SHADOW HEALTH EXAM (QUESTIONS AND ANSWERS) 2023/2024

SHADOW HEALTH EXAM (QUESTIONS AND ANSWERS) 2023/2024 A brief statement of the reason the patient is seeking health care is called the: - CORRECT ANSWER-chief complaint Which of the following is an "ABCD" characteristic of malignant melanoma? - CORRECT ANSWER-Irregular borders Which question would be considered a "leading question"? - CORRECT ANSWER-"You don't get headaches often, do you?" A flat, nonpalpable lesion is described as a macule if the diameter is: - CORRECT ANSWER-less than 1 cm. When you are questioning a patient regarding alcohol intake, she tells you that she is "only a social drinker." Which initial response is appropriate? - CORRECT ANSWER- "What amount and what kind of alcohol do you drink in a week?" Mrs. Britton is a 34-year-old patient who presents to the office with complaints of skin rashes. You have noted a 3-cm, rough, elevated area of psoriasis. This is an example of a: - CORRECT ANSWER-plaque Painful vesicles are associated with: - CORRECT ANSWER-herpes zoster A 29-year-old white woman appears jaundiced. An etiology of liver disease has been excluded. What history questions should the nurse ask? - CORRECT ANSWERWhether she eats a lot of yellow and orange vegetables. Mr. D. complains of a headache. During the history, he mentions his use of alcohol and illicit drugs. This information would most likely belong in the: - CORRECT ANSWERpersonal and social history. The thyroid gland is partially obscured by the: - CORRECT ANSWERsternocleidomastoid To perform the Rinne test, place the tuning fork on the: - CORRECT ANSWER-mastoid bone. You observe pupillary response as the patient looks at a distant object and then at an object held 10 cm from the bridge of the nose. You are assessing for: - CORRECT ANSWER-accommodation. Normal tympanic membrane color is: - CORRECT ANSWER-pearly gray. Ask the patient to look directly at the light of the ophthalmoscope when you are ready to examine the: - CORRECT ANSWER-macula. According to the AUDIT scale , a person who receives a score of 14 is : - CORRECT ANSWER-Is in the high risk category for alcohol abuse Bulging of an amber tympanic membrane without mobility is most often associated with: - CORRECT ANSWER-middle ear effusion. You ask your patient to perform the DAST questionnaire, and note that he scored a "5". You understand this means: - CORRECT ANSWER-the patient is at high risk for drug abuse After you have the patient complete the AUDIT questionnaire, your tally the score and realize the patient has scored a "9" . Your next communication with the patient should be: - CORRECT ANSWER-I see that you completed the questionnaire, may I discuss the results with you? You are conducting a brief negotiated interview with your young male patient after you have reviewed his AUDIT questionnaire results. You discuss the safe drinking limits per day for his gender . You explain to him that this number is: - CORRECT ANSWER-4 You are discussing the amount of alcohol in different drinks with your patient. You explain to your patient what constitutes a standard drink. You review that 12 oz of regular beer is equal to: - CORRECT ANSWER-5 oz. of table wine With consolidation in the lung tissue, the breath sounds are louder and easier to hear, whereas healthy lung tissue produces softer sounds. This is because: - CORRECT ANSWER-air-filled lung tissue is an insulator of sound The characteristic barrel chest of the older adult is due to a combination of factors including: - CORRECT ANSWER-skeletal changes of aging. You would expect to document the presence of a pleural friction rub for a patient being treated for: - CORRECT ANSWER-pleurisy. Both pleural effusion and lobar pneumonia are characterized by _____ percussion. - CORRECT ANSWER-dullness heard on Mr. L. has cyanotic lips and nail beds. His lips are pursed, and he has nasal flaring. You suspect he is having cardiac or pulmonary difficulty. What additional sign would support this impression? - CORRECT ANSWER-Clubbing of the fingers Breath sounds normally auscultated over most of the lung fields are called: - CORRECT ANSWER-vesicular. To begin counting the ribs and the intercostal spaces, you begin by palpating the reference point of the: - CORRECT ANSWER-manubriosternal junction. Which bronchial structure(s) is(are) most susceptible to aspiration of foreign bodies? - CORRECT ANSWER-Right mainstem bronchus What term would you use to document a respiratory rate greater than 20 breaths per minute in an adult? - CORRECT ANSWER-Tachyapnea The NP would document this assessment finding as: - CORRECT ANSWER-Pectus excavatum What is the correct procedure when percussing the chest? - CORRECT ANSWERPercuss systematically and symmetrically the anterior chest, moving from left to right side, then percuss the posterior chest. On assessment of the client's respiratory status, crepitaiton is felt over the third rib at the midaxillary line on the left side. What is the interpretation of this finding? - CORRECT ANSWER-Air is present in the subcutaneous tissue from an air leak in the respiratory system. Normal physiologic changes in the respiratory system of the geriatric client include an increased rigidity of rib cage and increase in anteroposterior (AP) diameter of the chest. (T/F) - CORRECT ANSWER-true During a new patient physical exam, you are ausculting the lungs and assess a few scattered expiratory wheezes. Which of the following review of system responses by the patient confirm that this is an expected and not unusual finding for this patient. - CORRECT ANSWER-History of asthma since childhood. Your 76 year old male patient's chief complaint today is a productive cough times two weeks. What percussion finding over the posterior chest during your physical exam would lead you to include pneumonia as one of your differential diagnoses? - CORRECT ANSWER-Dullness During your review of system questions for a new patient annual exam, you ask the patient - "Do you ever have shortness of breath or difficulty breathing? If the patient answers yes to this question, what additional questions related to using OLDCART would you need to ask? Mark all that apply. - CORRECT ANSWER-Can you tell me when this started? Is there anything that makes it worse? Is there anything that makes it better? COPD is most commonly caused by: - CORRECT ANSWER-smoking Risk factors for TB include: - CORRECT ANSWER-lower socioeconomic status and crowded conditions Risk factors for pulmonary embolism include: - CORRECT ANSWER-recent pregnancy What should always be considered for a patient with hemoptysis? - CORRECT ANSWER-malignancy The "pacing" structure of the heart's electrical activity is the: - CORRECT ANSWERsinoatrial (SA) node. If pitting edema is unilateral, you would suspect occlusion of a: - CORRECT ANSWERmajor vein Which ECG change would not be expected as an age-related pattern? - CORRECT ANSWER-Ventricular fibrillation The amplitude of pulses is recorded on a(n): - CORRECT ANSWER-numerical scale of 0 to 4. In the adult, the apical impulse should be most visible in a thin person or palpable when the patient is in what position? - CORRECT ANSWER-Upright Electrical activity recorded by the electrocardiogram (ECG) tracing that denotes the spread of the stimulus through the atria is the: - CORRECT ANSWER-P wave. The difference in blood pressure readings between the right and the left arms is considered normal up to _____ mm Hg. - CORRECT ANSWER-10 A patient you are seeing in the emergency department for chest pain is suspected of having a myocardial infarct. During the health history interview of his family history, he relates that his father had died of heart trouble. The most important follow-up question you should pose is which of the following? - CORRECT ANSWER-"What age was your father at the time of his death?" Which arterial pulse is most useful in evaluating heart activity? - CORRECT ANSWERCarotid The term claudication refers to: - CORRECT ANSWER-pain from muscle ischemia. Postural hypotension is defined as a _____ when the patient stands, compared with sitting or supine readings. - CORRECT ANSWER-systolic pressure drop of more than 15 mm Hg with a pulse rate increase Contraction of the ventricles causes: - CORRECT ANSWER-closure of the atrioventricular valves. Which of the following information belongs in the past medical history section related to heart and blood vessel assessment? - CORRECT ANSWER-Previous unexplained fever In which location would carotid bruits best be heard? - CORRECT ANSWER-Anterior margin of the sternocleidomastoid muscle Mr. O., age 50, comes for his yearly health assessment, which is provided by his employer. During your initial history-taking interview, Mr. O. mentions that he routinely engages in light exercise. At this time, you should: - CORRECT ANSWER-have the patient describe his exercise. In which of the following patient populations could a a S3 be considered a normal finding? - CORRECT ANSWER-pregnant female The NP knows that the correct ausculatory site for the aortic area is the: - CORRECT ANSWER-Right second interspace close to the sternum The NP is examining a client with a history of rheumatic fever who is being followed for the development of endocarditis. During the cardiac auscultation, where on the chest wall is the stethoscope placed to determine the most common murmurs associated with this condition? - CORRECT ANSWER-Fifth intercostal space, left side, at the midclavicular line. The NP notes that the patient has lymphadenopathy to the left axillary area. The expected lymph duct that is area will travel to is the: - CORRECT ANSWER-Thoracic duct A third heart sound is created by: - CORRECT ANSWER-diastolic filling. In assessing for potential appendicitis in your patient you perform the following exam. With the patient lying supine, you flex the patient's right leg by bending the knee, as you bring the knee in toward the chest and rotate it inward toward the navel, you stop because of the patient's increased pain. You would chart this as? - CORRECT ANSWER-A positive Psoas sign. Visible intestinal peristalsis may indicate: - CORRECT ANSWER-intestinal obstruction. After thorough inspection of the abdomen, the next assessment step is to: - CORRECT ANSWER-ausculate. Percussion of the abdomen begins with establishing: - CORRECT ANSWER-overall dullness and tympany in all four quadrants