SHADOW HEALTH PRACTICE EXAM SOLUTION

SHADOW HEALTH PRACTICE EXAM SOLUTION A brief statement of the reason the patient is seeking health care is called the: - chief complaint Which of the following is an "ABCD" characteristic of malignant melanoma? - Irregular borders Which question would be considered a "leading question"? - "You don't get headaches often, do you?" A flat, nonpalpable lesion is described as a macule if the diameter is: - less than 1 cm. When you are questioning a patient regarding alcohol intake, she tells you that she is "only a social drinker." Which initial response is appropriate? - "What amount and what kind of alcohol do you drink in a week?" Mrs. Britton is a 34-year-old patient who presents to the office with complaints of skin rashes. You have noted a 3-cm, rough, elevated area of psoriasis. This is an example of a: - plaque Painful vesicles are associated with: - herpes zoster A 29-year-old white woman appears jaundiced. An etiology of liver disease has been excluded. What history questions should the nurse ask? - Whether she eats a lot of yellow and orange vegetables. Mr. D. complains of a headache. During the history, he mentions his use of alcohol and illicit drugs. This information would most likely belong in the: - personal and social history. The thyroid gland is partially obscured by the: - sternocleidomastoid To perform the Rinne test, place the tuning fork on the: - mastoid bone. You observe pupillary response as the patient looks at a distant object and then at an object held 10 cm from the bridge of the nose. You are assessing for: - accommodation. Normal tympanic membrane color is: - pearly gray. Ask the patient to look directly at the light of the ophthalmoscope when you are ready to examine the: - macula. CLASSROOM CLASSROOM CLASSROOM CLASSROOM CLASSROOM CLASSROOM According to the AUDIT scale , a person who receives a score of 14 is : - Is in the high risk category for alcohol abuse Bulging of an amber tympanic membrane without mobility is most often associated with: - middle ear effusion. You ask your patient to perform the DAST questionnaire, and note that he scored a "5". You understand this means: - the patient is at high risk for drug abuse After you have the patient complete the AUDIT questionnaire, your tally the score and realize the patient has scored a "9" . Your next communication with the patient should be: - I see that you completed the questionnaire, may I discuss the results with you? You are conducting a brief negotiated interview with your young male patient after you have reviewed his AUDIT questionnaire results. You discuss the safe drinking limits per day for his gender . You explain to him that this number is: - 4 You are discussing the amount of alcohol in different drinks with your patient. You explain to your patient what constitutes a standard drink. You review that 12 oz of regular beer is equal to: - 5 oz. of table wine With consolidation in the lung tissue, the breath sounds are louder and easier to hear, whereas healthy lung tissue produces softer sounds. This is because: - air-filled lung tissue is an insulator of sound The characteristic barrel chest of the older adult is due to a combination of factors including: - skeletal changes of aging. You would expect to document the presence of a pleural friction rub for a patient being treated for: - pleurisy. Both pleural effusion and lobar pneumonia are characterized by _____ percussion. - dullness heard on Mr. L. has cyanotic lips and nail beds. His lips are pursed, and he has nasal flaring. You suspect he is having cardiac or pulmonary difficulty. What additional sign would support this impression? - Clubbing of the fingers Breath sounds normally auscultated over most of the lung fields are called: - vesicular. To begin counting the ribs and the intercostal spaces, you begin by palpating the reference point of the: - manubriosternal junction. Which bronchial structure(s) is(are) most susceptible to aspiration of foreign bodies? - Right mainstem bronchus CLASSROOM CLASSROOM CLASSROOM CLASSROOM CLASSROOM CLASSROOM What term would you use to document a respiratory rate greater than 20 breaths per minute in an adult? - Tachyapnea The NP would document this assessment finding as: - Pectus excavatum What is the correct procedure when percussing the chest? - Percuss systematically and symmetrically the anterior chest, moving from left to right side, then percuss the posterior chest. On assessment of the client's respiratory status, crepitaiton is felt over the third rib at the midaxillary line on the left side. What is the interpretation of this finding? - Air is present in the subcutaneous tissue from an air leak in the respiratory system. Normal physiologic changes in the respiratory system of the geriatric client include an increased rigidity of rib cage and increase in anteroposterior (AP) diameter of the chest. (T/F) - true During a new patient physical exam, you are ausculting the lungs and assess a few scattered expiratory wheezes. Which of the following review of system responses by the patient confirm that this is an expected and not unusual finding for this patient. - History of asthma since childhood. Your 76 year old male patient's chief complaint today is a productive cough times two weeks. What percussion finding over the posterior chest during your physical exam would lead you to include pneumonia as one of your differential diagnoses? - Dullness During your review of system questions for a new patient annual exam, you ask the patient - "Do you ever have shortness of breath or difficulty breathing? If the patient answers yes to this question, what additional questions related to using OLDCART would you need to ask? Mark all that apply. - Can you tell me when this started? Is there anything that makes it worse? Is there anything that makes it better? COPD is most commonly caused by: - smoking Risk factors for TB include: - lower socioeconomic status and crowded conditions Risk factors for pulmonary embolism include: - recent pregnancy What should always be considered for a patient with hemoptysis? - malignancy The "pacing" structure of the heart's electrical activity is the: - sinoatrial (SA) node. If pitting edema is unilateral, you would suspect occlusion of a: - major vein