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Exam (elaborations)

Mosby_PreTest_-_Answers_&_Rationales_v2 (4)

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Pretest Results Assessment Diagnosis Plan Evaluation NP Role 1. Which of the following heart sounds is abnormal in an adult? A. S1 B. S3 C. Split S2 D. S2 An S3 is abnormal when heard in an adult. It represents fluid overload (Kidd et al, 2003). *Assessment/Cardiovascular Category Points Earned: 1/1 Correct Answer: B Your Response: B 2. In a patient with presumed gonorrhea, which of the following symptoms would indicate PID? A. Positive clue cells B. Suprapubic tenderness C. Cervical motion tenderness D. Positive gonorrhea culture Diagnostic criteria for PID include CMT and uterine or adnexal tenderness along with a fever and mucopurulent cervical discharge (Miller, 2006). *Assessment/Infectious Disease Category Points Earned: 1/1 Correct Answer: C Your Response: C 3. A child returns to the office with little improvement after being treated with amoxicillin 45 mg/kg/day. Which historical data would indicate that he has resistant strep pneumococcus? A. He attends day care. B. His brother has strep throat. C. He recently had a head cold. D. He has allergic rhinitis. Children who attend day care, those who have taken antibiotics in the past month, and those who are less than 2 years of age are more likely to have resistant bacteria. A higher dose of 80 to 90 mg/kg is recommended for those children (AAP, 2004). *Assessment/Ears Category Points Earned: 1/1 Correct Answer: A Your Response: A 4. Which of the following symptoms is most indicative of diverticulitis? A. Pain improving with eating B. Lef t lower Quadrant pain C. Epigastric pain radiating upward D. Pain improving with bowel movement The inflammatory process in the bowel often results in an alteration in motility, leading to abdominal distention, nausea, and vomiting. These symptoms may also be accompanied by left lower Quadrant colicky pain. Epigastric pain radiating upward is often referred to as heartburn, common in GERD. Pain that improves with eating is associated with a duodenal ulcer. Pain improvement with bowel movements is noted among individuals with IBS. Such improvement may also occur with diverticulosis (Salzman and Lillie, 2005). *Assessment/Gastrointestinal Category Points Earned: 1/1 Correct Answer: B Your Response: B 5. Which best describes Tinel’s test? A. Compress median nerve with thumbs. B. Flex wrist maximally for 60 seconds and evaluate for symptoms. C. Tap on median nerve. D. Test ROM for wrist. Tinel’s sign refers to tapping the median nerve. The Phalen’s maneuver is to maximally flex the wrists for 60 seconds. Both of these objective tests are used to assess for carpal tunnel syndrome (Fox, 2000). *Assessment/Musculoskeletal Category

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