NURS 6512 Advanced Health Assessment Final Examination

Which portion of the physical examination is best done with the patient standing? spinal

To assess spinal levels L2, L3, and L4, which deep tendon reflex should be tested? patellar

To assess a cremasteric reflex, the examiner strokes the: lightly stroking the inner thigh

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Which condition is considered progressive rather than reversible? dementia

When palpating breast tissue, the examiner should use the _pads of the fingers____ at each site.

Palpation of a normal prostate in an older adult is likely to feel: rubbery

The difference in blood pressure readings between the right and the left arms is considered normal up to _5____ mm Hg.

Your 15-year-old patient is athletic and thin. Radiography of an ankle injury reveals a stress fracture. You should question this patient about her: menstrual cycles

Cranial nerve XII may be assessed in an infant by: sucking and swallowing

While collecting personal and social history data from a woman complaining of breast discomfort, you should question her regarding:

An idiopathic spasm of arterioles in the digits is termed: Raynauds

A 23-year-old white woman has come to the clinic because she has missed two menstrual periods. She states that her breasts have enlarged and that her nipples have turned a darker color. Your further response to this finding is to: pregnancy

Assessing orientation to person, place, and time helps determine:

The rectal past medical history of all patients should include inquiry about:

To hear diastolic heart sounds, you should ask patients to:

Loss of immediate and recent memory with retention of remote memory suggests: dementia

Your patient’s chief complaint is repeated pencil-like stools. Further examination should include:

Kawasaki disease is suspected when assessments of a child reveal:

The examiner percusses for diaphragmatic excursion along the:

If pitting edema is unilateral, you would suspect occlusion of a:

Which medical condition would exclude a person from sports participation? fever

The Mini-Mental State Examination:

An ophthalmoscopic eye examination involves: Lens

The Denver II is a tool used to determine:

A common finding in markedly obese and pregnant women is: Lordosis

When conducting a geriatric assessment, basic activities of daily living (ADLs) include: Bathing

The finger-to-nose test allows assessment of: coordination

Inspection of the scrotum should reveal: left lower than the right

Part of the screening orthopedic component of the examination includes evaluating the person while he or she is:

In the most effective percussion technique of the posterior lung fields, the patient cooperates by: crossing arms in front

Normal changes of the aging brain include:

Ulnar deviation and boutonniere deformities are characteristic of: Rheumatoid arthritis

A cervical polyp usually appears as a:

Bimanual examination of the uterus includes:

If a patient cannot shrug the shoulders against resistance, which cranial nerve (CN) requires further evaluation?

Electrical activity recorded by the electrocardiogram (ECG) tracing that denotes the spread of the stimulus through the atria is the: p wave

Inquiry about nocturnal muscle spasms would be most significant when taking the musculoskeletal history of:

The spread of the impulse through the ventricles (ventricular depolarization) is depicted on the ECG as the: QRS

As Mr. B. enters the room, you observe that his gait is wide based and he staggers from side to side while swaying his trunk. You would document Mr. B.’s pattern as:

The reliability of health-related findings and observations is the responsibility of the: patient and examiner

The physical assessment technique most frequently used to assess joint symmetry is: inspection

The presence of cervical motion tenderness may indicate:

The goals of preparticipation sports evaluation include:

A patient in the deepest coma would be scored a __3___ on the Glasgow Coma Scale.

The adnexa of the uterus are composed of the:

Montgomery tubercles are most prominent in the breasts of:

Palpation of epitrochlear nodes is part of the: upper extremities

During chest assessment, you note the patient’s voice quality while auscultating the lung fields. The voice sound is intensified, there is a nasal quality to the voice, and the e’s sound like a s. This sound is indicative of: bronchial obstruction

When palpating joints, crepitus may occur when: irregular bony surfaces rub together

Examination of the patient in the lithotomy, or knee-chest, position includes: anal sphincter

The best way to ease the apprehension of a 3-year-old child before a physical examination is to: let him hold the stethoscope during the exam

Recent unilateral inversion of a previously everted nipple suggests: cancer

A grade IV mitral regurgitation murmur would:

Breath sounds normally heard over the trachea are called: bronchial

Nerves that arise from the brain rather than the spinal cord are called: cranial

The checkout station for preparticipation physical evaluation (PPE) is critical because at this point: plan follow ups

You are interviewing a 20-year-old patient with a new-onset psychotic disorder. The patient is apathetic and has disturbed thoughts and language patterns. The nurse recognizes this behavior pattern as consistent with a diagnosis of: schizophrenia

A 12-year-old boy relates that his left scrotum has a soft swollen mass. The scrotum is not painful upon palpation. The left inguinal canal is without masses. The mass does transilluminate with a penlight. This collection of symptoms is consistent with: hydrocele

Postural hypotension is defined as a ___15 mm hg decrease__ when the patient stands, compared with sitting or supine readings.

While examining a 30-year-old woman, you note that one breast is slightly larger than the other. In response to this finding, you should: document in the record

You are inspecting the genitalia of an uncircumcised adult male. The foreskin is tight and cannot be easily retracted. You should: ask about previous infections

An examiner has rotated a brush several times into the cervical os. The brush was withdrawn and stroked lightly on a glass slide. The slide was sprayed with fixative. Which type of specimen requires this technique for collection? Cytology smear

When you attempt to move a 10-month-old child from his mother’s lap to the examination table, he screams loudly. Your best action is to: let them sit on the mothers lap

It is especially important to test for ankle clonus if: deep tendon reflexes are hyperactive

Which one of the following is a proper technique for use of a speculum during a vaginal examination?

Diabetic peripheral neuropathy will likely produce: decreased pain sensation

One of the most important aspects to consider in the orthopedic screening examination is: symmetry

The Mini-Mental State Examination should be administered for the patient who: get lost in their own neighborhood

When the Goodenough-Harris Drawing Test is administered to a child, the evaluator principally observes the:

During a routine prenatal visit, Ms. T. was noted as having dependent edema, varicosities of the legs, and hemorrhoids. She expressed concern about these symptoms. You explain to Ms. T. that her enlarged uterus is compressing her pelvic veins and her inferior vena cava. You would further explain that these findings: normal pregnancy

An apical PMI palpated beyond the left fifth intercostal space may indicate: left ventricular hypertrophy

Which one of the following techniques is used to detect a torn meniscus? McMurray

When assessing superficial pain, touch, vibration, and position perceptions, you are testing: sensory

Which of the following statements is true regarding the examination of peripheral arteries? Do not use your thumb

Tarry black stool should make you suspect: upper gastrointestinal bleed

A pulsation that is diminished to the point of being barely palpable would be graded as: 1

Temporalis and masseter muscles are evaluated by: clenching teeth

The foramen ovale should close: minutes after birth

A parent is advised to restrict contact or collision sports participation for their child. An example of a sport in which this child could participate is: riflery

When is the mental status portion of the neurologic system examination performed? constantly

Breath odors may clue the examiner to certain underlying metabolic conditions. The odor of ammonia on the breath may signify: uremia

You are conducting a preparticipation physical examination for a 10-year-old girl with Down syndrome who will be playing basketball. She has slight torticollis and mild ankle clonus. What additional diagnostic testing would be required for her? Cervical radiographs

For purposes of examination and communication of physical findings, the breast is divided into: 4 quadrants and a tail

A red, hot swollen joint in a 40-year-old man should lead you to suspect: gout

You are examining Mr. S., a 79-year-old diabetic man complaining of claudication. Which of the following physical findings is consistent with the diagnosis of arterial occlusion? Lack of hair growth

You are initially evaluating the equilibrium of Ms. Q. You ask her to stand with her feet together and arms at her sides. She loses her balance. Ms. Q. has a positive: Rombergs

Anterior cruciate ligament integrity is assessed via the _____ test. Lachmans

Throughout the history and physical examination, the clinician should:

Your older clinic patient is being seen today as a follow-up for a 2-day history of pneumonia. The patient continues to have a productive cough, shortness of breath, and lethargy and has been spending most of the day lying in bed. You should begin the chest examination by: auscultating lung bases

When assessing a 17-year-old for nuchal rigidity, you gently raise his head off the examination table. He involuntarily flexes his hips and knees. To confirm your suspicions associated with this positive test, you would also perform a test for the _____ sign.

You are assessing Mr. Z.’s fluid volume status as a result of heart failure. If your finger depresses a patient’s edematous ankle to a depth of 6 mm, you should record this pitting as: 4+

A finding that is indicative of osteoarthritis is: Herberdens

To spread the breast tissue evenly over the chest wall, you should ask the woman to lie supine with: arm up over head and pillow behind one shoulder

You are conducting an examination of Mr. Curtis’s heart and blood vessels and auscultate a grade III murmur. The intensity of this murmur is: moderately loud

At your first meeting with a patient, it is usually best to say: Tell me about yourself

Functional assessment is most important during the examination of a(n): older adult

Nancy Walker is a 16-year-old girl who presents to the clinic with complaints of severe, acute chest pain. Her mother reports that Nancy, apart from occasional colds, Nancy is not prone to respiratory problems. What potential risk factor is most important to assess with regards to Nancy’s current problem? Cocaine

A patient you are seeing in the emergency department for chest pain is suspected of having a myocardial infarction. During the health history interview of his family history, he relates that his father had died of “heart trouble.” The most important follow-up question you should pose is which of the following? How old was your father at the time of his death

Which cranial nerves are usually evaluated during the examination of the eyes?

While interviewing a 70-year-old female clinic patient, she tells you that she takes ginkgo biloba and St. John’s wort. You make a short note to check for results of the: MMSE