NURS 5220 EXAM 2 MODULE 2 CHAPTER 21, 22, 23, 24, 25, AND 26 ACTUAL EXAM QUESTIONS AND CORRECT VERIFIED ANSWERS

NURS 5220 EXAM 2 MODULE 2 CHAPTER 21, 22, 23, 24, 25, AND 26 ACTUAL EXAM QUESTIONS AND CORRECT VERIFIED ANSWERS Mr. Tucker is a 56-year-old patient who presents to your office with a complaint of rectal pain. On examination you are palpating the lateral and posterior rectal walls. What should you expect to feel? A. A smooth, even, and uninterrupted surface B. Small nodules from internal hemorrhoids C. Tissue folds from the valves of Houston D. Bulging from the bladder wall A: The walls should feel smooth, even, and uninterrupted. Mr. Yates is a 62-year-old patient who presents with a chief complaint of rectal pain. The examiner will focus the history and examination on which known fact? A. Rectal pain is almost always accompanied by an infection. B. Rectal pain is almost always an indication of local disease. C. A complaint of rectal pain is usually associated with a serious systemic process. D. One of the most common causes of rectal pain is prostatic enlargement. B: Rectal pain is almost always indicative of a local disease. Mr. McKnight, a 72-year-old patient, presents to your office for a routine office visit. Which finding on examination would be considered normal? A. Meningocele B. Myelomeningocele C. Kyphosis D. Scoliosis C; Kyphosis may be observed in aging adults. Mrs. Bower is a 38-year-old patient who presents to your office with complaints of pain and a clicking noise with jaw movement. The pain extends into the face. These symptoms are suggestive of which condition? A. Gout in the jaw B. Temporomandibular joint dysfunction C. Rheumatoid arthritis of the jaw D. Bursitis of the temporomandibular joint B: Temporomandibular joint syndrome includes unilateral facial pain that usually worsens with joint movement. In addition, clicking, popping, or crepitus commonly occurs. Normal" muscle strength is documented as grade ______. A. 0 B. 1 C. 5 D. 10 C: Grade 5 represents normal strength, which means full range of motion against gravity and full resistance. When measuring the circumference of the extremities of a 43-year-old patient, the examiner compares the right and left sides. What finding should the examiner expect? A. Identical measurements on the right and left B. Nearly equal right and left side measurement C. Right and left measurement differences within 2 inches D. Significantly larger muscle groups on the dominant side B: Expect to find bilateral symmetry in length, circumference, alignment, and the position and number of skinfolds. Mr. Jones is a 37-year-old patient who presents to your office with shoulder pain. Which test would help identify a problem with the rotator cuff? A. Neer test B. Phalen test C. Bragard stretch test D. McMurray test A; The Neer test is used to evaluate the rotator cuff for impingement (tendonitis or overuse injury from repetitive overhead activities) or a tear. To perform the Neer test, forward flex the patient's arm up to 150 degrees while depressing the scapula. This presses the greater tuberosity and supraspinatus muscle against the anteroinferior acromion. Increased shoulder pain is associated with rotator cuff inflammation or a tear. To assess muscle strength of the temporalis and masseter muscles, the examiner will ask the patient to: A. push the jaw forward while the examiner applies counterforce. B. attempt to open his or her mouth while the examiner applies counterforce. C. clench his or her teeth while the examiner palpates the contracted muscles and applies opposing force. D. move the mandible 2 cm or more to each side against an opposing force. C; Strength of the temporalis and masseter muscles may be evaluated by asking the patient to clench the teeth while you palpate the contracted muscles and apply opposing force. This maneuver simultaneously tests cranial nerve V. For which problem does a family history have significance? A. Rheumatoid arthritis B. Dislocation of the radius C. Lumbosacral radiculopathy D. Bursitis A: Persons with a family history of rheumatoid arthritis are considered at increased risk for the disease. You are examining a patient who had an ankle fracture of the tibia and fibula 12 weeks ago. You find that plantar flexion of the affected foot is 45 degrees. How do you interpret this finding? A. Plantar flexion is somewhat diminished but consistent with a healed fracture. B. Plantar flexion is significantly less than normal. C. Plantar flexion is normal. D. Plantar flexion is slightly greater than normal. C: Assess range of motion of the foot and ankle. Expect plantar flexion of 45 degrees. A straight leg raising test would appropriately be performed as part of the assessment for which problem? A. Lumbar nerve root irritation B. Flexion contracture of the hip C. Tear of the lateral meniscus D. Hip adductor muscle weakness A: The straight leg raising test is used to test for nerve root irritation or lumbar disk herniation at the L4, L5, and S1 levels. Which is an effect of increased levels of hormones in the pregnant woman? A. Muscle weakness B. Increased elasticity of ligaments C. Joint tenderness D. Osteoporosis B; Increased hormone levels contribute to the elasticity of ligaments and softening of the cartilage in the pelvis at about 12 to 20 weeks of gestation. During fetal development, bone develops from: A. ligaments and tendons. B. calcified cartilage. C. specialized muscle fibers that calcify. D. bursae cavities that enlarge and harden. B: During fetal development, the skeletal system emerges from embryologic connective tissues to form cartilage that calcifies and eventually becomes bone. Which condition may a woman develop during pregnancy to compensate for the enlarging uterus and shift her center of gravity over the lower extremities? A. Lordosis B. Kyphosis C. Contracture D. Genu valgum A: As the fetus grows, lordosis (inward curvature of the lower spine) occurs in an effort to shift the center of gravity back over the lower extremities. Changes in bone density occur in older adults as a result of which normal age change? A. Bone resorption is less than bone deposition. B. Bone deposition is less than bone resorption. C. Cartilage calcification is increased. D. Fibrosis of connective tissue increases. B: For menopausal women, decreased estrogen increases bone resorption and decreases calcium deposition, resulting in bone loss and decreased bone density. Which factor results in bony prominences becoming more apparent in older adults? A. Increased calcium deposits B. Decreased bursae function C. Loss of subcutaneous tissue D. Increased bone deposition C: Bony prominences become more apparent with the loss of subcutaneous fat. During inspection of the muscles of a male construction worker, you notice that his upper extremities are slightly asymmetrical with the right arm slightly larger than his left. Previous observations have led you to conclude that he is right dominant. Based on this information, you may safely conclude that: A. his right extremity is affected by an inflammatory process. B. his left extremity is suffering from a muscle wasting process. C. this is a perfectly normal finding and requires no further follow-up. D. there is the possibility of damage to motor neurons controlling the left extremity. C: Persons such as athletes who use the dominant arm almost exclusively in their activities (e.g., pitchers and tennis players) may have some discrepancy in circumference. Mr. Bower is a 78-year-old patient who is unable to assume a standing position for a routine rectal examination. Which is the best alternative position? A. Lithotomy position B. Left lateral position with the knees flexed C. Knee-chest position D. Prone position B: The rectal examination can be performed with the patient in any of these positions: knee-chest; left lateral with hips and knees flexed; lithotomy, or standing with the hips flexed and the upper body supported by the examining table. A pregnant woman presents to the emergency department with the complaint of dark stools. She tells the examiner, "I read in a magazine that this is a sign of bleeding." Which question by the examiner is most applicable for this situation? A. "Where did you read that information?" B. "Have you been giving yourself enemas?" C. "How much fruit and vegetable intake have you had in the last few days?" D. "Are you taking prenatal vitamins?" D: During pregnancy, the stool color may be dark green or black if the woman is taking iron supplements.