NR 509 Physical Assessment - Final Exam (Bates) Updated 2024/2025 Solved 100% – Chamberlain

NR 509 Physical Assessment - Final Exam (Bates) Updated 2024/2025 Solved 100%-Chamberlain Sensitivity Number of people who test positive. A test with a high sensitivity will rule (in/out)? IN Specificity Number of people who test negative. A test with a high specificity will rule (in/out)? OUT If 100 patients known to have a colon cancer were tested, and 43 tested positive, what percentage would be the sensitivity of the test? 43% Do we rule out a disease with high sensitivity or high specificity? Specificity If 100 patients with no known colon cancer are tested and 94 return with a negative results, what percentage would the specificity of the test? 94% What does the phrase Lets Tackle Symptoms with Q's and A's stand for? Location, timing (duration, onset, frequency), setting (when, where), quality/quantity (burning, itching, sharp, aggravating/associating/alleviating True or False: An established patient comes to your office with a new onset of sore throat and headache. She has recently given birth (3 weeks ago), which was uncomplicated. A comprehensive exam is necessary. True What is a macule? Flat lesion, <1cm What is a patch? Flat lesion, >1cm What is a papule? Raised lesion, <1cm, no fluid What is a plaque? Raised lesion, >1cm, no fluid What is a vesicle? Raised lesion, <1cm, fluid filled What is a bulla? Raised lesion, >1com, fluid filled True or False: A papule is a fluid filled lesion. False A patient recently had a malignant melanoma removed from her back. Which statement by the patient ensures she understood your instructions about preventing skin cancer and further skin care? A. Melanoma rarely metastasis only squamous cell. B. I will wear SPF greater than 30 and check for any skin changes weekly. C. I can go outside without sunscreen after 3 pm because the dangerous sun rays has gone away. D. I will only concern myself with moles that have had constant sun exposure. B The most sensitive criteria when ruling in melanoma is? Evolution During a full body skin assessment of a patient you see the following lesion with these characteristics: waxy border, red papule with a central crater. This describes what type of lesion? A. Basal Cell B. Normal nevi C. Squamous Cell D. Melanoma A A nurse assesses a client suspected of having major depressive disorder. Which client symptom would eliminate this diagnosis? A. The client is disheveled and malodorous. B. The client refuses to interact with others. C. The client is unable to feel any pleasure. D. The client has maxed-out charge cards and exhibits promiscuous behaviors. D What is the rationale for a nurse practitioner to perform a full physical health assessment on a client admitted with a diagnosis of major depressive disorder? A. The attention during the assessment is beneficial in decreasing social isolation. B. Depression can generate somatic symptoms that can mask actual physical disorders. C. Physical health complications are likely to arise from antidepressant therapy. D. Depressed clients avoid addressing physical health and ignore medical problems. B A nurse admits an older client who is experiencing memory loss, confused thinking, and apathy. A psychiatrist suspects depression. What is the rationale for performing a mini-mental status exam? A. To rule out bipolar disorder B. To rule out schizophrenia C. To rule out dementia D. To rule out a personality disorder C What are the functional syndromes? IBS, Chronic Fatigue, Fibro Myalgia, TMJ It is not uncommon for a patient to experience high volume nocturia when diagnosed with? A. CHF B. Benigh Prostate Hypertrophy C. Nephrotic Syndrome D. Hepatic Cirrohsis E. Pancretitis F. A & B G. A, B, & D H. A, C, & E I. A, C, & D I True or False? Low frequency nocturia is common in patients diagnosed with benign prostate hypertrophy? False (they are diagnosed with low volume nocturia) The nurse practitioner would expect to find which of the following in a patient diagnosed with chronic arterial insufficiencies? A. Red, dusky legs B. Pale with leg elevation C. Edema D. Normal Pulses E. A & B F. A, B, C G A, B, D E A patient that complains of intermittent claudication that progresses to pain while walking but resolves at rest may be diagnosed with what type of insufficiency? Arterial A patient with chronic venous insufficiency may present with? A. Cool legs and feet B. Brown pigmentation, staining C. Grangrene D. Ulceration on toes E. A & B F. A, B, & C G. B, C, & D B A patents ankle-brachial index was calculated as 0.74. This would be considered? Mid PAD Normal ankle-brachial index values are? >.90 Severe ankle-brachial index values are? <0.39 A 14 year old patient comes to the clinic for his yearly physical. Upon the eye examination, the nurse practitioner documents a red reflex in his left eye and a white reflex in his right eye. The NP would document this finding as: A. A normal finding. B. An unexpected finding. B Absence of red reflex suggests? Opacity of lens, opacity of vitreous, artificial eye, detached retina, or retinablastoma. What is amblyopia? "Lazy eye" What is myopia? Near-sighted What is hyperopia? Far-sighted What is presbyopia? Gradual vision changes with aging. A patient with presbyopia would expect to lose what type of vision first? Myopia What is diplopia? Double vision What is ptosis? Drooping of eyelid What is proptosis? Buldging of eyeball. A patient is diagnosed with strabismus. What would the NP expect to find following this diagnosis? A. Cross eyes B. Rapid movements of eyes C. A painful lesion on eyelid margin D. Eyelashes that turn inward, causing irritation of the corneas. A A patient complains of a painful lesion on the eyelid margin. The most likely diagnosis is? A. Chalazion B. Anasokoria C. Stye D. Drusen C Undigested cell debris that is typically seen in patients with macular degeneration is called? Drusen While preforming an opthalmoscope exam, the NP notices yellow spots. She would document this finding as? Drusen What are infarcted nerve fibers in the eyes called? Cotton wool patches Cotton Wool patches are commonly seen in patients with? A. Macular Degeneration B. Diabetes C. HTN D. A & B E. B &C E Risk factors for cataracts? DM, Cigarettes, Alcohol, Medications (steroids) What is anasorkia? Difference in pupil size (>.04mm) "Worst headache of my life"? Subarachnoid hemorhage or meningitis What assessment tool(s) would be most valuable when diagnosing meningitis? A. McBurneys Point B. Kernig's Sign C. Rosvings Sign D. Bowmans Sign B True or False A patient with meningitis may have acute mental status change? True A patient comes to the clinic wearing sunglasses and a jacket, complaining of a intense headache that has lasted for the past day with nausea and vomiting. She denies fever or a cough. Upon further evaluation, the patient states that she has a sensitivity to perfume and she visited a new perfume shop the day before. The most likely diagnosis would include? Migraine A patient has been diagnosed with a brain tumor. The NP would expect what type of headaches? A. Intermittent B. Constant C. Worsening over time D. A & B E. A & C E A 62 year old, female patient comes to the clinic complaining of a headache for the past 5 days. She is a fairly active woman, exercises 6 times per week and enjoys time playing with her grandson. She states that she is thankful she is in remission following her diagnosis of breast cancer 5 years earlier. She states that she has not been having trouble sleeping when she props herself up on pillows and dose not have any other symptoms. Which of the following would the NP want to evaluate further due to headache? A. Age B. Exercise 6 times per week. C. Cancer diagnosis D. Sleeping position E. A, B, C F. A, C, D G. C, D F What sinuses can be transilluminated? Maxillary and Frontal True of False It is common for a deviated septum to cause problems with breathing. False What are the two most common reasons that can restrict airflow through the nasal passage? Nasal polyps and foreign bodies What are boggy, pale, saclike growths in the nose? Nasal polyps Which of the following are true? A. Nasal polyps are boggy, saclike growths that obstruct airflow and can bleed. B. Both the medial and inferior turbinates can be noted on exam. C. A deviated septum indicates a problem that needs to be addressed. D. Purulent drainage can occur from a foreign body obstruction. A, B, D Which of the following require immediate attention? (select all that apply) A. Closed angle glaucoma B. Open Angle glaucoma C. Papilledema D. White reflex A, C, D The NP preforms the Weber test on a patient. The patient notes that he can hear the sound on the right ear, his impaired ear. The nurse would document? A. Appropriate lateralization noted. B. . Possible conduction hearing loss. C. Possible sensorineural hearing loss. D. Left sided conduction hearing loss. B In sensorineural hearing loss, during the Weber test the sound will lateralize to which ear? A. Impaired B. Good C. Both B When performing the Weber test on a patient, the patient notes that the sound is heard in the left ear. How would the NP document this finding? A. Air conduction is greater than bone conduction. B. Left sided conduction loss C. Right sided sensorineural loss D. A, B, C E. A, B F. B, C F When performing the Rinne test, where does the NP place the tuning form first? A. Behind ear B. On the top of the head C. In front of the ear D. Forehead A A normal finding for the Rinne test is? AC > BC True or False In conductive hearing loss, bone conduction is greater/equal than air conduction. True True or False In sensorineural hearing loss, air conduction is less than/equal to bone conduction False A patient demonstrates right sided conductive hearing loss. How would the NP document the finding? A. Weber - sound will lateralize to the right. B. Rinne - bone conduction will be greater/equal to air conduction C. Weber - sound will lateralize to the left. D. Rinne - air conduction will be greater/equal to bone conduction. E. A, D F. B, C G. A, B F. C, D G During a hearing assessment, the nurse notes that the sound lateralizes to the clients left ear with the Weber test. The NP analyzes this result as: A. A normal finding B. A sensorineural or conductive hearing oss C. Nystagmus D. Conductive hearing loss in right ear. B The NP has notes that the patient has a diagnosis of presbycusis on the client's chart. The NP plans care knowing the condition is: A. A sensorineural hearing loss that happens with age. B. A conductive hearing loss that happens with age. C. Tinnitus that occurs with aging. D. Abnormal nystagmus. A Finding: Weber Lateralizes Left. Rinne both ears AC>BC. What type of loss and what side is the impairment? Sensorineural, Right Finding: Weber Lateralizes Left. Rinne Left BC>AC. What type of loss and what side is the impairment? Conductive, Left Finding: Weber Lateralizes Right. Rinne both ears AC>BC. What type of loss and what side is the impairment? Sensorineural, Left Finding: Weber Lateralizes Right. Rinne Right BC>AC. What type of loss and what side is the impairment? Conductive, right Upon examination, a NP notes that the tympanic membrane is translucent and thin. She would document this finding as? A. A normal ear drum. B. Ottis media C. A healed perforated ear drum. D. A medical emergency to preserve conductive hearing loss. C Where would the lesion be in a Right Homonymous Hemianopsia? Left optic tract Where would the lesion be in a blind right eye? Right optic nerve Where would a lesion be in a left Homonymous Hemianopsia Right optic tract Where would the lesion be in a Bitemporal Hemianopsia? Optic chiasm A 13 year old patient comes to the clinic with complaints of a fever, and sore throat. Upon examination the NP notes exudate, lymph swelling, and fever, without cough. According to CENTORs criteria, what score would be given to the patient to determine if throat culture is necessary? 5 (rapid strep culture appropriate) A 48 year old, female patient comes to the clinic with a heavy cough and sore throat that began 4 days ago. Upon examination, the NP notes exudate and swollen tonsilles, no fever, and cough. According to CENTORs criteria, what score would be given to the patient to determine if throat culture is necessary? 1 (no testing or antibiotics required) What are the criterium that make up CENTORs? (select all that apply) A. Free from Cough (+1) B. Exudate on tonsills. (+1) C. Tender or swollen Nodes (+1) D. Temperature (+1) E. <14 (+1) OR >45 (-1) A, B, C, D, E What does the supraclavicular and infraclavicular drain? A. Neck B. Arms C. Abdomin D. Thoracic E. Head F. A, D G. B, D H. A, B, C, D I. D, E J. C, D J True or False The subraclavicular nodes get their drainage from the lateral nodes. False (from central) It is not uncommon to see generalized lymphadenopathy is which of the following diseases? A. HIV B. Strep C. Mono D. Sarcoidosis E. Leukemia F. A, B, C G. C, D H. A, C, D, E H What are common reasons for a deviated trachea? Tumor, pneumo, atelectisis Cranial Nerve II correlates with? Visual fields, snellen chart When using a Snellen chart, which cranial nerve is the NP testing? A. CN 1 B. CN II C. CN V D. CN VII B Cranial nerve(s) responsible for extraocular movements (select all that apply)? A. CN I B. CN II C. CN III D. CN IV E. CN V F. CN VI G. CN VII H. CN VIII C, D, F Cranial nerves II and III check for what? Pupillary reaction, direct and consentual True or False Cranial nerves I, III, VI, VIII, VIIII, X are all motor. False A NP is rounding in the hospital and is performing an assessment on a 73 year old man diagnosed with Parkinsons disease. The NP determines that he may be having difficulty swallowing after an absent gag reflex response. What cranial nerves did the NP check (select all that apply)? A. VII B. VIII C. VIIII D. X E. XI F. XII C, D A NP asks the patient to close their eyes and places a paperclip in his hand. She asks the patient to identify the object. She is testing for? A. Graphestesis B. Stereogenesis C. Sensory Cortex D. A, C E. B, C E The ridge under the sternal notch correlates with what rib? A. 2nd B. 3rd C. 4th D. 5th A To assess the functioning of the trigeminal and facial nerves (CNs V and VII), the nurse should a. shine a light into the patient's pupil. b. check for unilateral eyelid drooping. c. touch a cotton wisp strand to the cornea. d. have the patient read a magazine or book. A Which action will the NP include in the plan of care for a patient with impaired functioning of CN IX and the CN X? a. Withhold oral fluid or foods. b. Provide highly seasoned foods. c. Insert an oropharyngeal airway. d. Apply artificial tears every hour. A A 45-year-old patient has a dysfunction of the cerebellum. The NP will plan interventions to a. prevent falls. b. stabilize mood. c. avoid aspiration. d. improve memory. A The sternal angle is located on what structure? A. Clavicle B. Humerus C. Manubrium D. Xiphoid Process C Which of the following are considered consolidation of the lung fields? A. COPD B. Pneumonia C. Pneumothorax D. Asthma E. A, B F. B, C G. A, B, D B Fremitus will (increase/decrease) over areas of consoludation? Increase Upon percussion of the posterior back, a patient with pneumonia would expect to hear? A. Resonant percussion B. Tympanic C. Dull D. Hyperresonant C A patient with asthma and COPD would have what type of lung sound to percussion? Hyperresonant Inspiration is than expiration in vesicular lung sounds? greater Inspiration is than expiration in bronchovesicular lung sounds? equal Inspiration is than expiration in bronchial lung sounds? less Tracheal breath sounds are greater than, less than, or equal during inspiration and expiration? equal What position is the best when listening to PMI? A. Supine B. Prone C. LLD D. Leaning forward C Where does the NP place her stethoscope to listen to pulmonic valve? A. Right of the sternum, 2nd intercostal space B. Left of the sternum, 2nd intercostal space C. Manubrium D. Left of the sternum, 4th intercostal space B A NP suspects mitral regurgitation. Where does she place her stethoscope for best hearing? A. Right of the sternum, 5th intercostal space, mid clavicular line B. Left of the sternum, 4th intercostal space C. Left of the sternum, 5th intercostal space D. Left of the sternum, 5th intercostal space, mid clavicular line D Where does the NP place her stethoscope for suspected aortic regurgitation? A. Left of the sternum, 3rd intercostal space B. RIght of the sternum, 2nd intercostal space C. Left of the sternum, 2nd intercostal space D. Right of the sternum, 3rd intercostal space C The healthcare provider is caring for a patient with a diagnosis of mitral stenosis. When auscultating the patient's chest, which type of heart sound should the healthcare provider expect to hear? A. Systolic Murmur B. Diastolic Murmur C. Midsytolic Murmur D. Pansystolic Murmur E. B, C F. B, D B The healthcare provider is auscultating the heart of patient with valve disease. A quiet but immediately audible murmur is heard. How would this murmur be graded? A. Grade I B. Grade II C. Grade III D. Grade IV B The healthcare provider is caring for a patient with a systolic heart murmur. Which of these valve disorders are associated with a systolic murmur? A. Aortic and Tricuspid Stenosis B. Pulmonic Regurg and Tricuspic Regurg C. Aortic Stenosis and Mitral Regurg D. Pulmonic and mitral stenosis C What is the best position for a patient to be in for the NP to assess for aortic regurg? Have patient lean forward, exhale, and then hold breath. Mitral stenosis, S3, and S4 is best heard with which side of the stethoscope? Why? Bell, low pitch Ventricular gallop occurs in which stage of cycle? A. Late in diastole B. Late in systole C. Early in diastole D. Early in systole C Atrial gallope occurs in which stage of cycle? A. Late in diastole B. Late in systole C. Early in diastole D. Early in systole A JVP measures what? A. Central venous pressure B. Jugular venous pressure C. Right atrial pressure D. Left atrial pressure E. A, B F. A, C G. A, B, C F In which stage can a palpable thrill be noted (select all that apply)? A. Stage I B. Stage II C. Stage III D. Stage IV E. Stage V F. Stage VI D, E, F One would expect a patient with hyperthyroidism to exhibit the following signs: A. Moist skin B. Thin hair C. Increased heart rate D. Weight loss E. Constipation F. A, B G, A, C, D H. C, D G The NP suspects and injury to the right meniscus. Which test does she perform to support this conclusions? A. McBurneys B. Empty Can C. McMurphys D. Anterior Drawer E. McMurreys E The NP using the Lochmans test to inspect which body part? A. MCL B. ACL C. CCL D. LCL B Which of the following are appropriate tests to assess for rotator cuff injury (select all that apply)? A. McMurphys B. Empty Can C. Apley D. Hawkins E. Drop Arm F. Cross Over B, C, D, E A patient comes to clinic with pain in the epigastric region. the NP can suspect what? A. Appendix B. Pancreatitis C. Liver D. Small intestines B A patient comes to the clinic and complains of left sided, crampy pain. What would the NP suspect? A. Diverticulitis B. Crohns disease C. Fecal impaction D. Colon CA A Pain in the hypgastric region would include: A. Colon B. Uterus C. Bladder D. A, B E. B, C F. A, B, C F A patient comes to the clinic complaining of intense RLQ pain. The NP suspects appendicitis and using what exam to support her diagnosis? A. McBurneys B. Psoas C. Rovsing D. Kernigs E. A, B F. A, C G. A, B, C H. A, B, C, D G Murphys sign checks for? A. Appendicitis B. Liver englargement C. Stool impaction D. Pancreatitis B A client is admitted to the hospital after vomiting bright red blood and is diagnosed with a bleeding duodenal ulcer. The client develops a sudden, sharp pain in the mid epigastric area along with a rigid, board-like abdomen. These clinical manifestations most likely indicate which of the following? A. Intestinal herniation B. Ulcer perforation C. Esophageal inflamation D. Additional ulcer formation B Which type of hernia is most common? A. Direct B. Indirect C. Femoral D. Hiatal B True of False Indirect hernias only occur in adults greater than 18 and femoral hernias occur most frequently in femals. False Which type of hernia is most common in males? A. Indirect B. Direct C. Femoral D. Hiatal B Which type of speculum is most appropriate for a woman that has never had sexual intercourse? A. Graves B. Pederson C. Pediatric D. None B The Graves speculum is most appropriate for women who are sexually active? True True or False When collecting a pap smear sample, we use a brush before a scrapper. False What equipment is best used for a pregnant patient who needs a pap smear? A. Brush B. Scrapper C. Cotton D. A, B E. B, C C True or False Squamous cells replace columnar cells in the transformation zone. True Ovaries produce? A. Testosterone B. Estrogen C. Ovum D. Progesterone E. All of the above E What is the primary role of estrogen during pregnancy? A. Increases growth of uterus B. Increases growth of vagina C. Stimulates prostaglandin for clotting D. A, B E. A, C F. A, B, C F A pregnant patient comes to the clinic complaining of horrible heartburn. What is the best rationale for this symptom during pregnancy? A. Estrogen causes the tone of spinchter to relax. B. Testosterone causes the tone of spinchter to relax. C. Progesterone causes the tone of spinchter to relax. D. Progesterone increases gastric secretions, causing reflux. C A 34 year old female comes to clinic with complaints of nausea and vomiting. Her LMP was March 3, 2018 and she has a positive pregnancy test. Using Nagele's rule, what is her estimated due date? A. December 2, 2018 B. November 27, 2018 C. December 10, 2018 D. December 17, 2018 C Upon examination, a pregnant patient has a bluish cervix. What sign is this? A. Chadwicks B. Hedgars C. Rosvings D. Transformation Sign A A softening of the cervix during pregnancy is called? Hedgars Sign A pregnant patient comes to clinic complaining of vaginal white discharge with intense itching. She is diagnosed with vaginal candida. This is not uncommon due to? A. Increased vaginal secretions from pregnancy. B. Increased glycogen in vaginal cavity. C. Decrease pH, making vaginal cavity more prone to infection. D. Having sexual intercourse while pregnant. B The most common breast growth in patients between the ages of 15-35 is? Fibroadenoma When is it best to do a breast exam on a female patient? A. During menses B. 2-3 days after menses C. 4-5 days before menses begins D. 6-7 days after menses. D True or False Dense breast tissue makes a mammogram less sensitive and less specific. True A NP would expect a patient with delirium to exhibit the following signs and symptoms: A. A disruptive sleep/wake cycle B. ALC C. Poor concentration D. Chronic condition E. A, B F. B, C G. A, B, C, D F. A, B, C F True of False Dementia is a rapidly deteriorating condition that progresses to a loss of memory, learning, and language. False