PRE EXAM QUESTIONS & DETAILED
COMPLETE SOLUTIONS 100% CORRECT
1. During a post-hospital discharge visit, you notice your Diastole
71 year old female patient has been diagnosed
with a "new murmur" found by the hospitalist
during their recent hospitalization for CHF
exacerbation. In evalu- ating the patient, during
which phase of the cardiac cycle would you
anticipate auscultation of a S3 or S4 heart
sound?
*Diastole
*53 in systole while S4 in diastole
*Systole
*S4 in diastole while S3 in systole
2. The point of maximum impulse (PMI) is MOST
often palpable in healthy adults when positioned Left 5th intercostal
in the supine or left lateral decubitus position. space, midclavicular
Which one of the following locations is most line
commonly described as the PMI in a healthy
adult?
*Left 2nd intercostal space, midaxillary line.
*Left 5th intercostal space, midclavicular line.
*Right 4th intercostal space, midaxillary line.
*Right 2nd intercostal space, midclavicular line.
3. The nurse practitioner assessing the patient with
a rapid cardiac rhythm may assess for a pulse
deficit by auscultating the patient's heart while
watching the EKG rhythm. Where would the S1 Peak of the R wave.
heart sounds corre- late with the
electrocardiographic waves?
*At the end of the T wave.
*At the start of the T wave.
*Peak of the R wave.
*At the start of the P wave.
,PRE EXAM QUESTIONS & DETAILED
COMPLETE SOLUTIONS 100% CORRECT
4. Michael, a 72 year old male patient who previously Check for thyroid
dysfunc-
presented with stable cardiac-type chest pain has un- tion
derwent a stress test. He presents today to
review the stress test results, which show EKG
findings of ST segment depression during the
exam in leads V3 and V4 as well as some
concurrent chest discomfort. Based on these
findings, which of the following are NOT priority
medical decisions?
*Prescribe metoprolol (Lopressor) 12.5mg PO BID
*Prescribe aspirin 81mg PO daily
*Refer to cardiology for angiography
•Check for thyroid dysfunction
5. While examining a 53 year old female patient,
you auscultate abnormal breath sounds over all Positive for egophony
fields, and now assess transmission of voice
sounds by having the patient say "ee" while
auscultating the chest with the diaphragm of
your stethoscope. Normally, you should
auscultate a muffled "e" sound, however, you
hear hear a nasally "a" sound. Which one of the
follow- ing will you document is present?
*Positive stereognosis.
*Positive for egophony.
*Negative for bronchophony.
*Negative for egophony
6. While assessing the 19 year old patient for a new
To identify if underlying
onset cough, the nurse practitioner may inspect, aus- tissue are air-filled,
flu-
cultate, palpate, and/or percuss. assist the
How does performing percussion of the thorax provider
,PRE EXAM QUESTIONS & DETAILED
COMPLETE SOLUTIONS 100% CORRECT
during the physical examination? id-filled or consolidated
*To assist with the confirmation of cardiac origin
of
, PRE EXAM QUESTIONS & DETAILED
COMPLETE SOLUTIONS 100% CORRECT
angina.
*To assess for deep-seated lesion and tumors.
*To assess for any pain or discomfort prior to
palpita- tion of the chest wall.
*To identify if underlying tissue are air-filled,
flu- id-filled or consolidated
Approximately equal
7. Your 42 year old male patient has been referred level
to
your clinic for establishing care and on his intake sur- of change in the
descent
vey, you note he has documented diagnosis of of the diaphragm
inter- stitial lung disease. You have decided to
perform a diaphragmatic excursion test on the bilater- ally during
patient. Which one of the following results would maximal inspi- ration
you expect to see in this patient? and expiration. with a
*Approximately equal level of change in the decreased overall
descent of the diaphragm bilaterally during
maximal inspira- tion and expiration. with a inspi- ratory capacity
decreased overall inspira- tory capacity.
*Ascension of 8-12 inches of the diaphragm
noted bilaterally on expiration, though often much
less on the right side due to the location of the
heart and great vessels.
*Much greater descent of the diaphragm on the
right side due to the liver present (two-three
times larger).
*Absent or no change in movement of the
diaphragm noted between full inspiration and full
expiration measurement.
8. Your 50 year old Caucasian male patient has not seen Severe
hypothyroidism
a primary care giver in 20+ years and is here for
a history and physical examination. While
examining the head and face, you see your
patient has nonpitting
COMPLETE SOLUTIONS 100% CORRECT
1. During a post-hospital discharge visit, you notice your Diastole
71 year old female patient has been diagnosed
with a "new murmur" found by the hospitalist
during their recent hospitalization for CHF
exacerbation. In evalu- ating the patient, during
which phase of the cardiac cycle would you
anticipate auscultation of a S3 or S4 heart
sound?
*Diastole
*53 in systole while S4 in diastole
*Systole
*S4 in diastole while S3 in systole
2. The point of maximum impulse (PMI) is MOST
often palpable in healthy adults when positioned Left 5th intercostal
in the supine or left lateral decubitus position. space, midclavicular
Which one of the following locations is most line
commonly described as the PMI in a healthy
adult?
*Left 2nd intercostal space, midaxillary line.
*Left 5th intercostal space, midclavicular line.
*Right 4th intercostal space, midaxillary line.
*Right 2nd intercostal space, midclavicular line.
3. The nurse practitioner assessing the patient with
a rapid cardiac rhythm may assess for a pulse
deficit by auscultating the patient's heart while
watching the EKG rhythm. Where would the S1 Peak of the R wave.
heart sounds corre- late with the
electrocardiographic waves?
*At the end of the T wave.
*At the start of the T wave.
*Peak of the R wave.
*At the start of the P wave.
,PRE EXAM QUESTIONS & DETAILED
COMPLETE SOLUTIONS 100% CORRECT
4. Michael, a 72 year old male patient who previously Check for thyroid
dysfunc-
presented with stable cardiac-type chest pain has un- tion
derwent a stress test. He presents today to
review the stress test results, which show EKG
findings of ST segment depression during the
exam in leads V3 and V4 as well as some
concurrent chest discomfort. Based on these
findings, which of the following are NOT priority
medical decisions?
*Prescribe metoprolol (Lopressor) 12.5mg PO BID
*Prescribe aspirin 81mg PO daily
*Refer to cardiology for angiography
•Check for thyroid dysfunction
5. While examining a 53 year old female patient,
you auscultate abnormal breath sounds over all Positive for egophony
fields, and now assess transmission of voice
sounds by having the patient say "ee" while
auscultating the chest with the diaphragm of
your stethoscope. Normally, you should
auscultate a muffled "e" sound, however, you
hear hear a nasally "a" sound. Which one of the
follow- ing will you document is present?
*Positive stereognosis.
*Positive for egophony.
*Negative for bronchophony.
*Negative for egophony
6. While assessing the 19 year old patient for a new
To identify if underlying
onset cough, the nurse practitioner may inspect, aus- tissue are air-filled,
flu-
cultate, palpate, and/or percuss. assist the
How does performing percussion of the thorax provider
,PRE EXAM QUESTIONS & DETAILED
COMPLETE SOLUTIONS 100% CORRECT
during the physical examination? id-filled or consolidated
*To assist with the confirmation of cardiac origin
of
, PRE EXAM QUESTIONS & DETAILED
COMPLETE SOLUTIONS 100% CORRECT
angina.
*To assess for deep-seated lesion and tumors.
*To assess for any pain or discomfort prior to
palpita- tion of the chest wall.
*To identify if underlying tissue are air-filled,
flu- id-filled or consolidated
Approximately equal
7. Your 42 year old male patient has been referred level
to
your clinic for establishing care and on his intake sur- of change in the
descent
vey, you note he has documented diagnosis of of the diaphragm
inter- stitial lung disease. You have decided to
perform a diaphragmatic excursion test on the bilater- ally during
patient. Which one of the following results would maximal inspi- ration
you expect to see in this patient? and expiration. with a
*Approximately equal level of change in the decreased overall
descent of the diaphragm bilaterally during
maximal inspira- tion and expiration. with a inspi- ratory capacity
decreased overall inspira- tory capacity.
*Ascension of 8-12 inches of the diaphragm
noted bilaterally on expiration, though often much
less on the right side due to the location of the
heart and great vessels.
*Much greater descent of the diaphragm on the
right side due to the liver present (two-three
times larger).
*Absent or no change in movement of the
diaphragm noted between full inspiration and full
expiration measurement.
8. Your 50 year old Caucasian male patient has not seen Severe
hypothyroidism
a primary care giver in 20+ years and is here for
a history and physical examination. While
examining the head and face, you see your
patient has nonpitting
