NURS 634 Midterm Exam 2025

Upon auscultating someone's lungs there is decreased air movement and high pitch expiratory whistling. What diagnosis is at the top of the list? - -Asthma What can you do if someone comes in, is distracted, and needs redirecting - Summarize why the patient is here and the plan A patient presents with a bloody left eye. What questions should you ask? - - • Injury or trauma? No • Sneezing or coughing? No • BP? Normal • Changes in vision, double vision, visual disturbances? No • Blood thinners? No • Headaches? No • Eye hemorrhage from vomiting after drinking alcohol = subconjunctival hemorrhage What eye disorders are normal in geriatric patients? - -• Cataracts: no • Glaucoma: no • Macular degeneration: no (common but not expected) • Presbyopia (near sighted): yes The proper way to start an initial consult - - 1. Introduce yourself 2. Establish rapport 3. Ask for the chief complaint Which lymph nodes are behind the sternoclavicular mastoid? - -Posterior cervical lymph nodes A woman comes in with vague complaints: muscle ache, not sleeping well. What diagnosis is probable? - -Depression (always have a psych differential for vague symptoms) A patient with a history of GERD is being assessed. What education should be provided? - - • Eliminate spicy food • Eliminate acid foods • They should avoid eating late at night If a patient has blurred vision while covering one eye, what CN is involved? - -CN III - Oculomotor (blurred vision or double vision = CN III) MECHANIC MECHANIC Medial epicondyle and lateral epicondyle, what are the two disorders that happen with the elbow? - - • Lateral: swinging back (tennis) • Medial: swinging forward (golf) Percussion on lungs sound dull, what are differentials? - - • Consolidation (pneumonia) • Could be bilateral, depending on location If a patient has a large lump on the back and the I&D has cheesy like substance. What is it? - -Sebaceous cyst What is the normal cup to disk ratio in a normal eye exam? - -1:3 If the cup to disk ratio is 1:2, what is suspected? - -Glaucoma One differential to diagnose chest pain that does not radiate - -Angina A patient losses all vision in one eye, differentials? - - • Retinal detachment (painless) • Optic neuritis (painful) A spot between the wrist and thumb has palpation tenderness, what bone is suspected to have an injury? - -Scaphoid injury Landmarks for Point of Maximal Impulse (PMI) - -5th ICS and mid clavicular line What questions should be asked when a patient presents with jaw pain? - - • Does it hurt when you open your mouth? • Is there clicking? • Is it bilateral or one side? • Facial tenderness? (TMJ goes all the way to scalp) Pain in the TMJ are is known as - -TMJD You're taking a patient's history and they have a nursing degree, what section would you document that under? - -Social A young elementary school girl has hair falling out. What questions are you asking? - - • Are they stressed? • Family history? • Malnourished? • Alopecia (if all other areas are normal) A patient has spiderweb veins going up the neck, what is this indicative of? - Esophageal varices MECHANIC MECHANIC Which physical exam finding is consistent with meningitis? - -Nuchal rigidity Which CN is being assessed when looking at someone's soft palate? - -CN X A small moveable mass is located under someone's skin. What are differentials? - lymph node, cysts, or lipoma What is the medical term for a stye? - -Hordeolum A patient with a history of lupus has a new onset of dark rashes on her legs. Are you as a provider worried? - -No, it is related to the lupus Which acronym is used for women with incontinence? - -DIAPERS: • D: delirium • I: infection • A: atrophic uterus • P: psychology • E: excessive urine output • R: restricted mobility • S: stool impaction When you move a patient's shoulder passively and there is no pain, but when moved actively there is pain, where is the pain coming from? - -Extra-articular (muscles and joints) A daycare worker presents with jaundice, what is the differential? - -Hepatitis A Silvery scales should make you think of what diagnosis? - -Psoriasis You are assessing a patient's abdomen and feel a pulsating mass. What should you do? - -STOP touching the mass and get a stat CT Abdomen (Abdominal ultrasound to r/o AAA) What should be charted in the ROS? - -Patient "denies" or "reports" ABCDE skin assessment - -asymmetry, border, color, diameter, elevation and enlargement A patient presents with a rash that started as one large patch but is now a Christmas tree formed rash: - -Pityriasis rosea When assessing the CN II, a pen light is flashed in one eye and the other pupil constricts. This is known as: - -Consensual reaction