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NR 667.pdf!#()*_*$_!*$__________________________)(&)$*&!)($)(*&&*^(&(#()))))))))))))))))))))))))))))))________________________
NR 667
During a post-hospital discharge visit, you notice your 71 year old female patient has been
diagnosed with a "new murmur" found by the hospitalist during their recent hospitalization for
CHF exacerbation. In evaluating 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
Diastole
The point of maximum impulse (PMI) is MOST often palpable in healthy adults when positioned
in the supine or left lateral decubitus position. Which one of the following locations is most
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.
Left 5th intercostal space, midclavicular line
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
heart sounds correlate with the electrocardiographic waves?
*At the end of the T wave.
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NR 667.pdf!#()*_*$_!*$__________________________)(&)$*&!)($)(*&&*^(&(#()))))))))))))))))))))))))))))))________________________
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NR 667.pdf!#()*_*$_!*$__________________________)(&)$*&!)($)(*&&*^(&(#()))))))))))))))))))))))))))))))________________________
*At the start of the T wave.
*Peak of the R wave.
*At the start of the P wave.
Peak of the R wave.
Michael, a 72 year old male patient who previously presented with stable cardiac-type chest
pain has underwent 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
Check for thyroid dysfunction
While examining a 53 year old female patient, you auscultate abnormal breath sounds over all
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
following will you document is present?
*Positive stereognosis.
*Positive for egophony.
*Negative for bronchophony.
*Negative for egophony
Positive for egophony
_________________________________________________________________________________________________________
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NR 667.pdf!#()*_*$_!*$__________________________)(&)$*&!)($)(*&&*^(&(#()))))))))))))))))))))))))))))))________________________
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NR 667.pdf!#()*_*$_!*$__________________________)(&)$*&!)($)(*&&*^(&(#()))))))))))))))))))))))))))))))________________________
While assessing the 19 year old patient for a new onset cough, the nurse practitioner may
inspect, auscultate, palpate, and/or percuss.
How does performing percussion of the thorax assist the provider during the physical
examination?
*To assist with the confirmation of cardiac origin of angina.
*To assess for deep-seated lesion and tumors.
*To assess for any pain or discomfort prior to palpitation of the chest wall.
*To identify if underlying tissue are air-filled, fluid-filled or consolidated
To identify if underlying tissue are air-filled, fluid-filled or consolidated
Your 42 year old male patient has been referred to your clinic for establishing care and on his
intake survey, you note he has documented diagnosis of interstitial lung disease. You have
decided to perform a diaphragmatic excursion test on the patient. Which one of the following
results would you expect to see in this patient?
*Approximately equal level of change in the descent of the diaphragm bilaterally during
maximal inspiration and expiration. with a decreased overall inspiratory 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.
Approximately equal level of change in the descent of the diaphragm bilaterally during maximal
inspiration and expiration. with a decreased overall inspiratory capacity
Your 50 year old Caucasian male patient has not seen 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 periorbital edema, particularly underneath their eyes and very dry,
thinned hair, including the lateral third of eyebrows (as pictured below: Sparse hairline, thin
_________________________________________________________________________________________________________
(#()))))))))))))))))))))))))))))))__________________________________________________________________________________________
NR 667.pdf!#()*_*$_!*$__________________________)(&)$*&!)($)(*&&*^(&(#()))))))))))))))))))))))))))))))________________________
,_________________________________________________________________________________________________________
(#()))))))))))))))))))))))))))))))__________________________________________________________________________________________
NR 667.pdf!#()*_*$_!*$__________________________)(&)$*&!)($)(*&&*^(&(#()))))))))))))))))))))))))))))))________________________
lateral eyebrows, Periobital edema). Which one of the folowing would you expect to cause this
finding?
*Severe hypothyroidism
*Addison's disease
*Grave's disease
*Alzhemiers.
Severe hypothyroidism
A40 year old, female, African American patient presents for history and physical. Upon your
initial assessment, you notice she has severe exophthalmos as pictured below. Which one of
the following diagnoses below would be the highest on your differential diagnose of this
physical examination finding? (eyes bulging out of her head)
*Bilateral conjunctivitis.
*Hyperthyroidism.
*hypothyroidism
*myexedma
Hyperthyroidism.
Your patient with a suspected diagnosis of COPD has been seen by pulmonology and has
underwent a pulmonary function test (PFT) with spirometry. As the patient's primary
healthcare provider, you have been asked to explain the findings of the PFT to the patient in a
follow-up visit at which time the patient asks what the study was evaluating. To describe the
PFT to the patient in more useful terms, you state that the large inspiration of air to the
furthest extent they could reasonably accomplish followed by a full exhalation is referred to as
which of the following measurements during the PFT?
*Forced Expiratory Volume over 1 second (FEV1).
*Functional Reserve Capacity.
*Inspiratory Reserve
_________________________________________________________________________________________________________
(#()))))))))))))))))))))))))))))))__________________________________________________________________________________________
NR 667.pdf!#()*_*$_!*$__________________________)(&)$*&!)($)(*&&*^(&(#()))))))))))))))))))))))))))))))________________________
(#()))))))))))))))))))))))))))))))__________________________________________________________________________________________
NR 667.pdf!#()*_*$_!*$__________________________)(&)$*&!)($)(*&&*^(&(#()))))))))))))))))))))))))))))))________________________
NR 667
During a post-hospital discharge visit, you notice your 71 year old female patient has been
diagnosed with a "new murmur" found by the hospitalist during their recent hospitalization for
CHF exacerbation. In evaluating 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
Diastole
The point of maximum impulse (PMI) is MOST often palpable in healthy adults when positioned
in the supine or left lateral decubitus position. Which one of the following locations is most
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.
Left 5th intercostal space, midclavicular line
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
heart sounds correlate with the electrocardiographic waves?
*At the end of the T wave.
_________________________________________________________________________________________________________
(#()))))))))))))))))))))))))))))))__________________________________________________________________________________________
NR 667.pdf!#()*_*$_!*$__________________________)(&)$*&!)($)(*&&*^(&(#()))))))))))))))))))))))))))))))________________________
,_________________________________________________________________________________________________________
(#()))))))))))))))))))))))))))))))__________________________________________________________________________________________
NR 667.pdf!#()*_*$_!*$__________________________)(&)$*&!)($)(*&&*^(&(#()))))))))))))))))))))))))))))))________________________
*At the start of the T wave.
*Peak of the R wave.
*At the start of the P wave.
Peak of the R wave.
Michael, a 72 year old male patient who previously presented with stable cardiac-type chest
pain has underwent 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
Check for thyroid dysfunction
While examining a 53 year old female patient, you auscultate abnormal breath sounds over all
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
following will you document is present?
*Positive stereognosis.
*Positive for egophony.
*Negative for bronchophony.
*Negative for egophony
Positive for egophony
_________________________________________________________________________________________________________
(#()))))))))))))))))))))))))))))))__________________________________________________________________________________________
NR 667.pdf!#()*_*$_!*$__________________________)(&)$*&!)($)(*&&*^(&(#()))))))))))))))))))))))))))))))________________________
,_________________________________________________________________________________________________________
(#()))))))))))))))))))))))))))))))__________________________________________________________________________________________
NR 667.pdf!#()*_*$_!*$__________________________)(&)$*&!)($)(*&&*^(&(#()))))))))))))))))))))))))))))))________________________
While assessing the 19 year old patient for a new onset cough, the nurse practitioner may
inspect, auscultate, palpate, and/or percuss.
How does performing percussion of the thorax assist the provider during the physical
examination?
*To assist with the confirmation of cardiac origin of angina.
*To assess for deep-seated lesion and tumors.
*To assess for any pain or discomfort prior to palpitation of the chest wall.
*To identify if underlying tissue are air-filled, fluid-filled or consolidated
To identify if underlying tissue are air-filled, fluid-filled or consolidated
Your 42 year old male patient has been referred to your clinic for establishing care and on his
intake survey, you note he has documented diagnosis of interstitial lung disease. You have
decided to perform a diaphragmatic excursion test on the patient. Which one of the following
results would you expect to see in this patient?
*Approximately equal level of change in the descent of the diaphragm bilaterally during
maximal inspiration and expiration. with a decreased overall inspiratory 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.
Approximately equal level of change in the descent of the diaphragm bilaterally during maximal
inspiration and expiration. with a decreased overall inspiratory capacity
Your 50 year old Caucasian male patient has not seen 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 periorbital edema, particularly underneath their eyes and very dry,
thinned hair, including the lateral third of eyebrows (as pictured below: Sparse hairline, thin
_________________________________________________________________________________________________________
(#()))))))))))))))))))))))))))))))__________________________________________________________________________________________
NR 667.pdf!#()*_*$_!*$__________________________)(&)$*&!)($)(*&&*^(&(#()))))))))))))))))))))))))))))))________________________
,_________________________________________________________________________________________________________
(#()))))))))))))))))))))))))))))))__________________________________________________________________________________________
NR 667.pdf!#()*_*$_!*$__________________________)(&)$*&!)($)(*&&*^(&(#()))))))))))))))))))))))))))))))________________________
lateral eyebrows, Periobital edema). Which one of the folowing would you expect to cause this
finding?
*Severe hypothyroidism
*Addison's disease
*Grave's disease
*Alzhemiers.
Severe hypothyroidism
A40 year old, female, African American patient presents for history and physical. Upon your
initial assessment, you notice she has severe exophthalmos as pictured below. Which one of
the following diagnoses below would be the highest on your differential diagnose of this
physical examination finding? (eyes bulging out of her head)
*Bilateral conjunctivitis.
*Hyperthyroidism.
*hypothyroidism
*myexedma
Hyperthyroidism.
Your patient with a suspected diagnosis of COPD has been seen by pulmonology and has
underwent a pulmonary function test (PFT) with spirometry. As the patient's primary
healthcare provider, you have been asked to explain the findings of the PFT to the patient in a
follow-up visit at which time the patient asks what the study was evaluating. To describe the
PFT to the patient in more useful terms, you state that the large inspiration of air to the
furthest extent they could reasonably accomplish followed by a full exhalation is referred to as
which of the following measurements during the PFT?
*Forced Expiratory Volume over 1 second (FEV1).
*Functional Reserve Capacity.
*Inspiratory Reserve
_________________________________________________________________________________________________________
(#()))))))))))))))))))))))))))))))__________________________________________________________________________________________
NR 667.pdf!#()*_*$_!*$__________________________)(&)$*&!)($)(*&&*^(&(#()))))))))))))))))))))))))))))))________________________
