NSG 6005 TEST BANK

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” Ans: C Feedback: This patient is here to establish care, and because she is new to you, a comprehensive health history is appropriate. 2. The components of the health history include all of the following except which one? A) Review of systems B) Thorax and lungs C) Present illness D) Personal and social items Ans: B Feedback: The thorax and lungs are part of the physical examination, not part of the health history. The other answers are all part of a complete health history. 3. 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 PERSONAL SOCIAL REVEW OF SYSTEMS Ans: A Feedback: This is information given by the patient about the circumstances of his chief complaint. It does not represent an objective observation by the examiner. 9. The following information is best placed in which category? “The patient has had three cesarean sections.” A) Adult illnesses B) Surgeries C) Obstetrics/gynecology D) Psychiatric Ans: B Feedback: A cesarean section is a surgical procedure. Approximate dates or the age of the patient at the time of the surgery should also be recorded. 2. A patient comes to the emergency room for evaluation of shortness of breath. To which anatomic region would you assign the symptom? A) Reproductive B) Urinary C) Cardiac D) Hematologic Ans: C Feedback: Cardiac disorders such as congestive heart failure are the most likely on this list to result in shortness of breath. There are cases within the other categories which may also result in shortness of breath, such as anemia in the hematologic category, pregnancy in the reproductive category, or sepsis with UTI in the urinary category. This demonstrates the “tension” in clinical reasoning between making sure all possibilities are covered, while still being able to pick the most likely cause. 4. 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 Ans: B Feedback: The description is most consistent with an inflammatory process, although all the other etiologies should be considered. Lyme disease is an infection which commonly causes arthritis, hemophilia is a hematologic condition which can cause bleeding in the joints, and trauma can obviously cause joint pain. Your clinical reasoning skills are important for sorting through all of the data to arrive at the most likely conclusion. 6. A 15-year-old high school sophomore comes to the clinic for evaluation of a 3-we 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 Ans: C Feedback: This description is most consistent with allergic rhinitis. 8. A 37-year-old nurse comes for evaluation of colicky right upper quadrant abdominal pain. The pain is associated with nausea and vomiting and occurs 1 to 2 hours after eating greasy foods. Which one of the following physical examination descriptions would be most consistent with the diagnosis of cholecystitis? A) Abdomen is soft, nontender, and nondistended, without hepatosplenomegaly or masses. B) Abdomen is soft and tender to palpation in the right lower quadrant, without rebound or guarding. C) Abdomen is soft and tender to palpation in the right upper quadrant with inspiration, to the point of stopping inspiration, and there is no rebound or guarding. D) Abdomen is soft and tender to palpation in the mid-epigastric area, without rebound or guarding. Ans: C Feedback: