NGR 6002 MIDTERM QUESTIONS | WITH ACTUAL SOLUTIONS.
As the advanced practice nurse greets the client, which examination technique is first implemented? -
(ANSWER)inspection
Begin to inspect the patient as you greet him or her as you look for signs of distress or disease. Inspect
the appearance, gait, orientation, and difficulty in hearing or speech.
The position on a clock, topographic notations, and anatomic landmarks - (ANSWER)are methods for
recording locations of findings
Descriptions of the locations of findings are universally referenced by using positions on a clock,
topographic notations, or anatomic landmarks.
A 60-year-old female client reports a 5-day history of constipation. She describes a sensation of
"burning" in her perianal area. This information is considered which part of the assessment data? -
(ANSWER)subjective data
The client is describing a problem from her own perspective; therefore, this data is considered
subjective. The objective data set comprises the client signs, or what the nurse observes in the
assessment. The health history and physical exam are also part of the objective data set.
A client reports difficulty sleeping. Which question would be the most effective way for the advanced
practice nurse (APN) to open the interview? - (ANSWER)"Can you tell me about your sleep problem from
when it started until now?"
In order to open the interview, the APN should start with an open-ended question and then use the OLD
CART mnemonic to identify missing data. Asking when the sleep problem began is assessing for onset of
the problem. Asking the client to rate the sleep problem from 1 to 10 is part of assessing characteristic
symptoms. Asking the client what has been tried to help with the sleep is assessing for treatments.
What is secondary, tangential lighting most helpful in the detection of? - (ANSWER)variations in contour
of the body surface
,NGR 6002 MIDTERM QUESTIONS | WITH ACTUAL SOLUTIONS.
Tangential lighting is used to cast shadows to observe contours and variations in body surfaces best.
More direct lighting is needed when viewing the tonsils, assessing skin color variations, and observing
for foreign objects in the nose or ear.
After the subjective and objective data have been prioritized, what is the next step? -
(ANSWER)formulate a problem list
After the data have been prioritized, the next step is to begin a management plan. The first step is to
formulate a problem list. The problem list is used to develop the differential diagnoses. Ordering tests,
making referrals, or initiating therapy comes after the problem list, and hypothesizing the diagnosis.
During the review of systems within the comprehensive health history, the advanced practice nurse
(APN) notes that a client has multiple previous injuries and accidents. Which of the following issues is a
priority in the APN's assessment? - (ANSWER)investigate the possibility of physical abuse
Physical abuse should be considered if the client has a past history of repeated injuries or accidents.
There is not enough information for the APN to suspect that the patient has a health problem that
impacts balance. The APN will assess the patient for substance and alcohol abuse during the personal
and social history component of the comprehensive health history.
A client reports a ten pound weight loss in the past month, as well a decreased appetite. In which areas
of the review of systems will the advanced practice nurse (APN) note this information? (select all that
apply) - (ANSWER)general, musculoskeletal, gastrointestinal
In the review of systems, weight changes should be documented under general. Appetite is documented
under gastrointestinal. When joint pain is present, anorexia (decreased appetite) and weight loss should
be documented under musculoskeletal.
The sequence of the physical examination should be individualized to - (ANSWER)minimize the number
of times that the client must change positions
There is no one right way to put together the parts of the physical examination. The sequence should be
individualized to minimize the number of times the patient has to change positions to conserve the
client's energy.
, NGR 6002 MIDTERM QUESTIONS | WITH ACTUAL SOLUTIONS.
What can a well-obtained, valid history and physical examination serve to do? - (ANSWER)limit the
indiscriminate use of diagnostics
A comprehensive history with a competent clinical examination can lead the advanced practice nurse to
generate a more accurate problem list, and therefore increase the proper usage of diagnostic testing
while limiting its indiscriminate use.
Which technique is most likely to result in the client's understanding of questions? - (ANSWER)use the
client's own terms if possible
To ensure that questions have been correctly understood, be clear and explicit while using the client's
own terms and level of understanding. Using phrases commonly used by other clients may not help
ensure that the questions have been correctly understood by this client. Be clear and explicit while using
the client's own terms and level of understanding. Using the simplest language will not help ensure that
the questions have been correctly understood. It is important to avoid the use of medical terminology,
because the client may not understand it.
A client angrily tells the advanced practice nurse (APN) that, "It's a shame that you people can't ever be
on time. This interview was supposed to start 30 minutes ago." Which technique should the APN use to
diffuse this client's justified anger? - (ANSWER)acknowledge the client's anger by apologizing for the
delay
When working with an angry client, the APN needs to determine the cause of the anger. If like in this
situation the anger is justified, the APN should acknowledge the delay and apologize for the delay. While
providing an explanation may help diffuse the client's anger, the acknowledgment and apology is
needed initially. It may not be possible to reschedule the interview and referring the problem to the
administrator will not likely diffuse the client's anger.
A middle-aged client who becomes restless during the history and says, "I don't have time for all of this
conversation. I've got to get back to work." What is the most appropriate response? -
(ANSWER)acknowledge his anger and proceed with the history and examination
Acknowledging his anger and proceeding with the history and examination is the only response that
resists the tendency for patient manipulation, pursues the information, and confronts the anger.
As the advanced practice nurse greets the client, which examination technique is first implemented? -
(ANSWER)inspection
Begin to inspect the patient as you greet him or her as you look for signs of distress or disease. Inspect
the appearance, gait, orientation, and difficulty in hearing or speech.
The position on a clock, topographic notations, and anatomic landmarks - (ANSWER)are methods for
recording locations of findings
Descriptions of the locations of findings are universally referenced by using positions on a clock,
topographic notations, or anatomic landmarks.
A 60-year-old female client reports a 5-day history of constipation. She describes a sensation of
"burning" in her perianal area. This information is considered which part of the assessment data? -
(ANSWER)subjective data
The client is describing a problem from her own perspective; therefore, this data is considered
subjective. The objective data set comprises the client signs, or what the nurse observes in the
assessment. The health history and physical exam are also part of the objective data set.
A client reports difficulty sleeping. Which question would be the most effective way for the advanced
practice nurse (APN) to open the interview? - (ANSWER)"Can you tell me about your sleep problem from
when it started until now?"
In order to open the interview, the APN should start with an open-ended question and then use the OLD
CART mnemonic to identify missing data. Asking when the sleep problem began is assessing for onset of
the problem. Asking the client to rate the sleep problem from 1 to 10 is part of assessing characteristic
symptoms. Asking the client what has been tried to help with the sleep is assessing for treatments.
What is secondary, tangential lighting most helpful in the detection of? - (ANSWER)variations in contour
of the body surface
,NGR 6002 MIDTERM QUESTIONS | WITH ACTUAL SOLUTIONS.
Tangential lighting is used to cast shadows to observe contours and variations in body surfaces best.
More direct lighting is needed when viewing the tonsils, assessing skin color variations, and observing
for foreign objects in the nose or ear.
After the subjective and objective data have been prioritized, what is the next step? -
(ANSWER)formulate a problem list
After the data have been prioritized, the next step is to begin a management plan. The first step is to
formulate a problem list. The problem list is used to develop the differential diagnoses. Ordering tests,
making referrals, or initiating therapy comes after the problem list, and hypothesizing the diagnosis.
During the review of systems within the comprehensive health history, the advanced practice nurse
(APN) notes that a client has multiple previous injuries and accidents. Which of the following issues is a
priority in the APN's assessment? - (ANSWER)investigate the possibility of physical abuse
Physical abuse should be considered if the client has a past history of repeated injuries or accidents.
There is not enough information for the APN to suspect that the patient has a health problem that
impacts balance. The APN will assess the patient for substance and alcohol abuse during the personal
and social history component of the comprehensive health history.
A client reports a ten pound weight loss in the past month, as well a decreased appetite. In which areas
of the review of systems will the advanced practice nurse (APN) note this information? (select all that
apply) - (ANSWER)general, musculoskeletal, gastrointestinal
In the review of systems, weight changes should be documented under general. Appetite is documented
under gastrointestinal. When joint pain is present, anorexia (decreased appetite) and weight loss should
be documented under musculoskeletal.
The sequence of the physical examination should be individualized to - (ANSWER)minimize the number
of times that the client must change positions
There is no one right way to put together the parts of the physical examination. The sequence should be
individualized to minimize the number of times the patient has to change positions to conserve the
client's energy.
, NGR 6002 MIDTERM QUESTIONS | WITH ACTUAL SOLUTIONS.
What can a well-obtained, valid history and physical examination serve to do? - (ANSWER)limit the
indiscriminate use of diagnostics
A comprehensive history with a competent clinical examination can lead the advanced practice nurse to
generate a more accurate problem list, and therefore increase the proper usage of diagnostic testing
while limiting its indiscriminate use.
Which technique is most likely to result in the client's understanding of questions? - (ANSWER)use the
client's own terms if possible
To ensure that questions have been correctly understood, be clear and explicit while using the client's
own terms and level of understanding. Using phrases commonly used by other clients may not help
ensure that the questions have been correctly understood by this client. Be clear and explicit while using
the client's own terms and level of understanding. Using the simplest language will not help ensure that
the questions have been correctly understood. It is important to avoid the use of medical terminology,
because the client may not understand it.
A client angrily tells the advanced practice nurse (APN) that, "It's a shame that you people can't ever be
on time. This interview was supposed to start 30 minutes ago." Which technique should the APN use to
diffuse this client's justified anger? - (ANSWER)acknowledge the client's anger by apologizing for the
delay
When working with an angry client, the APN needs to determine the cause of the anger. If like in this
situation the anger is justified, the APN should acknowledge the delay and apologize for the delay. While
providing an explanation may help diffuse the client's anger, the acknowledgment and apology is
needed initially. It may not be possible to reschedule the interview and referring the problem to the
administrator will not likely diffuse the client's anger.
A middle-aged client who becomes restless during the history and says, "I don't have time for all of this
conversation. I've got to get back to work." What is the most appropriate response? -
(ANSWER)acknowledge his anger and proceed with the history and examination
Acknowledging his anger and proceeding with the history and examination is the only response that
resists the tendency for patient manipulation, pursues the information, and confronts the anger.
