Advanced Health Assessment Exam
A 10-yr-old is on the clinic for "a sore throat lasting 6 days." The nurse is conscious that
which of those findings might be consistent with an acute contamination?
A) Tonsils three+/1-4+ with big white spots
B) Tonsils 1+/1-4+ with pale coloring
C) Tonsils 1+/1-4+ and pink, identical color as oral mucosa
D) Tonsils 2+/1-4+ and purple with white particles inner deep crypts - ANS-A) Tonsils
three+/1-4+ with massive white spots
With an acute contamination, tonsils are vibrant pink and swollen and may have exudate or
massive white spots. Tonsils are enlarged to two+, 3+, or 4+ with an acute contamination.
A 15 month antique is added to you for a fever of a hundred and one F and fussiness. The
ear examination is as follows: external ear - normal look and no tenderness with
manipulation; canal - ordinary diameter with out proof of inflammation; tympanic membrane -
bulging, erythematous, and the mild reflex is dull. Insufflation is deferred due to ache. What
is your diagnosis?
A) ruptured tympanic membrane
B) cholesteatoma
C) otitis media
D) otitis externa - ANS-C) otitis media
Acute otitis media in a symptomatic baby typically has a crimson, bulging tympanic
membrane, with a stupid or absent light reflex.
A 15-12 months-old high school sophomore offers to the emergency room along with his
mother for evaluation of a place of blood inside the left eye. He denies trauma or injury but
has been coughing forcefully with a recent bloodless. He denies visible disturbances, eye
pain, or discharge from the attention. On physical exam, the scholars are identical, spherical,
and reactive to light, with a visible acuity of 20/20 in each eye and 20/20 bilaterally. There is
a homogeneous, sharply demarcated place at the lateral issue of the base of the left eye.
The cornea is obvious. Based on this description, what is the most probable prognosis?
A) Conjunctivitis
B) Acute iritis
C) Corneal abrasion
D) Subconjunctival hemorrhage - ANS-D) Subconjunctival hemorrhage
Leakage of blood outdoor of the vessels, producing a homogenous, sharply demarcated,
crimson area. The student isn't affected, imaginative and prescient isn't affected and the
cornea is obvious. May end result from trauma, bleeding problems, or surprising boom in
venous pressure, as from a cough.
A 27 12 months antique female affected person has 3 furuncles related round a hair follicle.
You use the following time period for your charting:
,A) nodules
B) carbuncle
C) macules
D) bulla - ANS-B) carbuncle
Multiple furuncles around a hair follicle form a carbuncle.
A 29-yr-old physical therapist gives for assessment of an eyelid trouble. On commentary, the
right eyeball appears to be protruding ahead. Based on this description, what's the most
probable diagnosis?
A) Epicanthus
B) Ptosis
C) Exophthalmos
D) Ectropion - ANS-C) Exophthalmos
Eye protrusion (proptosis or exophthalmos)
A 29-year-vintage girl tells the nurse that she has "excruciating ache" in her back. Which of
the following could be the suitable reaction by means of the nurse to her assertion?
A) "How does your circle of relatives react in your pain?"
B) "That have to be horrible. You probable pinched a nerve."
C) "I've had returned ache myself and it can be excruciating."
D) "How would you assert the ache impacts your capacity to do your every day sports?" -
ANS-D) "How could you say the pain impacts your capacity to do your each day activities?"
Inquire approximately the results of ache at the affected person's daily activities, temper,
sleep, work, and sexual activity.
A forty five-yr-old guy is within the health center for a routine bodily. During history the
patient states he has been having issue sleeping. "I'll be snoozing wonderful after which I
awaken and feel like I can't seize my breath." His signs and symptoms indicates sleep
associated symptoms of a sure kind of sickness, so which query would the NP need to ask?
A) Have you had a current sinus contamination or URI?
B) Do you've got any history of problems with your coronary heart?
C) Do you believe you studied it's far because it's been so warm at night time?
D) When turned into your remaining electroencephalogram? - ANS-B) Do you have any
history of troubles with your heart?
Paroxysmal nocturnal dyspnea occurs with heart failure. Lying down increases volume of
intrathoracic blood, and the weakened heart cannot accommodate the accelerated load.
Classically, the individual awakens after 2 hours of sleep, arises, and flings open a window
with the perception of needing fresh air. (Bates, p357)
A 46 12 months antique female affected person is in the sanatorium with a prime grievance
of chest pain. You are wanting to quality apprehend the affected person's perception of the
chest pain. Which fo the following questions would you ask first?
A) How do you price your ache on a scale of zero-10?
B) Is the pain associated with exertion?
, C) Tell me about your chest pain.
D) Are you taking all of your medications? - ANS-C) Tell me about your chest soreness.
Move from open ended to centered questions to allow for the waft of thoughts and mind from
the affected person.
A fifty three-12 months-vintage obese guy is available in for an exam. When he starts
offevolved to sit up, you notice a ridge/bulge vertically just beneath the sternum that resolves
once he sits up. This is most possibly:
A) lipoma
B) diastasis recti
C) a direct hernia
D) an indirect hernia - ANS-B) diastasis recti
A diastasis recti is the separation of the two rectus abdominus muscle groups that happens
while the pinnacle and shoulders are raised in a few sufferers, in particular obese, continual
lung disorder, or after repeated pregnancies (Bates, p499).
A fifty nine 12 months antique sufferers tells the nurse practitioner that he thinks he must
have ulcerative colitis. He has been having "black stools" for the closing 24 hours. How
would the nurse practitioner exceptional document THE FACTS for his cause for looking for
care?
A) JM is a fifty nine year vintage male right here for having "black stools" for the beyond 24
hours.
B) JM came into the health center complaining of black stools for the beyond 24 hours.
C) JM is a 59 12 months old male here for "ulcerative colitis."
D) JM, a 59 12 months old male, states he has ulcerative colitis and needs it checked. -
ANS-A) JM is a fifty nine year antique male here for having "black stools" for the past 24
hours.
Chief Complaint(s) The one or extra signs and symptoms or issues inflicting the patient to
are trying to find care. Make every effort to cite the patient's own phrases.
A seventy two-12 months-antique teacher comes to a professional nursing facility for
rehabilitation after being inside the health center for 6 weeks. She turned into handled for
sepsis and respiratory failure and had to be on a ventilator for three weeks. The nurse is
completing an preliminary evaluation and comparing the customer's skin situation. On her
sacrum there may be full-thickness skin loss that is five cm in diameter with damage to the
subcutaneous tissue. The underlying muscle isn't affected. What is the level of this stress
ulcer?
A) Stage 1
B) Stage 2
C) Stage three
D) Stage 4 - ANS-C) Stage three
A crater seems in the pores and skin, with complete-thickness pores and skin loss and
damage to or necrosis of subcutaneous tissue that may extend to, however now not thru
underlying muscle.
A 10-yr-old is on the clinic for "a sore throat lasting 6 days." The nurse is conscious that
which of those findings might be consistent with an acute contamination?
A) Tonsils three+/1-4+ with big white spots
B) Tonsils 1+/1-4+ with pale coloring
C) Tonsils 1+/1-4+ and pink, identical color as oral mucosa
D) Tonsils 2+/1-4+ and purple with white particles inner deep crypts - ANS-A) Tonsils
three+/1-4+ with massive white spots
With an acute contamination, tonsils are vibrant pink and swollen and may have exudate or
massive white spots. Tonsils are enlarged to two+, 3+, or 4+ with an acute contamination.
A 15 month antique is added to you for a fever of a hundred and one F and fussiness. The
ear examination is as follows: external ear - normal look and no tenderness with
manipulation; canal - ordinary diameter with out proof of inflammation; tympanic membrane -
bulging, erythematous, and the mild reflex is dull. Insufflation is deferred due to ache. What
is your diagnosis?
A) ruptured tympanic membrane
B) cholesteatoma
C) otitis media
D) otitis externa - ANS-C) otitis media
Acute otitis media in a symptomatic baby typically has a crimson, bulging tympanic
membrane, with a stupid or absent light reflex.
A 15-12 months-old high school sophomore offers to the emergency room along with his
mother for evaluation of a place of blood inside the left eye. He denies trauma or injury but
has been coughing forcefully with a recent bloodless. He denies visible disturbances, eye
pain, or discharge from the attention. On physical exam, the scholars are identical, spherical,
and reactive to light, with a visible acuity of 20/20 in each eye and 20/20 bilaterally. There is
a homogeneous, sharply demarcated place at the lateral issue of the base of the left eye.
The cornea is obvious. Based on this description, what is the most probable prognosis?
A) Conjunctivitis
B) Acute iritis
C) Corneal abrasion
D) Subconjunctival hemorrhage - ANS-D) Subconjunctival hemorrhage
Leakage of blood outdoor of the vessels, producing a homogenous, sharply demarcated,
crimson area. The student isn't affected, imaginative and prescient isn't affected and the
cornea is obvious. May end result from trauma, bleeding problems, or surprising boom in
venous pressure, as from a cough.
A 27 12 months antique female affected person has 3 furuncles related round a hair follicle.
You use the following time period for your charting:
,A) nodules
B) carbuncle
C) macules
D) bulla - ANS-B) carbuncle
Multiple furuncles around a hair follicle form a carbuncle.
A 29-yr-old physical therapist gives for assessment of an eyelid trouble. On commentary, the
right eyeball appears to be protruding ahead. Based on this description, what's the most
probable diagnosis?
A) Epicanthus
B) Ptosis
C) Exophthalmos
D) Ectropion - ANS-C) Exophthalmos
Eye protrusion (proptosis or exophthalmos)
A 29-year-vintage girl tells the nurse that she has "excruciating ache" in her back. Which of
the following could be the suitable reaction by means of the nurse to her assertion?
A) "How does your circle of relatives react in your pain?"
B) "That have to be horrible. You probable pinched a nerve."
C) "I've had returned ache myself and it can be excruciating."
D) "How would you assert the ache impacts your capacity to do your every day sports?" -
ANS-D) "How could you say the pain impacts your capacity to do your each day activities?"
Inquire approximately the results of ache at the affected person's daily activities, temper,
sleep, work, and sexual activity.
A forty five-yr-old guy is within the health center for a routine bodily. During history the
patient states he has been having issue sleeping. "I'll be snoozing wonderful after which I
awaken and feel like I can't seize my breath." His signs and symptoms indicates sleep
associated symptoms of a sure kind of sickness, so which query would the NP need to ask?
A) Have you had a current sinus contamination or URI?
B) Do you've got any history of problems with your coronary heart?
C) Do you believe you studied it's far because it's been so warm at night time?
D) When turned into your remaining electroencephalogram? - ANS-B) Do you have any
history of troubles with your heart?
Paroxysmal nocturnal dyspnea occurs with heart failure. Lying down increases volume of
intrathoracic blood, and the weakened heart cannot accommodate the accelerated load.
Classically, the individual awakens after 2 hours of sleep, arises, and flings open a window
with the perception of needing fresh air. (Bates, p357)
A 46 12 months antique female affected person is in the sanatorium with a prime grievance
of chest pain. You are wanting to quality apprehend the affected person's perception of the
chest pain. Which fo the following questions would you ask first?
A) How do you price your ache on a scale of zero-10?
B) Is the pain associated with exertion?
, C) Tell me about your chest pain.
D) Are you taking all of your medications? - ANS-C) Tell me about your chest soreness.
Move from open ended to centered questions to allow for the waft of thoughts and mind from
the affected person.
A fifty three-12 months-vintage obese guy is available in for an exam. When he starts
offevolved to sit up, you notice a ridge/bulge vertically just beneath the sternum that resolves
once he sits up. This is most possibly:
A) lipoma
B) diastasis recti
C) a direct hernia
D) an indirect hernia - ANS-B) diastasis recti
A diastasis recti is the separation of the two rectus abdominus muscle groups that happens
while the pinnacle and shoulders are raised in a few sufferers, in particular obese, continual
lung disorder, or after repeated pregnancies (Bates, p499).
A fifty nine 12 months antique sufferers tells the nurse practitioner that he thinks he must
have ulcerative colitis. He has been having "black stools" for the closing 24 hours. How
would the nurse practitioner exceptional document THE FACTS for his cause for looking for
care?
A) JM is a fifty nine year vintage male right here for having "black stools" for the beyond 24
hours.
B) JM came into the health center complaining of black stools for the beyond 24 hours.
C) JM is a 59 12 months old male here for "ulcerative colitis."
D) JM, a 59 12 months old male, states he has ulcerative colitis and needs it checked. -
ANS-A) JM is a fifty nine year antique male here for having "black stools" for the past 24
hours.
Chief Complaint(s) The one or extra signs and symptoms or issues inflicting the patient to
are trying to find care. Make every effort to cite the patient's own phrases.
A seventy two-12 months-antique teacher comes to a professional nursing facility for
rehabilitation after being inside the health center for 6 weeks. She turned into handled for
sepsis and respiratory failure and had to be on a ventilator for three weeks. The nurse is
completing an preliminary evaluation and comparing the customer's skin situation. On her
sacrum there may be full-thickness skin loss that is five cm in diameter with damage to the
subcutaneous tissue. The underlying muscle isn't affected. What is the level of this stress
ulcer?
A) Stage 1
B) Stage 2
C) Stage three
D) Stage 4 - ANS-C) Stage three
A crater seems in the pores and skin, with complete-thickness pores and skin loss and
damage to or necrosis of subcutaneous tissue that may extend to, however now not thru
underlying muscle.
