Download ADVANCED HEALTH ASSESSMENT FINAL EXAM 2024 | ALL QUESTIONS AND CORRECT ANSWERS | GRADED A+ and more Exams Health sciences in PDF only on Docsity!
ADVANCED HEALTH ASSESSMENT FINAL
EXAM 2024 | ALL QUESTIONS AND
CORRECT ANSWERS | GRADED A+ |
VERIFIED ANSWERS | LATEST VERSION
A 58 yo dentist presents for routine check up. He has been healthy. Non smoker, does not drink alcohol. You hear a moderately loud murmur, no palpable thrill. What is the appropriate grade for this murmur? ------ CORRECT ANSWER---------------Grade 3 57 yo college professor is hospitalized for SOB. As you examine her in ER, JVP of 45 degrees 8 cm above the clavicle. finding is most consistent with which of the following diagnoses? ------CORRECT ANSWER--------------- Right sided heart failure What technique should be used to best auscultate the 2nd heart sounds? -- ----CORRECT ANSWER---------------Diaphragm of the stethoscope at 2nd intercostal space at the base of the heart You hear a split s2 on auscultation of a 25 yo client. What is your best action? ------CORRECT ANSWER---------------Tell them to hold their breath and repeat The clinet has been told he has a heart murmur. He asks you what this means. You explain ------CORRECT ANSWER---------------It is the rushing sound blood makes moving through narrow places. Some are harmless and others indicate problems
Where would you expect to hear best an abnormal sound with mitral valve insufficiency? ------CORRECT ANSWER---------------5th ICS at MCL when auscultating the heart sounds of a 72 yo client with history of HTN. NP notes an S4. This finding could indicate ------CORRECT ANSWER------- --------An increased resistance to ventricular filling As you assess Ms Jones you recall that the most prevalent cardiac symptom is ------CORRECT ANSWER---------------Fatigue Joe Tiger presents with complaints of pain in his leg when walking that is relieved with rest. You perform ABI. Which result would be consistent with physical symptoms? ------CORRECT ANSWER---------------0. As you assess your patient you document Osler's nodes. You realize that this could be a sign of? ------CORRECT ANSWER---------------Endocarditis During the physical exam of 72 yo Mary Rose you note a BP of 140/90. According to JNC 8, what would you do first? ------CORRECT ANSWER---- -----------Calculate cardiac risk When auscultating a clients heart you note short, high-frequency click (opening snap) after S2 during the beginning of diastole. What could this indicate? ------CORRECT ANSWER---------------Mitral stenosis
Lung sounds that have low pitch and soft in intensity and are heard better on inspiration ------CORRECT ANSWER---------------Vesicular When auscultating for vocal resonance in a client with possible consolidation of lung tissue. The NP hears "a-a-a" when the client says "e- e-e". This is called: ------CORRECT ANSWER---------------Positive egophany The NP understands the following about hyperresonance in percussion of the lungs ------CORRECT ANSWER---------------It is expected finding with emphysema 55 yo client tells you she smoked 2ppd since age 14. How many pack years? ------CORRECT ANSWER--------------- 82 During pulmonary assessment, you observe the client to have diaphragmatic excursion of 4 cm bilaterally. What is your best action? ------ CORRECT ANSWER---------------Document the observation As you assess Ms L you understand that her dyspnea is basically a dysfunction with external respiratory physiology. Due to her___ ------ CORRECT ANSWER---------------emphysema You review a chart of a patient seen 2 days ago by your collegue. You see a positive whispered pectoriliquy test, you understand this is ------ CORRECT ANSWER---------------Abnormal - loud & clear finding
To ease their breathing, clients with COPD often position themselves in a tripod position which can result in which finding? ------CORRECT ANSWER---------------Dahl's sign Which is NOT a risk factor for breast cancer? ------CORRECT ANSWER---- ------------History of maternal breast cancer
- 1st pregnancy after age 35
- asymmetric breast development
- late menopause after 54 Which description is most characteristic of breast cancer? ------CORRECT ANSWER---------------Single, firm, nontender, ill-defined breast lump You are assessing a neonate and note breast engorgement. You document this as an abnormality. True or false ------CORRECT ANSWER--------------- FALSE With which of the following clients having a breast lump are you alerted to the possibility of a fibroadenoma? ------CORRECT ANSWER--------------- 25 yo woman with a single firm rubbery lump When performing a clinical breast exam, you take special care to examine the upper outer quadrants and axilla because ------CORRECT ANSWER---- -----------Most frequent location of breast cancer
Mr Bear presents c/o excessive daytime sleepiness. Exam reveals flushed face, SOB ambulating into the room. BMI>30 , +JVD, +HJR, HTN. Your possible list of diagnoses include all EXCEPT ------CORRECT ANSWER---- ------------pickwickian syndrome
- CHF
- Atrial fibrillation
- Metabolic syndrome In assessing for pneumonia, you would expect to find ____ in tactile vocal fremitus ------CORRECT ANSWER---------------Increase Lilly age 3 months was seen for a cold. Which physical finding is most common in the infant? ------CORRECT ANSWER---------------Wheeze An abnormal symmetric expansion would most likely be noted on which of the following patients? ------CORRECT ANSWER---------------Pneumonia You are assessing a pediatric patient with croup. What clinical finding would you expect to discover? ------CORRECT ANSWER---------------croup Mr Random is being seen for SOB you are assessing his neck veins and need to distinguish the jugular from the carotid. You understand that there is a change in respiration with the ___. ------CORRECT ANSWER------------- --Jugular
You are doing a physical on a male patient when he tells you he is concerned about breast cancer. All of the following are risk factors EXCEPT: ------CORRECT ANSWER----------------Testosterone
- 45-55 years old
- Low level of physical activity
- History of bone fracture after 45 A circumscribed, elevated lesion, >1 cm I diameter and containing clear serous fluid is best described as ------CORRECT ANSWER---------------Bulla The history and physical of a client indicates paste occurrences of lichenification. The NP identifies this as: ------CORRECT ANSWER----------- ----Rough, thickened epidermis, accentuated skin markings On examination of a client's skin, the nurse practitioner finds a lesion that is about 0.75 cm in diameter, brown, and circumscribed. Correct term for this lesion is: ------CORRECT ANSWER---------------Macule In performing a skin assessment, the NP understands that the following characteristic of a mole would need intervention: ------CORRECT ANSWER---------------A new 2mm mole that is brown with a red, irregular border, and occasionally pruritic The NP describes an annular skin lesion as usually arranged in ------ CORRECT ANSWER---------------A circle or ring shape An NP educating patients realizes that risk factors for skin cancer include all except: ------CORRECT ANSWER---------------Dark eyes
Mary D. an 84 y.o F has multiple solar lentils <1 cm. These are not uncommon for her age. You would describe these as: ------CORRECT ANSWER---------------Macules Lou, a 50 yo homeless man is diagnosed with tinea capitis. You realize this is cause by a(n): ------CORRECT ANSWER---------------Dermatophyte Ron R presents with dependent edema. You assess he has a >1 inch indentation up to mid-tibia bilaterally. You document this as: ------ CORRECT ANSWER---------------+4 edema The most common type of melanoma is the: ------CORRECT ANSWER------ ---------Superficial You are assessing Arlene C's skin complaint. You get a +Auspitz sign. This aides you in the diagnosis of: ------CORRECT ANSWER--------------- Psoriasis As you gather you history from a patient with atopic dermatitis what other items in the personal or family history would you expect with this patient? -- ----CORRECT ANSWER---------------Asthma Which of the following statements best describes squamous cell carcinoma? ------CORRECT ANSWER---------------Often has a keratinous horn
You are assessing a newborn and note the baby is jaundiced. He is 3 days old. You realize that for this to be a normal finding it must be gone within: -- ----CORRECT ANSWER---------------1 week What are the major components to be documented for a skin lesion? ------ CORRECT ANSWER----------------Distribution
- Configuration
- Palpable features
- Pattern
- All of the above Which of the following presentations suggests a diagnosis of a malignant melanoma? ------CORRECT ANSWER---------------Lesion with border irregularity All of the following statements concerning basal cell carcinoma are true EXCEPT? ------CORRECT ANSWER---------------It is most often found on abdomen or trunk The NP denotes a bruit above and to the left of the umbilicus. This finding is consistent with: ------CORRECT ANSWER---------------History of HTN As you palpate the abdomen, + rebound tenderness at McBurney's point would alert you to: ------CORRECT ANSWER---------------Appendicitis
ANSWER---------------Palpate the left side of the abdomen, then the right side, noting guarding and tenderness The most important goal of assessing a client with abdominal pain is ------ CORRECT ANSWER---------------Rule out emergent conditions While examining the abdomen of a post-op patient, you note that the bowel sounds are noted within 20 seconds. You. document that this is: ------ CORRECT ANSWER---------------a normal finding During your abdominal assessment you note purple striae. Your next step would be to: ------CORRECT ANSWER---------------Ask about cold/heat intolerance Ruay Smith is a 27 yo M diagnosed with ulcerative colitis at age 18. He needs a colonoscopy by age ------CORRECT ANSWER--------------- 30 When palpating the abdomen of an infant, the NP realizes that the spleen is easily palpable: ------CORRECT ANSWER---------------True In your examination of Gordon, age 29, you elicit L costa-vertebral angle tenderness. What do you expect? ------CORRECT ANSWER--------------- Pyelonephritis
When auscultating a patient's abdomen, the NP hears a systolic bruit in the epigastric area. It occurs at a fixed interval, most likely source of this bruit is: ------CORRECT ANSWER---------------abdominal aorta Jay Smith presents with abdominal pain. As you assess him you chat +AWT. This leads you to what possible diagnosis ------CORRECT ANSWER---------------Muscle strain Mr Java is an 85 yo M, you realize that abdominal disorders in the older patient are more difficult to diagnose because ------CORRECT ANSWER---- -----------Vague symptoms and often little to no pain Mrs Jones is a female patient with history of ETOH abuse. Your abdominal exam should include: ------CORRECT ANSWER---------------The scratch test When examining the eyes, the NP realizes that the pupils change in size when the client focuses from a close object to a far object. This is: ------ CORRECT ANSWER---------------Normal visual accommodation On ophthalmic examination, there appears to be narrowing or blocking of the vessels. Significance of this finding is: ------CORRECT ANSWER--------- ------The client should be evaluated for chronic hypertension Mr Smith has a +bruit upon examination of the thyroid. This most likely indicates: ------CORRECT ANSWER---------------Hyperthyroidism
you are giving an 85 yo nursing home resident her annual physical exam. History of HTN. Margin of lower lid is turned outward and conjuctiva is exposed ------CORRECT ANSWER---------------Ectropion 56 yo salesman evaluated area on the tongue that has been present for 3 ___, unable to scrape off. White painless plaques. What is the likely diagnosis? ------CORRECT ANSWER---------------Leukoplakia Client presents with conjunctivitis. Which lymph nodes would you expect to find enlarged? ------CORRECT ANSWER---------------Pre-auricular and anterior cervical Conducting an ophthalmic exam on a patient with chronic hypertension. What would you expect to see? ------CORRECT ANSWER--------------- cotton wool patches and flame hemorrhages When Judy, age 15, asks you to explain what 20/50 vision means you respond: ------CORRECT ANSWER---------------You can see at 20 feet what normal people can see at 50 feet Ms Ins presents with eye pain. The external eye is red, tender, swollen, raised area, pointing outward on the lash border. This is: ------CORRECT ANSWER---------------Hordeolum firm, painless, relatively fixed submandibular node would most likely be seen in the diagnosis of : ------CORRECT ANSWER---------------oral caner
As an APN, you believe strongly in anticipatory guidance and prevention education. You explain this to your patient that the development of screening and prevention guidelines is based on: ------CORRECT ANSWER---------------increased in average life expectancy ted who is 15 yo just moved into the community and is staying in a foster home temporality without any record of immunizations. Which immunizations does he need? ------CORRECT ANSWER---------------- meningococcal
- mmr
- tdap
- all of the above*** the client tells you that he takes aspirin daily. What question should you ask next? ------CORRECT ANSWER---------------Why do you take aspirin daily? Mr. Bill presents to your office for a physical. You note that his BMI is 27. You inform him that this is considered ------CORRECT ANSWER--------------
- overweight You are evaluating an elderly man who was brought by his distraught daughter. You explain that many physical changes occur as we age that affect nutrition. Including all of the following except? ------CORRECT ANSWER---------------total caloric needs increase Mr P complains of a "pain in his stomach". In your note you document that he is c/o pain in the LLQ, radiating with worsening intensity towards the
During the breast exam of a 30 year old nulliparous female. The NP palpates several rubbery areas of the breast tissue. They are slightly tender to palpation and present in both breasts. Expecting menses in 5 days. Which intervention is best? ------CORRECT ANSWER---------------Tell her to recheck 1 week after her menses All of the following symptoms associated with chest pain are likely to represent CAD except? ------CORRECT ANSWER---------------pain with inspiration 60 yo landscaper presents to your office to establish care, history of CHF controlled with medications. Denies cp, edema. Early diastolic? with opening snap ___. You suspect? ------CORRECT ANSWER--------------- Mitral stenosis When performing a H&P on a pediatric patient. Which important factor affects the outcome the most: ------CORRECT ANSWER---------------Child's developmental level The most important question to ask as you build your HPI is ------ CORRECT ANSWER---------------Have you ever had this before? Which of the following patients is least likely to become an alcohol abuser? ------CORRECT ANSWER---------------50 yo construction worker who drinks 1 beer nightly
You are describing a lesion noted on Mr Smith a 55 yo M. It is flat, nonpalpable, <1cm. You describe this as a ------CORRECT ANSWER-------- -------macule A patient states that she has had a rash on her breast for about 2 weeks. In order to determine if it is pagets disease you would expect to have all of the following on physical exam EXCEPT ------CORRECT ANSWER--------------- inverted nipple You notice a medium-pitched harsh systolic murmur during a routine exam or R upper border of the sternum. Which of the following is most likely? -----
- CORRECT ANSWER---------------Aortic stenosis Which of the following statements in NOT typical of the murmur it is describing? ------CORRECT ANSWER---------------Grade II/Grade VI murmur is associated with a thrill? you realize that as an APN you must ask sensitive questions, the most important thing is to be: ------CORRECT ANSWER--------------- nonjudgemental cultural competence is best enhanced when the healthcare provider ------ CORRECT ANSWER---------------uses self awareness and reflection you are assessing Jenna's broken arm in the ER and you suspect she may be a victim of violence. What statement triggered your concern? ------ CORRECT ANSWER---------------I hurt it about 4 days ago
