Medical Examination Questions and Answers, Exams of Nursing

Download Medical Examination Questions and Answers and more Exams Nursing in PDF only on Docsity!

Nu 518 Exam 2 Actual

Exam Question Bank

(Version 1-3)

All possible Questions

And Correct Answers

With

Latest Update

NU 518 EXAM 2

The findings from an assessment of a 70-year-old patient with swelling in his ankles include jugular venous pulsations 5 cm above the sternal angle when the head of his bed is elevated 45 degrees. The nurse knows that this finding indicates: a Decreased fluid volume. B Increased cardiac output. C Narrowing of jugular veins. D Elevated pressure related to heart failure. - ANSWER: D When assessing a newborn infant who is 5 minutes old, the nurse knows which of these statements to be true? A The left ventricle is larger and weighs more than the right ventricle. B The circulation of a newborn is identical to that of an adult. C Blood can flow into the left side of the heart through an opening in the atrial septum. D The foramen ovale closes just minutes before birth, and the ductus arteriosus closes immediately after. - ANSWER: C A 25-year-old woman in her fifth month of pregnancy has a blood pressure of 100/70 mm Hg. In reviewing her previous examination, the nurse notes that her blood pressure in her second month was 124/80 mm Hg. In evaluating this change, what does the nurse know to be true?

In assessing a patients major risk factors for heart disease, which would the nurse want to include when taking a history? A Family history, hypertension, stress, and age B Personality type, high cholesterol, diabetes, and smoking C Smoking, hypertension, obesity, diabetes, and high cholesterol D Alcohol consumption, obesity, diabetes, stress, and high cholesterol - ANSWER: C The mother of a 3-month-old infant states that her baby has not been gaining weight. With further questioning, the nurse finds that the infant falls asleep after nursing and wakes up after a short time, hungry again. What other information would the nurse want to have? A Infants sleeping position B Sibling history of eating disorders C Amount of background noise when eating D Presence of dyspnea or diaphoresis when sucking - ANSWER: D In assessing the carotid arteries of an older patient with cardiovascular disease, the nurse would: a Palpate the artery in the upper one third of the neck. B Listen with the bell of the stethoscope to assess for bruits. C Simultaneously palpate both arteries to compare amplitude. D Instruct the patient to take slow deep breaths during auscultation. - ANSWER: B During an assessment of a 68-year-old man with a recent onset of right-sided weakness, the nurse hears a blowing, swishing sound with the bell of the stethoscope over the left carotid artery. This finding would indicate:

a Valvular disorder. B Blood flow turbulence. C Fluid volume overload. D Ventricular hypertrophy. - ANSWER: B During an inspection of the precordium of an adult patient, the nurse notices the chest moving in a forceful manner along the sternal border. This finding most likely suggests a(n): a Normal heart. B Systolic murmur. C Enlargement of the left ventricle. D Enlargement of the right ventricle. - ANSWER: D During an assessment of a healthy adult, where would the nurse expect to palpate the apical impulse? A Third left intercostal space at the midclavicular line B Fourth left intercostal space at the sternal border C Fourth left intercostal space at the anterior axillary line D Fifth left intercostal space at the midclavicular line - ANSWER: D The nurse is examining a patient who has possible cardiac enlargement. Which statement about percussion of the heart is true? A Percussion is a useful tool for outlining the hearts borders. B Percussion is easier in patients who are obese. C Studies show that percussed cardiac borders do not correlate well with the true cardiac border.

A Have the patient turn to the left side while the nurse listens with the bell of the stethoscope. B Ask the patient to hold his or her breath while the nurse listens again. C No further assessment is needed because the nurse knows this sound is an S3. D Watch the patients respirations while listening for the effect on the sound. - ANSWER: D Which of these findings would the nurse expect to notice during a cardiac assessment on a 4-year-old child? A S3 when sitting up B Persistent tachycardia above 150 beats per minute C Murmur at the second left intercostal space when supine D Palpable apical impulse in the fifth left intercostal space lateral to midclavicular line - ANSWER: C While auscultating heart sounds on a 7-year-old child for a routine physical examination, the nurse hears an S3, a soft murmur at the left midsternal border, and a venous hum when the child is standing. What would be a correct interpretation of these findings? A S3 is indicative of heart disease in children. B These findings can all be normal in a child. C These findings are indicative of congenital problems. D The venous hum most likely indicates an aneurysm. - ANSWER: B A 57-year-old maintenance worker comes to your office for evaluation of pain in his legs. He has smoked two packs per day since the age of 16, but he is otherwise healthy. You are concerned that he may have peripheral vascular disease. Which of the following is part of common or concerning symptoms for the peripheral vascular system?

A) Intermittent claudication B) Chest pressure with exertion C) Shortness of breath D) Knee pain - ANSWER: A A 72-year-old teacher comes to your clinic for an annual examination. She is concerned about her risk for peripheral vascular disease and states that there is a place in town that does tests to let her know her if she has this or not. Which of the following disease processes is a risk factor for peripheral vascular disease? A) Gastroesophageal reflux disease B) Coronary artery disease C) Migraine headaches D) Osteoarthritis - ANSWER: B A 68-year-old retired truck driver comes to your office for evaluation of swelling in his legs. He is a smoker and has been taking medications to control his hypertension for the past 25 years. You are concerned about his risk for peripheral vascular disease. Which of the following tests are appropriate to order to initially evaluate for this condition? A) Venogram B) CT scan of the lower legs C) Ankle-brachial index (ABI) D) PET scan - ANSWER: C A 55-year-old secretary with a recent history of breast cancer, for which she underwent surgery and radiation therapy, and a history of hypertension comes to your office for a routine checkup. Which of the following aspects of the physical are important to note when assessing the patient for peripheral vascular disease in the arms?

A) Checked for patency of the radial artery B) Checked for patency of the brachial artery C) Checked for patency of the ulnar artery D) Checked for patency of the femoral artery - ANSWER: C You are assessing a 59-year-old gas station owner for atherosclerosis in the lower extremities. In which of the following locations would the patient's pain make you concerned for this disease process? A) Thigh B) Knee C) Calf D) Ankle - ANSWER: C You are performing a routine check-up on an 81-year-old retired cotton farmer in the vascular surgery clinic. You note that he has a history of chronic arterial insufficiency. Which of the following physical examination findings in the lower extremities would be expected with this disease? A) Normal pulsation B) Normal temperature C) Marked edema D) Thin, shiny, atrophic skin - ANSWER: D A 77-year-old retired nurse has an ulcer on a lower extremity that you are asked to evaluate when you do your weekly rounds at a local long-term care facility. All of the following are responsible for causing ulcers in the lower extremities except for which condition? A) Arterial insufficiency B) Venous insufficiency

C) Diminished sensation in pressure points D) Hypertension - ANSWER: D As the internal diameter of a blood vessel changes, the resistance changes as well. Which of the following descriptions depicts this relationship? A) Resistance varies linearly with the diameter. B) Resistance varies proportionally to the second power of the diameter. C) Resistance varies proportionally to the third power of the diameter. D) Resistance varies proportionally to the fourth power of the diameter. - ANSWER: D Which area of the arm drains to the epitrochlear nodes? A) Ulnar surface of the forearm and hand, little and ring fingers, and ulnar middle finger B) Radial surface of the forearm and hand, thumb and index fingers, and radial middle finger C) Ulnar surface of the forearm and hand; second, third, and fourth fingers D) Radial surface of the forearm and hand; second, third, and fourth fingers - ANSWER: A Mr. Edwards complains of cramps and difficulties with walking. The cramps occur in his calves consistently after walking about 100 yards. After a period of rest, he can start to walk again, but after 100 yards these same symptoms recur. Which of the following would suggest spinal stenosis as a cause of this pain? A) Coldness and pallor of the legs B) Relief of the pain with bending at the waist C) Color changes of the skin D) Swelling with tenderness of the skin - ANSWER: B

D) Early "warm" septic shock - ANSWER: C When assessing temperature of the skin, which portion of your hand should be used? A) Fingertips B) Palms C) Backs of fingers D) Ulnar aspect of the hand - ANSWER: C A patient presents with claudication symptoms and diminished pulses. Which of the following is consistent with chronic arterial insufficiency? A) Pallor of the foot when raised to 60 degrees for one minute B) Return of color to the skin within 5 seconds of allowing legs to dangle C) Filling of the veins of the ankles within 10 seconds of allowing the legs to dangle D) Hyperpigmentation of the skin - ANSWER: A You note a painful ulcerative lesion near the medial malleolus, with accompanying hyperpigmentation. Which of the following etiologies is most likely? A) Arterial insufficiency B) Neuropathic ulcer C) Venous insufficiency D) Trauma - ANSWER: C Which statement is true regarding the arterial system? a Arteries are large-diameter vessels. b The arterial system is a high-pressure system.

c The walls of arteries are thinner than those of the veins. d Arteries can greatly expand to accommodate a large blood volume increase - ANSWER: B The nurse is reviewing the blood supply to the arm. The major artery supplying the arm is the artery. a Ulnar b Radial c Brachial d Deep palmar - ANSWER: C The nurse is preparing to assess the dorsalis pedis artery. Where is the correct location for palpation? a Behind the knee b Over the lateral malleolus c In the groove behind the medial malleolus d Lateral to the extensor tendon of the great toe - ANSWER: D A 65-year-old patient is experiencing pain in his left calf when he exercises that disappears after resting for a few minutes. The nurse recognizes that this description is most consistent with the left leg. a Venous obstruction of b Claudication due to venous abnormalities in c Ischemia caused by a partial blockage of an artery supplying d Ischemia caused by the complete blockage of an artery supplying - ANSWER: C

b Person who has been on bed rest for 4 days c Person with a 30-year, 1 pack per day smoking habit d Older adult taking anticoagulant medication - ANSWER: B The nurse is teaching a review class on the lymphatic system. A participant shows correct understanding of the material with which statement? a Lymph flow is propelled by the contraction of the heart. b The flow of lymph is slow, compared with that of the blood. c one of the functions of the lymph is to absorb lipids from the biliary tract. d Lymph vessels have no valves; therefore, lymph fluid flows freely from the tissue spaces into the bloodstream. - ANSWER: B When performing an assessment of a patient, the nurse notices the presence of an enlarged right epitrochlear lymph node. What should the nurse do next? a Assess the patients abdomen, and notice any tenderness. b Carefully assess the cervical lymph nodes, and check for any enlargement. c Ask additional health history questions regarding any recent ear infections or sore throats. d Examine the patients lower arm and hand, and check for the presence of infection or lesions. - ANSWER: D A 35-year-old man is seen in the clinic for an infection in his left foot. Which of these findings should the nurse expect to see during an assessment of this patient? a Hard and fixed cervical nodes b Enlarged and tender inguinal nodes c Bilateral enlargement of the popliteal nodes d Pelletlike nodes in the supraclavicular region - ANSWER: B

The nurse is examining the lymphatic system of a healthy 3-year-old child. Which finding should the nurse expect? a Excessive swelling of the lymph nodes b Presence of palpable lymph nodes c No palpable nodes because of the immature immune system of a child d Fewer numbers and a smaller size of lymph nodes compared with those of an adult - ANSWER: B During an assessment of an older adult, the nurse should expect to notice which finding as a normal physiologic change associated with the aging process? a Hormonal changes causing vasodilation and a resulting drop in blood pressure b Progressive atrophy of the intramuscular calf veins, causing venous insufficiency c Peripheral blood vessels growing more rigid with age, producing a rise in systolic blood pressure d Narrowing of the inferior vena cava, causing low blood flow and increases in venous pressure resulting in varicosities - ANSWER: C A 67-year-old patient states that he recently began to have pain in his left calf when climbing the 10 stairs to his apartment. This pain is relieved by sitting for approximately 2 minutes; then he is able to resume his activities. The nurse interprets that this patient is most likely experiencing: a Claudication. b Sore muscles. c Muscle cramps. d Venous insufficiency. - ANSWER: A

c Check for calf pain. d Check capillary refill in the toes. - ANSWER: B When performing a peripheral vascular assessment on a patient, the nurse is unable to palpate the ulnar pulses. The patients skin is warm and capillary refill time is normal. Next, the nurse should: a Check for the presence of claudication. B Refer the individual for further evaluation. C Consider this finding as normal, and proceed with the peripheral vascular evaluation. d Ask the patient if he or she has experienced any unusual cramping or tingling in the arm. - ANSWER: C The nurse is assessing the pulses of a patient who has been admitted for untreated hyperthyroidism. The nurse should expect to find a(n) pulse. a Normal b Absent c Bounding d Weak, thready - ANSWER: C The nurse is preparing to perform a modified Allen test. Which is an appropriate reason for this test? A To measure the rate of lymphatic drainage B To evaluate the adequacy of capillary patency before venous blood draws C To evaluate the adequacy of collateral circulation before cannulating the radial artery d To evaluate the venous refill rate that occurs after the ulnar and radial arteries are temporarily occluded - ANSWER: C

A patient has been diagnosed with venous stasis. Which of these findings would the nurse most likely observe? A Unilateral cool foot B Thin, shiny, atrophic skin C Pallor of the toes and cyanosis of the nail beds D Brownish discoloration to the skin of the lower leg - ANSWER: D The nurse is attempting to assess the femoral pulse in a patient who is obese. Which of these actions would be most appropriate? A The patient is asked to assume a prone position. B The patient is asked to bend his or her knees to the side in a froglike position. C The nurse firmly presses against the bone with the patient in a semi-Fowler position. D The nurse listens with a stethoscope for pulsations; palpating the pulse in an obese person is extremely difficult. - ANSWER: B When auscultating over a patients femoral arteries, the nurse notices the presence of a bruit on the left side. The nurse knows that bruits: a Are often associated with venous disease. B Occur in the presence of lymphadenopathy. C In the femoral arteries are caused by hypermetabolic states. D Occur with turbulent blood flow, indicating partial occlusion. - ANSWER: D How should the nurse document mild, slight pitting edema the ankles of a pregnant patient? a 1+/0-4+