Health Assess

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  1. A nurse plans to get a specimen for a Papanicolaousmear during a vaginal examination. What should be used to lubricate the speculum
    water
  2. When is a specimen collected during a vaginal examination?
    After the cervix and vagina have been inspected
  3. Which characteristic of cervical secretions is considered abnormal?
    odorous
  4. Which position of the cervix is considered abnormal?
    lateral
  5. What will prolapse into the posterior wall of the vagina when the patient bears down?
    rectocele
  6. A patient reports spontaneous discharge from her left nipple. How would you determine if the discharge was from one or multiple ducts?
    • Selected Answer:
    • Compress the nipple and examine with a magnifying glass.
  7. A clear-to-yellow viscous nipple discharge that is associated with pregnancy is called:
    • Selected Answer:
    • colostrum.
  8. Mr. Hortsman is a 69-year-old patient who presents to your office for routine follow-up. On examination, you observe gynecomastia. This may be secondary to:
    • Selected Answer:
    • a decrease in testosterone.
  9. Mrs. Tucker is a 52-year-old patient who presents for her routine yearly physical examination. What do you call the nontender and nonsuppurative bumps seen on the areola?
    • Selected Answer:
    • Montgomery tubercles
  10. Mrs. Casey is a 68-year-old patient who presents for a yearly physical examination. While performing a breast examination, which finding is expected?
    • Selected Answer:
    • The breast tissue has a granular feel.
  11. When examining a 34-year-old mother of two who is a new patient in for a routine physical, you notice that the right nipple is inverted. Which question would you immediately ask?
    • Selected Answer:
    • "How long has your right nipple been inverted?"
  12. Mrs. Yates is a 58-year-old patient who presents to your office for her yearly physical examination. She asks you how often a mammogram is recommended. The best response by the examiner is:
    • Selected Answer:
    • "every year."
  13. While palpating the axilla, it is best to place the patient in a:
    • Selected Answer:
    • sitting position with the arms flexed at the elbows.
  14. When palpating for infraclavicular lymph nodes, which direction do you give the patient?
    • Selected Answer:
    • Turn your head toward the side being palpated and raise your shoulder on that side.
  15. Mrs. Harris presents to your office with a complaint of a red rash on her breast suggestive of either Paget disease or eczema. Which is a distinguishing factor between these two problems?
    • Selected Answer:
    • The response to cortisone
  16. Mrs. Bower, a 56-year-old patient, presents for a yearly physical examination. On examination, you note a fixed mass in the left breast. Given this finding, which area would you palpate for sentinel nodes?
    • Selected Answer:
    • Supraclavicular fossa
  17. Mrs. Newer brings her young child in for a yearly physical examination. On examination, you note a supernumerary nipple. For which other finding do you need to be alert?
    • Selected Answer:
    • Renal anomalies
  18. Which is a similarity between fibroadenoma and fibrocystic disease?
    • Selected Answer:
    • Both are nonmalignant breast problems.
  19. Which are risk factors for breast cancer for a 43-year-old woman?
  20. 1. Mother died of breast cancer
    • 2. Menarche at age 11
    • 3. Early onset of menopause
    • 4. 50-year-old sister currently has breast cancer
    • 5. History of alcoholism
    • 6. One child, a 7-year-old son
    • Selected Answer:
    • All but 3
  21. Mrs. Ginley is a 43-year-old mother of a 7 year old and a 5 year old who presents to your office for a routine physical. On examination, you note galactorrhea. Which question is most pertinent to this situation?
    • Selected Answer:
    • What medications do you take?
  22. Mrs. Venin brings her 18-year-old son in for a follow-up examination. You have examined him before due to his enlarged breast tissue, which has not resolved spontaneously. Which action is most appropriate?
    • Selected Answer:
    • Ask about illicit or prescription drug use.
  23. At what point in the menstrual cycle is a routine breast examination best done?
    • Selected Answer:
    • A week after menses
  24. A small nipple on the upper inner thigh is:
    • Selected Answer:
    • a supernumerary nipple.
  25. Mrs. Werner is a 30-year-old patient who presents to your office. After a thorough clinical examination, you diagnose mastitis. Which factor typically causes this clinical condition?
    • Selected Answer:
    • Clogged milk duct
  26. What is the cause of a Peau d'orange appearance to the skin of the breast?
    • Selected Answer:
    • Edema from blocked lymph drainage
  27. Mrs. Jones brings her newborn infant daughter in for a routine office visit. On examination, you express a clear to milky white fluid from the breast bud. Which term is used to describe this fluid?
    • Selected Answer:
    • Witch's milk
  28. How far is the normal projection of the cervix into the vagina?
    1-3 cm
  29. Which disease is caused by human papillomavirus?
    genital warts
  30. What is defined as cessation of menses for 1 year because of age?
    menopause
  31. What is included in the examination of the external genitalia? (Select all that apply.)
    • skene glands
    • urinary meatus
    • bartholin glands
  32. A nurse plans to get a specimen for a Papanicolaousmear during a vaginal examination. What should be used to lubricate the speculum
    water
  33. When is a specimen collected during a vaginal examination?
    After the cervix and vagina have been inspected
  34. Which characteristic of cervical secretions is considered abnormal?
    odorous
  35. Which position of the cervix is considered abnormal?
    lateral
  36. What will prolapse into the posterior wall of the vagina when the patient bears down?
    rectocele
  37. How far is the normal projection of the cervix into the vagina?
    1-3 cm
  38. Which disease is caused by human papillomavirus?
    genital warts
  39. What is defined as cessation of menses for 1 year because of age?
    menopause
  40. What is included in the examination of the external genitalia? (Select all that apply.)
    • skene glands
    • urinary meatus
    • bartholin glands
  41. Which instrument is commonly used to collect endocervical cells?
    cytobrush
  42. Mrs. Wolf is a 29-year-old patient who presents for a routine
    • examination. Which finding on examination leads you to suspect a
    • sexually transmitted infection?
    • ulcers and vesicles on vulva
  43. Which finding on examination of a 34-year-old woman is suggestive of pelvic inflammatory disease?
    Pain resulting from movement of the cervix
  44. Mrs. Kauffman is a 31-year-old patient who presents for a routine
    • examination. On inspection, you note a cauliflower-like mass on the
    • labia. What is the most likely cause?
    • Condyloma acuminatum
  45. Ms. Horter is a 27-year-old nulliparous woman who presents for a routine
    • examination. On examination, you observe a slit-shaped cervical os.
    • Which item in her history explains this finding?
    • Elective abortion
  46. How are early cervical cancer changes detected?
    pap smear
  47. Mrs. McKnight is a 58-year-old patient who presents with a complaint of
    • pelvic pain. Which finding on examination would make you concerned about
    • a pelvic mass?
    • A cervix deviating to the right
  48. A 62-year-old woman went through menopause about 14 years ago. Which
    • statement made by this patient indicates a need for further follow-up?
    • "I have small amounts of vaginal bleeding a couple of times a week."
  49. Mrs. Tucker is a 45-year-old patient who presents with a complaint of
    • urinary incontinence when she is engaging in physical activity. Which
    • associated finding might explain this problem?
    • Hernial protrusion through the anterior wall of the vagina
  50. Ms. Exeter is a 26-year-old patient who presents for a routine yearly Pap smear. She is in a monogamous relationship and reports no problems currently. Which information would you give the patient following a Pap
    • smear?
    • "You may experience mild bleeding or spotting over the next couple of hours."
  51. Mrs. Sandstrom brings in her 6-year-old daughter and expresses concern that her daughter seems to be experiencing vaginal bleeding. Which statement regarding vaginal bleeding in children is true?
    Vaginal bleeding in children is always clinically important.
  52. Mrs. Mills is a 33-year-old patient who presents with a complaint of pelvic pain. On examination, you plan to do a DNA test for gonorrhea. Which instrument would you use for this purpose?
    dacron swab
  53. Thepatient lies on her back with knees bent apart and the feet resting on the examination table near the buttocks. What position is this?
    M-shape
  54. Infertility is associated with which condition?
    varicocele
  55. What term is used to describe a loop of bowel that cannot be reduced?
    incarcerated hernia
  56. Which assessment finding is associated with a left testicular torsion?
    • Nausea and vomiting
    • Scrotal discoloration
    • Severe left testicular pain
    • Absence of the cremasteric reflex on the left side
  57. Mr. Haupt presents at your clinical for his annual physical. Upon examination of the penis, you note a painless lesion and enlarged regional lymph nodes. What do you suspect is occurring in this client?
    Sexually transmitted infection of the lymphatics
  58. Mr. Jones brings his son to you following a softball game. The child complains of a swollen testicle, acute pain and vomiting. Upon examination, you note the absence of the cremasteric reflex on the side
    • of acute swelling. What do you suspect is occurring?
    • Torsion
  59. Mrs. Jones brings her newborn infant son in for a routine physical examination. On examination, you palpate a testicle in the inguinal canal that cannot with gentle pushing be moved into the scrotum. This
    • finding is consistent with:
    • an undescended testicle.
  60. The examiner inspects the scrotum of a 43-year-old man. Which finding requires further evaluation or follow-up?
    The skin on the scrotum is shiny and smooth.
  61. Mr. Walker is a 28-year-old patient who presents for a routine office visit. On examination, you note reddish lesions on the prepuce, glans, and shaft that may also be present within the urethra. Which of the
    • following best describes your clinical findings?
    • genital warts
  62. How is the prostate gland examined?
    Palpation through the anterior wall of the rectum
  63. Which characteristic of the prostate gland found upon examination indicates benign prostatic hypertrophy?
    Protrusion into the rectum 2 cm
  64. How is a rectal polyp determined to be malignant?
    pathology results
  65. Which condition causes severe rectal pain that interferes with sitting and defecation?
    anal fissure
  66. Which observation determines that a newborn infant has anal patency?
    passing of meconium stool
  67. What is the meaning of a stool specimen testing positive for chemical guaiac?
    blood is present in stool
  68. What can a male patient do to lower his risk of developing prostate cancer according to the American Cancer Society (2012)?
    engage in regular physical activity
  69. Dimpling with inflammation in the sacrococcygeal area indicates which condition?
    pilonidal cyst
  70. What risk factors are associated with the development of hemorrhoids?
    • pregnany
    • dehydration
    • standing for long periods
  71. What information do you give the parents of an infant on whom you have done a rectal examination?
    Some bleeding and rectal prolapse may be seen right after the exam.
  72. Mr. Santos is a 67-year-old patient who presents to your office. On examination, you palpate his prostate, noting that it is hard and irregular. The median sulcus is not palpable. These findings are consistent with:
    prostate CA
  73. The primary function of the rectum is:
    storage of feces
  74. Mr. Mills, a 38-year-old patient, presents with severe rectal pain and fever. Which condition might be the cause of the symptoms?
    perianal abscess
  75. On rectal examination, you note a lax anal sphincter. This is an indication of which problem?
    neuro deficit
  76. "Boggy, enlarged, and tender" on rectal examination is descriptive of which condition?
    prostatitis
  77. A toddler requires a rectal examination. How do you position the child?
    supine
  78. Enlargement of the prostate may cause:
    urinary retention
  79. Which is a routine screening test performed in conjunction with a rectal examination?
    Guiaic test of stool to r/o presence of blood
  80. The adult internal rectal sphincter is controlled by the:
    autonomic nervous system
  81. Mr. Tucker is a 56-year-old patient who presents to your office with a complaint of rectal pain. On examination you are palpating the lateral and posterior rectal walls. What should you expect to feel?
    a smooth, even, and uninterrupted surface.
  82. A newborn does not pass meconium in the first 24 hours after birth. Which is a problem that must be suspected?
    cystic fibrosis
  83. __________ presents as an elevated red granular tissue opening on perianal skin with purulent drainage.
    anorectal fistula
  84. Mr. Custer is a 56-year-old patient who presents to your office. On examination, you note a smooth and firm protrusion into the rectum. Which condition can present as as a smooth, firm 4-cm protrusion into the rectum?
    BPH
  85. Mr. Yates is a 62-year-old patient who presents with a chief complaint of rectal pain. The examiner will focus the history and examination on which known fact?
    Rectal pain is almost always an indication of local disease.
  86. Mrs. Black brings her infant son to your office. She tells you that his stools are thin, slimy, and brown to green. This is a normal finding for a _____________________
    3- to 6-day-old infant.
  87. During a rectal examination, you find shelf lesions when you palpate the anterior rectal wall. What is the significance of this finding?
    Peritoneal metastases are present.
  88. How is the anal ring assessed?
    Rotation of a finger within the anal sphincter
  89. You are teaching a parent how to check for pinworms. When is the best time to have the parent assess the child?
    while child is sleeping
  90. What is the best method of verifying anal patency in a newborn?
    • Selected Answer:
    • Checking for the passage of meconium in the first 24 to 48 hours after birth
  91. Which example best describes how firm you expect a healthy prostate gland to feel?
    • Selected Answer:
    • It feels like a pencil eraser
  92. A pregnant woman presents to the emergency department with the complaint of dark stools. She tells the examiner,"I read in a magazine that this is a sign of bleeding." Which question by the examiner is most applicable for this situation?
    • Selected Answer:
    • "Are you taking prenatal vitamins?"
  93. Which is a possible explanation for an examination finding of "absence of the anal wink"?
    • Selected Answer:
    • Chronic abuse
  94. Mr. Horstman is a 42-year-old patient who presents with a complaint of rectal pain. During the examination, you observe inflammation of the sacrococcygeal area. The patient complains of pain when it is palpated. Which problem is not consistent with such a finding?
    • Selected Answer:
    • Hemorrhoids
  95. When examining the prostate, you feel fluctuant softness. This finding indicates:
    • Selected Answer:
    • prostatic abscess.
  96. Early prostate cancer is:
    • Selected Answer:
    • asymptomatic.
  97. A patient states that he has severe foot pain that started hours earlier. The area of pain is the metatarsophalangeal joint of the first toe. The skin over the joint is red, warm, and swollen. This is consistent with what condition?
    gout
  98. Which finding is consistent with the assessment of a patient’s left leg that was injured several months earlier and has significantly limited the patient’s ability to walk because of pain since the injury?
    Slight atrophy of the left gastrocnemius muscle
  99. Which change is most commonly observed in aging patients?
    kyphosis
  100. While palpating the patient’s knee, the nurse finds effusion in the joint. What further assessment will support this finding?
    testing for ballottement
  101. A patient states he injured his right ankle while walking the previous day. How should the nurse assess the ankle initially?
    Observe and compare the right with the left ankle.
  102. Which assessment finding is associated with lumbar stenosis?
    Pain associated with prolonged standing
  103. A patient tells the nurse he has back pain. The nurse later asks the patient to walk on his heels and then his toes. What is the significance of this test?
    To determine the specific spinal nerve involved
  104. Which assessment finding is consistent with carpal tunnel syndrome? (Select all that apply.)
    • Weakness in the hand
    • Awakened by hand numbness and burning
  105. Select a risk factor for osteoarthritis. (Select all that apply.)
    • obesity
    • age > 4o years
    • family history of OA
  106. The elbow joint consists of articulation of the:
    • Selected Answer:
    • humerus, radius, and ulna.
  107. he FABER test is a part of the assessment of which joint?
    • Selected Answer:
    • Hip
  108. The spine of a newborn infant is palpated and a split is noted in one of the spinal processes, which problem does the examiner suspect?
    • Selected Answer:
    • Bifid defect
  109. Which factor results in bony prominences becoming more apparent in older adults?
    • Selected Answer:
    • Loss of subcutaneous tissue
  110. Mr. McKnight, a 72-year-old patient, presents to your office for a routine office visit. Which finding on examination would be considered normal?
    • Selected Answer:
    • Kyphosis
  111. When assessing for carpal tunnel syndrome, which nerve is tapped to elicit the Tinel sign?
    • Selected Answer:
    • The median nerve
  112. Mr. Jones is a 37-year-old patient who presents to your office with shoulder pain. Which test would help identify a problem with the rotator cuff?
    • Selected Answer:
    • Neer test
  113. "Normal" muscle strength is documented as Grade ______.
    • Selected Answer:
    • 5
  114. Mrs. Bower is a 38-year-old patient who presents to your office with complaints of pain and a clicking noise with jaw movement. The pain extends into the face. These symptoms are suggestive of which condition?
    • Selected Answer:
    • Temporomandibular joint dysfunction
  115. The rubbing of two irregular bony edges together produces:
    • Selected Answer:
    • crepitus.
  116. The curves of the cervical and lumbar spines are:
    • Selected Answer:
    • concave.
  117. What are you testing when you ask a patient to extend the head against the pressure of your hand?
    • Selected Answer:
    • Sternocleidomastoid muscle strength
  118. Mr. Booker is a 47-year-old patient who presents to your office with a complaint of knee pain. When performing the drawer test, you note there is excessive movement of the knee in the anterior/posterior plane. What conclusion do you draw?
    • Selected Answer:
    • There is possible injury to the anterior cruciate ligament.
  119. To assess muscle strength of the temporalis and masseter muscles, the examiner will ask the patient to:
    all of the above.
  120. Which statement made by a patient helps the examiner differentiate osteoarthritis from rheumatoid arthritis?
    • Selected Answer:
    • "I get extremely tired by mid-morning, even when I sleep well."
  121. Which condition may a woman develop during pregnancy to compensate for the enlarging uterus and shift her center of gravity over the lower extremities?
    • Selected Answer:
    • Lordosis
  122. Which is an effect of increased levels of hormones in the pregnant female?
    • Selected Answer:
    • Increased elasticity of ligaments
  123. Mrs. Harris is a 69-year-old patient who presents to your office for follow-up of her rheumatoid arthritis. Which deformity would be an expected finding associated with her disease?
    • Selected Answer:
    • Boutonnière deformity
  124. For which type of problem does a family history have significance?
    • Selected Answer:
    • Rheumatoid arthritis
  125. A straight leg raising test would appropriately be performed as part of the assessment for which problem?
    • Selected Answer:
    • Lumbar nerve root irritation
  126. Muscles are attached to the bones by:
    • Selected Answer:
    • tendons.
  127. You are planning to assess range of motion in a 56-year-old patient with a complaint of joint pain. Which is an important fact related to this assessment that must be considered?
    • Selected Answer:
    • Passive ROM is normally 5 degrees greater than active ROM.
  128. While measuring the circumference of the extremities of a 43-year-old patient, the examiner compares of the right and left sides. What findings should the examiner expect to find?
    • Selected Answer:
    • Nearly equal right and left side measurement
  129. A Hawkins test would appropriately be performed as part of the assessment for which problem?
    • Selected Answer:
    • Rotator cuff injury
  130. Mr. Bartlet is a 24-year-old patient who presents to your office with a complaint of knee pain. On examination, what degree of knee flexion is considered a normal finding?
    • Selected Answer:
    • 130 degrees
  131. Mr. Treven is a 48-year-old patient who presents to your office with a complaint of poor balance. In assessing this complaint which test do you perform first?
    • Selected Answer:
    • Romberg test
  132. Mr. Arena is a 64-year-old patient. On examination, you note a positive Brudzinski and Kernig sign. The Brudzinski and Kernig signs are indicators of:
    • Selected Answer:
    • meningeal irritation.
  133. Which condition is required when testing discriminatory sensory function of an individual?
    • Selected Answer:
    • Individual's eyes closed
  134. Mrs. Bowers is a 63-year-old patient. On examination, you need to test joint position sensation. In testing position sensation, the examiner moves the individual's:
    • Selected Answer:
    • finger/toe up or down.
  135. By simultaneously touching the individual in two distinct areas of the body and asking how many stimuli are present, you are testing:
    • Selected Answer:
    • extinction phenomenon.
  136. The examiner is assessing deep tendon reflex response in a 12-year-old boy. The response is an expected reflex response. Which score should be documented?
    • Selected Answer:
    • 2+
  137. Mrs. Jones is a 24-year-old patient who presents to your office 2 days postpartum with a complaint of foot drop. Which problem should you consider?
    • Selected Answer:
    • Lumbosarcal plexopathy
  138. Motor maturation in an infant proceeds in which direction?
    • Selected Answer:
    • Cephalocaudal
  139. Mrs. Morrison brings in her 5-year-old son in for an examination. What is your best approach to the neurologic assessment of the child?
    • Selected Answer:
    • Make various aspects of the neurologic examination a game.
  140. By asking the individual to make various faces at you, you are testing:
    • Selected Answer:
    • CN VII.
  141. What is the goal of a sports participation evaluation?
    Ensure that the student can safely participate in the sports activity.
  142. The parents of a child with Down syndrome who wants to play on a school soccer team should be educated that the child has an increased risk for which type of injury?
    spinal cord injury
  143. Which assessment finding from a sports participation evaluation alerts the nurse that a student may have an eating disorder?
    decreased tooth enamel
  144. The risk of which cardiac condition is associated with serious complications for student athletes?
    sudden cardiac death
  145. Which assessment finding of a student with Down syndrome warrants an immediate referral for neurologic evaluation?
    hyperactive DTRs
  146. What blood pressure is considered the upper limit of normal for pediatric patients?
    120/80
  147. School-age and adolescent females who compete in sports where weight control and physique are emphasized are at increased risk to develop which health problem? (Select all that apply.)
    • amenorrhea
    • osteoporosis
    • eating disorder
  148. The presence of which condition is an absolute contraindication for a student to participate in a school sport? (Select all that apply.)
    • fever
    • carditis
  149. Mrs. Kauffman brings in her 16-year-old daughter for a preparticipation examination for high school softball. On examination, you note mouth ulcerations, multiple caries, decreased tooth enamel, edema, normal body weight, and irregular menses. With which problem are these findings most consistent?
    • Selected Answer:
    • Eating disorder
  150. The American Academy of Pediatrics recommends limiting participation in which sport until the adolescent achieves sexual rating 5?
    • Selected Answer:
    • Bodybuilding
  151. Mrs. Harris brings in her 15-year-old son for a preparticipation examination. He plans to start football practice in 2 days. You explain that the preparticipation examination should be completed at least 6 weeks before the start of the sports event or practice so that:
    • Selected Answer:
    • any identified problems can, if possible, be rehabilitated.
  152. To reduce injuries, the American Academy of Pediatrics recommends limiting the amount of body checking allowed for hockey players ___ years of age and younger.
    • Selected Answer:
    • 15
  153. The main goal of the preparticipation examination is to:
    • Selected Answer:
    • ensure safe participation in an appropriate physical activity.
  154. When performing a preparticipation examination on a child with Down syndrome, you assess for signs of atlantoaxial instability. Which findings would indicate this problem?
    • Selected Answer:
    • Radicular pain and change in bowel function
  155. Mrs. Mills brings in her 17-year-old daughter for a preparticipation examination for field hockey. She has stated that her daughter has a cardiac history. As the examiner, you know that sudden cardiac death in athletes is a great concern. Which problem absolutely precludes an athlete from participation in sports?
    • Selected Answer:
    • Carditis
  156. Mr. Simmons brings in his 17-year-old son for a preparticipation examination for wrestling. What is the importance of looking for asymmetries in range of motion, strength, and muscle bulk as part of the orthopedic component of the examination?
    • Selected Answer:
    • Acute or old poorly rehabilitated injuries are identified.
  157. The American Academy of Pediatrics opposes the participation of children, adolescents, and young adult in which sport?
    • Selected Answer:
    • Boxing
  158. Mrs. Planer brings in her 16-year-old daughter for a preparticipation examination for gymnastics. Her concern is her daughter's weight and growth. As the examiner, you are aware that in the female athlete during teenage years, a too thin body frame encourages:
    • Selected Answer:
    • hypoestrogenic state.
  159. A 16-year-old cheerleader comes for a required physical. Her health history is benign and she has no current complaints. On examination, her blood pressure is 124/82. Which action do you take?
    • Selected Answer:
    • Arrange to recheck the blood pressure in a week.
  160. Which is an accurate statement regarding the preparticipation examination?
    • Selected Answer:
    • There is nothing legally binding about the provider's recommendation.
  161. Mrs. Jones brings in her 16-year-old daughter for a routine preparticipation examination. Your concerns include the female athlete triad. This triad includes:
    • Selected Answer:
    • eating disorder, amenorrhea, and osteoporosis.
  162. Which is an example of a Special Olympics sport which is particularly risky for persons with atlantoaxial instability?
    • Selected Answer:
    • Swimming
  163. Secondary amenorrhea occurs in as many as ______% of female athletes.
    • Selected Answer:
    • 69%
  164. Mr. Torres is a 16-year-old patient who presents for a preparticipation sports examination. Why is it important to determine and document normal neuropsychologic status in the preparticipation examination?
    • Selected Answer:
    • To better judge the return to normal in the event of injury.
  165. What is the minimal amount of time that a child with mononucleosis must refrain from playing his or her sport?
    • Selected Answer:
    • 3 weeks
  166. Mrs. Tucker presents to your office today for a follow-up appointment. She appears to fidget in her seat and with her hands. Which of the following would assess her attention span?
    • Selected Answer:
    • Could you take this paper, fold it in half, and put it on the counter?
  167. Which area in the brain regulates the level of arousal?
    • Selected Answer:
    • Reticular activating system
  168. Which part of the brain contains the Wernicke speech area, which permits speech and comprehension of written language?
    • Selected Answer:
    • Temporal lobe
  169. Mr. Green returns to your office with his son, 3 months following his CVA. The son questions when his father's speech will improve. Which of the following areas of the brain are integral to motor speech?
    • Selected Answer:
    • The Broca area (frontal lobe)
  170. A mother brings her child, an 18-month-old boy, to the clinic. She states that the child rarely talks or smiles. She has also noticed that he does not like to be held. She states that his motor development seems to be normal. With what condition are these symptoms consistent?
    • Selected Answer:
    • Autistic disorder
  171. Mr. Santos is a 78-year-old patient who presents to your office with his daughter. The daughter describes difficulties that include a sudden onset of cognitive impairment, illogical flow of ideas, and hallucinations. Which of the following best describes this condition?
    • Selected Answer:
    • Delirium
  172. Which is a major difference between Alzheimer disease and vascular dementia?
    • Selected Answer:
    • Etiology
  173. At what age do babies usually say one or two words such as "Mama" and "Dada?"
    • Selected Answer:
    • 10 to 12 months
  174. Change in thought process reflects:
    • Selected Answer:
    • cognitive abilities.
    • emotional stability
  175. Mr. Gates is a 68-year-old man who is brought to your office by his daughter. Which of the following would demonstrate an evaluation of thought process and content?
    • Selected Answer:
    • Observing the person's patterns of thinking, especially the appropriateness of sequence, logic, coherence, and relevance to the topics discussed
  176. How does the nurse demonstrate respect for the patient?
    Introduce self, including name.
  177. How can the nurse evaluate whether an elderly patient comprehends during a physical examination?
    Ask the patient to verbalize his or her understanding.
  178. Which activity is included in an assessment of instrumental activities of daily living (ADLs)?
    Ability to prepare meals
  179. Which examination should be done last when assessing a 10-month-old infant?
    otoscopic exam
  180. Which is the best question or statement to begin a physical examination?
    tell me about yourself
  181. hich observation cannot be made when the nurse first meets the patient?
    amount of pain
  182. During a health assessment, an elderly patient stares at the nurse wide eyed and gives mostly one-word answers. Select the best approach to deal with the tension initially?
    Slow down the examination and include more simple explanations.
  183. Which assessment should the nurse delegate to a trained health assistant?
    measuring ht and wt
  184. Mr. Whaler is a 73-year-old patient who presents to your office for a routine physical examination. Which of the following positions would Mr. Whaler be likely to have most difficulty assuming?
    • Selected Answer:
    • Knee-chest
  185. Mrs. Casey brings her 14-month-old baby in for a checkup. Which examination approach is suggested for this patient?
    • Selected Answer:
    • The baby should be wearing only a diaper and be sitting on his or her parent's lap.
  186. Mrs. Black is a 28-year-old patient who presents to your office for a routine examination during her pregnancy. Examination of the pregnant woman in the supine position may predispose her to:
    • Selected Answer:
    • hypotension.
  187. Mr. Wolf is a 74-year-old patient who presents to your office with his son. Which of the aspects of examination is probably most relevant to the evaluation of this patient?
    • Selected Answer:
    • Functional assessment
  188. Ms. Mills is a 27-year-old patient who presents to your office. She complains of a sore throat. Which aspect of the examination may be eliminated?
    • Selected Answer:
    • Deep tendon reflexes
  189. Which is the best description of the goal of a functional assessment of an older patient?
    • Selected Answer:
    • how well an individual deals with the daily demands of life.
  190. The purpose of the general inspection is to:
    • Selected Answer:
    • provide an opportunity to look for initial signs of distress or disease.
  191. In determining the gestational age of an infant, which of the following observations is least helpful?
    • Selected Answer:
    • Mother's menstrual history
  192. Mrs. Harris presents to your office as a new patient for a physical examination. When performing a physical examination, you should consider the examination to begin:
    • Selected Answer:
    • as soon as you meet the patient.
  193. Mr. Smith is a 48-year-old patient presenting for a routine physical examination. All of the following equipment is necessary except:
    • Selected Answer:
    • monofilament.
  194. Which is a general guideline to be followed when performing a physical examination?
    • Selected Answer:
    • Integrate obtaining the history and performing the physical examination according to the demands of the situation.
  195. How do you decrease the likelihood of triggering the gag reflex when you use a tongue blade to inspect a patient's throat?
    • Selected Answer:
    • Run the tongue blade under water before use.
  196. All of the following can be assessed initially during the general inspection except:
    • Selected Answer:
    • cognitive ability.
  197. Which of the following assists the examiner in determining the gestational age of a newborn?
    • Selected Answer:
    • Inspection of the sole of the foot
  198. On which of the following is it best to perform the examination of the young child?
    • Selected Answer:
    • On his/her parent's lap
  199. When examining a newborn or young infant, which area of the body should be assessed right after the general inspection?
    • Selected Answer:
    • Chest, lungs, and heart
  200. Mrs. Kiltner brings in her 4-year-old daughter for a routine examination. What technique will most likely facilitate the examination of this patient?
    • Selected Answer:
    • Tell the child a story in order to distract her.
  201. Which statement is the best guide to an effective sequence of physical examination?
    process flows smoothly, minimizes number of times the pt has to change positions, and conserves pt energy
  202. Ms. Darren is a 29-year-old patient who presents with a firm, irregular mass with an area of discoloration. Which of the following diagnoses is associated with these clinical findings?
    • Selected Answer:
    • Fat necrosis
  203. Mrs. Tucker brings her infant daughter in for a newborn visit. On examination, you are able to express a clear to milky white fluid from the breast bud. You explain to Mrs. Tucker that this is an expected finding for an infant at which age?
    • Selected Answer:
    • Up to 3 months
  204. The midaxillary nodes are:
    • Selected Answer:
    • superficial and easy to palpate.
  205. Which of the following is the correct position in which to place the patient for breast palpation?
    • Selected Answer:
    • Supine with the arms over the head and small pillow under the shoulder of the side being assessed
  206. What is the purpose of doing a chest wall sweep as part of a breast examination?
    • Selected Answer:
    • To feel superficial lumps
  207. An examiner may wish to use a bimanual technique for abdominal palpation when:
    • Selected Answer:
    • meeting muscle resistance while performing deep palpation.
  208. In which age group does abdominal palpation become easier and more accurate?
    • Selected Answer:
    • Older adults
  209. Mr. Graham is a 56-year-old patient who presents to your office with a complaint of knifelike pain and epigastric tenderness. Knifelike pain may indicate:
    • Selected Answer:
    • pancreatitis
  210. An absence of bowel sounds in the right lower quadrant is referred to as the ________________ sign.
    • Selected Answer:
    • Dance
  211. When percussing the abdomen, which is the predominant sound you expect?
    • Selected Answer:
    • Tympany
  212. Mr. Goldberg is a 45-year-old patient who presents to your office. Which finding is indicative of peritoneal irritation or appendicitis?
    • Selected Answer:
    • Palpation of rebound tenderness
  213. Mrs. Tate is going on vacation to a foreign country and wants to know what to do to decrease her change of experiencing "traveler's diarrhea." What should you tell her?
    • Selected Answer:
    • Stay away from street vendor food.
  214. A 61-year-old man has a presenting complaint of frequent constipation. He tells the examiner that there has been a change in his bowel movement habits-he gets constipated easily, the stool is very "skinny-looking," and it is a different color than usual. He denies pain. Which disorder do these symptoms suggest?
    • Selected Answer:
    • Colon or rectal cancer
  215. When assessing bowel sounds, how long should you auscultate before determining the bowl sounds are absent?
    • Selected Answer:
    • 5 minutes
  216. A bluish periumbilical discoloration known as ________ is indicative of intraabdominal bleeding.
    • Selected Answer:
    • Cullen sign
  217. A 32-year-old woman tells the examiner that when she goes running, she dribbles urine. Which problem should the examiner consider?
    • Selected Answer:
    • Stress incontinence
  218. When examining a newborn infant, which finding suggests a congenital anomaly?
    • Selected Answer:
    • The umbilical cord has one artery and one vein.
  219. Which finding indicates the possibility of liver disease in the neonate?
    • Selected Answer:
    • Spider nevi
  220. A hiatal hernia is best described as:
    • Selected Answer:
    • a protrusion of the stomach through the esophageal hiatus of the diaphragm.
  221. Mrs. Cody is 36 weeks pregnant. She tells the examiner she feels like her stomach muscle is splitting. A light protrusion of the abdomen midline is observed. This is recognized as:
    • Selected Answer:
    • diastasis recti.
  222. The examiner auscultates a friction rub in the abdomen of the patient. This finding should make the examiner consider:
    • Selected Answer:
    • inflammation of the peritoneal surface.
  223. Abdominal pain that has a colic quality may indicate:
    • Selected Answer:
    • renal stone.
  224. Which techniqueis used to confirm the presence of abdominal ascites?
    • Selected Answer:
    • Percussion of dullness over dependent areas of the abdomen
  225. An abnormal accumulation of fluid within the peritoneal cavity is referred to as:
    • Selected Answer:
    • ascites.
  226. A 44-year-old man presents with a complaint of lower left quadrant (LLQ) pain. Which approach would you use in examining his abdomen?
    • Selected Answer:
    • Examine all other areas of the abdomen before examing the tender area.
  227. Mr. Walker is a 46-year-old patient who presents for a routine monthly appointment. You note that the midclavicular liver span is 18 cm. With palpation, you note that the liver is enlarged with a firm, nontender border. Which problem do these findings suggest?
    cirrhosis
  228. The patient lies on the back with the knees bent so that the legs are spread flat and the heels meet at the end of the table. This is what position?
    • Selected Answer:
    • Diamond shape
  229. Which is an important guideline to be followed when collecting a specimen for a DNA test for Chlamydia trachomatis?
    • Selected Answer:
    • Check the expiration date on the reagent.
  230. Mrs. Davis is a 46-year-old patient who presents to your office with a complaint of a thin vaginal discharge with a fishy odor. She is not experiencing any itching. What condition do these symptoms indicate?
    • Selected Answer:
    • Bacterial vaginosis
  231. Which instrument is used to collect both ectocervical and endocervical cells?
    • Selected Answer:
    • Cytobroom
  232. A patient complains of pain, dysmenorrhea, and heavy prolonged menstrual flow. Tender nodules are palpable along the uterosacral ligament. The symptoms and findings suggest:
    • Selected Answer:
    • endometriosis.
  233. Mrs. Jones presents to your office with complaints of pain following sexual intercourse, pain during urination, and irregular menstrual bleeding. What do you suspect is occurring in this client?
    • Selected Answer:
    • She has pelvic inflammatory disease.
  234. When is Frog position used as part of a patient assessment?
    • Selected Answer:
    • To examine the external genitalia of a neonate
  235. A 27-year-old patient presents to your office saying that for the past 2 ½ months she has been getting a period every 16 or 17 days. Which term would you use to describe this problem?
    • Selected Answer:
    • Polymenorrhea
  236. The vagina, uterus, fallopian tubes, and ovaries are supported by four ligaments. Which of the following is a normal examination finding that evaluates this support?
    • Selected Answer:
    • The uterus can be moved back and forth with manipulation.
  237. The patient lies on her back with the legs straightened out and spread wide to either side of the table. What position is this?
    • Selected Answer:
    • V-shape
  238. Which is a defining symptom of endometrial cancer?
    • Selected Answer:
    • Postmenopausal bleeding
  239. Mrs. Jones is a 68-year-old patient who presents to your office with a complaint of abdominal pain. Her husband died 1 year ago and she reports that she is not sexually active. Which finding would be of concern?
    • Selected Answer:
    • Palpable ovaries
  240. ________ is an inflammation of the glans penis.
    • Selected Answer:
    • Balanitis
  241. Mr. Frank is a 32-year-old patient who presents to your office with a complaint of a penile lesion. On examination, you note a painless lesion with a clear base and indurated borders located on the glans penis. What do you conclude this lesion is?
    • Selected Answer:
    • Syphilitic chancre
  242. Mr. Tucker is a 28-year-old patient who presents to your office with a concern that during an erection his penis is bent and painful. This clinical finding is characterized by a fibrous band in the corpus cavernosum and is called:
    • Selected Answer:
    • Peyronie disease.
  243. Mr. Walker is a 24-year-old patient who is being seen for a health promotion visit. You have given Mr. Walker information regarding genital self-examination (GSE). Which statement made by the patient indicates that further teaching is necessary?
    • Selected Answer:
    • "I should look for a hernia while doing this."
  244. ____________ is an initially painless erosion on or near the coronal sulcus.
    • Selected Answer:
    • Lymphogranuloma
  245. While examining the genitalia of a 2-year-old boy, the examiner should be aware that:
    • Selected Answer:
    • the foreskin of the uncircumcised penis is not fully retractable until 3 or 4 years of age.
  246. Which finding when assessing a 17-year-old would be a cause for concern?
    • Selected Answer:
    • Complaint of heaviness in the scrotum
  247. Attempting to retract the foreskin is associated with:
    • Selected Answer:
    • checking for phimosis.
  248. Which assessment finding would be expected when examining a 14 year old with Klinefelter syndrome?
    • Selected Answer:
    • Small scrotum
  249. In which situation is transillumination of the scrotum indicated?
    • Selected Answer:
    • A mass is felt within the sac.
  250. When examining the testes, it is important to palpate the vas deferens. How should a normal vas deferens feel?
    • Selected Answer:
    • Smooth
  251. Mr. Taper is a 50-year-old male who presents to your clinical with a deep ulceration with rolled edges. What do you suspect is occurring in this client?
    • Selected Answer:
    • Penile carcinoma
  252. Which disorder is suggested by the presence of painful superficial vesicles on the penis and perineum?
    • Selected Answer:
    • Herpes simplex
  253. Identification of which condition can be assisted by transillumination?
    • Selected Answer:
    • Observing for hydrocele
  254. ______________ is a fluid accumulation in the tunica typically seen in infants.
    • Selected Answer:
    • Hydrocele
  255. Mr. Garbin is a 42-year-old patient who presents to your office for a yearly physical examination. On examination, you note that the foreskin of the penis is retracted over the glans and is unable to relax into its normal position. Which condition is most consistent with this clinical finding?
    • Selected Answer:
    • Paraphimosis
  256. Which is an expected characteristic of the scrotum of a full-term newborn male?
    • Selected Answer:
    • Pendulous
  257. Mrs. Baker presents to your office with her 2-year-old son. On examination, you note that the urinary meatus appears at the base of the penis. What is the name of this condition?
    • Selected Answer:
    • Hypospadias
  258. The examiner inspects the scrotum of a 43-year-old man. Which finding requires further evaluation or follow-up?
    • Selected Answer:
    • The skin on the scrotum is shiny and smooth.
  259. A premature infant's scrotum will likely be:
    • Selected Answer:
    • smooth.
  260. When examining the penis of an uncircumcised neonate, what is the basis for your conclusion that the foreskin is not too tight?
    • Selected Answer:
    • The foreskin pulls back enough to allow a good urinary stream.
  261. Which fact from a patient history indicates a risk factor for cancer of the penis?
    • Selected Answer:
    • The patient has a history of condyloma acuminatum infections.
  262. Mr. Yates, a 47-year-old patient, presents to your office with a concern over a lesion on his penis. On examination, you note dome-shaped, umbilicated, smooth, pearly-gray lesions on the penis. Which disorder do you conclude Mr. Yates has?
    • Selected Answer:
    • Molluscum contagiosum
  263. An enlarged, painless testicle in an adolescent or adult may indicate:
    • Selected Answer:
    • a tumor.
  264. Which finding may indicate diabetes?
    • Selected Answer:
    • The vas deferens feels beaded or lumpy.
  265. Mr. Torres is a 42-year-old patient who presents for a routine examination. On examination, you note abnormal dilation and tortuosity of the veins along the spermatic cord. Which of the following conditions best describes this clinical finding?
    • Selected Answer:
    • Varicocele
  266. A patient tells the examiner that she has had small flecks of blood stained mucous in her stools. Stools of this type result from:
    • Selected Answer:
    • amebiasis.
  267. Mr. Bower is a 78-year-old patient who is unable to assume a standing position for a routine rectal examination. Which is the best alternative position?
    • Selected Answer:
    • Left lateral position with the knees flexed
  268. In which situation would the examiner perform a rectal examination on an infant or child?
    • Selected Answer:
    • A stool of a 6-year-old child is guaiac-positive.
  269. Mr. Harrien is a 56-year-old patient who presents to your office. On examination, you note impaired pain sensation. Which additional test is appropriate to further evaluate this finding?
    • Selected Answer:
    • Temperature and deep pressure sensation
  270. Which assessment finding is consistent with lower motor neuron disease affecting the face?
    • Selected Answer:
    • Total paralysis of the affected side of the face
  271. Which finding is associated with an increased risk of skin breakdown and injury?
    • Selected Answer:
    • An inability to feel pressure applied by a monofilament
  272. The Babinski response of the plantar reflex is normally seen in individuals who:
    • Selected Answer:
    • are younger than 24 months of age.
  273. Mr. Smith, a 75-year-old, tells you during his physical that he is experiencing tremors in his hands that occur at rest. Which disorder does this finding cause you to suspect?
    • Selected Answer:
    • Parkinson's disease
  274. A deep tendon reflex that is more brisk than expected and slightly hyperactive would be graded as:
    • Selected Answer:
    • 3+.
  275. The examiner asks the patient to close her eyes, then places a vibrating tuning fork on the patient's ankle and asks her to indicate what is felt. What is being assessed?
    • Selected Answer:
    • Peripheral nerve sensory function
  276. Which is a function of the basal ganglia?
    • Selected Answer:
    • Exert a fine-tuning effect on motor movements
  277. Mrs. Green brings her 6 month old infant in for examination. Which observation is most indicative of a normal timetable of neurological development?
    • Selected Answer:
    • The infant takes and holds a spoon in one hand.
  278. Mr. McKnight is a 48-year-old patient who presents to your office with a complaint of dizziness. He states "I sometimes feel as if the whole room is spinning." What type of neurologic dysfunction should the examiner suspect?
    • Selected Answer:
    • Inner ear dysfunction affecting the acoustic nerve
  279. A patient presents with a bilaterally symmetric intention tremor of the hands that she describes as "worse when I'm stressed and better when I have a cocktail." How would you document this tremor?
    • Selected Answer:
    • Essential tremor
  280. When stroking the inner thigh of a male, which of the following is expected to occur?
    • Selected Answer:
    • The scrotum and testicle on the stroked side will rise.
  281. A dermatome is that part of the body that:
    • Selected Answer:
    • is innervated by a particular spinal nerve.
  282. Which finding should an examiner consider normal finding if associated with pregnancy?
    • Selected Answer:
    • Acroparesthesia
  283. The finger-to-nose test is used to test for:
    • Selected Answer:
    • accuracy of movement.
  284. Mr. Black is a 41-year-old construction worker who comes in to your office. You squeeze the patient's biceps muscle as part of an examination. Which of the following responses verbalized by the patient is considered normal?
    • Selected Answer:
    • "That is uncomfortable."
  285. The main function of cerebrospinal fluid is to:
    • Selected Answer:
    • act as a shock absorber.
  286. Which question asked by the examiner may help to determine prevention strategies for seizures that a patient is experiencing?
    • Selected Answer:
    • "Are there any factors or activities that seem to start the seizures?"
  287. Clonus is associated with reflexes that are:
    • Selected Answer:
    • hyperactive.
  288. You are obtaining a history on a new patient. A family history of which disorder would be of greatest concern?
    • Selected Answer:
    • Huntington chorea
  289. Mr. Tucker is a 68-year-old patient who presents to your office for follow-up. He tells you, "I feel numb and I am so slow when I move." On examination, you note postural instability. This assessment data are suggestive of which problem?
    • Selected Answer:
    • Parkinson's disease
  290. You are examining a patient who had an ankle fracture of the tibia and fibula 12 weeks ago. You find that plantar flexion of the affected foot is 45 degrees. How do you interpret this finding?
    • Selected Answer:
    • Plantar flexion is normal.
  291. Which group is susceptible to subluxation of the head of the radius?
    • Selected Answer:
    • Infants/toddlers
  292. Mrs. Bower brings in her 8-year-old daughter for an office visit. You note generalized muscle weakness indicated by the Gower sign. Which is the best description of the Gower sign?
    • Selected Answer:
    • The child rises from a sitting position by placing her hands on her legs and pushing the trunk up.
  293. Which is not a function of the musculoskeletal system?
    • Selected Answer:
    • Secretion of minerals
  294. Which item from a patient's history indicates an increased risk of osteomyelitis?
    • Selected Answer:
    • An open fracture of the radius
  295. A variation in leg alignment identified as genu varum is commonly known as:
    • Selected Answer:
    • bow-leg
  296. Mrs. Blain is a 45-year-old patient who presents to your office. On examination, you note a positive Tinel sign. A positive Tinel sign is associated with which problem?
    • Selected Answer:
    • Carpal tunnel syndrome
  297. For which type of problem does a family history have significance?
    • Selected Answer:
    • Rheumatoid arthritis
  298. Which statement best describes the procedure for testing muscle strength?
    • Selected Answer:
    • Have the individual contract a muscle by flexing or extending a joint as you apply opposing force and feel the resistance.
  299. Emilio Sanchez is a 12-year-old who presents for evaluation after getting hit on the side of the head with a fast ball during a game. Which standardized tool would be appropriate to use to evaluate for concussion?
    • Selected Answer:
    • SCAT2 form
  300. Ms. Baker is a 19-year-old college student who presents to your office for a preparticipation examination for girls' basketball. As the examiner, you know that during the preparticipation examination, the component that most often detects problems affecting athletes is the:
    • Selected Answer:
    • history.
  301. Change in thought process reflects:
    emotional stability
  302. roblem solving and short-term recall memory are associated with which section of the brain?
    • Selected Answer:
    • Frontal lobe
  303. Which of the following actions would best evaluate the patient's judgment?
    • Selected Answer:
    • Ask the patient, "What do you plan to do after you are discharged from the hospital?"
  304. Social smiling usually occurs around:
    • Selected Answer:
    • 2 to 3 months.
  305. An inability to describe similarities or differences between common objects such as carrots and green beans is suggestive of which problem?
    • Selected Answer:
    • A left cerebral hemisphere lesion
  306. The limbic system controls:
    • Selected Answer:
    • emotions.
  307. Mrs. Bates is a 56-year-old patient who presents to your office with her son. He states she has had a change in mental status. On examination, you note that her judgment is poor. With which problem is poor judgment most closely associated?
    • Selected Answer:
    • Dementia
  308. Mrs. Hilliard brings her 9-year-old daughter to your office. She has been diagnosed with autistic disorder. Which of the following statements best describes this disorder?
    • Selected Answer:
    • Pervasive neurodevelopmental disorder
  309. Which is a classical indication of Alzheimer disease?
    • Selected Answer:
    • Disintegration of personality
  310. Which part of the brain contains the Wernicke speech area, which permits speech and comprehension of written language?
    • Selected Answer:
    • Temporal lobe
  311. Mr. Jared is a 68-year-old patient who presents to your office with his daughter. During the interview, you note that he has a slumped posture in the chair and lack of facial expression. Which of the following best describes this condition?
    • Selected Answer:
    • Parkinson disease
  312. Schizophrenia affects which of the following?
    • Selected Answer:
    • A person's perceptions
  313. Mr. Reasoner brings his son in for a routine physical examination. On examination, you note inappropriate developmental inattention, impulsivity, and hyperactivity. Your diagnosis is attention deficit hyperactivity disorder. You know that this occurs in children before they are:
    • Selected Answer:
    • 7 years old.
  314. Mr. Yates is a 67-year-old patient who presents to your office with his son. Which of the following would best test Mr. Yates comprehension?
    • Selected Answer:
    • Ask him to follow one- and two-step commands.
  315. You administer the Isaac Set Test to evaluate mental function in a 78-year-old woman whose family reports apparent changes in her cognition. You would interpret a score in which range as indicative of dementia?
    • Selected Answer:
    • 14 or less

Card Set Information

Author:
fnpsr
ID:
319016
Filename:
Health Assess
Updated:
2016-05-07 02:25:58
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Description:
health assessment
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