NU 518 EXAM 2 AND PRACTICE 441 QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+

NU 518 EXAM 2 AND PRACTICE 441 QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ A 38-year-old accountant comes to your clinic for evaluation of a headache. The throbbing sensation is located in the right temporal region and is an 8 on a scale of 1 to 10. It started a few hours ago, and she has noted nausea with sensitivity to light; she has had headaches like this in the past, usually less than one per week, but not as severe. She does not know of any inciting factors. There has been no change in the frequency of her headaches. She usually takes an over the-counter analgesic, and this results in resolution of the headache. Based on this description, what is the most likely diagnosis of the type of headache? A) Tension B) Migraine C) Cluster D) Analgesic rebound - Correct Answer B" "A 73-year-old nurse comes to your office for evaluation of new onset of tremors. She is not on any medications and does not take herbs or supplements. She has no chronic medical conditions. She does not smoke or drink alcohol. She walks into the examination room with slow movements and shuffling steps. She has decreased facial mobility and a blunt expression, without any changes in hair distribution on her face. Based on this description, what is the most likely reason for the patient's symptoms? A) Cushing's syndrome B) Nephrotic syndrome C) Myxedema D) Parkinson's disease - Correct Answer D" "A 29-year-old physical therapist presents for evaluation of an eyelid problem. On observation, the right eyeball appears to be protruding forward. Based on this description, what is the most likely diagnosis? A) Ptosis B) Exophthalmos C) Ectropion D) Epicanthus - Correct Answer B" "A 29-year-old computer programmer comes to your office for evaluation of a headache. The tightening sensation is located all over the head and is of moderate intensity. It used to last minutes, but this time it has lasted for 5 days. He denies photophobia and nausea. He spends several hours each day at a computer monitor/keyboard. He has tried over-the-counter medication; it has dulled the pain but not taken it away. Based on this description, what is your most likely diagnosis? A) Tension B) Migraine C) Cluster D) Analgesic rebound - Correct Answer A" "Which of the following is a symptom involving the eye? A) Scotomas B) Tinnitus C) Dysphagia D) Rhinorrhea - Correct Answer A" "A 49-year-old administrative assistant comes to your office for evaluation of dizziness. You elicit the information that the dizziness is a spinning sensation of sudden onset, worse with head position changes. The episodes last a few seconds and then go away, and they are accompanied by intense nausea. She has vomited one time. She denies tinnitus. You perform a physical examination of the head and neck and note that the patient's hearing is intact to Weber and Rinne and that there is nystagmus. Her gait is normal. Based on this description, what is the most likely diagnosis? A) Benign positional vertigo B) Vestibular neuronitis C) Ménière's disease D) Acoustic neuroma - Correct Answer A" "A 55-year-old bank teller comes to your office for persistent episodes of dizziness. The first episode started suddenly and lasted 3 to 4 hours. He experienced a lot of nausea with vomiting; the episode resolved spontaneously. He has had five episodes in the past 1½ weeks. He does note some tinnitus that comes and goes. Upon physical examination, you note that he has a normal gait. The Weber localizes to the right side and the air conduction is equal to the bone conduction in the right ear. Nystagmus is present. Based on this description, what is the most likely diagnosis? A) Benign positional vertigo B) Vestibular neuronitis C) Ménière's disease D) Acoustic neuroma - Correct Answer C" "A 12-year-old presents to the clinic with his father for evaluation of a painful lump in the left eye. It started this morning. He denies any trauma or injury. There is no visual disturbance. Upon physical examination, there is a red raised area at the margin of the eyelid that is tender to palpation; no tearing occurs with palpation of the lesion. Based on this description, what is the most likely diagnosis? A) Dacryocystitis B) Chalazion C) Hordeolum D) Xanthelasma - Correct Answer C" "A 15-year-old high school sophomore presents to the emergency room with his mother for evaluation of an area of blood in the left eye. He denies trauma or injury but has been coughing forcefully with a recent cold. He denies visual disturbances, eye pain, or discharge from the eye. On physical examination, the pupils are equal, round, and reactive to light, with a visual acuity of 20/20 in each eye and 20/20 bilaterally. There is a homogeneous, sharply demarcated area at the lateral aspect of the base of the left eye. The cornea is clear. Based on this description, what is the most likely diagnosis? A) Conjunctivitis B) Acute iritis C) Corneal abrasion D) Subconjunctival hemorrhage - Correct Answer D" "A 67-year-old lawyer comes to your clinic for an annual examination. He denies any history of eye trauma. He denies any visual changes. You inspect his eyes and find a triangular thickening of the bulbar conjunctiva across the outer surface of the cornea. He has a normal pupillary reaction to light and accommodation. Based on this description, what is the most likely diagnosis? A) Corneal arcus B) Cataracts C) Corneal scar D) Pterygium - Correct Answer D" "Which of the following is a "red flag" regarding patients presenting with headache? A) Unilateral headache B) Pain over the sinuses C) Age over 50 D) Phonophobia and photophobia - Correct Answer C" "A sudden, painless unilateral vision loss may be caused by which of the following? A) Retinal detachment B) Corneal ulcer C) Acute glaucoma D) Uveitis - Correct Answer A" "Sudden, painful unilateral loss of vision may be caused by which of the following conditions? A) Vitreous hemorrhage B) Central retinal artery occlusion C) Macular degeneration D) Optic neuritis - Correct Answer D" "Diplopia, which is present with one eye covered, can be caused by which of the following problems? A) Weakness of CN III B) Weakness of CN IV C) A lesion of the brainstem D) An irregularity in the cornea or lens - Correct Answer D" "A patient complains of epistaxis. Which other cause should be considered? A) Intracranial hemorrhage B) Hematemesis C) Intestinal hemorrhage D) Hematoma of the nasal septum - Correct Answer B" "Glaucoma is the leading cause of blindness in African Americans and the second leading cause of blindness overall. What features would be noted on funduscopic examination? A) Increased cup-to-disc ratio B) AV nicking C) Cotton wool spots D) Microaneurysms - Correct Answer A" "Very sensitive methods for detecting hearing loss include which of the following? A) The whisper test B) The finger rub test C) The tuning fork test D) Audiometric testing - Correct Answer D" "Which area of the fundus is the central focal point for incoming images? A) The fovea B) The macula C) The optic disk D) The physiologic cup - Correct Answer A" "A light is pointed at a patient's pupil, which contracts. It is also noted that the other pupil contracts as well, though it is not exposed to bright light. Which of the following terms describes this latter phenomenon? A) Direct reaction B) Consensual reaction C) Near reaction D) Accommodation - Correct Answer B" "A patient is assigned a visual acuity of 20/100 in her left eye. Which of the following is true? A) She obtains a 20% correct score at 100 feet. B) She can accurately name 20% of the letters at 20 feet. C) She can see at 20 feet what a normal person could see at 100 feet. D) She can see at 100 feet what a normal person could see at 20 feet. - Correct Answer C" "On visual confrontation testing, a stroke patient is unable to see your fingers on his entire right side with either eye covered. Which of the following terms would describe this finding? A) Bitemporal hemianopsia B) Right temporal hemianopsia C) Right homonymous hemianopsia D) Binasal hemianopsia - Correct Answer C" "You note that a patient has anisocoria on examination. Pathologic causes of this include which of the following? A) Horner's syndrome B) Benign anisocoria C) Differing light intensities for each eye D) Eye prosthesis - Correct Answer A" "A patient is examined with the ophthalmoscope and found to have red reflexes bilaterally. Which of the following have you essentially excluded from your differential? A) Retinoblastoma B) Cataract C) Artificial eye D) Hypertensive retinopathy - Correct Answer D" "A patient presents with ear pain. She is an avid swimmer. The history includes pain and drainage from the left ear. On examination, she has pain when the ear is manipulated, including manipulation of the tragus. The canal is narrowed and erythematous, with some white debris in the canal. The rest of the examination is normal. What diagnosis would you assign this patient? A) Otitis media B) External otitis C) Perforation of the tympanum D) Cholesteatoma - Correct Answer B" "A patient with hearing loss by whisper test is further examined with a tuning fork, using the Weber and Rinne maneuvers. The abnormal results are as follows: bone conduction is greater than air on the left, and the patient hears the sound of the tuning fork better on the left. Which of the following is most likely? A) Otosclerosis of the left ear B) Exposure to chronic loud noise of the right ear C) Otitis media of the right ear D) Perforation of the right eardrum - Correct Answer A" "A young man is concerned about a hard mass he has just noticed in the midline of his palate. On examination, it is indeed hard and in the midline. There are no mucosal abnormalities associated with this lesion. He is experiencing no other symptoms. What will you tell him is the most likely diagnosis? A) Leukoplakia B) Torus palatinus C) Thrush (candidiasis) D) Kaposi's sarcoma - Correct Answer B" "A young woman undergoes cranial nerve testing. On touching the soft palate, her uvula deviates to the left. Which of the following is likely? A) CN IX lesion on the left B) CN IX lesion on the right C) CN X lesion on the left D) CN X lesion on the right - Correct Answer D" "A college student presents with a sore throat, fever, and fatigue for several days. You notice exudates on her enlarged tonsils. You do a careful lymphatic examination and notice some scattered small, mobile lymph nodes just behind her sternocleidomastoid muscles bilaterally. What group of nodes is this? A) Submandibular B) Tonsillar C) Occipital D) Posterior cervical - Correct Answer D" "You feel a small mass that you think is a lymph node. It is mobile in both the up-and-down and side-to-side directions. Which of the following is most likely? A) Cancer B) Lymph node C) Deep scar D) Muscle - Correct Answer B" "You are conducting a pupillary examination on a 34-year-old man. You note that both pupils dilate slightly. Both are noted to constrict briskly when the light is placed on the right eye. What is the most likely problem? A) Optic nerve damage on the right B) Optic nerve damage on the left C) Efferent nerve damage on the right D) Efferent nerve damage on the left - Correct Answer B" "A physician tells the nurse that a patients vertebra prominens is tender and asks the nurse to reevaluate the area in 1 hour. The area of the body the nurse will assess is: a Just above the diaphragm. b Just lateral to the knee cap. c At the level of the C7 vertebra. d At the level of the T11 vertebra. - Correct Answer C" "A mother brings her 2-month-old daughter in for an examination and says, My daughter rolled over against the wall, and now I have noticed that she has this spot that is soft on the top of her head. Is something terribly wrong? The nurses best response would be: a Perhaps that could be a result of your dietary intake during pregnancy. b Your baby may have craniosynostosis, a disease of the sutures of the brain. c That soft spot may be an indication of cretinism or congenital hypothyroidism. d That soft spot is normal, and actually allows for growth of the brain during the first year of your baby's life. - Correct Answer D" "The nurse notices that a patients palpebral fissures are not symmetric. On examination, the nurse may find that damage has occurred to which cranial nerve (CN)? a III b V c VII d VIII - Correct Answer C" "A patient is unable to differentiate between sharp and dull stimulation to both sides of her face. The nurse suspects: a Bell palsy. b Damage to the trigeminal nerve. c Frostbite with resultant paresthesia to the cheeks. d Scleroderma. - Correct Answer B" "When examining the face of a patient, the nurse is aware that the two pairs of salivary glands that are accessible to examination are the and glands. a Occipital; submental b Parotid; jugulodigastric c Parotid; submandibular d Submandibular; occipital - Correct Answer C" "A patient comes to the clinic complaining of neck and shoulder pain and is unable to turn her head. The nurse suspects damage to CN and proceeds with the examination by a XI; palpating the anterior and posterior triangles b XI; asking the patient to shrug her shoulders against resistance c XII; percussing the sternomastoid and submandibular neck muscles d XII; assessing for a positive Romberg sign - Correct Answer B" "When examining a patient's CN function, the nurse remembers that the muscles in the neck that are innervated by CN XI are the: a Sternomastoid and trapezius. b Spinal accessory and omohyoid. c Trapezius and sternomandibular. d Sternomandibular and spinal accessory. - Correct Answer A" "A patients laboratory data reveal an elevated thyroxine (T4) level. The nurse would proceed with an examination of the gland. a Thyroid b Parotid c Adrenal d Parathyroid - Correct Answer A" "A patient says that she has recently noticed a lump in the front of her neck below her Adams apple that seems to be getting bigger. During the assessment, the finding that leads the nurse to suspect that this may not be a cancerous thyroid nodule is that the lump (nodule): a Is tender. B Is mobile and not hard. C Disappears when the patient smiles. D Is hard and fixed to the surrounding structures. - Correct Answer B" "The nurse notices that a patients submental lymph nodes are enlarged. In an effort to identify the cause of the node enlargement, the nurse would assess the patients: a Infraclavicular area. B Supraclavicular area. C Area distal to the enlarged node. D Area proximal to the enlarged node. - Correct Answer D" "The nurse is aware that the four areas in the body where lymph nodes are accessible are the: A Head, breasts, groin, and abdomen. B Arms, breasts, inguinal area, and legs. C Head and neck, arms, breasts, and axillae. D Head and neck, arms, inguinal area, and axillae - Correct Answer D" "A mother brings her newborn in for an assessment and asks, Is there something wrong with my baby? His head seems so big. Which statement is true regarding the relative proportions of the head and trunk of the newborn? A At birth, the head is one fifth the total length. B Head circumference should be greater than chest circumference at birth. C The head size reaches 90% of its final size when the child is 3 years old. D When the anterior fontanel closes at 2 months, the head will be more proportioned to the body. - Correct Answer B" "A patient, an 85-year-old woman, is complaining about the fact that the bones in her face have become more noticeable. What explanation should the nurse give her? A Diets low in protein and high in carbohydrates may cause enhanced facial bones. B Bones can become more noticeable if the person does not use a dermatologically approved moisturizer. C More noticeable facial bones are probably due to a combination of factors related to aging, such as decreased elasticity, subcutaneous fat, and moisture in her skin. D Facial skin becomes more elastic with age. This increased elasticity causes the skin to be more taught, drawing attention to the facial bones. - Correct Answer C" "A patient reports excruciating headache pain on one side of his head, especially around his eye, forehead, and cheek that has lasted approximately to 2 hours, occurring once or twice each day. The nurse should suspect: a Hypertension. B Cluster headaches. C Tension headaches. D Migraine headaches. - Correct Answer B" "A patient complains that while studying for an examination he began to notice a severe headache in the frontotemporal area of his head that is throbbing and is somewhat relieved when he lies down. He tells the nurse that his mother also had these headaches. The nurse suspects that he may be suffering from: a Hypertension. B Cluster headaches. C Tension headaches. D Migraine headaches. - Correct Answer D" "A 19-year-old college student is brought to the emergency department with a severe headache he describes as, Like nothing I've ever had before. His temperature is 40 C, and he has a stiff neck. The nurse looks for other signs and symptoms of which problem? A Head injury B Cluster headache C Migraine headache D Meningeal inflammation - Correct Answer D" "During a well-baby checkup, the nurse notices that a 1-week-old infants face looks small compared with his cranium, which seems enlarged. On further examination, the nurse also notices dilated scalp veins and downcast or setting sun eyes. The nurse suspects which condition? A Craniotabes B Microcephaly C Hydrocephalus D Caput succedaneum - Correct Answer C" "The nurse needs to palpate the temporomandibular joint for crepitation. This joint is located just below the temporal artery and anterior to the: a Hyoid bone. b Vagus nerve. c Tragus. d Mandible. - Correct Answer C" "A patient has come in for an examination and states, I have this spot in front of my ear lobe on my cheek that seems to be getting bigger and is tender. What do you think it is? The nurse notes swelling below the angle of the jaw and suspects that it could be an inflammation of his: a Thyroid gland. B Parotid gland. C Occipital lymph node. D Submental lymph node. - Correct Answer B" "A male patient with a history of acquired immunodeficiency syndrome (AIDS) has come in for an examination and he states, I think that I have the mumps. The nurse would begin by examining the: a Thyroid gland. B Parotid gland. C Cervical lymph nodes. D Mouth and skin for lesions. - Correct Answer B" "The nurse suspects that a patient has hyperthyroidism, and the laboratory data indicate that the patients T4 and T3 hormone levels are elevated. Which of these findings would the nurse most likely find on examination? A Tachycardia B Constipation C Rapid dyspnea D Atrophied nodular thyroid gland - Correct Answer A" "A visitor from Poland who does not speak English seems to be somewhat apprehensive about the nurse examining his neck. He would probably be more comfortable with the nurse examining his thyroid gland from: a Behind with the nurses hands placed firmly around his neck. B The side with the nurses eyes averted toward the ceiling and thumbs on his neck. C The front with the nurses thumbs placed on either side of his trachea and his head tilted forward. D The front with the nurses thumbs placed on either side of his trachea and his head tilted backward. - Correct Answer C" "A patient's thyroid gland is enlarged, and the nurse is preparing to auscultate the thyroid gland for the presence of a bruit. A bruit is a sound that is heard best with the of the stethoscope. A Low gurgling; diaphragm B Loud, whooshing, blowing; bell C Soft, whooshing, pulsatile; bell D High-pitched tinkling; diaphragm - Correct Answer C" "The nurse notices that an infant has a large, soft lump on the side of his head and that his mother is very concerned. She tells the nurse that she noticed the lump approximately 8 hours after her babys birth and that it seems to be getting bigger. One possible explanation for this is: a Hydrocephalus. B Craniosynostosis. C Cephalhematoma. D Caput succedaneum. - Correct Answer C" "A mother brings in her newborn infant for an assessment and tells the nurse that she has noticed that whenever her newborns head is turned to the right side, she straightens out the arm and leg on the same side and flexes the opposite arm and leg. After observing this on examination, the nurse tells her that this reflex is: a Abnormal and is called the atonic neck reflex. B Normal and should disappear by the first year of life. C Normal and is called the tonic neck reflex, which should disappear between 3 and 4 months of age. D Abnormal. The baby should be flexing the arm and leg on the right side of his body when the head is turned to the right. - Correct Answer C" "A 21-year-old college senior presents to your clinic, complaining of shortness of breath and a nonproductive nocturnal cough. She states she used to feel this way only with extreme exercise, but lately she has felt this way continuously. She denies any other upper respiratory symptoms, chest pain, gastrointestinal symptoms, or urinary tract symptoms. Her past medical history is significant only for seasonal allergies, for which she takes a nasal steroid spray but is otherwise on no other medications. She has had no surgeries. Her mother has allergies and eczema and her father has high blood pressure. She is an only child. She denies smoking and illegal drug use but drinks three to four alcoholic beverages per weekend. She is a junior in finance at a local university and she has recently started a job as a bartender in town. On examination she is in no acute distress and her temperature is 98.6. Her blood pressure is - Correct Answer C" "A 47-year-old receptionist comes to your office, complaining of fever, shortness of breath, and a productive cough with golden sputum. She says she had a cold last week and her symptoms have only gotten worse, despite using over-the-counter cold remedies. She denies any weight gain, weight loss, or cardiac or gastrointestinal symptoms. Her past medical history includes type 2 diabetes for 5 years and high cholesterol. She takes an oral medication for both diseases. She has had no surgeries. She denies tobacco, alcohol, or drug use. Her mother has diabetes and high blood pressure. Her father passed away from colon cancer. On examination you see a middleaged woman appearing her stated age. She looks ill and her temperature is elevated, at 101. Her blood pressure and pulse are unremarkable. Her head, eyes, ears, nose, and throat examinations are unremarkable except for edema of the nasal turbinates. On auscultation she - Correct Answer D" "A 68-year-old retired truck driver comes to your office for evaluation of swelling in his legs. He is a smoker and has been taking medications to control his hypertension for the past 25 years. You are concerned about his risk for peripheral vascular disease. Which of the following tests are appropriate to order to initially evaluate for this condition? A) Venogram B) CT scan of the lower legs C) Ankle-brachial index (ABI) D) PET scan - Correct Answer C" "A 55-year-old secretary with a recent history of breast cancer, for which she underwent surgery and radiation therapy, and a history of hypertension comes to your office for a routine checkup. Which of the following aspects of the physical are important to note when assessing the patient for peripheral vascular disease in the arms? A) Femoral pulse, popliteal pulse B) Dorsalis pedis pulse, posterior tibial pulse C) Carotid pulse D) Radial pulse, brachial pulse - Correct Answer D" "You are a student in the vascular surgery clinic. You are asked to perform a physical examination on a patient with known peripheral vascular disease in the legs. Which of the following aspects is important to note when you perform your examination? A) Size, symmetry, and skin color B) Muscle bulk and tone C) Nodules in joints D) Lower extremity strength - Correct Answer A" "You are assessing a patient for peripheral vascular disease in the arms, secondary to a complaint of increased weakness and a history of coronary artery disease and diabetes. You assess the brachial and radial pulses and note that they are bounding. What does that translate to on a scale of 0 to 3? A) 0 B) 3+ C) 2+ D) 1+ - Correct Answer B" "A 17-year-old high school senior presents to your clinic in acute respiratory distress. Between shallow breaths he states he was at home finishing his homework when he suddenly began having right-sided chest pain and severe shortness of breath. He denies any recent traumas or illnesses. His past medical history is unremarkable. He doesn't smoke but drinks several beers on the weekend. He has tried marijuana several times but denies any other illegal drugs. He is an honors student and is on the basketball team. His parents are both in good health. He denies any recent weight gain, weight loss, fever, or night sweats. On examination you see a tall, thin young man in obvious distress. He is diaphoretic and is breathing at a rate of 35 breaths per minute. On auscultation you hear no breath sounds on the right side of his superior chest wall. On percussion he is hyperresonant over the right upper lobe. With palpation he h - Correct Answer A" "A 62-year-old construction worker presents to your clinic, complaining of almost a year of chronic cough and occasional shortness of breath. Although he has had worsening of symptoms occasionally with a cold, his symptoms have stayed about the same. The cough has occasional mucous drainage but never any blood. He denies any chest pain. He has had no weight gain, weight loss, fever, or night sweats. His past medical history is significant for high blood pressure and arthritis. He has smoked two packs a day for the past 45 years. He drinks occasionally but denies any illegal drug use. He is married and has two children. He denies any foreign travel. His father died of a heart attack and his mother died of Alzheimer's disease. On examination you see a man looking slightly older than his stated age. His blood pressure is 130/80 and his pulse is 88. He is breathing comfortably with respirations of 12. His head, eyes, ears - Correct Answer B" "A 36-year-old teacher presents to your clinic, complaining of sharp, knifelike pain on the left side of her chest for the last 2 days. Breathing and lying down make the pain worse, while sitting forward helps her pain. Tylenol and ibuprofen have not helped. Her pain does not radiate to any other area. She denies any upper respiratory or gastrointestinal symptoms. Her past medical history consists of systemic lupus. She is divorced and has one child. She denies any tobacco, alcohol, or drug use. Her mother has hypothyroidism and her father has high blood pressure. On examination you find her to be distressed, leaning over and holding her left arm and hand to her left chest. Her blood pressure is 130/70, her respirations are 12, and her pulse is 90. On auscultation her lung fields have normal breath sounds with no rhonchi, wheezes, or crackles. Percussion and palpation are unremarkable. Auscultation of the heart has an - Correct Answer B" "A 68-year-old retired postman presents to your clinic, complaining of dull, intermittent left sided chest pain over the last few weeks. The pain occurs after he mows his lawn or chops wood. He says that the pain radiates to the left side of his jaw but nowhere else. He has felt light-headed and nauseated with the pain but has had no other symptoms. He states when he sits down for several minutes the pain goes away. Ibuprofen, Tylenol, and antacids have not improved his symptoms. He reports no recent weight gain, weight loss, fever, or night sweats. He has a past medical history of high blood pressure and arthritis. He quit smoking 10 years ago after smoking one pack a day for 40 years. He denies any recent alcohol use and reports no drug use. He is married and has two healthy children. His mother died of breast cancer and his father died of a stroke. His younger brother has had bypass surgery. On examination you find - Correct Answer A" "A 75-year-old retired teacher presents to your clinic, complaining of severe, unrelenting anterior chest pain radiating to her back. She describes it as if someone is "ripping out her heart." It began less than an hour ago. She states she is feeling very nauseated and may pass out. She denies any trauma or recent illnesses. She states she has never had pain like this before. Nothing seems to make the pain better or worse. Her medical history consists of difficult-to-control hypertension and coronary artery disease requiring two stents in the past. She is a widow. She denies any alcohol, tobacco, or illegal drug use. Her mother died of a stroke and her father died of a heart attack. She has one younger brother who has had bypass surgery. On examination you see an elderly female in a great deal of distress. She is lying on the table, curled up, holding her left and right arms against her chest and is restless, trying t - Correct Answer C" "A 25-year-old accountant presents to your clinic, complaining of intermittent lower right sided chest pain for several days. He describes it as knifelike and states it only lasts for 3 to 5 seconds, taking his breath away. He states he feels like he has to breathe shallowly to keep it from recurring. The only thing that makes it better is lying quietly on his right side. It is much worse when he takes a deep breath. He has taken some Tylenol and put a heating pad on his side but neither has helped. He remembers that 2 weeks ago he had an upper respiratory infection with a severe hacking cough. He denies any recent trauma. His past medical history is unremarkable. His parents and siblings are in good health. He has recently married, and his wife has a baby due in 2 months. He denies any smoking or illegal drug use. He drinks two to three beers once a month. He states that he eats a healthy diet and runs regularly, but - Correct Answer C" "A 60-year-old baker presents to your clinic, complaining of increasing shortness of breath and nonproductive cough over the last month. She feels like she can't do as much activity as she used to do without becoming tired. She even has to sleep upright in her recliner at night to be able to breathe comfortably. She denies any chest pain, nausea, or sweating. Her past medical history is significant for high blood pressure and coronary artery disease. She had a hysterectomy in her 40s for heavy vaginal bleeding. She is married and is retiring from the local bakery soon. She denies any tobacco, alcohol, or drug use. Her mother died of a stroke and her father died from prostate cancer. She denies any recent upper respiratory illness, and she has had no other symptoms. On examination she is in no acute distress. Her blood pressure is 160/100 and her pulse is 100. She is afebrile and her respiratory rate is 16. With auscul - Correct Answer D" "A grandmother brings her 13-year-old grandson to you for evaluation. She noticed last week when he took off his shirt that his breastbone seemed collapsed. He seems embarrassed and tells you that it has been that way for quite a while. He states he has no symptoms from it and he just tries not to take off his shirt in front of anyone. He denies any shortness of breath, chest pain, or lightheadedness on exertion. His past medical history is unremarkable. He is in sixth grade and just moved in with his grandmother after his father was deployed to the Middle East. His mother died several years ago in a car accident. He states that he does not smoke and has never touched alcohol. On examination you see a teenage boy appearing his stated age. On visual examination of his chest, you see that the lower portion of the sternum is depressed. Auscultation of the lungs and heart are unremarkable. What disorder of the thorax best - Correct Answer B" "Which of the following anatomic landmark associations is correct? A) 2nd intercostal space for needle insertion in tension pneumothorax B) T6 for lower margin of endotracheal tube C) Sternal angle marks the 4th rib D) 5th intercostal space for chest tube insertion - Correct Answer A" "A 55-year-old smoker complains of chest pain and gestures with a closed fist over her sternum to describe it. Which of the following diagnoses should you consider because of her gesture? A) Bronchitis B) Costochondritis C) Pericarditis D) Angina pectoris - Correct Answer D" "A 62-year-old smoker complains of "coughing up small amounts of blood," so you consider hemoptysis. Which of the following should you also consider? A) Intestinal bleeding B) Hematoma of the nasal septum C) Epistaxis D) Bruising of the tongue - Correct Answer C" "Which of the following occurs in respiratory distress? A) Speaking in sentences of 10-20 words B) Skin between the ribs moves inward with inspiration C) Neck muscles are relaxed D) Patient torso leans posteriorly - Correct Answer B" "Which of the following is consistent with good percussion technique? A) Allow all of the fingers to touch the chest while performing percussion. B) Maintain a stiff wrist and hand. C) Leave the plexor finger on the pleximeter after each strike. D) Strike the pleximeter over the distal interphalangeal joint. - Correct Answer D" "Which of the following percussion notes would you obtain over the gastric bubble? A) Resonance B) Tympany C) Hyperresonance D) Flatness - Correct Answer B" "Which of the following conditions would produce a hyperresonant percussion note? A) Large pneumothorax B) Lobar pneumonia C) Pleural effusion D) Empyema - Correct Answer A" "Which lung sound possesses the characteristics of being louder and higher in pitch, with a short silence between inspiration and expiration and with expiration being longer than inspiration? A) Bronchovesicular B) Vesicular C) Bronchial D) Tracheal - Correct Answer C" "A patient complains of shortness of breath for the past few days. On examination, you note late inspiratory crackles in the lower third of the chest that were not present a week ago. What is the most likely explanation for these? A) Asthma B) COPD C) Bronchiectasis D) Heart failure - Correct Answer D" "When crackles, wheezes, or rhonchi clear with a cough, which of the following is a likely etiology? A) Bronchitis B) Simple asthma C) Cystic fibrosis D) Heart failure - Correct Answer A" "A patient with longstanding COPD was told by another practitioner that his liver was enlarged and this needed to be assessed. Which of the following would be reasonable to do next? A) Percuss the lower border of the liver B) Measure the span of the liver C) Order a hepatitis panel D) Obtain an ultrasound of the liver - Correct Answer B" "You are at your family reunion playing football when your uncle takes a hit to his right lateral thorax and is in pain. He asks you if you think he has a rib fracture. You are in a very remote area. What would your next step be? A) Call a medevac helicopter B) Drive him to the city (4 hours away) C) Press on his sternum and spine simultaneously D) Examine him for tenderness over the injured area - Correct Answer C" "Which of these statements is true regarding the vertebra prominens? The vertebra prominens is: a The spinous process of C7. B Usually nonpalpable in most individuals. C Opposite the interior border of the scapula. D Located next to the manubrium of the sternum. - Correct Answer A" "When performing a respiratory assessment on a patient, the nurse notices a costal angle of approximately 90 degrees. This characteristic is: a Observed in patients with kyphosis. B Indicative of pectus excavatum. C A normal finding in a healthy adult. D An expected finding in a patient with a barrel chest. - Correct Answer C" "When assessing a patients lungs, the nurse recalls that the left lung: A Consists of two lobes. B Is divided by the horizontal fissure. C Primarily consists of an upper lobe on the posterior chest. D Is shorter than the right lung because of the underlying stomach. - Correct Answer A" "Which statement about the apices of the lungs is true? The apices of the lungs: A Are at the level of the second rib anteriorly. B Extend 3 to 4 cm above the inner third of the clavicles. C Are located at the sixth rib anteriorly and the eighth rib laterally. D Rest on the diaphragm at the fifth intercostal space in the midclavicular line (MCL). - Correct Answer B" "During an examination of the anterior thorax, the nurse is aware that the trachea bifurcates anteriorly at the: a Costal angle. B Sternal angle. C Xiphoid process. D Suprasternal notch. - Correct Answer B" "During an assessment, the nurse knows that expected assessment findings in the normal adult lung include the presence of: a Adventitious sounds and limited chest expansion. b Increased tactile fremitus and dull percussion tones. c Muffled voice sounds and symmetric tactile fremitus. d Absent voice sounds and hyperresonant percussion tones. - Correct Answer C" "The primary muscles of respiration include the: A Diaphragm and intercostals. B Sternomastoids and scaleni. C Trapezii and rectus abdominis. d External obliques and pectoralis major. - Correct Answer A" "A 65-year-old patient with a history of heart failure comes to the clinic with complaints of being awakened from sleep with shortness of breath. Which action by the nurse is most appropriate? A Obtaining a detailed health history of the patients allergies and a history of asthma b Telling the patient to sleep on his or her right side to facilitate ease of respirations c Assessing for other signs and symptoms of paroxysmal nocturnal dyspnea d Assuring the patient that paroxysmal nocturnal dyspnea is normal and will probably resolve within the next week - Correct Answer C" "When assessing tactile fremitus, the nurse recalls that it is normal to feel tactile fremitus most intensely over which location? A Between the scapulae B Third intercostal space, MCL C Fifth intercostal space, midaxillary line (MAL) d Over the lower lobes, posterior side - Correct Answer A" "The nurse is reviewing the technique of palpating for tactile fremitus with a new graduate. Which statement by the graduate nurse reflects a correct understanding of tactile fremitus? Tactile fremitus: A Is caused by moisture in the alveoli. B Indicates that air is present in the subcutaneous tissues. C Is caused by sounds generated from the larynx. D Reflects the blood flow through the pulmonary arteries. - Correct Answer C" "During percussion, the nurse knows that a dull percussion note elicited over a lung lobe most likely results from: a Shallow breathing. B Normal lung tissue. C Decreased adipose tissue. D Increased density of lung tissue. - Correct Answer D" "The nurse is observing the auscultation technique of another nurse. The correct method to use when progressing from one auscultatory site on the thorax to another is comparison. A Side-to-side B Top-to-bottom C Posterior-to-anterior D Interspace-by-interspace - Correct Answer A" "When auscultating the lungs of an adult patient, the nurse notes that low-pitched, soft breath sounds are heard over the posterior lower lobes, with inspiration being longer than expiration. The nurse interprets that these sounds are: A Normally auscultated over the trachea. B Bronchial breath sounds and normal in that location. C Vesicular breath sounds and normal in that location. D Bronchovesicular breath sounds and normal in that location. - Correct Answer C" "The nurse is auscultating the chest in an adult. Which technique is correct? A Instructing the patient to take deep, rapid breaths B Instructing the patient to breathe in and out through his or her nose C Firmly holding the diaphragm of the stethoscope against the chest D Lightly holding the bell of the stethoscope against the chest to avoid friction - Correct Answer C" "The nurse is percussing over the lungs of a patient with pneumonia. The nurse knows that percussion over an area of atelectasis in the lungs will reveal: a Dullness. B Tympany. C Resonance. D Hyperresonance. - Correct Answer A" "During auscultation of the lungs, the nurse expects decreased breath sounds to be heard in which situation? A When the bronchial tree is obstructed B When adventitious sounds are present C In conjunction with whispered pectoriloquy D In conditions of consolidation, such as pneumonia - Correct Answer A" "The nurse knows that a normal finding when assessing the respiratory system of an older adult is: a Increased thoracic expansion. B Decreased mobility of the thorax. C Decreased anteroposterior diameter. D Bronchovesicular breath sounds throughout the lungs. - Correct Answer B" "A mother brings her 3-month-old infant to the clinic for evaluation of a cold. She tells the nurse that he has had a runny nose for a week. When performing the physical assessment, the nurse notes that the child has nasal flaring and sternal and intercostal retractions. The nurses next action should be to: a Assure the mother that these signs are normal symptoms of a cold. B Recognize that these are serious signs, and contact the physician. C Ask the mother if the infant has had trouble with feedings. D Perform a complete cardiac assessment because these signs are probably indicative of early heart failure. - Correct Answer B" "When assessing the respiratory system of a 4-year-old child, which of these findings would the nurse expect? A Crepitus palpated at the costochondral junctions B No diaphragmatic excursion as a result of a childs decreased inspiratory volume C Presence of bronchovesicular breath sounds in the peripheral lung fields D Irregular respiratory pattern and a respiratory rate of 40 breaths per minute at rest - Correct Answer C" "When inspecting the anterior chest of an adult, the nurse should include which assessment? A Diaphragmatic excursion B Symmetric chest expansion C Presence of breath sounds D Shape and configuration of the chest wall - Correct Answer D" "The nurse knows that auscultation of fine crackles would most likely be noticed in: A A healthy 5-year-old child. B A pregnant woman. C The immediate newborn period. D Association with a pneumothorax. - Correct Answer C" "During an assessment of an adult, the nurse has noted unequal chest expansion and recognizes that this occurs in which situation? A In an obese patient B When part of the lung is obstructed or collapsed C When bulging of the intercostal spaces is present D When accessory muscles are used to augment respiratory effort - Correct Answer B" "During auscultation of the lungs of an adult patient, the nurse notices the presence of bronchophony. The nurse should assess for signs of which condition? A Airway obstruction B Emphysema C Pulmonary consolidation D Asthma - Correct Answer C" "The nurse is reviewing the characteristics of breath sounds. Which statement about bronchovesicular breath sounds is true? Bronchovesicular breath sounds are: a Musical in quality. b Usually caused by a pathologic disease. c Expected near the major airways. d Similar to bronchial sounds except shorter in duration. - Correct Answer C" "The nurse is listening to the breath sounds of a patient with severe asthma. Air passing through narrowed bronchioles would produce which of these adventitious sounds? a Wheezes b Bronchial sounds c Bronchophony d Whispered pectoriloquy - Correct Answer A" "You are performing a thorough cardiac examination. Which of the following chambers of the heart can you assess by palpation? A) Left atrium B) Right atrium C) Right ventricle D) Sinus node - Correct Answer C" "What is responsible for the inspiratory splitting of S2? A) Closure of aortic, then pulmonic valves B) Closure of mitral, then tricuspid valves C) Closure of aortic, then tricuspid valves D) Closure of mitral, then pulmonic valves - Correct Answer A" "A 25-year-old optical technician comes to your clinic for evaluation of fatigue. As part of your physical examination, you listen to her heart and hear a murmur only at the cardiac apex. Which valve is most likely to be involved, based on the location of the murmur? A) Mitral B) Tricuspid C) Aortic D) Pulmonic - Correct Answer A" "A 58-year-old teacher presents to your clinic with a complaint of breathlessness with activity. The patient has no chronic conditions and does not take any medications, herbs, or supplements. Which of the following symptoms is appropriate to ask about in the cardiovascular review of systems? A) Abdominal pain B) Orthopnea C) Hematochezia D) Tenesmus - Correct Answer B" "You are screening people at the mall as part of a health fair. The first person who comes for screening has a blood pressure of 132/85. How would you categorize this? A) Normal B) Prehypertension C) Stage 1 hypertension D) Stage 2 hypertension - Correct Answer B" "You are participating in a health fair and performing cholesterol screens. One person has a cholesterol of 225. She is concerned about her risk for developing heart disease. Which of the following factors is used to estimate the 10-year risk of developing coronary heart disease? A) Ethnicity B) Alcohol intake C) Gender D) Asthma - Correct Answer C" "You are evaluating a 40-year-old banker for coronary heart disease risk factors. He has a history of hypertension, which is well-controlled on his current medications. He does not smoke; he does 45 minutes of aerobic exercise five times weekly. You are calculating his 10-year coronary heart disease risk. Which of the following conditions is considered to be a coronary heart disease risk equivalent? A) Hypertension B) Peripheral arterial disease C) Systemic lupus erythematosus D) Chronic obstructive pulmonary disease (COPD) - Correct Answer B" "You are conducting a workshop on the measurement of jugular venous pulsation. As part of your instruction, you tell the students to make sure that they can distinguish between the jugular venous pulsation and the carotid pulse. Which one of the following characteristics is typical of the carotid pulse? A) Palpable B) Soft, rapid, undulating quality C) Pulsation eliminated by light pressure on the vessel D) Level of pulsation changes with changes in position - Correct Answer A" "A 68-year-old mechanic presents to the emergency room for shortness of breath. You are concerned about a cardiac cause and measure his jugular venous pressure (JVP). It is elevated. Which one of the following conditions is a potential cause of elevated JVP? A) Left-sided heart failure B) Mitral stenosis C) Constrictive pericarditis D) Aortic aneurysm - Correct Answer C" "You are palpating the apical impulse in a patient with heart disease and find that the amplitude is diffuse and increased. Which of the following conditions could be a potential cause of an increase in the amplitude of the impulse? A) Hypothyroidism B) Aortic stenosis, with pressure overload of the left ventricle C) Mitral stenosis, with volume overload of the left atrium D) Cardiomyopathy - Correct Answer B" "You are performing a cardiac examination on a patient with shortness of breath and palpitations. You listen to the heart with the patient sitting upright, then have him change to a supine position, and finally have him turn onto his left side in the left lateral decubitus position. Which of the following valvular defects is best heard in this position? A) Aortic B) Pulmonic C) Mitral D) Tricuspid - Correct Answer C" "You are concerned that a patient has an aortic regurgitation murmur. Which is the best position to accentuate the murmur? A) Upright B) Upright, but leaning forward C) Supine D) Left lateral decubitus - Correct Answer B" "A 68-year-old retired waiter comes to your clinic for evaluation of fatigue. You perform a cardiac examination and find that his pulse rate is less than 60. Which of the following conditions could be responsible for this heart rate? A) Second-degree A-V block B) Atrial flutter C) Sinus arrhythmia D) Atrial fibrillation - Correct Answer A" "Where is the point of maximal impulse (PMI) normally located? A) In the left 5th intercostal space, 7 to 9 cm lateral to the sternum B) In the left 5th intercostal space, 10 to 12 cm lateral to the sternum C) In the left 5th intercostal space, in the anterior axillary line D) In the left 5th intercostal space, in the midaxillary line - Correct Answer A" "Which of the following events occurs at the start of diastole? A) Closure of the tricuspid valve B) Opening of the pulmonic valve C) Closure of the aortic valve D) Production of the first heart sound (S1) - Correct Answer C" "Which is true of a third heart sound (S3)? A) It marks atrial contraction. B) It reflects normal compliance of the left ventricle. C) It is caused by rapid deceleration of blood against the ventricular wall. D) It is not heard in atrial fibrillation. - Correct Answer C" "Which is true of splitting of the second heart sound? A) It is best heard over the pulmonic area with the bell of the stethoscope. B) It normally increases with exhalation. C) It is best heard over the apex. D) It does not vary with respiration. - Correct Answer A" "Which of the following is true of jugular venous pressure (JVP) measurement? A) It is measured with the patient at a 45-degree angle. B) The vertical height of the blood column in centimeters, plus 5 cm, is the JVP. C) A JVP below 9 cm is abnormal. D) It is measured above the sternal notch. - Correct Answer B" "Which of the following regarding jugular venous pulsations is a systolic phenomenon? A) The "y" descent B) The "x" descent C) The upstroke of the "a" wave D) The downstroke of the "v" wave - Correct Answer B" "How much does cardiovascular risk increase for each increment of 20 mm Hg systolic and 10 mm Hg diastolic in blood pressure? A) 25% B) 50% C) 75% D) 100% - Correct Answer D" "In healthy adults over 20, how often should blood pressure, body mass index, waist circumference, and pulse be assessed, according to American Heart Association guidelines? A) Every 6 months B) Every year C) Every 2 years D) Every 5 years - Correct Answer C" "Which of the following is a clinical identifier of metabolic syndrome? A) Waist circumference of 38 inches for a male B) Waist circumference of 34 inches for a female C) BP of 134/88 for a male D) BP of 128/84 for a female - Correct Answer C" "Mrs. Adams would like to begin an exercise program and was told to exercise as intensely as necessary to obtain a heart rate 60% or greater of her maximum heart rate. She is 52. What heart rate should she achieve? A) 80 B) 100 C) 120 D) 140 - Correct Answer B" "In measuring the jugular venous pressure (JVP), which of the following is important? A) Keep the patient's torso at a 45-degree angle. B) Measure the highest visible pressure, usually at end expiration. C) Add the vertical height over the sternal notch to a 5-cm constant. D) Realize that a total value of over 12 cm is abnormal. - Correct Answer B" "You find a bounding carotid pulse on a 62-year-old patient. Which murmur should you search out? A) Mitral valve prolapse B) Pulmonic stenosis C) Tricuspid insufficiency D) Aortic insufficiency - Correct Answer D" "To hear a soft murmur or bruit, which of the following may be necessary? A) Asking the patient to hold her breath B) Asking the patient in the next bed to turn down the TV C) Checking your stethoscope for air leaks D) All of the above - Correct Answer D" "27. Which of the following may be missed unless the patient is placed in the left lateral decubitus position and auscultated with the bell? A) Mitral stenosis murmur B) Opening snap of the mitral valve C) S3 and S4 gallops D) All of the above - Correct Answer D" "How should you determine whether a murmur is systolic or diastolic? A) Palpate the carotid pulse. B) Palpate the radial pulse. C) Judge the relative length of systole and diastole by auscultation. D) Correlate the murmur with a bedside heart monitor. - Correct Answer A" "Which of the following correlates with a sustained, high-amplitude PMI? A) Hyperthyroidism B) Anemia C) Fever D) Hypertension - Correct Answer D" "You are examining a patient with emphysema in exacerbation and are having difficulty hearing his heart sounds. What should you do to obtain a good examination? A) Listen in the epigastrium. B) Listen to the patient in the left lateral decubitus position. C) Ask the patient to hold his breath for 30 seconds. D) Listen posteriorly. - Correct Answer A" "You are listening carefully for S2 splitting. Which of the following will help? A) Using the diaphragm with light pressure over the 2nd right intercostal space B) Using the bell with light pressure over the 2nd left intercostal space C) Using the diaphragm with firm pressure over the apex D) Using the bell with firm pressure over the lower left sternal border - Correct Answer B" "Which of the following is true of a grade 4-intensity murmur? A) It is moderately loud. B) It can be heard with the stethoscope off the chest. C) It can be heard with the stethoscope partially off the chest. D) It is associated with a "thrill." - Correct Answer D" "Which valve lesion typically produces a murmur of equal intensity throughout systole? A) Aortic stenosis B) Mitral insufficiency C) Pulmonic stenosis D) Aortic insufficiency - Correct Answer B" "You notice a patient has a strong pulse and then a weak pulse. This pattern continues. Which of the following is likely? A) Emphysema B) Asthma exacerbation C) Severe left heart failure D) Cardiac tamponade - Correct Answer C" "Suzanne is a 20-year-old college student who complains of chest pain. This is intermittent and is located to the left of her sternum. There are no associated symptoms. On examination, you hear a short, high-pitched sound in systole, followed by a murmur which increases in intensity until S2. This is heard best over the apex. When she squats, this noise moves later in systole along with the murmur. Which of the following is the most likely diagnosis? A) Mitral stenosis B) Mitral insufficiency C) Mitral valve prolapse D) Mitral valve papillary muscle ischemia - Correct Answer C" "The sac that surrounds and protects the heart is called the: A Pericardium. B Myocardium. C Endocardium. d Pleural space. - Correct Answer A" "The direction of blood flow through the heart is best described by which of these? A Vena cava right atrium right ventricle lungs pulmonary artery left atrium left ventricle b Right atrium right ventricle pulmonary artery lungs pulmonary vein left atrium left ventricle c Aorta right atrium right ventricle lungs pulmonary vein left atrium left ventricle vena cava d Right atrium right ventricle pulmonary vein lungs pulmonary artery left atrium left ventricle - Correct Answer B" "The nurse is reviewing the anatomy and physiologic functioning of the heart. Which statement best describes what is meant by atrial kick? A The atria contract during systole and attempt to push against closed valves. B Contraction of the atria at the beginning of diastole can be felt as a palpitation. C Atrial kick is the pressure exerted against the atria as the ventricles contract during systole. D The atria contract toward the end of diastole and push the remaining blood into the ventricles. - Correct Answer D" "When listening to heart sounds, the nurse knows the valve closures that can be heard best at the base of the heart are: a Mitral and tricuspid. B Tricuspid and aortic. C Aortic and pulmonic. D Mitral and pulmonic. - Correct Answer C" "Which of these statements describes the closure of the valves in a normal cardiac cycle? A The aortic valve closes slightly before the tricuspid valve. B The pulmonic valve closes slightly before the aortic valve. C The tricuspid valve closes slightly later than the mitral valve. D Both the tricuspid and pulmonic valves close at the same time. - Correct Answer C" "The component of the conduction system referred to as the pacemaker of the heart is the: A Atrioventricular (AV) node. B Sinoatrial (SA) node. C Bundle of His. D Bundle branches. - Correct Answer B" "The electrical stimulus of the cardiac cycle follows which sequence? A AV node SA node bundle of His B Bundle of His AV node SA node C SA node AV node bundle of His bundle branches D AV node SA node bundle of His bundle branches - Correct Answer D" "The findings from an assessment of a 70-year-old patient with swelling in his ankles include jugular venous pulsations 5 cm above the sternal angle when the head of his bed is elevated 45 degrees. The nurse knows that this finding indicates: a Decreased fluid volume. B Increased cardiac output. C Narrowing of jugular veins. D Elevated pressure related to heart failure. - Correct Answer D" "When assessing a newborn infant who is 5 minutes old, the nurse knows which of these statements to be true? A The left ventricle is larger and weighs more than the right ventricle. B The circulation of a newborn is identical to that of an adult. C Blood can flow into the left side of the heart through an opening in the atrial septum. D The foramen ovale closes just minutes before birth, and the ductus arteriosus closes immediately after. - Correct Answer C" "A 25-year-old woman in her fifth month of pregnancy has a blood pressure of 100/70 mm Hg. In reviewing her previous examination, the nurse notes that her blood pressure in her second month was 124/80 mm Hg. In evaluating this change, what does the nurse know to be true? A This decline in blood pressure is the result of peripheral vasodilatation and is an expected change. B Because of increased cardiac output, the blood pressure should be higher at this time. C This change in blood pressure is not an expected finding because it means a decrease in cardiac output. D This decline in blood pressure means a decrease in circulating blood volume, which is dangerous for the fetus. - Correct Answer A" "In assessing a 70-year-old man, the nurse finds the following: blood pressure 140/100 mm Hg; heart rate 104 beats per minute and slightly irregular; and the split S2 heart sound. Which of these findings can be explained by expected hemodynamic changes related to age? A Increase in resting heart rate B Increase in systolic blood pressure C Decrease in diastolic blood pressure D Increase in diastolic blood pressure - Correct Answer B" "A 45-year-old man is in the clinic for a routine physical examination. During the recording of his health history, the patient states that he has been having difficulty sleeping. Ill be sleeping great, and then I wake up and feel like I cant get my breath. The nurses best response to this would be: a When was your last electrocardiogram? B Its probably because its been so hot at night. C Do you have any history of problems with your heart? D Have you had a recent sinus infection or upper respiratory infection? - Correct Answer C" "In assessing a patients major risk factors for heart disease, which would the nurse want to include when taking a history? A Family history, hypertension, stress, and age B Personality type, high cholesterol, diabetes, and smoking C Smoking, hypertension, obesity, diabetes, and high cholesterol D Alcohol consumption, obesity, diabetes, stress, and high cholesterol - Correct Answer C" "The mother of a 3-month-old infant states that her baby has not been gaining weight. With further questioning, the nurse finds that the infant falls asleep after nursing and wakes up after a short time, hungry again. What other information would the nurse want to have? A Infants sleeping position B Sibling history of eating disorders C Amount of background noise when eating D Presence of dyspnea or diaphoresis when sucking - Correct Answer D" "In assessing the carotid arteries of an older patient with cardiovascular disease, the nurse would: a Palpate the artery in the upper one third of the neck. B Listen with the bell of the stethoscope to assess for bruits. C Simultaneously palpate both arteries to compare amplitude. D Instruct the patient to take slow deep breaths during auscultation. - Correct Answer B" "During an assessment of a 68-year-old man with a recent onset of right-sided weakness, the nurse hears a blowing, swishing sound with the bell of the stethoscope over the left carotid artery. This finding would indicate: a Valvular disorder. B Blood flow turbulence. C Fluid volume overload. D Ventricular hypertrophy. - Correct Answer B" "During an inspection of the precordium of an adult patient, the nurse notices the chest moving in a forceful manner along the sternal border. This finding most likely suggests a(n): a Normal heart. B Systolic murmur. C Enlargement of the left ventricle. D Enlargement of the right ventricle. - Correct Answer D" "During an assessment of a healthy adult, where would the nurse expect to palpate the apical impulse? A Third left intercostal space at the midclavicular line B Fourth left intercostal space at the sternal border C Fourth left intercostal space at the anterior axillary line D Fifth left intercostal space at the midclavicular line - Correct Answer D" "The nurse is examining a patient who has possible cardiac enlargement. Which statement about percussion of the heart is true? A Percussion is a useful tool for outlining the hearts borders. B Percussion is easier in patients who are obese. C Studies show that percussed cardiac borders do not correlate well with the true cardiac border. D Only expert health care providers should attempt percussion of the heart. - Correct Answer C" "The nurse is preparing to auscultate for heart sounds. Which technique is correct? A Listening to the sounds at the aortic, tricuspid, pulmonic, and mitral areas B Listening by inching the stethoscope in a rough Z pattern, from the base of the heart across and down, then over to the apex c Listening to the sounds only at the site where the apical pulse is felt to be the strongest d Listening for all possible sounds at a time at each specified area - Correct An