NSG 6020: Health Assessment

When preparing to perform a physical examination on an infant, the examiner should: Question 1 options: instruct the parent to feed the infant immediately before the exam. encourage the infant to suck on a pacifier during the abdominal exam. ask the parent to briefly leave the room when assessing the infant’s vital signs. A patient’s laboratory data reveal an elevated thyroxine level. The nurse would proceed with an examination of the: Question 2 options: parotid gland. adrenal gland. thyroxine gland. The nurse practitioner is doing an oral assessment on a 40-year-old black patient and notes the presence of a 1-cm, nontender, grayish-white lesion on the left buccal mucosa. Which of the following is true concerning this lesion? Question 3 options: This is the result of hyperpigmentation and is normal. This is torus palatinus and would normally only be found in smokers. This type of lesion is indicative of cancer and should be tested immediately. During an examination, the nurse knows that Paget’s disease would be indicated by which of the following findings? Question 4 options: Positive Macewen’s sign Premature closure of the sagittal suture Elongated head with heavy eyebrow ridge A 30-year-old woman with a history of mitral valve problems states that she has been “very tired.” She has started waking up at night and feels like her “heart is pounding.” During the assessment, the nurse practitioner palpates a thrill and lift at the fifth left intercostal space midclavicular line. In the same area the nurse practitioner also auscultates a blowing, swishing sound right after S1. These findings would be most consistent with: Question 5 options: heart failure. aortic stenosis. This lesion is leukoedema and is common in blacks. thyroid gland. have the parent remove all clothing except the diaper on a boy. 1 6 7 9 8 10 pulmonary edema. mitral regurgitation. 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 6 options: infraclavicular area. supraclavicular area. area distal to the enlarged node. area proximal to the enlarged node. During an assessment of a newborn infant, the nurse practitioner recalls that pyloric stenosis would be manifested by: Question 7 options: projectile vomiting. hypoactive bowel activity. palpable olive-sized mass in right lower quadrant. pronounced peristaltic waves crossing from right to left. A patient has been shown to have a sensorineural hearing loss. During the assessment, it would be important for the nurse to: Question 8 options: speak loudly so he can hear the questions. assess for middle ear infection as a possible cause. ask the patient what medications he is currently taking. look for the source of the obstruction in the external ear. The most important reason to share information and offer brief teaching while performing the physical examination is to help: Question 9 options: the examiner feel more comfortable and gain control of the situation. 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. A patient’s thyroid is enlarged, and the nurse practitioner is preparing to auscultate the thyroid for the presence of a bruit. A bruit is a: Question 10 options: low gurgling sound best heard with the diaphragm of the stethoscope. loud, whooshing, blowing sound best heard with the bell of the stethoscope. 11 12 13 14 15 soft, whooshing, pulsatile sound best heard with the bell of the stethoscope. high-pitched tinkling sound best heard with the diaphragm of the stethoscope. 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 11 options: Fluid overload Atrial septal defect Myocardial infarction Heart failure When examining an infant, the nurse practitioner should examine which area first? Question 12 options: Ear Nose Throat Abdomen Which of the following techniques uses the sense of touch when assessing a patient? Question 13 options: Palpation Inspection Percussion Auscultation An example of objective information obtained during the physical assessment includes the: Question 14 options: patient’s history of allergies. patient’s use of medications at home. last menstrual period 1 month ago. 2 Χ 5 cm scar present on the right lower forearm. 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 15 options: “Do you perform testicular self-exams?” 16 17 18 19 20 “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?” 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 16 options: hydrocephalus. craniosynostosis. cephalhematoma. caput succedaneum. A mother asks when her newborn infant’s eyesight will be developed. The nurse practitioner should reply: Question 17 options: “Vision is not totally developed until 2 years of age.” “Infants develop the ability to focus on an object at around 8 months.” “By about 3 months, infants develop more coordinated eye movements and can fixate on an object.” “Most infants have uncoordinated eye movements for the first year of life.” The temporomandibular joint is just below the temporal artery and anterior to the: Question 18 options: hyoid. vagus. tragus. mandible. The nurse practitioner notes the presence of periorbital edema when performing an eye assessment on a 70-year-old patient. The nurse practitioner will: Question 19 options: check for the presence of exophthalmos. suspect that the patient has hyperthyroidism. ask the patient if he or she has a history of heart failure. assess for blepharitis because this is often associated with periorbital edema. 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: 24 21 22 23 25 Question 20 options: she has an iodine deficiency. she is exhibiting early signs of goiter. this is a normal finding during pregnancy. further tests are needed for possible thyroid cancer. 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 21 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 external ear.” “Your son’s eustachian tube is shorter and wider than yours because of his age, which allows for infections to develop more easily.” In performing an examination of a 3-year-old with a suspected ear infection, the nurse practitioner would: Question 22 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. perform the otoscopic examination at the end of the assessment. 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 23 options: hypertension. cluster headaches. tension headaches. migraine headaches. The nurse practitioner would use bimanual palpation technique in which situation? Question 24 options: Palpating the thorax of an infant Palpating the kidneys and uterus Assessing pulsations and vibrations Assessing the presence of tenderness and pain Percussion notes heard during the abdominal assessment may include: 26 27 28 29 Question 25 options: flatness, resonance, and dullness. resonance, dullness, and tympany. tympany, hyperresonance, and dullness. resonance, hyperresonance, and flatness. A patient complains that while studying for an examination he began to notice a severe headache in the frontotemporal area of his head that is throbbing and is somewhat relieved when he lies down. He tells the nurse practitioner that his mother also had these headaches. The nurse practitioner suspects that he may be suffering from : Question 26 options: hypertension. cluster headaches. tension headaches. migraine headaches. Which of the following statements regarding the aging adult and abdominal assessment is true? Question 27 options: The abdominal tone is increased. The abdominal musculature is thinner. The abdominal rigidity with acute abdominal conditions is more common. The aging person complains of more pain with an acute abdomen than a younger person would. When preparing to examine a 6-year-old child, which action is most appropriate? Question 28 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. Keep in mind that a child this age will have a sense of modesty. Have the child undress from the waist up. In assessing the sclera of a black patient, which of the following would be an expected finding? Question 29 options: Yellow fatty deposits over the cornea Pallor near the outer canthus of the lower lid Yellow color of the sclera that extends up to the iris