NR 509 week 2 Quiz questions and answers (New 2021/2022). Graded A+

NR 509 week 2 Quiz questions and answers (New 2021/2022). Graded A+ Document Content and Description Below NR 509 week 2 Quiz questions and answers (New 2021/2022) When performing a physical assessment, the first technique the nurse will always use A. Palpation B. Inspection C. Percussion D. Ausculta tion Correct Answer- B. Inspection The nurse is preparing to perform a physical assessment. Which statement is true about the physical assessment? The inspection phase: A. Usually yields little information B. Takes time and reveals a surprising amount of information C. May be somewhat uncomfortable for the expert practitioner D. Requires a quick glance at the patient's body systems before proceeding with palpation Correct Answer- B. Takes time and reveals a surprising amount of information The nurse is assessing a patient's skin during an office visit. What part of the hand and technique should be used to best assess the patient's skin temperature? A. Fingertips; they are more sensitive to small changes in temperature B. Dorsal surface of the hand; the skin is thinner on this surface than on the palms C. Ulnar portion of the hand, increased blood supply in this area enhances temperature sensitivity D. Palmar surface of the hand; this surface is the most sensitive to temperature variations because of its increased nerve supply in this area. Correct Answer- B. Dorsal surface of the hand; the skin is thinner on this surface than on the palms Which of these techniques uses the sense of touch to assess texture, temperature, moisture, and swelling when the nurse is assessing a patient? A. Palpation B. Inspection C. PercussionD. Auscultation Correct Answer- A. Palpation The nurse is preparing to assess a patient's abdomen by palpation. How should the nurse proceed? A. Palpation of reportedly tender areas are avoided because palpation in these areas may cause pain B. Palpating a tender area is quickly performed to avoid any discomfort that the patient may experience C. The assessment begins with deep palpation, while encouraging the patient to relax and to take deep breaths. D. The assessment begins with light palpation to detect surface characteristics and to accustom the patient to being touched. Correct Answer- D. The assessment begins with light palpation to detect surface characteristics and to accustom the patient to being touched. The nurse would use bimanual palpation technique in which situation? A. Palpating the thorax of an infant B. Palpating the kidneys and the uterus C. Assessing pulsations and vibrations D. Assessing the presence of tenderness and pain Correct Answer- B. Palpating the kidneys and the uterus The nurse is preparing to percuss the abdomen of a patient. The purpose of the percussion is to assess the ___________ of the underlying tissue. A. Turgor B. Texture C. Density D. Consistency Correct Answer- C. Density The nurse is reviewing percussion techniques with a newly graduated nurse. Which technique, if used by the new nurse, indicates that more review is needed? A. Percussing once over each area B. Quickly lifting be striking finger after each stroke C. Striking with the fingertip, not the finger pad D. Using the wrist to make the strikes, not the arm Correct Answer- A. Percussing once over each areaWhen percussing over the liver of a patient, the nurse notices a dull sound. The nurse should: A. Consider this a normal finding B. Palpate this area for an underlying mass C. Reposition the hands, and attempt to percuss in this area again D. Consider this finding abnormal, and refer the patient for additional treatment Correct Answer- A. Consider this a normal finding The nurse is unable to identify any changes in sound when percussing over the abdomen of an obese patient. What should the nurse do next? A. Ask the patient to take deep breaths to relax the abdominal musculature B. Consider this finding as normal and proceed with the abdominal assessment C. Increase the amount of strength used when attempting to percuss over the abdomen D. Decrease the amount of strength used when attempting to percuss over the abdomen. Correct Answer- C. Increase the amount of strength used when attempting to percuss over the abdomen The nurse hears bilateral loud, long and low tones when percussing over the lungs of a 4 year old child. The nurse should A. Palpate over the area for increased pain and tenderness B. Ask the child to take shallow breaths and percuss over the area again C. Immediately refer the child because of an increased amount of air in the lungs D. Consider this finding as normal for a child this age and proceed with the examination Correct AnswerD. Consider this finding as normal for a child this age and proceed with the examination A patient has suddenly developed shortness of breath and appears to be insignificant respiratory distress. After calling the position and placing the patient on oxygen, which of these actions is the best for the nurse to take went further assisting this patient? A. Count the patient's respirations B. Bilaterally percuss the thorax, noting any differences in percussion tones C. Call for a chest x-ray study and wait for the results before beginning an assessment D. Inspect the thorax for any new masses and bleeding associated with respirations Correct Answer- B. Bilaterally percuss the thorax, noting any differences in percussion tonesThe nurse is teaching a class on basic assessment skills. Which of these statements is true regarding the stethoscope and its use? A. Slope of the earpieces should point posteriorly (toward to occiput) B. Although the stethoscope does not magnify sound, it does block out extraneous room noise C. Fit and quality of the stethoscope are not as important as its ability to magnify sound D. Ideal tubing length should be 22 inches to dampen the distortion of sound Correct Answer- B. Although the stethoscope does not magnify sound, it does block out extraneous room noise The nurse is preparing to use a stethoscope for auscultation. Which statement is true regarding the diaphragm of the stethoscope? The diaphragm: A. Is used to listen for high-pitched sounds B. Is used to listen for low-pitched sounds C. Should be lightly held against the persons skin to block out low-pitched sounds D. Should be lightly held again the person skin to listen for extra heart sounds and murmurs Correct Answer- A. Is used to listen for high-pitched sounds Before auscultating the abdomen for the presence of bowel sounds on a patient, the nurse should: A. Warm the endpiece of the stethoscope by placing it in warm water B. Leave the gown on the patient to ensure that she or he does not get chilled during the examination C. Ensure that the bell side of the stethoscope is turned to the on position D. Check the temperature of the room and offer blankets to the patient if she or he feels cold. Correct Answer- D. Check the temperature of the room and offer blankets to the patient if she or he feels cold. The nurse will use which technique of assessment to determine the presence of crepitus, swelling and pulsations? A. Palpation B. Inspection C. Percussion D. Auscultation Correct Answer- A. PalpationThe nurse is preparing to use an otoscope for an examination. Which statement is true regarding the otoscope? The otoscope: A. Is often used to direct light onto the sinuses B. Uses a short, broad speculum to help visualize the ear C. Is used to examine the structures of the internal ear D. Directs light into the ear canal and onto the tympanic membrane Correct Answer- D. Directs light into the ear canal and onto the tympanic membrane An examiner is using an ophthalmoscope to examine a patient's eyes. The patient has astigmatism and is nearsighted. The use of which of these techniques would indicate that the examination is being correctly performed? A. Using the large full circle of light when assessing pupils that are not dilated B. Rotating the lens selector dial to the black numbers to compensate for astigmatism C. Using the grid on the lens aperture to visualize the external structures of the eye D. Rotating the lens selector dial to bring the object into focus Correct Answer- D. Rotating the lens selector dial to bring the object into focus The nurse is unable to palpate the right radial pulse on a patient. The best action would be to: A. Auscultate over the area with a fetoscope B. Use a goniometer to measure the pulsations C. Use a Doppler device to check for pulsations over the area D. Check for the presence of pulsations with a stethoscope Correct Answer- C. Use a Doppler device to check for pulsations over the area The nurse is preparing to perform a physical assessment. The correct action by the nurse is reflected by which statement? The nurse: A. Performs the examination from the left side of the bed B. Examines the tender of painful areas first to help relieve the patient's anxiety C. Follows the same examination sequence, regardless of the patients age or condition D. Organizes the assessment to ensure that the patient does not change positions too often Correct Answer- D. Organizes the assessment to ensure that the patient does not change positions too oftenA man is at the clinic for a physical examination. He states that he is very anxious about the physical examination. What steps can the nurse take to make him more comfortable? A. Appear unhurried and confident when examining him B. Stay in the room when he undresses in case he needs assistance C. Ask him to change into an examination gown to take off his undergarments D. Defer measuring vital signs until the end of the examination which allows him time to become comfortable Correct Answer- A. Appear unhurried and confident when examining him When performing a physical examination, safety must be considered to protect the examiner in the patient against the spread of the infection. Which of these statements describes the most appropriate action the nurse should take when performing a physical examination ? A. Washing one's hands after removing gloves is not necessary, as long as the gloves are still intact B. Hands are washed before and after every physical patient encounter C. Hands are washed before the examination of each body system to prevent the spirit of bacteria from one part of the body to another D. Gloves are worn throughout the entire examination to demonstrate to the patient concern regarding the spread of infectious disease Correct Answer- B. Hands are washed before and after every physical patient encounter The nurses examining a patient lower leg and notices a training ulceration. Which of these actions is most appropriate in this situation? A. Washing hands and contacting the physician B. Continuing to examine the ulceration, and then washing hands C. Washing hands, putting on gloves, and continuing with the examination of the ulceration D. Washing hands, proceeding with the rest of the physical examination, and then continuing with the examination of the leg ulceration Correct Answer- C. Washing hands, putting on gloves, and continuing with the examination of the ulceration During the examination offering some brief teaching about the patient's body or examiners finding is often appropriate. Which one of these statements by the nurse is most appropriate? A. Your atrial dysrhythmias are under control B. You have pitting edema and mild varicosities C. Your pulse is 80 beats per minute which is within the normal rangeD. I am using my stethoscope to listen for any crackles, wheezes or rubs Correct Answer- C. Your pulse is 80 beats per minute which is within the normal range The nurse keeps in mind that the most important reason to share information and to offer brief teaching while performing be physical examination is to help the: A. Examiner feel more comfortable and to gain control of the situation B. Examiner to build rapport and to increase patient's confidence in him or her C. Patient understand his or her disease process and treatment modalities D. Patient identify questions about his or her disease and the potential areas of patient education Correct Answer- B. Examiner to build rapport and to increase patient's confidence in him or her The nurses examining an infant and prepares to elicit the Moro reflex at which time during the examination? A. When the infant is sleeping B. At the end of the examination C. Before auscultation of the thorax D. Halfway through the examination Correct Answer- B. At the end of the examination When preparing to perform a physical examination of the infant, the nurse should: A. Have the parent remove all clothing except the diaper on a boy. B. Instructed the parent to feed the infant immediately before the examination C. Encourage the infant to suck on a pacifier during the abdominal examination D. Ask the parents to leave the room briefly when assessing be infants' vital signs Correct Answer- A. Have the parent remove all clothing except the diaper on a boy. A 6-month-old infant has been brought to the well child clinic for a checkup. she is currently sleeping. What should the nurse do first when beginning the examination? A. Auscultate the lungs and heart while the infant is sleeping B. Examine the instance hips, because this procedure is uncomfortable C. Begin with the assessment of the eye, and continue with the remainder of the examination in a head to toe approachD. Wake the infant before beginning any portion of the examination to obtain the most accurate assessment of body systems Correct Answer- A. Auscultate the lungs and heart while the infant is sleeping A 2-year-old child has been brought to the clinic for a well child checkup. the best way for the nurse to begin the assessment is to: A. Ask the parent to place the child on the examining table B. Happy parents remove all of the child's clothing before the examination C. Allow the child to keep a security object such as a toy or blanket during the examination D. Initially focus the interactions on the child, essentially ignoring the parent until the child's trust has been obtained Correct Answer- C. Allow the child to keep a security object such as a toy or blanket during the examination The nurses examining a 2-year-old child and asks may I listen to your heart now? Which critique of the nurse's technique is most accurate A. Asking questions enhances the child autonomy B. Asking the child for permission helps develop a sense of trust C. This question is inappropriate statement because children at this age like to have choices D. Children at this age like to say no. the examiner should not offer a choice when no choice is available Correct Answer- D. Children at this age like to say no. the examiner should not offer a choice when no choice is available With which of these patients would it be most appropriate for the nurse to use games during the assessment, such as having the patient blow out the light on a pen light? A. Infant B. Preschool child C. School age child D. Adolescent Correct Answer- B. Preschool child The nurse is preparing to examine a 4-year-old child. which action is appropriate for this age group? A. Explain the procedures in detail to alleviate the child anxiety B. Give the child feedback and reassurance during the examinationC. Do not ask the child to remove his or her clothes because children at this age are usually very private D. Perform an examination of the ear, nose, and throat first, and then examine the thorax and abdomen Correct Answer- B. Give the child feedback and reassurance during the examination When examining a 16-year-old male teenager, the nurse should: A. Discuss health teaching with the parent because the team is unlikely to be interested in promoting wellness B. Ask his parents to stay in the room during the history and physical examination to answer any questions and to alleviate his anxiety C. Talk to him the same manner as one would talk to a younger child because 18 level of understanding may not match his or her speech D. Provide feedback that his body is developing normally, and discuss the wide variation among teenagers on the rate of growth and development Correct Answer- D. Provide feedback that his body is developing normally, and discuss the wide variation among teenagers on the rate of growth and development When examining an older adult, the nurse should use which technique? A. Avoid touching the patient too much B. Attempt to perform the entire physical examination during one visit C. Speak loudly and slowly because most aging adults have hearing deficits D. The range the sequence of the examination to allow as few position changes as possible Correct Answer- D. The range the sequence of the examination to allow as few position changes as possible The most important step that the nurse can take to prevent the transmission of microorganisms in the hospital setting is too: A. Wear protective eyewear at all times B. Wear gloves during any and all contact with patients C. Wash hands before and after contact with each patient D. Clean the stethoscope with an alcohol swab between patients Correct Answer- C. Wash hands before and after contact with each patient Which of the statements is true regarding the use of standard precautions in the health care setting?A. Standard precautions apply to all body fluids, including sweat B. Use alcohol-based hand rub is the hands are visibly dirty C. Standard precautions are intended for use with all patients, regardless of their risk or presumed infection status D. Standard precautions are to be used only when non-intact skin, excretions containing visible blood, or expected contact with mucus membranes is present Correct Answer- C. Standard precautions are intended for use with all patients, regardless of their risk or presumed infection status The nurse is preparing to assess a hospitalized patient who is experiencing significant shortness of breath. How should the nurse proceed with the assessment? A. Be patient should lie down to obtain an accurate cardiac, respiratory, and abdominal assessment B. A thorough history and physical assessment information should be obtained from the patient's family member C. A complete history and physical assessment should be immediately performed to obtain baseline information D. Body areas appropriate to the problem should be examined and then the assessment completed after the problem has resolved Correct Answer- D. Body areas appropriate to the problem should be examined and then the assessment completed after the problem has resolved When examining an instant, the nurse should examine which area first? A. Ear B. Nose C. Throat D. Abdomen Correct Answer- D. Abdomen While auscultating heart sounds, the nurse here is a murmur. Which of these instruments should be used to assess this murmur? A. Electrocardiogram B. Bell of the stethoscope C. Diaphragm of the stethoscope D. Palpation with the nurse is palm of the hand Correct Answer- B. Bell of the stethoscopeDuring an examination of a patient abdomen, the nurse notes that the abdomen is rounded and firm to the touch period during percussion, the nurse notes a drum like quality of the sounds across the quadrants. this type of sound indicates: A. Constipation B. Air filled areas C. Presence of a tumor D. Presence of dense organs Correct Answer- B. Air filled areas The nurse is preparing to examine a 6-year-old child. which action is the most appropriate? A. The thorax, abdomen, and genitalia are examined before the head B. Talking about the equipment being used is avoided because doing so may increase the child anxiety C. The nurse should keep in mind that a child at this age will have a sense of modesty D. The child is asked to undress from the waist up Correct Answer- C. The nurse should keep in mind that a child at this age will have a sense of modesty During auscultation of a patient's heart sounds, the nurse here's an unfamiliar sound. the nurse should: A. Document the findings in the patients record B. Wait 10 minutes, and auscultate the sound again C. Ask the patient hell he or she is feeling D. Ask another nurse to double check the finding Correct Answer- D. Ask another nurse to double check the finding The nurse is preparing to palpate the thorax and abdomen of a patient. which of these statements describes the correct technique for this procedure? select all that apply A. Warm the hands before touching be patient B. For deep palpation, use one long continuous palpation when assessing the liver C. Start with light palpation to detect surface characteristics D. Use the fingertip to examine skin texture, swelling, pulsation, and presence of lumps E. Identify any tender areas and palpate them last F. Use the palms of the hands to assess temperature of the skin Correct Answer- Answer A,C,D,EThe nurse is performing a general survey period which action is a component of the general survey? A. Observing the patient's body stature and nutritional status B. Interpreting the subjective information, the patient has reported C. Measuring the patient's temperature, pulse, respirations, and blood pressure D. Observing specific body systems while performing the physical assessment Correct Answer- A. Observing the patient's body stature and nutritional status When measuring a patients wait, the nurse is aware of which of these guidelines? A. Be patient is always weighed wearing only his or her undergarments B. The type of scale does not matter, as long as the weights are similar from day to day C. Be patient may leave on his or her jacket and shoes as long as these are documented next to the weight D. In temp should be made to weigh the patient at approximately the same time of day, if a sequence of weight is necessary Correct Answer- D. In temp should be made to weigh the patient at approximately the same time of day, if a sequence of weight is necessary A patient's weekly blood pressure readings for 2 months have ranged between 124/84 mmHg and 138/88 mmHg, with an average reading of 126/86 mmHg. The nurse knows that this blood pressure falls within which blood pressure category? A. Normal blood pressure B. Prehypertension C. Stage 1 hypertension D. Stage 2 hypertension Correct Answer- B. Prehypertension During an examination of a child, the nurse considers that physical growth is the best index of a child's : A. general Health B. genetic makeup C. Nutritional status D. Activity and exercise patterns Correct Answer- A. general HealthA one-month old infant has a head measurement of 34 centimeters and has a chest circumference of 32 centimeters. Based on the interpretation of these findings, the nurse would: A. Refer the infant to a physician for further evaluations B. Consider these findings normal for a one-month old infant C. Expect the chest circumference to be greater than the head circumference D. Ask the parent to return in 2 weeks to reevaluate the head and chest circumferences Correct AnswerB. Consider these findings normal for a one-month old infant The nurse is assessing and 80-year-old male patient. which assessment findings would be considered normal? A. Increase in body weight from his younger years B. Additional deposits at sat on the thighs and lower legs C. Presence of kyphosis and flexion in the knees and hips D. Change and overall body proportion, Including a longer trunk and shorter extremities Correct AnswerC. Presence of kyphosis and flexion in the knees and hips The nurse should measure rectal temperatures in which of these patients? A. School age child B. Older adult C. Comatose adult D. Patient receiving oxygen my nasal cannula Correct Answer- C. Comatose adult The nurse is preparing to measure the length, wait, just, and head circumference of a 6 month old infant. Which measurement technique is correct? A. Measuring the infants linked by using a tape measure B. Weighing the infant by placing him or her on an electronic standing scale C. Measuring the chest circumference at the nipple line with a tape measure D. Measuring the head circumference by wrapping the tape measure over the nose and cheekbones Correct Answer- C. Measuring the chest circumference at the nipple line with a tape measure The nurse knows that one advantage of the tympanic membrane thermometer is that:A. Rapid measurement is useful for uncooperative young children B. Using the TMT is the most accurate method for measuring body temperature in newborn infants C. Measuring temperature using the TMT is inexpensive D. Studies strongly supports the use of TMT in children under the age of 6 years Correct Answer- A. Rapid measurement is useful for uncooperative young children When assessing an older adult, which vital signs changes occur with aging? A. Increase in pulse rate B. Widened pulse pressure C. Increase in body temperature D. Decrease in diastolic blood pressure Correct Answer- B. Widened pulse pressure The nurses examining a patient who is complaining of feeling cold. Which is a mechanism of heat loss in the body? A. Exercise B. Radiation C. Metabolism D. Food digestion Correct Answer- B. Radiation When measuring a patient's body temperature, the nurse keeps in mind that the body temperature is influenced by : A. Constipation B. Patients emotional state C. Diurnal cycle D. Nocturnal Cycle Correct Answer- C. Diurnal cycle When evaluating the temperature of older adults, the nurse should remember which aspect about an older adult's body temperature? A. The body temperature of the older adult is lower than that is a younger adult B. In older adults, body temperature is approximately the same as that of a young childC. Body temperature depends on the type of thermometer used D. In the older adult the body temperature varies widely because of less effective heat control mechanisms Correct Answer- A. The body temperature of the older adult is lower than that is a younger adult A 60-year-old male patient has been treated for pneumonia for the past 6 weeks. he is seen today in the clinic for an unexplained weight loss of 10 pounds over the last 6 weeks. the nurse knows that: A. Weight loss is probably the result of unhealthy eating habits B. Chronic diseases such as hypertension cause weight loss C. Unexplained weight loss often accompanies short term illnesses D. Weight loss is probably the result of a mental health dysfunction Correct Answer- C. Unexplained weight loss often accompanies short term illnesses When assessing a 75 year old patient who has asthma, the nurse notes that he assumes a tripod position, leaning forward with arms braced on the chair. on the basis of this observation, the nurse should: A. Assume that the patient is eager and interested in participating in the interview B. Evaluate the patient for abdominal pain, which may be exacerbated in the sitting position C. Assume that the patient is having difficulty breathing and assist him to a supine position D. Recognize that a tripod position is often used when a patient is having respiratory difficulties Correct Answer- D. Recognize that a tripod position is often used when a patient is having respiratory difficulties which of these actions illustrates the correct technique the nurse should use when assessing oral temperature with a mercury thermometer? A. Wait 30 minutes if the patient has ingested hot or iced liquids B. Leave the thermometer in place for 3 to 4 minutes if the patient is afebrile C. Place the thermometer in front of the tongue and ask the patient to close his or her lips D. Check the Mercury in glass thermometer down to below 36.6 C before taking the temperature Correct Answer- B. Leave the thermometer in place for 3 to 4 minutes if the patient is afebrile The nurse is taking temperatures in a clinic with a TMT. Which statement is true regarding the use of the TMT?A. A tympanic temperature is more time consuming than a rectal temperature B. The tympanic method is more invasive and uncomfortable than the oral method C. The risk of cross-contamination is reduced, compared to the rectal route D. The tympanic membrane most accurately reflects the temperature in the ophthalmic artery Correct Answer- C. The risk of cross-contamination is reduced, compared to the rectal route To assess a rectal temperature accurately in an adult, the nurse would: A. Use a lubricated blunt tip thermometer B. Insert the thermometer 2 to 3 inches into the rectum C. Read the thermometer in place of up to 8 minutes if the patient is febrile D. Wait 2 to 3 minutes if the patient has recently smoked a cigarette Correct Answer- A. Use a lubricated blunt tip thermometer Which technique is correct when the nurse is assessing the radial pulse of a patient? The post is counted for: A. One minute if the rhythm is irregular B. 15 seconds and then multiplied by 4 if the rhythm is regular C. 2 full minutes to detect any variation in amplitude D. 10 seconds and then multiplied by 6, if the patient has no history of cardiac abnormalities Correct Answer- A. One minute if the rhythm is irregular When assessing a patient's pulse comment the nurse should also notice which of these characteristics? A. Force B. Pallor C. Capillary refill time D. Timing in the cardiac cycle Correct Answer- A. Force When assessing the pulse of a 6-year-old boy, the nurse notices that his heart rate varies with his respiratory cycle, speeding up at the peak of inspiration and slowing to normal with expiration. the nurses next action would be to: A. Notify the physician immediatelyB. Consider this finding normal in children and young adults C. Check the child's blood pressure, and note any variation with respiration D. Document that this child has bradycardia and continue with the assessment Correct Answer- B. Consider this finding normal in children a