NUR 6001 Exam 1–3 Advanced Health Assessment
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Susanne is a 27 year old who has had headaches, muscle aches, and fatigue for the last 2 months. You have
completed a thorough history, examination, and laboratory workup but have not found a cause. What would
your next action be?
A) A referral to a neurologist
B) A referral to a rheumatologist
C) To tell the patient you can't find anything
D) To screen for depression - Correct Answer :D) To screen for depression
You ask a patient to draw a clock. He fills in all the numbers on the right half of the circle. What do you suspect?
A) Hemianopsia
B) Fatigue
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C) Oppositional defiant disorder
D) Depression - Correct Answer :A) Hemianopsia
A young woman comes to you with a cut on her finger caused by the lid of a can she was opening. She is pacing
about the room, crying loudly, and through her sobs she says, "My career as a pianist is finished!" Which
personality type exhibits these features?
A) Narcissistic
B) Paranoid
C) Histrionic
D) Avoidant - Correct Answer :C) Histrionic
Adam is a very successful 15-year-old student and athlete. His mother brings him in today because he no longer
studies, works out, or sees his friends. This has gone on for a month and a half. When you speak with him alone
in the room, he states it "would be better if he were not here." What would you do next?
A) Tell him that he has a very promising career in anything he chooses and soon he will feel better.
B) Tell him that he needs an antidepressant and it will take about 4 weeks to work.
C) Speak with his mother about getting him together more with his friends.
D) Assess his suicide risk. - Correct Answer :D) Assess his suicide risk.
A 29-year-old woman comes to your office. As you take the history, you notice that she is speaking very quickly,
and jumping from topic to topic so rapidly that you have trouble following her. You are able to find some
connections between ideas, but it is difficult. Which word describes this thought process?
A) Derailment
B) Flight of ideas
C) Circumstantiality
D) Incoherence - Correct Answer :B) Flight of ideas
In obtaining a history, you note that a patient uses the word "largely" repeatedly, to the point of being a
distraction to your task. Which word best describes this speech pattern?
A) Clanging
B) Echolalia
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C) Confabulation
D) Perseveration - Correct Answer :D) Perseveration
A 28-year-old book editor comes to your clinic, complaining of strange episodes. He states that about once a
week for the last 3 months his left hand and arm will stiffen and then start jerking. He says that after a few
seconds his whole left arm and then his left leg will also start to jerk. He denies any loss of consciousness or loss
of bowel or bladder control. When the symptoms resolve, his arm and leg feel tired but otherwise he feels fine.
His past medical history is significant for a cyst in his brain that was removed 6 months ago. He is married and
has two children. His parents are both healthy. On examination you see a scar over the right side of his head but
otherwise his neurologic examination is unremarkable.
What type of seizure disorder is he most likely to have?
A) Generalized tonic-clonic seizure
B) Generalized absence seizure
C) Simple partial seizure (Jacksonian)
D) Complex partial seizure - Correct Answer :C) Simple partial seizure (Jacksonian)
A 7-year-old child is brought to your clinic by her mother. The mother states that her daughter is doing poorly in
school because she has some kind of "ADD" (attention deficit disorder). You ask the mother what makes her
think the child has ADD. The mother tells you that both at home and at school her daughter will just zone out for
several seconds and lick her lips. She states it happens at least four to six times an hour. She says this has been
happening for about a year. After several seconds of lip-licking her daughter seems normal again. She states her
daughter has been generally healthy with just normal childhood colds and ear infections. The patient's parents
are both healthy and no other family members have had these symptoms.
What type of seizure disorder is she most likely to have?
A) Generalized tonic-clonic seizure
B) Generalized absence seizure
C) Simple partial seizure (Jacksonian)
D) Complex partial se - Correct Answer :B) Generalized absence seizure
A 37-year-old insurance agent comes to your office, complaining of trembling hands. She says that for the past 3
months when she tries to use her hands to fix her hair or cook they shake badly. She says she doesn't feel
particularly nervous when this occurs but she worries that other people will think she has an anxiety disorder or
that she's a drinker. She admits to having some recent fatigue, trouble with vision, and difficulty maintaining
bladder control. Her past medical history is remarkable for hypothyroidism. Her mother has lupus and her father
is healthy. She has an older brother with type 1 diabetes. She is married and has three children. She denies
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tobacco, alcohol, or drug use. On examination, when she tries to reach for a pencil to fill out the health form she
has obvious tremors in her dominant hand.
What type of tremor is she most likely to have?
A) Resting tremor
B) Postural tremor
C) Intention tremor - Correct Answer :C) Intention tremor
The nurse practitioner might see which of the following physical findings in a patient with otitis externa?
A) a bulging, red tympanic membrane
B) an unusually prominent short process and prominent handle.
C) a chalky, white patch with irregular margins on the inferior part of the tympanic membrane.
D) Pain with the movement of the auricle and tragus (tug test): a swollen, narrowed, moist, pale and tender ear
canal. - Correct Answer :D) Pain with the movement of the auricle and tragus (tug test): a swollen, narrowed,
moist, pale and tender ear canal.
Frank blood or clear watery drainage (cerebrospinal leak) after trauma suggest a basal skull fracture and
warrants immediate referral. Purulent drainage indicates otitis externa or otitis media. (Bates, 245-246)
An Annual Low Dose Computed Tomography (LDCT) screening would be recommended for which patient?
A) Tammy, age 57, who smokes a half pack of cigarettes a day for the last 20 years.
B) Bob, age 72, who quit smoking 10 years ago after a 30-pack year history.
C) Angela, age 43, and started smoking when she was 15 years old.
D) George, age 80, who lives with his wife and is a smoker. - Correct Answer :B) Bob, age 72, who quit smoking
10 years ago after a 30-pack year history.
LDCT screenings are recommended to patients 55-74 years, a 30-pack year smoking history or current smoking
or have quit in the last 15 years (Bates, p315-316).
NP is preparing to perform an otoscopic examination of a newborn infant. Which statement is true regarding this
examination?
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