NUR 3306 FINAL GUIDE QUIZZES 5-11 2024/2025 COMPLETE
QUESTIONS WITH CORRECT ANSWERS GUARANTEED PASS |
RATED A+
When percussing the scapula of a client, which of the following would the nurse expect to
hear? - Answer>>> CorrectC. Flatness
Response Feedback:
Normally, percussion over the scapula elicits flat tones. Resonance is heard over the normal lung
tissue. Dullness is heard when fluid or solid tissue replaces air in the lung. Hyperresonance is
elicited in cases of trapped air, such as in emphysema or pneumothorax.
A client with an acute appendicitis is ordered a barium enema. What should the nurse do
first? - Answer>>> Correct
Question the order because you thought a barium enema was contraindicated in cases like this.
The nurse is assessing a client and notes dullness to percussion in the lowest point of the
abdomen. When rolling the client to the left, the nurse notes that there is now dullness on the left
side. This indicates ascites, which can be caused by - Answer>>> CorrectA.
Cirrhosis and nephrosis
D.
Congestive heart failure and coronary artery disease
Response Feedback:
Ascites is the accumulation of fluid in the abdomen. The fluid descends with gravity, resulting in
dullness to percussion in the lowest point of the abdomen based on client position. Changing the
client's position should move the fluid shift to the most dependent point. Ascites occurs in
cirrhosis of the liver, congestive heart failure, nephrosis, peritonitis, and metastatic neoplasms.
The other options are distracters to the question.
Why is the appearance of urine important to evaluate during an abdominal exam? -
Answer>>> Correct
Dark urine could indicate dehydration.
When assessing the extremities of a client, the nurse notes muscle atrophy. What does the
nurse know may be the cause? - Answer>>> CorrectB.
Peripheral arterial disease
Response Feedback:
Peripheral arterial disease may result in muscle atrophy. Hypertrophy may result from activity in
which the patient uses one arm more than the other, such as tennis. Muscle atrophy is not caused
by chronic lymphedema, venous insufficiency, or arterial aneurysm.
,When assessing cranial nerves IX and X, which of the following would the nurse consider asan
abnormal finding? - Answer>>> CorrectD.
Impaired swallowing.
Response Feedback:
Normal findings associated with testing cranial never IX and cranial nerve X include a uvula and
soft palate rising bilaterally and symmetrically on phonation. A stationary or asymmetrical soft
palate or deviation of the uvula would be considered an abnormal finding.
The nurse is assessing balance. Which test would the nurse plan on omitting from the exam?
Answer>>> CorrectC.
Achilles reflexes
During the assessment of deep tendon reflexes, the nurse finds that a patient's responses are
bilaterally normal. What number is used to indicate normal deep tendon reflexes when the
documenting this finding? + - Answer>>> 2
The nurse is testing the function of CN XI. Which statement best describes the response the
nurse should expect if this nerve is intact? The patient: - Answer>>> Correct
Moves the head and shoulders against resistance with equal strength.
A nurse is preparing to assess a client's cerebellar function. Which of the following would the
nurse expect to test? - Answer>>> CorrectD.
Balance
Response Feedback:
Balance and coordination are functions of the pyramidal and extrapyramidal tracts of the motor
and cerebellar systems. Remote memory and mental status exam provide information about the
client's cognitive ability. Testing for sensation would address issues with specific cranial nerves
or problems involving the parietal lobe.
Which of the following tests would be most appropriate for the nurse to use when assessing
motor function of the trigeminal nerve? - Answer>>> CorrectB.
Palpate the temporal and masseter muscles while the client clenches teeth
Response Feedback:
To test the motor function of the trigeminal nerve (CN V), the nurse would ask the client to
clench the teeth and palpate the temporal and masseter muscles for contraction. Touching the
client's face for dullness or sharp sensations tests the sensory function of the trigeminal nerve.
Having the client frown, smile, and wrinkle the forehead tests the motor function of the facial
nerve (CN VI). Assessing pupillary dilation tests the oculomotor (CN III) nerve.
The wife of a 65-year-old man tells the nurse that she is concerned because she has noticed a
change in her husband's personality and ability to understand. He also cries very easily and
, becomes angry. The nurse recalls that the cerebral lobe responsible for these behaviors is the
lobe. - Answer>>> Frontal
Which of the following assessment findings would lead the nurse to suspect that a client has
Bell's palsy? - Answer>>> CorrectC.
Inability to wrinkle the forehead
Response Feedback:
Inability to close eyes, wrinkle forehead, or raise the forehead, along with paralysis of the lower
part of the face on the affected side, is seen with Bell's palsy. Inability to detect sharp and dull
stimuli is associated with lesions of the trigeminal nerve (CN V). Closure of the affected eye
from swelling would suggest trauma. Paralysis, not muscle spasm, occurs with Bell's palsy.
During the taking of the health history, a patient tells the nurse that "it feels like the room is
spinning around me." The nurse would document this finding as: - Answer>>> Vertigo
When the nurse asks a 68-year-old patient to stand with his feet together and arms at his side
with his eyes closed, he starts to sway and moves his feet farther apart. The nurse would
document this finding as: - Answer>>> CorrectB.
Positive Romberg sign
A client presents to the emergency department after falling off a ladder while doing some
outside painting at home. The client's ankle appears swollen, out of alignment, and is painful to
touch. What is the nurse's first action? - Answer>>> CorrectC. Check for a pulse, color,
temperature, and capillary refill.
Response Feedback:
The first nursing actions include taking vital signs, monitoring pulses, and assessing color,
temperature, and capillary refill distal to the injury to evaluate tissue perfusion. The ankle should
then be immobilized after assessment. An ice pack may be applied after assessing for
temperature and pulses, etc. The first action is no weight bearing until the ankle is fully assessed.
The nurse is assessing the musculoskeletal system of a teenage boy for participation in
athletics. The nurse would expect to find that this client's bones are what as compared to a
female of the same age? - Answer>>> CorrectB. Larger and stronger
Response Feedback:
Gender affects the skeletal system. Males have larger and stronger bones than women; therefore,
males are less prone to problems related to osteoporosis. Male bones are not the same as female
bones; they are not necessarily longer and they do not have a greater curvature.
A client is thought to have a balance problem. What would be an advanced method of
assessing balance in this client? (Mark all that apply.) - Answer>>> CorrectC.
Romberg's test
QUESTIONS WITH CORRECT ANSWERS GUARANTEED PASS |
RATED A+
When percussing the scapula of a client, which of the following would the nurse expect to
hear? - Answer>>> CorrectC. Flatness
Response Feedback:
Normally, percussion over the scapula elicits flat tones. Resonance is heard over the normal lung
tissue. Dullness is heard when fluid or solid tissue replaces air in the lung. Hyperresonance is
elicited in cases of trapped air, such as in emphysema or pneumothorax.
A client with an acute appendicitis is ordered a barium enema. What should the nurse do
first? - Answer>>> Correct
Question the order because you thought a barium enema was contraindicated in cases like this.
The nurse is assessing a client and notes dullness to percussion in the lowest point of the
abdomen. When rolling the client to the left, the nurse notes that there is now dullness on the left
side. This indicates ascites, which can be caused by - Answer>>> CorrectA.
Cirrhosis and nephrosis
D.
Congestive heart failure and coronary artery disease
Response Feedback:
Ascites is the accumulation of fluid in the abdomen. The fluid descends with gravity, resulting in
dullness to percussion in the lowest point of the abdomen based on client position. Changing the
client's position should move the fluid shift to the most dependent point. Ascites occurs in
cirrhosis of the liver, congestive heart failure, nephrosis, peritonitis, and metastatic neoplasms.
The other options are distracters to the question.
Why is the appearance of urine important to evaluate during an abdominal exam? -
Answer>>> Correct
Dark urine could indicate dehydration.
When assessing the extremities of a client, the nurse notes muscle atrophy. What does the
nurse know may be the cause? - Answer>>> CorrectB.
Peripheral arterial disease
Response Feedback:
Peripheral arterial disease may result in muscle atrophy. Hypertrophy may result from activity in
which the patient uses one arm more than the other, such as tennis. Muscle atrophy is not caused
by chronic lymphedema, venous insufficiency, or arterial aneurysm.
,When assessing cranial nerves IX and X, which of the following would the nurse consider asan
abnormal finding? - Answer>>> CorrectD.
Impaired swallowing.
Response Feedback:
Normal findings associated with testing cranial never IX and cranial nerve X include a uvula and
soft palate rising bilaterally and symmetrically on phonation. A stationary or asymmetrical soft
palate or deviation of the uvula would be considered an abnormal finding.
The nurse is assessing balance. Which test would the nurse plan on omitting from the exam?
Answer>>> CorrectC.
Achilles reflexes
During the assessment of deep tendon reflexes, the nurse finds that a patient's responses are
bilaterally normal. What number is used to indicate normal deep tendon reflexes when the
documenting this finding? + - Answer>>> 2
The nurse is testing the function of CN XI. Which statement best describes the response the
nurse should expect if this nerve is intact? The patient: - Answer>>> Correct
Moves the head and shoulders against resistance with equal strength.
A nurse is preparing to assess a client's cerebellar function. Which of the following would the
nurse expect to test? - Answer>>> CorrectD.
Balance
Response Feedback:
Balance and coordination are functions of the pyramidal and extrapyramidal tracts of the motor
and cerebellar systems. Remote memory and mental status exam provide information about the
client's cognitive ability. Testing for sensation would address issues with specific cranial nerves
or problems involving the parietal lobe.
Which of the following tests would be most appropriate for the nurse to use when assessing
motor function of the trigeminal nerve? - Answer>>> CorrectB.
Palpate the temporal and masseter muscles while the client clenches teeth
Response Feedback:
To test the motor function of the trigeminal nerve (CN V), the nurse would ask the client to
clench the teeth and palpate the temporal and masseter muscles for contraction. Touching the
client's face for dullness or sharp sensations tests the sensory function of the trigeminal nerve.
Having the client frown, smile, and wrinkle the forehead tests the motor function of the facial
nerve (CN VI). Assessing pupillary dilation tests the oculomotor (CN III) nerve.
The wife of a 65-year-old man tells the nurse that she is concerned because she has noticed a
change in her husband's personality and ability to understand. He also cries very easily and
, becomes angry. The nurse recalls that the cerebral lobe responsible for these behaviors is the
lobe. - Answer>>> Frontal
Which of the following assessment findings would lead the nurse to suspect that a client has
Bell's palsy? - Answer>>> CorrectC.
Inability to wrinkle the forehead
Response Feedback:
Inability to close eyes, wrinkle forehead, or raise the forehead, along with paralysis of the lower
part of the face on the affected side, is seen with Bell's palsy. Inability to detect sharp and dull
stimuli is associated with lesions of the trigeminal nerve (CN V). Closure of the affected eye
from swelling would suggest trauma. Paralysis, not muscle spasm, occurs with Bell's palsy.
During the taking of the health history, a patient tells the nurse that "it feels like the room is
spinning around me." The nurse would document this finding as: - Answer>>> Vertigo
When the nurse asks a 68-year-old patient to stand with his feet together and arms at his side
with his eyes closed, he starts to sway and moves his feet farther apart. The nurse would
document this finding as: - Answer>>> CorrectB.
Positive Romberg sign
A client presents to the emergency department after falling off a ladder while doing some
outside painting at home. The client's ankle appears swollen, out of alignment, and is painful to
touch. What is the nurse's first action? - Answer>>> CorrectC. Check for a pulse, color,
temperature, and capillary refill.
Response Feedback:
The first nursing actions include taking vital signs, monitoring pulses, and assessing color,
temperature, and capillary refill distal to the injury to evaluate tissue perfusion. The ankle should
then be immobilized after assessment. An ice pack may be applied after assessing for
temperature and pulses, etc. The first action is no weight bearing until the ankle is fully assessed.
The nurse is assessing the musculoskeletal system of a teenage boy for participation in
athletics. The nurse would expect to find that this client's bones are what as compared to a
female of the same age? - Answer>>> CorrectB. Larger and stronger
Response Feedback:
Gender affects the skeletal system. Males have larger and stronger bones than women; therefore,
males are less prone to problems related to osteoporosis. Male bones are not the same as female
bones; they are not necessarily longer and they do not have a greater curvature.
A client is thought to have a balance problem. What would be an advanced method of
assessing balance in this client? (Mark all that apply.) - Answer>>> CorrectC.
Romberg's test
