NSG 6020: Health Assessment

In performing an examination of a 3-year-old with a suspected ear infection, the nurse practitioner would: Question 1 options: omit the otoscopic exam if the child has a fever. pull the ear up and back before inserting the speculum. ask the mother to leave the room while examining the child. Save Question 2 (2 points) A female patient tells the nurse that she has had six pregnancies, with four live births at term and two spontaneous abortions. Her four children are still living. How would the nurse record this information? Question 2 options: P-6, B-4, (S)Ab-2. Patient has had four living babies. perform the otoscopic examination at the end of the assessment. Grav 6, Term 4, (S)Ab 2, Living 4. firm but freely movable. Patient has been pregnant six times. Save Question 3 (2 points) During an examination of a female patient, the nurse practitioner notes lymphadenopathy and suspects an acute infection. Acutely infected lymph nodes would be: Question 3 options: clumped. unilateral. hard and nontender. Save Question 4 (2 points) A visitor from Poland who does not speak English seems to be somewhat apprehensive about the nurse practitioner examining his neck. He would probably be most comfortable with the nurse practitioner examining his thyroid: Question 4 options: from behind with the examiner’s hands placed firmly around his neck. from the side with the examiner’s eyes averted toward the ceiling and thumbs on his neck. from the front with the examiner’s thumbs placed on either side of his trachea and his head tilted backward. Save Question 5 (2 points) When palpating the abdomen of a 20-year-old patient, the nurse practitioner notes the presence of tenderness in the left upper quadrant with deep palpation. Which of the following structures is most likely to be involved? Question 5 options: Sigmoid Appendix Gallbladder Save Question 6 (2 points) A 6-month-old infant has been brought to the well-child clinic for a check-up. She is currently sleeping. What should the examiner do first? Question 6 options: from the front with the examiner’s thumbs placed on either side of his trachea and his head tilted forward. Spleen Auscultate the lungs and heart while the infant is still sleeping. Pulmonary edema Examine the infant’s hips because this procedure is uncomfortable. Begin with the assessment of the eye and continue with the remainder of the examination in a head-to-toe approach. Wake the infant before beginning any portion of the examination to obtain the most accurate assessment of body systems. Save Question 7 (2 points) During a morning assessment, the nurse practitioner notes that the patient’s sputum is frothy and pink. Which condition could this finding indicate? Question 7 options: Croup Tuberculosis Viral infection Save Question 8 (2 points) myxedema. A woman comes to the clinic and states, “My eyes have gotten so puffy, and my eyebrows and hair have become coarse and dry.” The nurse practitioner suspects: Question 8 options: cachexia. cretinism. scleroderma. Save Question 9 (2 points) In performing auscultation of heart sounds, which sequence would the nurse practitioner use? Question 9 options: Pulmonic area—aortic area—Erb’s point—tricuspid area—mitral area Aortic area—tricuspid area—Erb’s point—mitral area—pulmonic area Pulmonic area—Erb’s point—tricuspid area—pulmonic area—mitral area Save Question 10 (2 points) Aortic area—pulmonic area—Erb’s point—tricuspid area—mitral area During an admission assessment, the nurse practitioner notices that a male patient has an enlarged and rather thick skull. The nurse practitioner suspects acromegaly and would further assess for: Question 10 options: exophthalmos. bowed long bones. an acorn-shaped cranium. Save Question 11 (2 points) During an examination of a patient in her third trimester of pregnancy, the nurse practitioner notices that the patient’s thyroid gland is slightly enlarged. No enlargement had been noted previously. The nurse practitioner suspects that: Question 11 options: she has an iodine deficiency. she is exhibiting early signs of goiter. further tests are needed for possible thyroid cancer. Save Question 12 (2 points) coarse facial features. this is a normal finding during pregnancy. During an assessment of a newborn infant, the nurse practitioner recalls that pyloric stenosis would be manifested by: Question 12 options: hypoactive bowel activity. palpable olive-sized mass in right lower quadrant. pronounced peristaltic waves crossing from right to left. Save Question 13 (2 points) The nurse practitioner is obtaining a history from a 30-year-old male patient and is concerned about health promotion activities. Which of the following questions would be appropriate to use to assess health promotion activities for this patient? Question 13 options: “Have you ever noticed any pain in your testicles?” “Have you had any problems with passing your urine?” “Do you have any history of sexually transmitted disease?” projectile vomiting. “Do you perform testicular self-exams?” Save Question 14 (2 points) Which of the following best describes the purpose of a functional assessment? Question 14 options: It assesses how the individual is coping with life at home. It determines how children are meeting developmental milestones. It can identify any problems with memory the individual may be experiencing. Save Question 15 (2 points) A mother brings her newborn in for an assessment and asks, “Is there something wrong with my baby? His head seems so big.” The nurse practitioner knows the following about relative proportions of the head and trunk of the newborn: Question 15 options: At birth, the head is one fifth the total length. The head size reaches 90% of its final size when the child is 3 years old. With the elderly, it helps to determine how they are managing day-to-day activities. Head circumference should be greater than chest circumference at birth. When the anterior fontanel closes at 2 months, the head will be more proportioned to the body. Save Question 16 (2 points) When performing a physical assessment, the technique the nurse practitioner will always use first is: Question 16 options: palpation. percussion. auscultation. Save Question 17 (2 points) The mother of a 2-year-old is concerned because her son has had three ear infections in the past year. What would be an appropriate response by the nurse practitioner? Question 17 options: . “It is unusual for a small child to have frequent ear infections unless there is something else wrong.” “We need to check the immune system of your son to see why he is having so many ear infections.” “Ear infections are not uncommon in infants and toddlers because they tend to have more cerumen in the inspection. external ear.” Save Question 18 (2 points) Which technique of assessment is used to determine the presence of crepitus, swelling, and pulsations? Question 18 options: Inspection Percussion Auscultation Save Question 19 (2 points) Percussion notes heard during the abdominal assessment may include: Question 19 options: flatness, resonance, and dullness. resonance, dullness, and tympany. “Your son’s eustachian tube is shorter and wider than yours because of his age, which allows for infections to develop more easily.” Palpation mental illness. resonance, hyperresonance, and flatness. Save Question 20 (2 points) The nurse practitioner is taking a family history. Important diseases or problems to ask the patient about include: Question 20 options: emphysema. head trauma. fractured bones. Save Question 21 (2 points) The nurse practitioner is preparing to assess a patient’s abdomen by palpation. How should the nurse practitioner proceed? Question 21 options: Avoid palpation of reported “tender” areas because this may cause the patient pain. Quickly palpate the area to avoid any discomfort that the patient may experience. tympany, hyperresonance, and dullness. Meningeal inflammation Begin the assessment with deep palpation, encouraging the patient to relax and take deep breaths. Save Question 22 (2 points) A 19-year-old college student is brought to the emergency department with a severe headache he describes as “Like nothing I’ve ever had before.” His temperature is 104° F, and he has a stiff neck. What do these signs and symptoms suggest? Question 22 options: Head injury Cluster headache Migraine headache Save Question 23 (2 points) A patient has been diagnosed with pernicious anemia. The nurse practitioner knows that this condition could be related to: Start with light palpation to detect surface characteristics and to accustom the patient to being touched. Question 23 options: increased gastric acid secretion. delayed gastrointestinal emptying time. increased gastrointestinal emptying time. Save Question 24 (2 points) A patient presents with excruciating headache pain on one side of his head, especially around his eye, forehead, and cheek that lasts about 1/2 to 2 hours, occurring once or twice each day. The nurse practitioner suspects: Question 24 options: hypertension. tension headaches. migraine headaches. Save Question 25 (2 points) The temporomandibular joint is just below the temporal artery and anterior to the: decreased gastric acid secretion. cluster headaches. tragus. Question 25 options: hyoid. vagus. mandible. Save Question 26 (2 points) The nurse practitioner is preparing to examine a 4-year-old child. Which action is appropriate first? Question 26 options: Explain procedures in detail to alleviate the child’s anxiety. Do not ask the child to remove his clothes because children at this age are usually very private. Perform an examination of the ear, nose, and throat first and then examine the thorax and abdomen. Save Question 27 (2 points) Give the child feedback and reassurance during the examination. know that “floaters” are usually not significant and are caused by condensed vitreous fibers. A 52-year-old patient describes the presence of occasional “floaters or spots” moving in front of his eyes. The nurse should: Question 27 options: examine the retina to determine the number of floaters. presume the patient has glaucoma and refer him for further testing. consider this an abnormal finding and refer him to an ophthalmologist. Save Question 28 (2 points) A patient has a long history of chronic obstructive pulmonary disease. During the assessment, the nurse practitioner is most likely to observe: Question 28 options: unequal chest expansion. increased tactile fremitus. atrophied neck and trapezius muscles. Save Question 29 (2 points) an anteroposterior-to-transverse diameter ratio of 1:1. The nurse practitioner is assessing a patient’s skin during an office visit. What is the best technique to use to best assess the patient’s skin temperature? Question 29 options: Use the fingertips because they’re more sensitive to small changes in temperature. Use the ulnar portion of the hand because there is increased blood supply that enhances temperature sensitivity. Use the palmar surface of the hand because it is most sensitive to temperature variations because of increased nerve supply in this area. Save Question 30 (2 points) When examining the face, the nurse practitioner is aware that the two pairs of salivary glands that are accessible to examination are the _____ glands. Question 30 options: occipital and submental parotid and jugulodigastric submandibular and occipital Use the dorsal surface of the hand because the skin is thinner than on the palms. parotid and submandibular Appendix Save Question 31 (2 points) Tenderness on light palpation in the right lower quadrant could indicate a disorder of which of the following structures? Question 31 options: Spleen Sigmoid Gallbladder Save Question 32 (2 points) The nurse practitioner notices that a patient’s submental lymph nodes are enlarged. In an effort to identify the cause of the node enlargement, the nurse would assess the: Question 32 options: infraclavicular area. supraclavicular area. area distal to the enlarged node. area proximal to the enlarged node. had a cerebrovascular accident (stroke). Save Question 33 (2 points) A patient visits the clinic because he has recently noticed that the left side of his mouth is paralyzed. He states that he cannot raise his eyebrow or whistle. The nurse practitioner suspects that he has: Question 33 options: Cushing’s syndrome. Parkinson’s syndrome. Bell’s palsy. Save Question 34 (2 points) Which of the following statements is true concerning air conduction? Question 34 options: It is caused by the vibrations of bones in the skull. It is the most efficient pathway for hearing. The amplitude of sound determines the pitch that is heard. A loss of air conduction is called a conductive hearing loss. Save Question 35 (2 points) A patient comes into the clinic complaining of pain in her right eye. On examination, the nurse practitioner sees a pustule at the lid margin that is painful to touch, red, and swollen. The nurse practitioner recognizes that this is Question 35 options: a chalazion. a hordeolum (stye). blepharitis. Save Question 36 (2 points) While performing a well-child assessment on a 5-year-old, the nurse practitioner notes the presence of palpable, bilateral, cervical, and inguinal lymph nodes. They are approximately 0.5 cm in size, round, mobile, and nontender. The nurse practitioner suspects that this: Question 36 options: dacryocystitis. is a normal finding for a well child of this age. child has chronic allergies. child may have an infection. child should be referred for additional evaluation. Save Question 37 (2 points) During an assessment of an infant, the nurse practitioner notes that the fontanels are depressed and sunken. The nurse practitioner suspects which condition? Question 37 options: Rickets Mental retardation Increased intracranial pressure Save Question 38 (2 points) The nurse practitioner is assessing a patient for possible peptic ulcer disease and knows that which condition often causes this problem? Question 38 options: Dehydration Hypertension Streptococcus infections History of constipation and frequent laxative use Save Question 39 (2 points) Which of the following techniques uses the sense of touch when assessing a patient? Question 39 options: Inspection Percussion Auscultation Save Question 40 (2 points) The nurse practitioner suspects that a patient has hyperthyroidism and laboratory data indicate that the patient’s thyroxine and tri-iodothyronine hormone levels are elevated. Which of the following findings would the nurse practitioner most likely find on examination? Frequent use of nonsteroidal anti-inflammatory drugs Palpation Question 40 options: Constipation Rapid dyspnea Atrophied nodular thyroid Save Question 41 (2 points) During an examination of a 3-year-old child, the nurse practitioner notes a bruit over the left temporal area. What should the nurse practitioner do? Question 41 options: Check for the bruit again in 1 hour. Notify the parents that a bruit has been detected in their child. Stop the examination and notify the physician. Save Question 42 (2 points) The primary muscles of respiration include the: Tachycardia Continue the examination because this is a normal finding for this age. cephalhematoma. Question 42 options: sternomastoids and scaleni. trapezius and rectus abdominis. external obliques and pectoralis major. Save Question 43 (2 points) The nurse practitioner notices that an infant has a large, soft lump on the side of his head and that his mother is very concerned. She tells the nurse practitioner that she noticed the lump about 8 hours after her baby’s birth, and that it seems to be getting bigger. One possible explanation for this is: Question 43 options: hydrocephalus. craniosynostosis. caput succedaneum. Save Question 44 (2 points) diaphragm and intercostals. Abdomen When examining an infant, the nurse practitioner should examine which area first? Question 44 options: Ear Nose Throat Save Question 45 (2 points) Which statement is true regarding the diaphragm of the stethoscope? Question 45 options: Use the diaphragm to listen for low-pitched sounds. Hold the diaphragm lightly against the person’s skin to block out low-pitched sounds. Hold the diaphragm lightly against the person’s skin to listen for extra heart sounds and murmurs. Save Question 46 (2 points) Use the diaphragm to listen for high-pitched sounds. Chest pain that is worse on deep inspiration, dyspnea A patient has been admitted to the emergency department with a possible medical diagnosis of pulmonary embolism. The nurse practitioner recognizes which assessment findings related to this condition? Question 46 options: Absent or decreased breath sounds Productive cough with thin, frothy sputum Diffuse infiltrates with areas of dullness upon percussion Save Question 47 (2 points) A man is at the clinic for a physical examination. He states that he is “very anxious” about the physical exam. What steps can the examiner take to make him more comfortable? Question 47 options: Stay in the room when he undresses in case he needs assistance. Ask him to change into an examining gown and take off his undergarments. Defer measuring vital signs until the end of the examination, which allows him. time to become comfortable. Save Appear unhurried and confident when examining him. Question 48 (2 points) During a cardiac assessment on an adult patient in the hospital for “chest pain,” the nurse practitioner finds the following: jugular vein pulsations 4 cm above sternal angle when he is elevated at 45 degrees, BP 98/60, HR 130; ankle edema; difficulty in breathing when supine; and an S3 on auscultation. Which of the following best explains the cause of these findings? Question 48 options: Fluid overload Atrial septal defect Myocardial infarction Save Question 49 (2 points) When preparing to examine a 6-year-old child, which action is most appropriate? Question 49 options: Start with the thorax, abdomen, and genitalia before examining the head. Avoid talking about the equipment being used because it may increase the child’s anxiety. Heart failure Keep in mind that a child this age will have a sense of modesty. Have the child undress from the waist up. Save Question 50 (2 points) A 31-year-old patient tells the nurse that he has noticed a progressive loss in his hearing. He says that it does seem to help when people speak louder or if he turns up the volume. The most likely cause of his hearing loss is: Question 50 options: presbycusis. trauma to the bones. frequent ear infections. Save Question 51 (2 points) A patient tells the nurse that she has had abdominal pain for the past week. What would be the best response by the nurse? Question 51 options: “We’ll talk more about that later in the interview.” “What have you had to eat in the last 24 hours?” otosclerosis. “Can you point to where it hurts?” “Have you ever had any surgeries on your abdomen?” Save Question 52 (2 points) The nurse practitioner is doing an assessment on a 21-yearold patient and notes that his nasal mucosa appears pale, gray, and swollen. What would be the most appropriate question to ask the patient? Question 52 options: “Do you have an elevated temperature?” “Have you had any symptoms of a cold?” “Have you been having frequent nosebleeds?” Save Question 53 (2 points) The most important reason to share information and offer brief teaching while performing the physical examination is to help: Question 53 options: the examiner feel more comfortable and gain control of the situation. “Are you aware of having any allergies?” build rapport and increase the patient’s confidence in the examiner. the patient understand his or her disease process and treatment modalities. the patient identify questions about his or her disease and potential areas of patient education. Save Question 54 (2 points) Which of the following statements is true regarding the otoscope? Question 54 options: The otoscope is often used to direct light onto the sinuses. The otoscope uses a short broad speculum to visualize the ear. The otoscope is used to examine the structures of the internal ear. Save Question 55 (2 points) A 59-year-old patient, J.M., tells the nurse that he is here today to “check his ulcerative colitis.” He has been having “black stools” for the last 24 hours. How would the nurse document his reason for seeking care? Question 55 options: J. M. is a 59-year-old male here for “ulcerative colitis.” J. M. came into the clinic complaining of black stools for the past 24 hours.