NURS-6512 | MID – TERM EXAM READY VERSION MADE UP OF QUESTIONS AND THEIR CORRECT ANSWERS

NURS-6512 | MID – TERM EXAM READY VERSION MADE UP OF QUESTIONS AND THEIR CORRECT ANSWERS What grading scale is used for demonstrating physical examination techniques? - Answer 2/4 = Demonstrated thoroughly with correct technique, 1/2 = Demonstrated partially with mostly correct technique, 0 = Did not demonstrate or demonstrated with incorrect technique. What approach should be used when conducting a physical examination? - Answer A head to toe (cephalo-caudal) and anterior-posterior approach. What must students verbalize during the physical examination? - Answer Each exam step and identify all cranial nerves by name and number. What is the significance of documentation in the physical examination? - Answer Appropriate documentation must be noted in blue. What lymph nodes should be palpated during the head and face examination? - Answer Preauricular, postauricular, occipital, tonsillar, submandibular, submental, anterior cervical, posterior cervical, and supraclavicular. What cranial nerve is tested by palpating the masseter muscle as the patient clenches their jaw? - Answer Cranial Nerve 5 (Trigeminal). What sensory test is performed to assess Cranial Nerve 5 (Trigeminal)? - Answer Light touch sensation to the forehead, cheeks, chin, and nose. How is Cranial Nerve 7 (Facial) assessed? - Answer By inspecting for facial symmetry during smile, frown, raise eyebrows, puff cheeks, and pucker lips. What is inspected during the ear examination using an otoscope? - Answer The auditory canal and tympanic membrane (TM) for clarity, swelling, redness, drainage, or cerumen. What is the normal appearance of the tympanic membrane? - Answer Pearly gray with no effusion. What test is used to assess Cranial Nerve 8 (Acoustic)? - Answer The Whisper Test. What does the Whisper Test involve? - Answer Whispering three words out of the patient's sight and having the patient repeat them back. How is peripheral vision assessed for Cranial Nerve 2 (Optic)? - Answer By standing at the same eye level and bringing hands from beside the patient to see if they notice them. What does PERRL stand for in the context of pupil examination? - Answer Pupils Equal, Round, Reactive to Light. What is the procedure for checking pupillary response to light? - Answer Using an ophthalmoscope with a light source. What should be noted about the lymph nodes during examination? - Answer They should show no enlargements and be equal bilaterally. What is the proper technique for inspecting the auditory canal? - Answer Pull the ear up and back. What is the purpose of the physical examination check-off rubric? - Answer To evaluate the thoroughness and correctness of the physical examination technique. What is the expected outcome for hearing during the Whisper Test? - Answer Hearing is intact bilaterally. What should a student do if exam steps are out of order? - Answer No deductions are given for exam steps out of order. What is the role of appropriate documentation in the physical examination? - Answer To ensure clarity and accountability in the examination process. What cranial nerve is assessed when checking for facial symmetry? - Answer Cranial Nerve 7 (Facial). Examination Findings of a child with Kawasaki disease - Answer Fever, Conjunctival Injection, Strawberry Tongue, and Edema of the Hands and Feet. Lymphadenopathy and Polymorphous Nonvesicular Rashes. Peripheral Edema - Answer Grading: 1+ Slight Pitting, no visible distortion, disappears rapidly. 2+ A Somewhat Deeper Pit than in 12+, but again no readily detectable distortion, disappears in 10-15 seconds. 3+ Noticeably Deep Pit that may last more than a minute; dependent extremity looks fuller and swollen. 4+ Very Deep Pit that lasts as long as 2-5 min; dependent extremity is grossly distorted. Ammonia in breath odor - Answer Uremia (ammonia) Grading of Pulses - Answer 4+ Bounding 3+ Full, Increased 2+ Expected 1+ Diminished, barely palpable 0 Absent, not palpable Acute Limb Ischemia (ALI) - Answer Stage I - Viable - No sensory impairment - No motor impairment - Audible Arterial Doppler Signal - Audible Venous Dopler Signal Stage IIa - Marginally Threatened - Minimal Sensory Impairment - No Motor Impairment - Often inaudible Arterial Doppler Signal - Audible Venous Doppler Signal Stage IIb - Immediately Threatened - Rest Pain Sensory Impairment - Mild to moderate Motor Impairment - Inaudible Arterial Doppler Signal - Audible Venous Doppler Signal Stage III - Irreversible - Anesthetic Sensory Impairment - Paralytic/rigor Motor Impairment - Inaudible Arterial Doppler Signal - Inaudible Venous Doppler Signal Assessment for Peripheral Arterial Disease - Answer Site of Pain is Distal to the Narrowing. Note: Pulses (strong, weak or possibly absent) Possible systolic bruits over the arteries that may extend through diastole. Loss of expected body warmth. Localized pallor and cyanosis. Collapsed superficial veins, with delay in venous filling. Thin, atrophied skin; muscle atrophy. WBC level Newborn - Answer 9-30 Billion cells/L until 2 weeks old WBC Levels in Adults - Answer 3.4 to 9.6 billion 5 types of WBC - Answer Neutrophils lymphocytes monocytes eosinophils basophils Usually What WBC is the largest - Answer Neutrophils What WBC type is the largest as a newborn - Answer Lymphocytes until 8 years old Leukopenia - Answer less than 4000 * viral infection * bacterial infection * bone marrow issue Severe leukopenia - Answer less than 500 can be at risk for fatal infection dying of even a cold when is leukocytosis common - Answer during pregnancy due to increased neutrophils What wbc type elevates with allergies - Answer Eosinophils what wbc type elevates with infections (bacterial and viral) - Answer Viral: lymphocytes bacterial: neutrophils Hemoglobin (Hgb) what does it go - Answer carries oxygen throughout the body making up 95% of dry wt of RBC Hemoglobin is what type of structure - Answer quaternary structure made of 4 globular proteins (2 alpha/2beta) with an iron center for o2 binding Erythocytosis and 6 causes - Answer elevated Hgb caused by: polycythemia, high altitude, heart disease, copd/pulm disease, dehydration, renal issue anemia and at least 5 causes - Answer low hbg, due to : iron deficiency or vitamin b12 /folate deficiency, chronic renal failure, aplastic anemia, bone marrow issue, leukemia, lymphoma, or blood loss What lymph nodes should be palpated in the head and neck? - Answer Preauricular, postauricular, occipital, tonsillar, submandibular, submental, anterior cervical, posterior cervical, supraclavicular. How should cranial nerve V (Trigeminal) be assessed? - Answer Motor: palpate over the masseter muscle as the patient clenches jaw; Sensory: light touch sensation to forehead, cheeks, chin, nose. What is the procedure for assessing cranial nerve VII (Facial)? - Answer Inspect for facial symmetry while the patient smiles, frowns, raises eyebrows, puffs cheeks, and puckers lips. What should be inspected in the ear examination? - Answer Auditory canal and tympanic membrane (TM) for clarity, swelling, redness, drainage, cerumen, and the TM should be pearly gray with no effusion. How is cranial nerve VIII (Acoustic) assessed? - Answer Using the Whisper Test: whisper three words out of the patient's sight, and the patient repeats them back. What are the steps for assessing cranial nerve II (Optic)? - Answer Assess peripheral vision and check pupillary response to light (PERRL). What is the procedure for assessing extraocular movements? - Answer Test for conjugate gaze using an H pattern and have the patient follow with only their eyes. What should be assessed in the nose examination? - Answer Nasal turbinates and septum for color and alignment, palpation of frontal and maxillary sinuses for tenderness. What structures should be inspected in the throat and mouth? - Answer Lips, teeth, gums, buccal mucosa, palate, tongue, floor of the mouth, posterior pharynx, and tonsils. How is cranial nerve IX (Glossopharyngeal) and X (Vagus) assessed? - Answer Have the patient say 'Ahh' and check if the soft palate and uvula rise symmetrically. What is the procedure for assessing cranial nerve XII (Hypoglossal)? - Answer Ask the patient to stick out their tongue and move it left to right. What should be palpated in the neck examination? - Answer Trachea for midline position and thyroid gland for nodules while the patient swallows. How is the carotid artery auscultated? - Answer Auscultate for bruits using the bell of the stethoscope while the patient holds their breath. What areas should be auscultated for heart sounds? - Answer Aortic, pulmonic, Erb's point, tricuspid, and mitral areas. What should be assessed during the anterior chest examination? - Answer Auscultate lung sounds in the anterior lung fields. What is the procedure for assessing the posterior chest? - Answer Auscultate posterior lung fields, starting above the scapula and alternating side-to-side. What should be assessed in the upper extremities? - Answer Range of motion (ROM) and deep tendon reflexes (DTR) unilaterally; strength testing bilaterally. What is the procedure for assessing the abdomen? - Answer Auscultate for bowel sounds in all four quadrants, palpate for tenderness and masses. What should be done to assess the liver and spleen? - Answer Palpate while the patient takes a deep breath to feel the lower edge of the liver and check for spleen. What should be assessed in the lower extremities? - Answer Passive unilateral ROM of hips, knees, and ankles; strength at the knees and ankles bilaterally. What is the procedure for assessing active ROM of the spine? - Answer Assess flexion, extension, lateral