APEA 3P EVALUATED QUESTIONS AND ANSWERS

APEA 3P EVALUATED QUESTIONS AND ANSWERS Recommend a method or test to help assess a patient's cerebellar function. - CORRECT ANSWER-Finger-nose-finger testing Choose an accurate statement regarding deep tendon reflexes and their location of assessment. - CORRECT ANSWER-Achilles reflex corresponds to L2-S2. Brachioradialis reflex corresponds to C5-C6. Determine a finding that would be abnormal in a motor assessment. - CORRECT ANSWER-Presence of tremor Muscle weakness Propose an accurate statement regarding the sensory assessment. - CORRECT ANSWER-Tactile discrimination of fine touch assesses the sensory cortex. Decide what should be considered in assessing a patient's appearance and behavior. - CORRECT ANSWER-Level of consciousness Determine the accurate description regarding the strength of reflex. - CORRECT ANSWER-Hypoactive or diminished response is classified as 1+. Very brisk, hyperactive response is classified as 4+. Determine a step or technique in the assessment of the trigeminal nerve. - CORRECT ANSWER-Assess muscles of mastication. Ask the patient to identify the location of the light touch sensation on the forehead while eyes are closed. Recommend an appropriate examination method to assess spinal accessory nerve function. - CORRECT ANSWER-Ask the patient to shrug shoulders against resistance. Ask the patient to rotate the head forcibly against resistance. Determine an important item to assess while testing a patient's language and comprehension. - CORRECT ANSWER-Expressive or receptive aphasia Language coherency All of the following are components of the classic ophthalmological emergency except __________. - CORRECT ANSWER-purulent eye discharge Mrs. Murphy is a 58-year-old woman presenting with a sudden left-sided headache that is most painful in her left eye. Her vision is blurred, and her left pupil is slightly dilated and poorly reactive. The left conjunctiva is markedly injected, and the eyeball is firm. Vision screen with the Snellen chart is 20/30 OD and 20/90 OS. When caring for Mrs. Murphy, the most appropriate next action is __________. - CORRECT ANSWER-prompt referral to an ophthalmologist Recommend an appropriate question to ask when assessing a patient's mood and affect. - CORRECT ANSWER-How are you? Propose an accurate statement regarding the mental status examination. - CORRECT ANSWER-A patient's overall appearance is part of the mental status examination. Determine an appropriate question to ask when assessing a patient's perception. - CORRECT ANSWER-Do you feel as if you're being watched? How do people treat you? Choose an accurate description of expressive aphasia. - CORRECT ANSWER-Having difficulty in expressing words Describe the technique to assess facial nerve function. - CORRECT ANSWER-Ask the patient to smile. Instruct the patient to lift eyebrows. Ask the patient to close eyelids tightly against your attempt to open them. What is a common vision problem in a person with untreated primary open-angle glaucoma (POAG)? - CORRECT ANSWER-Peripheral vision loss Propose a component of assessing the thought process of a patient. - CORRECT ANSWER-Screening for suicidal thoughts Which of the following is the most likely to be found on the funduscopic examination of a patient with untreated POAG? - CORRECT ANSWER-Excessive cupping of the optic disk Propose an indicator that a headache can be the presenting symptom of a serious illness and may require neuroimaging. - CORRECT ANSWER-Headache causing confusion, dizziness, or lack of coordination Headache causing awakening from sleep Sudden or new-onset headache A clinician is performing a middle ear assessment on a 15-year-old patient. When examining the right tympanic membrane, the clinician sees the presence of dense white patches. The tympanic membrane is otherwise unremarkable. It is pearly, with the light reflex at 5 o'clock and landmarks visible. Propose a statement that reflects this finding. - CORRECT ANSWER-This is known as tympanosclerosis. This is associated with calcification of the tympanic membrane. There are scars caused from frequent ear infection. This is associated with calcification of the tympanic membrane. A clinician is testing the hearing of a 78-year-old man. Establish which of the following is important to keep in mind in terms of changes in hearing that occur with aging. - CORRECT ANSWER-The aging person may find it harder to hear consonants than vowels. Sounds may be garbled and difficult to localize. The tympanic membrane thickens with age. The progression is slow. Propose a way to examine a patient who presents to your office with vertigo. - CORRECT ANSWER-Ask the patient to close his or her eyes and march in place for 30 seconds. Perform the Romberg test. Check for nystagmus. An 83-year-old male is in the clinic for a checkup. Determine a question that should be considered before the clinician begins screening for a hearing deficit. - CORRECT ANSWER-Is the evaluation for perceived hearing problems related to the hearing loss? Has there been exposure to ototoxic agents? The clinician is assessing a patient who may have hearing loss. Determine the statement concerning air conduction. - CORRECT ANSWER-It is the normal pathway for hearing. The Rinne test is used to determine normal conduction. When hearing conduction is impaired, air conduction is less than bone conduction on the affected side. A clinician is performing an oral assessment. Determine which of the following findings would cause the greatest concern. - CORRECT ANSWER-Ulceration on the side of the tongue Unexplained bleeding from the tongue Rolled edges on the side of the tongue When examining the ear with an otoscope, the clinician notes that the tympanic membrane should appear __________. - CORRECT ANSWER-mobile with air inflation with a visible cone of light A male patient has been shown having a sensorineural hearing loss. Establish what would be important for the clinician to do. - CORRECT ANSWER-Ask the patient if he has difficulty understanding when others speak Ask the patient what medications he is taking A 70-year-old male patient tells the nurse that he has noticed that he is having trouble hearing, especially in large groups. He says that he cannot always tell where the sound is coming from and that the words often sound mixed up. Justify a cause for this change. - CORRECT ANSWER-Degeneration of the acoustic nerve Sensorineural hearing loss Nerve degeneration in the inner ear Degeneration of cranial nerve VII A male patient has been shown having a sensorineural hearing loss. Establish what would be important for the clinician to do during the assessment. - CORRECT ANSWER-Ask the patient about exposure to loud noises Ask the patient about exposure to mumps Ask if there is anyone in the family who suffered from sensorineural hearing loss Predict a finding in allergic rhinitis from a physical examination. - CORRECT ANSWERBoggy nasal mucosa Nasal crease A patient complains of rhinorrhea, sneezing, and nasal itch due to a cold virus. Recommend a reasonable treatment. - CORRECT ANSWER-Inhaled corticosteroids A clinician is teaching a patient with acute sinusitis. Determine the intervention that should be included in the teaching session. - CORRECT ANSWER-Saline nasal sprays can be made at home and used to wash out secretions. You will be more comfortable if you keep your head in an upright position. Taking a hot shower will increase sinus drainage and decrease pain. Decongestants can be used to relieve swelling. A patient comes to the clinic with a 3-day history of fever and a severe cough that interferes with sleep. The patient asks about using a cough suppressant to help with sleep. Advise the NP about the best strategy for this situation. - CORRECT ANSWERObtain a thorough history of the patient's symptoms. Obtain a thorough history of the patient's past medical history. Determine a precipitating factor for sinusitis. - CORRECT ANSWER-Past history of allergic rhinitis Persistent bacterial infections A recent cold Determine what the treatment of rhinorrhea should include. - CORRECT ANSWERNasal corticosteroids Oral antihistamines Topical decongestants The new guidelines from the joint task force of the AAAAI and ACAAI suggest an updated approach to the treatment of allergic rhinitis. Assess the following and determine the first step of this new approach. - CORRECT ANSWER-Monotherapy with intranasal corticosteroids