NU 673 Assessment Midterm Exam 2024

A patient is suspected to have COPD. The APRN instructs the patient to take a deep breath in, and then with his mouth open, breathe out as fast and completely as he can. For what is the APRN checking? A. Whispered pectoriloquy B. Forced expiratory time C. Egophony D. Tactile fremitus - B. Forced expiratory time A pt presents to the clinic with severe right sided abdominal pain for 12 hours. He began having a "stomach ache" yesterday, with decreased appetite, but today the pain seems to be just on the lower right side. He has had some nausea & vomiting, but no constipation or diarrhea. His last BM was last night and was normal. He has had no fever or chills. He denies any recent illness or injuries. His PMH is unremarkable. He denies any tobacco or drug use and drinks 4-6 beers/week. on exam, he appears ill and is lying on his right side. His temp is 100.4 F and HR is 110. His bowel sounds are decreased and he has rebound pain and guarding one third of the way between anterior superior iliac spine and the umbilicus in the right lower quadrant. What is the most likely cause of his pain? A. Acute appendicitis B. Mesenteric ischemia C. Acute mechanical intestinal obstruction D. Acute cholecystitis - A. Acute appendicitis An APRN notes a 12 mm Hg difference in systolic BP during inspiration. How should the APRN document this finding? A. Acute stenosis B. Carotid arterial disease C. Paradoxical pulse D. Pulsus alternans - C. Paradoxical pulse Which of the following percussion notes is obtained over a gastric bubble? A. Flatness B. Hyperresonance C. Tympany D. Resonance - C. Tympany The APRN is performing a cardiac exam on a pt with SOB and palpitations. She listens to the heart with the pt sitting upright, then has the pt change to a supine position, and finally she has the pt turn onto the left side in the left lateral decubitus position. Which of the following valvular defects is best heard in this position?