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MARYVILLE NURS 612 EXAM 1 QUESTIONS
AND ANSWERS 100% CORRECT
1. Which of the following will best facilitate the interview
when obtaining a history for a deaf patient who can read lips? ANS speaking slowly
2. During a history, the patient indicates he has an uncle
and a brother with sickle cell disease. Which of the following is an appropriate method to document this information? ANS Include it in the family history.
3. Which approach is recommended at the onset of an
interview? ANS Use an open-ended approach; let the patient explain the problem or reason for the visit.
4. Which of the following questions may lead to an
inaccurate patient response? ANS "That was a horrible experience, wasn't it?"
5. Repeating a patient's answer is an attempt to
ANS confirm an accurate under- standing.
6. During an interview, your patient admits to feeling
worthless and having a sleep disturbance for the
past 3 weeks. These are clues that warrant the exploration of ANS risk for suicide
7. Jerry, a 26-year-old homosexual man, is having a
health history taken. Which question regarding sexual activity would most likely hamper trust between Jerry and the interviewer? ANS Are you married or do you have a girlfriend
8. When questioning a patient regarding a sensitive
issue, such as drug use, it is best to ANS be direct, firm, and to the point
9. Direct questions are designed to
ANS obtain or clarify specific details about an answer
10. Interviewers should identify and assess their own
feelings, such as hostility and prejudice, in order to ANS reduce communication barriers
11. During an interview, a patient describes abdominal
pain that often awakens him at night. Which of the following responses by the interviewer would facilitate the interviewing process? ANS "Tell me what you mean by often."
ANS eye color, temperature, and visual acuity
19. Which of the following is an example of a physical,
as opposed to a cultural, characteristic? ANS Skin color
20. Despite repeated instruction over a period of 3 years,
the mother of three young children has still not had her children immunized. Which of the following questions would help the health care provider understand this situation? ANS What are your beliefs about immunizations
21. Which mode of communication may be offensive to a
patient whose cultural perspective differs from that of the practitioner ANS maintaining firm and direct eye contact
22. Which of the following infection control guidelines
are currently recommended by the Centers for Disease Control and Prevention (CDC)? ANS standard precautions
23. A patient presents with multiple raised lesions on her
skin. Which instrument should be used to examine these lesions ANS ruler
24. In an outpatient setting such as a clinic, how should
infection control practice differ from that in the acute care setting? ANS Infection control practice is applicable in all healthcare settings.
25. In which of the following situations is transillumination
an appropriate examination technique ANS Detection of fluid within the sinuses
26. Which of the following instruments is used in conjunction
with a simple nasal speculum to visualize the lower and middle turbines of the nose? ANS penlight
27. On first meeting, the examiner notices that the patient
has an obvious odor. Which examination technique is the examiner using in this scenario? ANS Inspection
28. Focused visual attention obtains data from
ANS inspection
29. Which technique is applied throughout the entire
examination and interview process ANS inspection
30. As a component of palpation, which surface is most
sensitive to vibration ANS ulnar surface of the hand
38. While performing an internal eye examination, the
examiner observes a fundal lesion. What feature on the ophthalmoscope permits the examiner to estimate the size and location of the lesion? ANS grid light
39. An ophthalmoscope has positive and negative magnification in order to
ANS compensate for myopia or hyperopia in the examiner's or the patient's eyes.
40. According to the Centers for Disease Control and
Prevention, the health care provider should apply infection control measures when caring for which group of patients? ANS All patients regardless of their infectious status
41. Unless a life-threatening situation exists, the best
guide to determining the priority for the patient's condition should be based on ANS intuition
42. When determining a need for additional examination,
testing, or procedures, the examiner knows that these should be done ANS if they relate to the examiner's hypothesis
43. After an examiner has identified and confirmed a
problem, the next step is to ANS determine the managment plan
44. The use of a computer could potentially be detrimental
to the examiner because ANS it may become a substitute for critical thinking.
45. To identify problems based on clinical examination,
the examiner should organize the data ANS by body systems
46. Each of the following could become a barrier to the
critical thinking process, except for the examiner's ANS objectivity (feelings, atti- tudes, and values could be barriers)
47. Which statement best characterizes a belief that supports a sound deci-
sion-making process? ANS Common problems occur commonly, and rare ones occur rarely
48. Laboratory tests should be used to
ANS develop a list of potential problems
49. EBP is defined as
ANS the best available scientific evidence to clinical decision making.
50. Which of the following examples illustrates a vague or nondescriptive
term ANS "skin color is normal"
ANS Rosen- baum chart
59. To visualize the macula, the examiner should ask the patient to
ANS look directly into the light of the ophthalmoscope.
60. A 51-year-old patient tells the examiner, "My mother had glaucoma. What
can I do to prevent myself from getting it?" Which of the following responses is most appropriate? ANS "Although it can't be prevented, regular screening and testing assist in early detection."
61. Which examination finding may be indicative of a retro-orbital tumor?
ANS -
Unilateral exophthalmos
62. A patient tells the examiner, "I have a loss of vision in the outer half of
each eye." Which of the following underlying problems should the examiner consider? ANS glaucoma
63. Which of the following would be applicable to a family history?
ANS -
Retinoblastoma
64. Mrs. Carter has vision that, at best, is
20/210. Mrs. Carter is considered ANS legally blind
65. Which of the following is the correct technique while performing an
ophthalmoscopic examination? ANS Examine the patient's right eye with your right eye and the pt's left eye with your left eye
66. A cobblestone appearance of the conjunctiva is most likely related to
ANS -
allergic or infectious conjunctivitis
67. Mr. Barclay is a 48-year-old patient who presents to the office for follow
up. On his eye examination, you note peripheral fundus changes and ves- sels that appear whitish. The most likely cause for these findings is ANS lipemia retinalis
68. Which of the following cranial nerves innervate the six muscles that
control eye movement? ANS III, IV, VI
69. When you are examining the eyelid, you note ptosis on the right side.
Which cranial nerve innervates the muscle that elevated the upper eyelid? ANS - CN III
70. Mr. Kasey is a 57-year-old patient who presents to your office. During the
eye examination, you note that his pupils are not equal in size; however, they react to light and accommodation. This is called ANS anisocoria
71. When performing a Weber test, which of the following is considered a
normal finding?
78. Mr. Cruz presents for a physical examination. On examination, you note
that the lower molars are distally positioned in relation to the upper molars. How would you classify this malocclusion? ANS Class II malocclusion
79. The most important clinical signs for sinusitis in adults includes which of
the following? ANS Maxillary toothache, purulent nasal drainage, poor response to decongestants
80. Normal findings in elderly mouth/pharynx
ANS Oral tissues may be dryer (xe- rostomia)
81. General findings in elderly mouth/pharynx
ANS xerostomia, Periodontal dis- ease, Oral cancer, Aspiration pneumonia, fully edentulous
82. Abnormal findings in elderly mouth/pharynx
ANS Gingivitis, periodontal dis- ease, dental caries, teeth may appear longer, Dental malocclusion
83. Initial symptoms are cracking sound when yawning or swallowing, dis-
comfort, feeling of fullness (no drainage) ANS Otitis media with effusion
84. Exam shows conductive loss as ears fills with fluid, retracted or bulging
TM, impaired mobility, yellowish air-fluid level and bubbles ANS Otitis media with effusion
85. Initial symptoms of Abrupt onset, fever, feels blocked, anorexia, irritabili-
ty, deep-seated ear ache, if TM ruptured foul-smelling discharge
ANS Acute Otitis Media
86. Exam shows conductive loss as ears fills with pus, TM with distinct
erythema, thickened or clouding; bulging, impaired mobility, air-fluid level and bubbles ANS Acute Otitis Media
87. Exam shows Meatus inflamed, tender and weeping, extreme pain, nothing
can be seen of interior canal. ANS Otitis Externa (Swimmer's ear)
88. What tests are done to test hearing?
ANS Whisper, Weber, & Rinne
89. expected findings of Weber test
ANS sound heard equally in both ears
90. expected findings for the Rinne test
ANS air conduction (AC) greater than bone conduction (BC); 2 ANS1 ration
91. Abnormal findings with elderly Conjunctiva
ANS Cataracts Age related macular degeneration Diabetic retinopathy Glaucoma
99. presbyopia, decrease in dim light sight, decreased ability to adjust to
change in lighting ANS Normal findings with elderly Conjunctiva
100. What is being looked at with ophthalmoscope
ANS Red reflex, vascular supply of the retina, optic disc and macula
101. if someone of a different culture comes in with pain how would you
address that? ANS ask if they any cultural beliefs that will affect how you need to treat the pain, does the pain frighten you, how do you cope with pain, what ways do you usually treat pain
102. How would you like to be addressed?; How are you feeling today?; What
would you like for us to do today?; What do you think is causing your symptoms?; What is your understanding of your diagnosis? ANS examples of patient-centered questions
103. If language is a barrier how should it be handled
ANS professional interpreter, rather than a family member, should be used
104. What do open-ended questions allow?
ANS gives the patient discretion about the extent of an answer
105. What do direct questions allow?
ANS to seeks specific information
106. What tests would you use to check vision acuity?
ANS Rosenbaum (near vision) & Snellen (far vision)
107. Know some red flags of the eye (send to ED or eye doctor)
ANS uneven pupils with HA, sudden loss of vision, floaters/flashers
108. When a patient has retinal detachment what is their main complaint?
ANS -
"curtain" feeling, floaters or flashes
109. How do you check for glaucoma?
ANS Check intraocular pressure (tonometry); optic disc assessment, peripherial vision exam, whether intraocular drainage sys- tem is "open" or "closed" (gonioscopy)
110. how to identify bacterial conjunctivitis vs allergic conjunctivitis
ANS Bacte- rial- starts in one eye and spreads to the other, yellow/ crusty drainage Allergic- both eyes, puffy and/ or runny
111. What is first thing visualized with ophthalmascope 12 inchs away?
ANS red reflex
112. What will be the first thing seen with ophthalmascope as you approach 3-
5 cm away? ANS blood vessel
113. If your patient is myopic (nearsighted) what lens will be used with
ophthalmascope ANS minus (red) len
121. What is the worst differential diagnosis for a patient that comes in with
an ear infection? ANS Mastoid infection or meningitis
122. How is the Rinne test performed?
ANS Place the base of the tuning fork against patients mastoid bone, ask patient to tell you when sound is no longer heard (bone conduction) Place the still vibrating tines (1-2 cm) in from the auditory canal and ask patient to tell you when sound is no longer heard (air conduction)
123. You have a 42 y/o female that comes in to you saying "I have dizziness"
what differential diagnoses could be and what test can you do to check if it is vertigo? ANS Ear infection, Meniere's disease, vertigo; Dix Hallpike maneuver (Head tilt and lay back maneuver)
124. What are some tests that you would run if you see a patient with oral
ulcers that are not resolving ANS Check for HIV, syphilis, imunosuppression
125. What is the number one virus that causes oral ulcers with fever?
ANS Herpes Simplex
126. if a patient comes in with any complaints of mouth problems whats an
important question to ask? ANS if they are a smoker or not
127. If a patient comes in with a herpes lesion or shingles on face close to
eyes, what is the number one thing that you would think of and send this patient to the emergency department? ANS optic neuritis
128. What is the number one thing that you should document on a sinusitis
patient? ANS Length of symptoms (to know whether to treat viral or bacterial)
129. How would you diagnose a patient with an allergy?
ANS Clear rhinorrhea as opposed to purulent, throat irritation, POST NASAL DRIP
130. What placement should the uvula have?
ANS midline
131. What if the uvula is not midline?
ANS Suspect a problem on the opposite side that the uvula deviates
132. What differential diagnoses would you think of if the uvula is deviated?-
ANS Peritonsillar abscess
133. When you are taking a history on a patient is it best to ask straight
forward questions or open ended questions? ANS Start with open-ended and then narrow it down with straight forward questions
134. An integral part of the overall effort to respond adequately to a person
in need is ANS cultural awareness
