NSG6020 MIDTERM EXAM / NSG 6020 MIDTERM EXAM (VERSION-1, 100 Q &A, LATEST-2022): SOUTH UNIVERSITY |100% CORRECT ANSWERS, DOWNLOAD TO SCORE HIGHGRADE|
NSG6020 Midterm Quiz / NSG 6020 Midterm Quiz (Latest): South University
South University NSG6020 Midterm Quiz / South University NSG 6020 Midterm Quiz (Latest)
Question 1 (2 points)
In performing an examination of a 3-year-old with a suspected ear infection, the nurse practitioner would:
Question 1 options:
omit the otoscopic exam if the child has a fever.
pull the ear up and back before inserting the speculum.
ask the mother to leave the room while examining the child.
perform the otoscopic examination at the end of the assessment.
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Question 2 (2 points)
A female patient tells the nurse that she has had six pregnancies, with four live births at term and two spontaneous abortions. Her four children are still living. How would the nurse record this information?
Question 2 options:
P-6, B-4, (S)Ab-2.
Grav 6, Term 4, (S)Ab 2, Living 4.
Patient has had four living babies.
Patient has been pregnant six times.
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Question 3 (2 points)
During an examination of a female patient, the nurse practitioner notes lymphadenopathy and suspects an acute infection. Acutely infected lymph nodes would be:
Question 3 options:
clumped.
unilateral.
firm but freely movable.
hard and nontender.
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Question 4 (2 points)
A visitor from Poland who does not speak English seems to be somewhat apprehensive about the nurse practitioner examining his neck. He would probably be most comfortable with the nurse practitioner examining his thyroid:
Question 4 options:
from behind with the examiner’s hands placed firmly around his neck.
from the side with the examiner’s eyes averted toward the ceiling and thumbs on his neck.
from the front with the examiner’s thumbs placed on either side of his trachea and his head tilted forward.
from the front with the examiner’s thumbs placed on either side of his trachea and his head tilted backward.
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Question 5 (2 points)
When palpating the abdomen of a 20-year-old patient, the nurse practitioner notes the presence of tenderness in the left upper quadrant with deep palpation. Which of the following structures is most likely to be involved?
Question 5 options:
Spleen
Sigmoid
Appendix
Gallbladder
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Question 6 (2 points)
A 6-month-old infant has been brought to the well-child clinic for a check-up. She is currently sleeping. What should the examiner do first?
Question 6 options:
Auscultate the lungs and heart while the infant is still sleeping.
Examine the infant’s hips because this procedure is uncomfortable.
Begin with the assessment of the eye and continue with the remainder of the examination in a head-to-toe approach.
Wake the infant before beginning any portion of the examination to obtain the most accurate assessment of body systems.
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Question 7 (2 points)
During a morning assessment, the nurse practitioner notes that the patient’s sputum is frothy and pink. Which condition could this finding indicate?
Question 7 options:
Croup
Tuberculosis
Viral infection
Pulmonary edema
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Question 8 (2 points)
A woman comes to the clinic and states, “My eyes have gotten so puffy, and my eyebrows and hair have become coarse and dry.” The nurse practitioner suspects:
Question 8 options:
cachexia.
cretinism.
myxedema.
scleroderma.
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Question 9 (2 points)
In performing auscultation of heart sounds, which sequence would the nurse practitioner use?
Question 9 options:
Aortic area—pulmonic area—Erb’s point—tricuspid area—mitral area
Pulmonic area—aortic area—Erb’s point—tricuspid area—mitral area
Aortic area—tricuspid area—Erb’s point—mitral area—pulmonic area
Pulmonic area—Erb’s point—tricuspid area—pulmonic area—mitral area
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Question 10 (2 points)
During an admission assessment, the nurse practitioner notices that a male patient has an enlarged and rather thick skull. The nurse practitioner suspects acromegaly and would further assess for:
Question 10 options:
exophthalmos.
bowed long bones.
coarse facial features.
an acorn-shaped cranium.
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Question 11 (2 points)
During an examination of a patient in her third trimester of pregnancy, the nurse practitioner notices that the patient’s thyroid gland is slightly enlarged. No enlargement had been noted previously. The nurse practitioner suspects that:
Question 11 options:
she has an iodine deficiency.
she is exhibiting early signs of goiter.
this is a normal finding during pregnancy.
further tests are needed for possible thyroid cancer.
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Question 12 (2 points)
During an assessment of a newborn infant, the nurse practitioner recalls that pyloric stenosis would be manifested by:
Question 12 options:
projectile vomiting.
hypoactive bowel activity.
palpable olive-sized mass in right lower quadrant.
pronounced peristaltic waves crossing from right to left.
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Question 13 (2 points)
The nurse practitioner is obtaining a history from a 30-year-old male patient and is concerned about health promotion activities. Which of the following questions would be appropriate to use to assess health promotion activities for this patient?
Question 13 options:
“Do you perform testicular self-exams?”
“Have you ever noticed any pain in your testicles?”
“Have you had any problems with passing your urine?”
“Do you have any history of sexually transmitted disease?”
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Question 14 (2 points)
Which of the following best describes the purpose of a functional assessment?
Question 14 options:
It assesses how the individual is coping with life at home.
It determines how children are meeting developmental milestones.
It can identify any problems with memory the individual may be experiencing.
With the elderly, it helps to determine how they are managing day-to-day activities.
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Question 15 (2 points)
A mother brings her newborn in for an assessment and asks, “Is there something wrong with my baby? His head seems so big.” The nurse practitioner knows the following about relative proportions of the head and trunk of the newborn:
Question 15 options:
At birth, the head is one fifth the total length.
Head circumference should be greater than chest circumference at birth.
The head size reaches 90% of its final size when the child is 3 years old.
When the anterior fontanel closes at 2 months, the head will be more proportioned to the body.
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Question 16 (2 points)
When performing a physical assessment, the technique the nurse practitioner will always use first is:
Question 16 options:
palpation.
inspection.
percussion.
auscultation.
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Question 17 (2 points)
The mother of a 2-year-old is concerned because her son has had three ear infections in the past year. What would be an appropriate response by the nurse practitioner?
Question 17 options:
. “It is unusual for a small child to have frequent ear infections unless there is something else wrong.”
“We need to check the immune system of your son to see why he is having so many ear infections.”
“Ear infections are not uncommon in infants and toddlers because they tend to have more cerumen in the external ear.”
“Your son’s eustachian tube is shorter and wider than yours because of his age, which allows for infections to develop more easily.”
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Question 18 (2 points)
Which technique of assessment is used to determine the presence of crepitus, swelling, and pulsations?
Question 18 options:
Palpation
Inspection
Percussion
Auscultation
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Question 19 (2 points)
Percussion notes heard during the abdominal assessment may include:
Question 19 options:
flatness, resonance, and dullness.
resonance, dullness, and tympany.
tympany, hyperresonance, and dullness.
resonance, hyperresonance, and flatness.
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Question 20 (2 points)
The nurse practitioner is taking a family history. Important diseases or problems to ask the patient about include:
Question 20 options:
emphysema.
head trauma.
mental illness.
fractured bones.
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Question 21 (2 points)
The nurse practitioner is preparing to assess a patient’s abdomen by palpation. How should the nurse practitioner proceed?
Question 21 options:
Avoid palpation of reported “tender” areas because this may cause the patient pain.
Quickly palpate the area to avoid any discomfort that the patient may experience.
Begin the assessment with deep palpation, encouraging the patient to relax and take deep breaths.
Start with light palpation to detect surface characteristics and to accustom the patient to being touched.
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Question 22 (2 points)
A 19-year-old college student is brought to the emergency department with a severe headache he describes as “Like nothing I’ve ever had before.” His temperature is 104° F, and he has a stiff neck. What do these signs and symptoms suggest?
Question 22 options:
Head injury
Cluster headache
Migraine headache
Meningeal inflammation
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Question 23 (2 points)
A patient has been diagnosed with pernicious anemia. The nurse practitioner knows that this condition could be related to:
Question 23 options:
increased gastric acid secretion.
decreased gastric acid secretion.
delayed gastrointestinal emptying time.
increased gastrointestinal emptying time.
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Question 24 (2 points)
A patient presents with excruciating headache pain on one side of his head, especially around his eye, forehead, and cheek that lasts about 1/2 to 2 hours, occurring once or twice each day. The nurse practitioner suspects:
Question 24 options:
hypertension.
cluster headaches.
tension headaches.
migraine headaches.
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Question 25 (2 points)
The temporomandibular joint is just below the temporal artery and anterior to the:
Question 25 options:
hyoid.
vagus.
tragus.
mandible.
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Question 26 (2 points)
The nurse practitioner is preparing to examine a 4-year-old child. Which action is appropriate first?
Question 26 options:
Explain procedures in detail to alleviate the child’s anxiety.
Give the child feedback and reassurance during the examination.
Do not ask the child to remove his clothes because children at this age are usually very private.
Perform an examination of the ear, nose, and throat first and then examine the thorax and abdomen.
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Question 27 (2 points)
A 52-year-old patient describes the presence of occasional “floaters or spots” moving in front of his eyes. The nurse should:
Question 27 options:
examine the retina to determine the number of floaters.
presume the patient has glaucoma and refer him for further testing.
consider this an abnormal finding and refer him to an ophthalmologist.
know that “floaters” are usually not significant and are caused by condensed vitreous fibers.
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Question 28 (2 points)
A patient has a long history of chronic obstructive pulmonary disease. During the assessment, the nurse practitioner is most likely to observe:
Question 28 options:
unequal chest expansion.
increased tactile fremitus.
atrophied neck and trapezius muscles.
an anteroposterior-to-transverse diameter ratio of 1:1.
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Question 29 (2 points)
The nurse practitioner is assessing a patient’s skin during an office visit. What is the best technique to use to best assess the patient’s skin temperature?
Question 29 options:
Use the fingertips because they’re more sensitive to small changes in temperature.
Use the dorsal surface of the hand because the skin is thinner than on the palms.
Use the ulnar portion of the hand because there is increased blood supply that enhances temperature sensitivity.
Use the palmar surface of the hand because it is most sensitive to temperature variations because of increased nerve supply in this area.
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Question 30 (2 points)
When examining the face, the nurse practitioner is aware that the two pairs of salivary glands that are accessible to examination are the _____ glands.
Question 30 options:
occipital and submental
parotid and jugulodigastric
parotid and submandibular
submandibular and occipital
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Question 31 (2 points)
Tenderness on light palpation in the right lower quadrant could indicate a disorder of which of the following structures?
Question 31 options:
Spleen
Sigmoid
Appendix
Gallbladder
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Question 32 (2 points)
The nurse practitioner notices that a patient’s submental lymph nodes are enlarged. In an effort to identify the cause of the node enlargement, the nurse would assess the:
Question 32 options:
infraclavicular area.
supraclavicular area.
area distal to the enlarged node.
area proximal to the enlarged node.
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Question 33 (2 points)
A patient visits the clinic because he has recently noticed that the left side of his mouth is paralyzed. He states that he cannot raise his eyebrow or whistle. The nurse practitioner suspects that he has:
Question 33 options:
Cushing’s syndrome.
Parkinson’s syndrome.
Bell’s palsy.
had a cerebrovascular accident (stroke).
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Question 34 (2 points)
Which of the following statements is true concerning air conduction?
Question 34 options:
It is the most efficient pathway for hearing.
It is caused by the vibrations of bones in the skull.
The amplitude of sound determines the pitch that is heard.
A loss of air conduction is called a conductive hearing loss.
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Question 35 (2 points)
A patient comes into the clinic complaining of pain in her right eye. On examination, the nurse practitioner sees a pustule at the lid margin that is painful to touch, red, and swollen. The nurse practitioner recognizes that this is
Question 35 options:
a chalazion.
a hordeolum (stye).
dacryocystitis.
blepharitis.
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Question 36 (2 points)
While performing a well-child assessment on a 5-year-old, the nurse practitioner notes the presence of palpable, bilateral, cervical, and inguinal lymph nodes. They are approximately 0.5 cm in size, round, mobile, and nontender. The nurse practitioner suspects that this:
Question 36 options:
child has chronic allergies.
child may have an infection.
is a normal finding for a well child of this age.
child should be referred for additional evaluation.
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Question 37 (2 points)
During an assessment of an infant, the nurse practitioner notes that the fontanels are depressed and sunken. The nurse practitioner suspects which condition?
Question 37 options:
Rickets
Dehydration
Mental retardation
Increased intracranial pressure
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Question 38 (2 points)
The nurse practitioner is assessing a patient for possible peptic ulcer disease and knows that which condition often causes this problem?
Question 38 options:
Hypertension
Streptococcus infections
History of constipation and frequent laxative use
Frequent use of nonsteroidal anti-inflammatory drugs
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Question 39 (2 points)
Which of the following techniques uses the sense of touch when assessing a patient?
Question 39 options:
Palpation
Inspection
Percussion
Auscultation
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Question 40 (2 points)
The nurse practitioner suspects that a patient has hyperthyroidism and laboratory data indicate that the patient’s thyroxine and tri-iodothyronine hormone levels are elevated. Which of the following findings would the nurse practitioner most likely find on examination?
Question 40 options:
Tachycardia
Constipation
Rapid dyspnea
Atrophied nodular thyroid
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Question 41 (2 points)
During an examination of a 3-year-old child, the nurse practitioner notes a bruit over the left temporal area. What should the nurse practitioner do?
Question 41 options:
Continue the examination because this is a normal finding for this age.
Check for the bruit again in 1 hour.
Notify the parents that a bruit has been detected in their child.
Stop the examination and notify the physician.
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Question 42 (2 points)
The primary muscles of respiration include the:
Question 42 options:
diaphragm and intercostals.
sternomastoids and scaleni.
trapezius and rectus abdominis.
external obliques and pectoralis major.
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Question 43 (2 points)
The nurse practitioner notices that an infant has a large, soft lump on the side of his head and that his mother is very concerned. She tells the nurse practitioner that she noticed the lump about 8 hours after her baby’s birth, and that it seems to be getting bigger. One possible explanation for this is:
Question 43 options:
hydrocephalus.
craniosynostosis.
cephalhematoma.
caput succedaneum.
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Question 44 (2 points)
When examining an infant, the nurse practitioner should examine which area first?
Question 44 options:
Ear
Nose
Throat
Abdomen
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Question 45 (2 points)
Which statement is true regarding the diaphragm of the stethoscope?
Question 45 options:
Use the diaphragm to listen for high-pitched sounds.
Use the diaphragm to listen for low-pitched sounds.
Hold the diaphragm lightly against the person’s skin to block out low-pitched sounds.
Hold the diaphragm lightly against the person’s skin to listen for extra heart sounds and murmurs.
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Question 46 (2 points)
A patient has been admitted to the emergency department with a possible medical diagnosis of pulmonary embolism. The nurse practitioner recognizes which assessment findings related to this condition?
Question 46 options:
Absent or decreased breath sounds
Productive cough with thin, frothy sputum
Chest pain that is worse on deep inspiration, dyspnea
Diffuse infiltrates with areas of dullness upon percussion
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Question 47 (2 points)
A man is at the clinic for a physical examination. He states that he is “very anxious” about the physical exam. What steps can the examiner take to make him more comfortable?
Question 47 options:
Appear unhurried and confident when examining him.
Stay in the room when he undresses in case he needs assistance.
Ask him to change into an examining gown and take off his undergarments.
Defer measuring vital signs until the end of the examination, which allows him. time to become comfortable.
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Question 48 (2 points)
During a cardiac assessment on an adult patient in the hospital for “chest pain,” the nurse practitioner finds the following: jugular vein pulsations 4 cm above sternal angle when he is elevated at 45 degrees, BP 98/60, HR 130; ankle edema; difficulty in breathing when supine; and an S3 on auscultation. Which of the following best explains the cause of these findings?
Question 48 options:
Fluid overload
Atrial septal defect
Myocardial infarction
Heart failure
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Question 49 (2 points)
When preparing to examine a 6-year-old child, which action is most appropriate?
Question 49 options:
Start with the thorax, abdomen, and genitalia before examining the head.
Avoid talking about the equipment being used because it may increase the child’s anxiety.
Keep in mind that a child this age will have a sense of modesty.
Have the child undress from the waist up.
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Question 50 (2 points)
A 31-year-old patient tells the nurse that he has noticed a progressive loss in his hearing. He says that it does seem to help when people speak louder or if he turns up the volume. The most likely cause of his hearing loss is:
Question 50 options:
otosclerosis.
presbycusis.
trauma to the bones.
frequent ear infections.
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Question 51 (2 points)
A patient tells the nurse that she has had abdominal pain for the past week. What would be the best response by the nurse?
Question 51 options:
“Can you point to where it hurts?”
“We’ll talk more about that later in the interview.”
“What have you had to eat in the last 24 hours?”
“Have you ever had any surgeries on your abdomen?”
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Question 52 (2 points)
The nurse practitioner is doing an assessment on a 21-year-old patient and notes that his nasal mucosa appears pale, gray, and swollen. What would be the most appropriate question to ask the patient?
Question 52 options:
“Are you aware of having any allergies?”
“Do you have an elevated temperature?”
“Have you had any symptoms of a cold?”
“Have you been having frequent nosebleeds?”
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Question 53 (2 points)
The most important reason to share information and offer brief teaching while performing the physical examination is to help:
Question 53 options:
the examiner feel more comfortable and gain control of the situation.
build rapport and increase the patient’s confidence in the examiner.
the patient understand his or her disease process and treatment modalities.
the patient identify questions about his or her disease and potential areas of patient education.
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Question 54 (2 points)
Which of the following statements is true regarding the otoscope?
Question 54 options:
The otoscope is often used to direct light onto the sinuses.
The otoscope uses a short broad speculum to visualize the ear.
The otoscope is used to examine the structures of the internal ear.
The otoscope directs light into the ear canal and onto the tympanic membrane.
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Question 55 (2 points)
A 59-year-old patient, J.M., tells the nurse that he is here today to “check his ulcerative colitis.” He has been having “black stools” for the last 24 hours. How would the nurse document his reason for seeking care?
Question 55 options:
J. M. is a 59-year-old male here for “ulcerative colitis.”
J. M. came into the clinic complaining of black stools for the past 24 hours.
J. M., a 59-year-old male, states he has ulcerative colitis and wants it checked.
J. M. is a 59-year-old male here for having “black stools” for the past 24 hours.
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Question 56 (2 points)
During an examination, the nurse knows that Paget’s disease would be indicated by which of the following findings?
Question 56 options:
Positive Macewen’s sign
Premature closure of the sagittal suture
Headache, vertigo, tinnitus, and deafness
Elongated head with heavy eyebrow ridge
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Question 57 (2 points)
The nurse practitioner is performing an assessment on a 7-year-old child who has symptoms of chronic watery eyes, sneezing, and clear nasal drainage. The nurse practitioner notes the presence of a transverse line across the bridge of the nose, dark blue shadows below the eyes, and a double crease on the lower eyelids. These findings are characteristic of:
Question 57 options:
allergies.
a sinus infection.
nasal congestion.
an upper respiratory infection.
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Question 58 (2 points)
In assessing a patient’s major risk factors for heart disease, which would the nurse practitioner want to include when taking a history?
Question 58 options:
Family history, hypertension, stress, age
Personality type, high cholesterol, diabetes, smoking
Smoking, hypertension, obesity, diabetes, high cholesterol
Alcohol consumption, obesity, diabetes, stress, high cholesterol
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Question 59 (2 points)
The nurse practitioner is aware that a change that may occur in the gastrointestinal system of an aging adult is:
Question 59 options:
increased salivation.
decreased peristalsis.
increased esophageal emptying.
decreased gastric acid secretion.
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Question 60 (2 points)
A woman who is in the second trimester of pregnancy mentions that she has had “more nosebleeds than ever” since she became pregnant. The nurse recognizes that this is due to:
Question 60 options:
a problem with the patient’s coagulation system.
increased vascularity in the upper respiratory tract as a result of the pregnancy.
increased susceptibility to colds and nasal irritation.
inappropriate use of nasal sprays.
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Question 61 (2 points)
The inspection phase of the physical assessment:
Question 61 options:
yields little information.
takes time and reveals a surprising amount of information.
may be somewhat uncomfortable for the expert practitioner.
requires a quick glance at the patient’s body systems before proceeding on with palpation.
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Question 62 (2 points)
A patient says that she has recently noticed a lump in the front of her neck below her “Adam’s apple” that seems to be getting bigger. During the assessment, the finding that reassures the nurse practitioner that this may not be a cancerous thyroid nodule is that the lump (nodule):
Question 62 options:
is tender.
is mobile and not hard.
disappears when the patient smiles.
is hard and fixed to the surrounding structures.
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Question 63 (2 points)
An example of objective information obtained during the physical assessment includes the:
Question 63 options:
patient’s history of allergies.
patient’s use of medications at home.
last menstrual period 1 month ago.
2 Χ 5 cm scar present on the right lower forearm.
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Question 64 (2 points)
A male patient with a history of AIDS has come in for an examination and he states, “I think that I have the mumps.” The nurse practitioner would begin by examining the:
Question 64 options:
thyroid gland.
parotid gland.
cervical lymph nodes.
mouth and skin for lesions.
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Question 65 (2 points)
Which of the following statements best describes the purpose of a health history?
Question 65 options:
To provide an opportunity for interaction between patient and nurse
To provide a form for obtaining the patient’s biographic information
To document the normal and abnormal findings of a physical assessment
To provide a database of subjective information about the patient’s past and current health
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Question 66 (2 points)
A patient has been shown to have a sensorineural hearing loss. During the assessment, it would be important for the nurse to:
Question 66 options:
speak loudly so he can hear the questions.
assess for middle ear infection as a possible cause.
ask the patient what medications he is currently taking.
look for the source of the obstruction in the external ear.
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Question 67 (2 points)
Which of the following statements regarding the aging adult and abdominal assessment is true?
Question 67 options:
The abdominal tone is increased.
The abdominal musculature is thinner.
The abdominal rigidity with acute abdominal conditions is more common.
The aging person complains of more pain with an acute abdomen than a younger person would.
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Question 68 (2 points)
Which of the following statements represents subjective data obtained from the patient regarding his skin?
Question 68 options:
Skin appears dry.
No obvious lesions
Denies color change
Lesion noted lateral aspect right arm
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Question 69 (2 points)
A patient comes to the emergency department after a boxing match, and his left eye is swollen almost shut. He has bruises on his face and neck. He says he is worried because he “can’t see well” from his left eye. The nurse practitioner recognizes that signs of retinal detachment include:
Question 69 options:
loss of central vision.
shadow or diminished vision in one quadrant or one half visual field.
loss of peripheral vision.
sudden loss of pupillary constriction and accommodation.
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Question 70 (2 points)
A patient complains that while studying for an examination he began to notice a severe headache in the frontotemporal area of his head that is throbbing and is somewhat relieved when he lies down. He tells the nurse practitioner that his mother also had these headaches. The nurse practitioner suspects that he may be suffering from:
Question 70 options:
hypertension.
cluster headaches.
tension headaches.
migraine headaches.
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Question 71 (2 points)
The nurse practitioner is examining a 2-year-old child and asks, “May I listen to your heart now?” Which critique of her technique is most accurate?
Question 71 options:
Asking questions enhances the child’s autonomy.
Asking the child for permission helps to develop a sense of trust.
This is an appropriate statement because children at this age like to have choices.
Children at this age like to say “No.” The examiner should not offer a choice when there is none.
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Question 72 (2 points)
A 65-year-old patient with a history of heart failure comes to the clinic with complaints of “being awakened from sleep with shortness of breath.” Which action by the nurse practitioner is most appropriate?
Question 72 options:
Obtain a detailed history of the patient’s allergies and history of asthma.
Tell the patient to sleep on his or her right side to facilitate ease of respirations.
Assess for other signs and symptoms of paroxysmal nocturnal dyspnea.
Assure the patient that this is normal and will probably resolve within the next week.
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Question 73 (2 points)
When examining the aging adult, the nurse practitioner should:
Question 73 options:
avoid touching the patient too much.
attempt to perform the entire physical during one visit.
speak loudly and slowly because most aging adults have hearing deficits.
arrange the sequence to allow as few position changes as possible.
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Question 74 (2 points)
During an examination, the nurse practitioner knows that the best way to palpate the lymph nodes in the neck is described by which statement?
Question 74 options:
Using gentle pressure, palpate with both hands to compare the two sides.
Using strong pressure, palpate with both hands to compare the two sides.
Gently pinch each node between one’s thumb and forefinger and move down the neck muscle.
Using the index and middle fingers, gently palpate by applying pressure in a rotating pattern.
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Question 75 (2 points)
The physician reports that a patient has a tracheal shift. The nurse practitioner is aware that this means that the patient’s trachea is:
Question 75 options:
pulled to the affected side with systole.
pushed to the unaffected side with a tumor.
pulled to the unaffected side with plural adhesions.
pushed to the affected side with thyroid enlargement.
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Question 76 (2 points)
A 2-year-old child has been brought to the clinic for a well-child check-up. How should the examiner proceed with the assessment?
Question 76 options:
Ask the parent to place the child on the examining table.
Have the parent remove all the child’s clothing before the examination.
Allow the child to keep a security object such as a toy or blanket during the examination.
Initially focus interactions on the child, essentially “ignoring” the parent, until the child’s trust has been obtained.
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Question 77 (2 points)
The patient’s record, laboratory studies, objective data, and subjective data combine to form the:
Question 77 options:
database.
admitting data.
financial statement.
discharge summary.
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Question 78 (2 points)
A patient’s thyroid is enlarged, and the nurse practitioner is preparing to auscultate the thyroid for the presence of a bruit. A bruit is a:
Question 78 options:
low gurgling sound best heard with the diaphragm of the stethoscope.
loud, whooshing, blowing sound best heard with the bell of the stethoscope.
soft, whooshing, pulsatile sound best heard with the bell of the stethoscope.
high-pitched tinkling sound best heard with the diaphragm of the stethoscope.
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Question 79 (2 points)
A 35-year-old recent immigrant is being seen in the clinic for complaints of a cough that is associated with rust-colored sputum, low-grade afternoon fevers, and night sweats for the past 2 months. The nurse’s preliminary analysis, based on this history, is that this patient may be suffering from:
Question 79 options:
bronchitis.
pneumonia.
tuberculosis.
pulmonary edema.
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Question 80 (2 points)
With which of the following patients would it be most appropriate to use games during the assessment, such as, having the patient “blow out” the light on the penlight?
Question 80 options:
An infant
A preschool child
A school-age child
An adolescent
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Question 81 (2 points)
When performing the physical assessment, the examiner should:
Question 81 options:
perform the examination from the left side of the bed.
examine tender or painful areas first to help relieve the patient’s anxiety.
follow the same examination sequence regardless of the patient’s age or condition.
organize the assessment so that the patient does not change positions too often.
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Question 82 (2 points)
A patient tells the nurse that he is allergic to penicillin. What would be the nurse practitioner’s best response to this information?
Question 82 options:
“Are you allergic to any other drugs?”
“How often have you received penicillin?”
“I’ll write your allergy on your chart so you won’t receive any.”
“Please describe what happens to you when you take penicillin.”
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Question 83 (2 points)
A patient states that she is unable to hear well with her left ear. The Weber test shows lateralization to the right ear. Rinne has ACBC with ratio of 2:1 in both ears, left-AC 10 sec and BC 5 sec, right-AC 30 sec and BC 15 sec. What would be the interpretation of these results?
Question 83 options:
The patient may have sensorineural loss.
The test results are reflective of normal hearing.
Conduction of sound through bones is impaired.
These results make no sense, so further tests should be done.
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Question 84 (2 points)
A patient tells the nurse practitioner that he is very nervous, that he is nauseated, and that he “feels hot.” This type of data would be:
Question 84 options:
objective.
reflective.
subjective.
introspective
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Question 85 (2 points)
An adult patient with a history of allergies comes to the clinic complaining of wheezing and difficulty in breathing when working in his yard. The assessment findings include the following: tachypnea, use of accessory neck muscles, prolonged expiration, intercostal retractions, decreased breath sounds, and expiratory wheezes. This description is consistent with:
Question 85 options:
asthma.
atelectasis.
lobar pneumonia.
congestive heart failure.
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Question 86 (2 points)
In recording the childhood illnesses of a patient who denies having had any, which of the following notes by the nurse would be most accurate?
Question 86 options:
Patient denies usual childhood illnesses.
Patient states he was a “very healthy” child.
Patient states sister had measles, but he didn’t.
Patient denies measles, mumps, rubella, chickenpox, pertussis, or strep throat.
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Question 87 (2 points)
The nurse practitioner notes the presence of periorbital edema when performing an eye assessment on a 70-year-old patient. The nurse practitioner will:
Question 87 options:
check for the presence of exophthalmos.
suspect that the patient has hyperthyroidism.
ask the patient if he or she has a history of heart failure.
assess for blepharitis because this is often associated with periorbital edema.
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Question 88 (2 points)
The nurse practitioner is doing an oral assessment on a 40-year-old black patient and notes the presence of a 1-cm, nontender, grayish-white lesion on the left buccal mucosa. Which of the following is true concerning this lesion?
Question 88 options:
This lesion is leukoedema and is common in blacks.
This is the result of hyperpigmentation and is normal.
This is torus palatinus and would normally only be found in smokers.
This type of lesion is indicative of cancer and should be tested immediately.
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Question 89 (2 points)
A patient comes into the emergency department after an accident at work. A machine blew dust into his eyes and he was not wearing safety glasses. The nurse practitioner examines his corneas by shining a light from the side across the cornea. What findings would suggest that he has suffered a corneal abrasion?
Question 89 options:
Smooth and clear corneas
Opacity of the lens behind the cornea
Bleeding from the areas across the cornea
A shattered look to the light rays reflecting off the cornea
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Question 90 (2 points)
During an examination, the nurse practitioner finds that a patient’s left temporal artery is more tortuous and feels hardened and tender compared with the right temporal artery. The nurse practitioner suspects which condition?
Question 90 options:
Crepitation
Mastoiditis
Temporal arteritis
Bell’s palsy
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Question 91 (2 points)
In obtaining the history from the mother of a 2-year-old with pneumonia, the nurse practitioner asks the mother if she smoked or used drugs during her pregnancy. Her response is, “What does that have to do with pneumonia?” How would the nurse practitioner answer her question?
Question 91 options:
“You don’t need to answer if it makes you uncomfortable.”
“It’s not really that important; we just ask everyone the same questions.”
“The use of tobacco during pregnancy could be the cause of your daughter’s pneumonia.”
“Knowing about your pregnancy gives us a more complete picture of your daughter’s health.”
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Question 92 (2 points)
In infants, the nurse practitioner knows to elicit the Moro reflex:
Question 92 options:
when the infant is sleeping.
at the end of the examination.
before auscultation of the thorax.
halfway through the examination.
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Question 93 (2 points)
In obtaining a review of systems on a “healthy” 7-year-old girl, the health care provider knows that it would be important to include the:
Question 93 options:
last glaucoma exam.
date of her last electrocardiogram.
frequency of breast self-exam.
limitations related to her involvement in sports activities.
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Question 94 (2 points)
When assessing a newborn infant who is just 5 minutes old, the nurse practitioner knows that which of the following would be true?
Question 94 options:
The left ventricle is larger and weighs more than the right.
The circulation of a newborn is identical to that of an adult.
There is an opening in the atrial septum where blood can flow into the left side of the heart.
The foramen ovale closes just minutes before birth and the ductus arteriosus closes immediately after.
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Question 95 (2 points)
During a well-baby check, the nurse practitioner notices that a 1-week-old infant’s face looks small compared with his cranium, which seems enlarged. On further examination, the nurse practitioner also notes dilated scalp veins and downcast, or “setting sun,” eyes. The nurse practitioner suspects which condition?
Question 95 options:
Craniotabes
Microcephaly
Hydrocephalus
Caput succedaneum
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Question 96 (2 points)
A mother asks when her newborn infant’s eyesight will be developed. The nurse practitioner should reply:
Question 96 options:
“Vision is not totally developed until 2 years of age.”
“Infants develop the ability to focus on an object at around 8 months.”
“By about 3 months, infants develop more coordinated eye movements and can fixate on an object.”
“Most infants have uncoordinated eye movements for the first year of life.”
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Question 97 (2 points)
In assessing the sclera of a black patient, which of the following would be an expected finding?
Question 97 options:
Yellow fatty deposits over the cornea
Pallor near the outer canthus of the lower lid
Yellow color of the sclera that extends up to the iris
The presence of small brown macules on the sclera
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Question 98 (2 points)
When performing a physical examination, safety must be considered to protect the examiner and the patient against the spread of infection. Which of the following statements describes the most appropriate actions the examiner should take when performing a physical examination?
Question 98 options:
There is no need to wash one’s hands after removing gloves, as long as the gloves are still intact.
Wash hands at the beginning of the examination and any time that one leaves and re-enters the room.
Wash hands between the examination of each body system to prevent the spread of bacteria from one part of the body to another. d. Wear gloves throughout the entire examination to demonstrate to the patient concern regarding the spread of infectious diseases.
Wear gloves throughout the entire examination to demonstrate to the patient concern regarding the spread of infectious diseases.
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Question 99 (2 points)
During an examination of a patient’s abdomen, the nurse practitioner notes that the abdomen is rounded and firm to the touch. During percussion, the nurse practitioner notes a drum-like quality of the sound across the quadrants. This type of sound indicates:
Question 99 options:
constipation.
air-filled areas.
the presence of a tumor.
the presence of dense organs.
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Question 100 (2 points)
During a hearing assessment the nurse practitioner finds that sound lateralizes to the patient’s left ear with the Weber test. What can the nurse practitioner conclude from this?
Question 100 options:
The patient has a conductive hearing loss in the right ear.
Lateralization is a normal finding with the Weber test.
The patient could have either a sensorineural or a conductive loss.
A mistake has occurred; the test must be repeated.
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NSG 6020 Midterm Exam
1. For which of the following patients would a comprehensive health history be
appropriate?
A) A new patient with the chief complaint of “I sprained my ankle”
B) An established patient with the chief complaint of “I have an upper respiratory
infection”
C) A new patient with the chief complaint of “I am here to establish care”
D) A new patient with the chief complaint of “I cut my hand”
2. Is the following information subjective or objective?
Mr. M. has shortness of breath that has persisted for the past 10 days; it is worse with
activity and relieved by rest.
A) Subjective
B) Objective
3. Is the following information subjective or objective?
Mr. M. has a respiratory rate of 32 and a pulse rate of 120.
A) Subjective
B) Objective
,4. The following information is recorded in the health history: “Patient denies chest pain,
palpitations, orthopnea, and paroxysmal nocturnal dyspnea.”
Which category does it belong to?
A) Chief complaint
B) Present illness
C) Personal and social history
D) Review of systems
5. A patient presents for evaluation of a sharp, aching chest pain which increases with
breathing. Which anatomic area would you localize the symptom to?
A) Musculoskeletal
B) Reproductive
C) Urinary
D) Endocrine
,6. A 22-year-old advertising copywriter presents for evaluation of joint pain. The pain is
new, located in the wrists and fingers bilaterally, with some subjective fever. The patient
denies a rash; she also denies recent travel or camping activities. She has a family
history significant for rheumatoid arthritis. Based on this information, which of the
following pathologic processes would be the most correct?
A) Infectious
B) Inflammatory
C) Hematologic
D) Traumatic
7. A 15-year-old high school sophomore comes to the clinic for evaluation of a 3-week
history of sneezing; itchy, watery eyes; clear nasal discharge; ear pain; and
nonproductive cough. Which is the most likely pathologic process?
A) Infection
B) Inflammation
C) Allergic
D) Vascular
, 8. You are seeing an elderly man with multiple complaints. He has chronic arthritis, pain
from an old war injury, and headaches. Today he complains of these pains, as well as
dull chest pain under his sternum. What would the order of priority be for your problem
list?
A) Arthritis, war injury pain, headaches, chest pain
B) War injury pain, arthritis, headaches, chest pain
C) Headaches, arthritis, war injury pain, chest pain
D) Chest pain, headaches, arthritis, war injury pain
9. Suzanne, a 25 year old, comes to your clinic to establish care. You are the student
preparing to go into the examination room to interview her. Which of the following is
the most logical sequence for the patient–provider interview?
A) Establish the agenda, negotiate a plan, establish rapport, and invite the patient's
story.
B) Invite the patient's story, negotiate a plan, establish the agenda, and establish
rapport.
C) Greet the patient, establish rapport, invite the patient's story, establish the
agenda, expand and clarify the patient's story, and negotiate a plan.
D) Negotiate a plan, establish an agenda, invite the patient's story, and establish
rapport.