly, and rare ones occur rarely Laboratory tests should be used to - ...ANSWER...develop a list of potential problems EBP is defined as - ...ANSWER...the best available scientific evidence to clinical decision making. Which of the following examples illustrates a vague or nondescriptive term - ...ANSWER..."skin color is normal" How are "normal findings" best documented - ...ANSWER...Document what was actually assessed in specific terms. How is the Rinne test performed? - ...ANSWER...Place the base of the tuning fork against patients mastoid bone, ask patient to tell you when sound is no longer heard (bone conduction) Place the still vibrating tines (1-2 cm) in from the auditory canal and ask patient to tell you when sound is no longer heard (air conduction) You have a 42 y/o female that comes in to you saying "I have dizziness" what differential diagnoses could be and what test can you do to check if it is vertigo? - questions? - ...ANSWER...Start with open-ended and then narrow it down with straight forward questions An integral part of the overall effort to respond adequately to a person in need is - ...ANSWER...cultural awareness What diseases are associated with periodontal disease? - ...ANSWER...DM, PVD and CV disease If the eye is very firm when palpated what disease should be considered - ...ANSWER...Glaucoma markedly asymmetric cupping between the 2 eyes can indicate? - ...ANSWER...Glaucoma What is usually observed before visual field losses appear in Glaucoma? - ...ANSWER...optic disc cupping If you do not see a red reflex what could that indicate - ...ANSWER...Retinoblastoma If you see white flakes, or dense plaques in the ear what could that indicate? - ...ANSWER...healed inflammation What type of glaucoma is caused by a decrease in absorption of the aqueous humor? - ...ANSWER...Open angle What does a chalky white TM or redness mean? - ...ANSWER...middle ear infection (Acute otitis media) What causes peripheral cataracts? - ...ANSWER...hypoparathyroidism Pathophysiology of cataracts - ...ANSWER...denaturation of lens protein caused by aging When assessing the mouth what are some things that you should be looking for? - ...ANSWER...color, lesions, tonsils, uvula, erythema, oral ulcers, teeth, tongue What else would you want to know on a history of a patient that comes in with lesions or mouth sores? - ...ANSWER...tobacco use, if immunocompromised, stress levels What does a Herpes lesion look like? - ...ANSWER...vesicular lesion If the patient presents with sudden vision disturbances, "curtains", floaters, or flashing lights with a wrinkled and grey retina following a trauma what would you suspect? - ...ANSWER...retinal detachment A patient has xanthelasma on their eyes what is this caused by? - ...ANSWER...abnormality of lipid metabolism What is the most common cause of loss of vision in the adult over 45? - .....ANSWER...Presbyopia During the cardiac examination, the nurse can best hear the S1 heart sound by placing the stethoscope at the patient's: - .....ANSWER...Apex of the heart. A palpable rushing vibration over the base of the heart at the second intercostal space is called a: - .....ANSWER...Thrill. The nurse is assessing a patient's mouth for possible oral cancer. The nurse should explain to the patient that the most common site of oral cancer is the: - .....ANSWER...Area underneath the tongue. When conducting the abdominal examination, after you inspect, you proceed next to: - .....ANSWER...Auscultation. A pulsation that is diminished to the point of being barely palpable would be graded as: - .....ANSWER...1. Examination to assess for extraocular muscle imbalance is conducted by: - .....ANSWER...Having the patient follow your finger through planes. The nurse is listening to a patient's heart beat and is focusing on the second heart sound. Which heart valves produce this sound? - .....ANSWER...Aortic and pulmonic. The nurse is auscultating the heart sounds of an adult patient. To auscultate Erb's point, the nurse should place the stethoscope at the: - .....ANSWER...Third to fifth intercostal space, left sternal border. When a heart valve fails to open properly, it is said to be: - .....ANSWER...Stenotic. Which arterial pulse is most useful in evaluating heart activity? - .....ANSWER...Carotid The carotid pulse should coincide with which heart sound? - .....ANSWER...S1 A patient you are seeing in the emergency department for chest pain is suspected of having a myocardial infarct. During the health history interview of his family history, he relates that his father had died of heart trouble. The most important follow-up question you should pose is which of the following? - .....ANSWER...What age was your father at the time of his death? Xanthelasma may suggest that the patient has an abnormality of: - .....ANSWER...Lipid metabolism. You are conducting an examination of Mr. C.'s heart and blood vessels and auscultate a grade III murmur.