NURS6512 / NURS 6512: (Advanced Health Assessment and Diagnostic Reasoning) Midterm Exam-Questions and Answers (UPDATED 2020) - $25.06   Add to cart

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NURS6512 / NURS 6512: (Advanced Health Assessment and Diagnostic Reasoning) Midterm Exam-Questions and Answers (UPDATED 2020)

NURS 6512 -Advanced Health Assessment and Diagnostic Reasoning (Mid Term Exam) 1. A 2-month-old male child comes into the Shadow General Hospital Emergency Department with dehydration due to projectile vomiting since birth. On physical exam you note marked peristalsis (waves visible on inspection of the abdomen). This is a sign of what pathologic process? A) Pyloric stenosis B) Diastasis recti C) Enlarged kidneys D) Umbilical hernia RATIONALE: Infants with pyloric stenosis present with projectile vomiting as a chief complaint with marked peristalsis noted on physical exam. 2. A 3-year-old child with Down's syndrome is in the cardiac ICU of Shadow General Hospital following open heart surgery. Which of the following musculoskeletal physical exam findings would you expect to find on this child? A) Fixed joints B) Lordosis C) Hyperextensible joints D) Scoliosis RATIONALE: 3. A 76-year-old is admitted to the Shadow General Hospital ICU with severe abdominal pain and nausea. On physical exam you find rebound tenderness, guarding on palpation and abdominal wall rigidity. These are common findings with what problem? A) Peritonitis B) Constipation C) Hiatal hernia D) Peptic ulcer RATIONALE: 4. An 82-year-old is on the cardiac floor of Shadow General Hospital after being admitted for chest pain. Which of the following findings would be due to vessel narrowing? A) Bruits B) Tachycardia C) Harsh holosystolic murmur D) Regurgitation RATIONALE: 5. An 86-year-old woman has been admitted to the Shadow General surgical floor after a knee replacement. She has a history of degenerative joint disease (DJD). What physical exam findings would you expect to find? A) Joint deformity B) Shuffling gait C) Postural instability D) Humpback RATIONALE: 6. abdomen normally moves with breathing until the age of ____ years. A) 4 B) 7 C) 14 D) 75 7. The ability of the heart to contract independently of any signals or stimulation is due to: A) depolarization. B) automaticity. C) conduction. D) repolarization. RATIONALE: 8. Adnexa is (are): A) an absence of menstruation. B) uterine accessory organs. C) a membranous fold of tissue partly closing the vaginal orifice. D) painful intercourse. RATIONALE: 9. Arteriosclerosis refers to: A) a variation from the heart's normal rhythm. B) a sac formed by dilation in the arterial wall. C) thickening and loss of elasticity of the arterial walls. D) deposition of fatty plaques along the intima of the arteries. RATIONALE: 10. Ascites is defined as: A) a bowel obstruction. B) a proximal loop of the large intestine. C) an abnormal enlargement of the spleen. D) an abnormal accumulation of serous fluid within the peritoneal cavity. RATIONALE: 11. A bruit heard while auscultating the carotid artery of a 65-year-old patient is caused by: A) decreased velocity of blood flow through the carotid artery. B) turbulent blood flow through the carotid artery. C) rapid blood flow through the carotid artery. D) increased viscosity of blood. RATIONALE: 12. Bundles of muscle fibers that compose skeletal muscle are identified as: A) fasciculi. B) fasciculations. C) ligaments. D) tendons. RATIONALE: 13. A caruncle is a(n): A) vestibular gland located on either side of the vaginal orifice. B) small, red mass protruding from the urethral meatus. C) aberrant growth of endometrial tissue. D) hard, painless nodule in the uterine wall. 14. The cervical nodes drain the: A) upper arm and breast. B) hand and lower arm. C) external genitalia. D) head and neck. RATIONALE: 15. Claudication is caused by: A) venous insufficiency. B) arterial insufficiency. C) varicose veins. D) stasis ulcerations. RATIONALE: 16. The corona is: A) a shoulder where the glans joins the shaft. B) a hood or flap of skin over the glans. C) a corpus spongiosum cone of erectile tissue. D) folds of thin skin on the scrotal wall. RATIONALE: 17. Decreased estrogen levels during menopause cause: A) an enlargement of the uterus. B) pelvic muscles and ligaments to tighten. C) the ovaries to atrophy. D) the cervix to enlarge and turn blue. RATIONALE: 18. A deep recess formed by the peritoneum between the rectum and the cervix is called: A) the Chadwick sign. B) a cystocele. C) a rectocele. D) a rectouterine pouch. RATIONALE: 19. The ejaculatory duct is: A) the passage formed by the joining of the vas deferens and the seminal vesicle. B) a muscular duct continuous with the epididymis. C) a narrow tunnel inferior to the inguinal ligament. D) a narrow tunnel superior to the inguinal ligament. RATIONALE: 20. The first heart sound (S1) is produced by the: A) closure of the semilunar valves. B) closure of the AV valves. C) opening of the semilunar valves. D) opening of the AV valves. RATIONALE: 21. The first sign of puberty in boys is: A) enlargement of the testes. B) the appearance of pubic hair. C) an increase in penis size. D) pubic hair growth extending up the abdomen. RATIONALE: 22. The first sign of puberty in girls is: A) the first menstrual cycle (menarche). B) axillary hair development. C) rapid increase in height. D) breast and pubic hair development. RATIONALE: 23. The four layers of large, flat abdominal muscles form the: A) linea alba. B) rectus abdominis. C) ventral abdominal wall. D) viscera. RATIONALE: 24. The functions of the musculoskeletal system include: A) protection and storage. B) movement and elimination. C) storage and control. D) propulsion and preservation. RATIONALE: 25. Heberden and Bouchard nodes are hard and nontender and are associated with: A) osteoarthritis. B) rheumatoid arthritis. C) Dupuytren contracture. D) metacarpophalangeal bursitis. RATIONALE: 26. If Tina had displayed limited abduction of the left shoulder, it would mean that: A) She has limited movement forward B) She has limited movement in a circular motion C) She has limited movement toward her body D) She has limited movement away from her body RATIONALE: 27. Imagine that Tina was unable to move her right ankle. You notice that her muscles contract as she attempts to dorsiflex her ankle, but no movement occurs. How would you grade her ankle strength? A) 1/5 B) 2/5 C) 4/5 D) 3/5 RATIONALE: 28. In pulsus paradoxus: A) the rhythm is irregular; every other beat is premature. B) there is a deficiency of arterial blood to a body part. C) the rhythm is regular, but the force of the pulse varies with alternating beats. D) beats have weaker amplitude with respiratory inspiration and stronger amplitude with expiration. RATIONALE: . 29. In young children, the thymus gland: A) produces T lymphocytes. B) is small and begins to atrophy. C) is not important in immune function. D) produces B lymphocytes. RATIONALE: 30. _____________ is acute inflammation of the testes. A) Genital herpes B) Priapism C) Orchitis D) Paraphimosis RATIONALE: 31. _____________ is an emergency requiring surgery. A) A scrotal hernia B) Epididymitis C) Testicular torsion D) Cryptorchidism RATIONALE: 32. The jugular venous pressure is an indirect reflection of the: A) heart's efficiency as a pump. B) cardiac cycle. C) conduction effectiveness. D) synchronization of mechanical activity. RATIONALE: 33. The leaflets of the tricuspid and mitral valves are anchored by __________________ to the _________________, which are embedded in the ventricular floor. A) endocardial ligaments; mediastinal muscles B) atrioventricular tendons; pericardial bundles C) chordae tendineae; papillary muscles D) pericardial cords; ventricular sheaths RATIONALE: 34. The Left Upper Quadrant (LUQ) contains the: A) Gallbladder B) Spleen C) Liver D) Appendix RATIONALE: 35. Lymphedema is: A) the indentation left after the examiner depresses the skin over swollen edematous tissue. B) a thickening and loss of elasticity of the arterial walls. C) an inflammation of the vein associated with thrombus formation. D) the swelling of an extremity caused by an obstructed lymph channel. RATIONALE: 36. Methods to enhance abdominal wall relaxation during examination include: A) a cool environment. B) having the patient place arms above the head. C) examining painful areas first. D) positioning the patient with the knees bent. RATIONALE: 37. Moles on the abdomen: A) are common. B) are uncommon. C) require a biopsy. D) are no cause for concern. RATIONALE: 38. The most common sexually transmitted infection in the United States is: A) gonorrhea. B) syphilis. C) chlamydia. D) trichomoniasis. 39. Normal capillary refill is: A) Nails turning from blanched to pink B) > 2 seconds C) 1-2 seconds D) < 1 second 40. Most capillaries have such small inner diameters that only one red blood cell can move through at a time. Older adults have: A) decreased salivation leading to dry mouth. B) increased gastric acid secretion. C) increased liver size. D) decreased incidence of gallstones. RATIONALE: 41. One of the leg's deep veins is the: A) great saphenous. B) small saphenous. C) tibial. D) popliteal. RATIONALE: 42. Orchitis is (are): A) a meatus opening on the dorsal side of the glans or shaft. B) hard, subcutaneous plaques associated with painful bending of the erect penis. C) a circumscribed collection of serous fluid in the tunica vaginalis surrounding the testes. D) an acute inflammation of the testes. RATIONALE: 43. The organ in the right upper quadrant of the abdomen is the: A) spleen. B) liver. C) cecum. D) sigmoid colon. RATIONALE: 44. Palpable inguinal lymph nodes are: A) normal if small (less than 1 cm), movable, and nontender. B) abnormal in adults but common in children and infants. C) normal if fixed and tender. D) abnormal and indicate the presence of malignant disease. RATIONALE: 45. A patient has severe bilateral lower extremity edema. The most likely cause is: A) an infection of the right great toe. B) Raynaud phenomenon. C) heart failure. D) an aortic aneurysm. RATIONALE: 46. The penis: A) is composed of two corpora cavernosa and one corpus spongiosum. B) is a loose protective sac that is a continuation of the abdominal wall. C) and scrotum are the internal structures of the male genitals. D) size is controlled by the cremaster muscle. RATIONALE: 47. The production of red blood cells in the bone marrow is called: A) hematopoiesis. B) hemolysis. C) hemoptysis. D) hemianopsia. RATIONALE: 48. Pyloric stenosis is a(n): A) abnormal enlargement of the pyloric sphincter. B) inflammation of the pyloric sphincter. C) congenital narrowing of the pyloric sphincter. D) abnormal opening in the pyloric sphincter. 49. Pyrosis is: A) an inflammation of the peritoneum. B) a burning sensation in the upper abdomen. C) a congenital narrowing of the pyloric sphincter. D) an abnormally sunken abdominal wall. RATIONALE: 50. A retention cyst in the epididymis filled with milky fluid containing sperm is called: A) a varicocele. B) a spermatocele. C) Peyronie disease. D) a prepuce. RATIONALE: 51. The second heart sound is the result of which of the following? A) Opening of aortic and pulmonic valves B) Closing of aortic and pulmonic valves C) Opening of mitral and tricuspid valve D) Closing of mitral and tricuspid valve RATIONALE: 52. The semilunar valves separate the: A) atria from the ventricles. B) right atria from the left atria. C) ventricles from the arteries. D) atria from the veins. RATIONALE: 53. Soft, pointed, fleshy papules that occur on the genitalia caused by human papillomavirus (HPV) are known as: A) chancres. B) genital warts. C) urethritis. D) varicoceles. RATIONALE: 54. Suppose that Tina reported pain when you assessed for costovertebral angle (CVA) tenderness. Which of the following would be true? A) CVA tenderness may indicate kidney infection B) CVA tenderness may indicate liver enlargement C) CVA tenderness is an expected finding D) CVA tenderness is a rare finding RATIONALE: 55. Suppose that you suspected ascites because Tina's abdomen is large. Which of the following assessment findings would confirm ascites? A) Shifting dullness B) Murphy's sign C) Deep organ palpation D) Peristaltic fluid wave test RATIONALE: 56. Suppose you noted that Tina's left knee was swollen. Which of the following tests should be done? A) Balloon test B) Fluid wave C) Bulge sign D) Tinel's sign RATIONALE: 57. The symptoms occurring with lactose intolerance include: A) bloating and flatulence. B) gray stools. C) hematemesis. D) anorexia. RATIONALE: 58. Tina's left tibial pulse is graded as 2 . This finding is: A) Bounding B) Increased C) Normal D) Weak RATIONALE: 59. Vaginal lubrication during intercourse is produced by: A) Skene glands. B) Bartholin glands. C) sebaceous glands. D) adrenal glands. RATIONALE: 60. A water-hammer or Corrigan pulse is associated with: A) hyperkinetic states. B) decreased cardiac output. C) aortic valve regurgitation. D) conduction disturbance. RATIONALE: 61. When assessing for the presence of a herniated nucleus pulposus, the examiner would: A) raise each of the patient's legs straight while keeping the knee extended. B) ask the patient to bend over and touch the floor while keeping the legs straight. C) instruct the patient to do a knee bend. D) abduct and adduct the patient's legs while keeping the knee extended. RATIONALE: 62. When auscultating the heart of a newborn within 24 hours after birth, the examiner hears a continuous sound that mimics the sound of a machine. This finding most likely indicates: A) the presence of congenital heart disease. B) a normal sound because of the thinner chest wall of the newborn. C) an expected sound caused by non-closure of the ductus arteriosus. D) pathology only when accompanied by an increased heart rate. RATIONALE: 63. When listening to the heart of an 18-month-old admitted to Shadow General Hospital for physical abuse, what is the normal heart rate range? A) 90-150 beats per minute B) 80-140 beats per minute C) 100-160 beats per minute D) 60-100 beats per minute RATIONALE: 64. Which of the following cardiac alterations occurs during pregnancy? A) An increase in cardiac output and blood pressure B) An increase in cardiac volume and a decrease in blood pressure C) An increased heart rate and increased blood pressure D) An increased stroke volume and decreased cardiac output RATIONALE: 65. Which of the following ethnic groups has the lowest incidence of osteoporosis? A) African Americans B) Whites C) Asians D) American Indians RATIONALE: 66. Which of the following guidelines may be used to identify which heart sound is S1? A) S1 is louder than S2 at the base of the heart. B) S1 coincides with the A wave of the jugular venous pulse wave. C) S1 coincides with the carotid artery pulse. D) S1 coincides with the Q wave of the QRS electrocardiogram complex. RATIONALE: 67. Which of the following is an appropriate position to have the patient assume when auscultating for extra heart sounds or murmurs? A) Roll toward the left side B) Roll toward the right side C) Trendelenburg position D) Recumbent position RATIONALE:

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