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NR 509 / NR509 Advanced Physical Assessment
Midterm Exam
Questions with Verified Answers - Chamberlain
Consist of 100 multiple choices Questions with Answers
1. A teenage girl has arrived complaining of pain in her left wrist. She was play- ing basketball when she fell and landed on her left hand. The FNP examined her hand and will expect a fracture if the girl complains: A. of a dull ache B. that the pain in her wrist is deep C. of sharp pain that increases with movement D. of dull throbbing pain that increases with rest .: Of sharp pain that increases with movement
2. A patient has been diagnosed with osteoporosis and asked the FNP "what is osteoporosis?" The FNP explains to the patient that osteoporosis is defined as: A. increased bone matrix B. loss of bone density C. new, weaker bone growth D. increased phagocytic activity. : Loss of bone density 3. Patient states, "I can hear a crunching or grating sound when I kneel". She also states "that it is very difficult to get out of bed in the morning because of stiffness and pain in my joints". The FNP should assess for signs of what problem? A. Crepitation B. A bone spur C. A loose tendon D. Fluid in the knee joint : Crepitation
Weight-bearing exercises include walking, low-impact aerobics, dancing, or sta- tionary cycling. Swimming is not considered a weight-bearing exercise. The other responses are correct.
6. The FNP is performing a neurological assessment on a 41-year-old woman with a history of diabetes. When testing her ability to feel the vibrations of a tuning fork the FNP notices that the patient is unable to feel vibrations on the great toe or ankle bilaterally, but she is able to feel vibrations on both patella. Given this information what would the FNP suspect? A. Hyperalgesia B. Hyperesthesia C. Peripheral neuropathy D. Lesion of sensory cortex : Peripheral neuropathy 7. An 80-year-old woman is visiting the clinic for a check-up. She states "I can't walk as much as I used to". The FNP is observing from motor dysfunction in her hip and should have her:
A) internally rotate her hip while she is sitting. B) abduct her hip while she is lying on her back. C) adduct her hip while she is lying on her back. D) externally rotate her hip while she is standing. : B. Abduct her hip while she is lying on her back
8. The FNP is testing the function of cranial nerve XI. Which of these best describes the response the FNP should expect if the nerve is intact? The patient A) demonstrates the ability to hear normal conversation. B) sticks tongue out midline without tremors or deviation. C) follows an object with eyes without nystagmus or strabismus. D) moves the head and shoulders against resistance with equal strength.: - Moves the head and shoulders against resistance with equal strength These are the expected normal findings when testing cranial nerve XI (spinal accessory nerve): The patient's sternomastoid and trapezius muscles are of equal size; the person can rotate the head both ways forcibly against resistance applied to the side of the chin with equal strength; the patient can shrug the shoulders against resistance with equal strength on both sides.
D. Slight pain with some directions of movement: Mild, even resistance to movement
11. A woman who is 8 months pregnant comments that she has noticed a change in posture and is having lower back pain. The FNP tells her that during pregnancy women have a posture shift to compensate for the enlarging fetus. This shift and posture is known as: A. Lordosis. B. Scoliosis. C. Ankylosis. D. Kyphosis.: Lordosis 12. A patient is able to flex his right arm forward without difficulty or pain but is unable to abduct his arm because of pain and muscle spasms. The FNP should suspect: A. Crepitation. B. Rotator cuff lesions. C. Dislocated shoulder. D. Rheumatoid arthritis.: Rotator cuff lesions 13. A professional tennis player comes into the clinic complaining of a
sore elbow. The FNP will assess for tenderness at the: A. Olecranon bursa. B. Annular ligament. C. Base of the radius. D. Medial and lateral epicondyle.: Medial and lateral epicondyle
In testing his pain perception the FNP decides to complete the test as quickly as possible. When the FNP applies the sharp point of a pin on his arm several times he is only able to identify these as one very sharp prick. What would be the most accurate explanation for this? A. The patient has hyperesthesia as a result of the aging process. B. This response is most likely the result of the summation effect. C. The nurse was probably not poking hard enough with the pin in the other areas. D. The patient most likely has analgesia in some areas of arm and hyperalgesia in others.: This is most likely the result of the summation effect
17. An 85-year-old patient comments during his annual physical that "he seems to be getting shorter as he ages". The FNP should explain that de- creased height occurs with aging because: A. Long bones tend to shorten with age. B. The vertebral column shortens. C. A significant loss of subcutaneous fat occurs. D. A thickening of the intervertebral disks develops.: Of the shortening of the vertebral column
18. A patient is complaining of pain in his joints that is worse in the morning, is better after he has moved around for a while, and then gets worse again if he sits for long periods of time. The FNP should assess for other signs of what problem? A. Tendinitis B. Osteoarthritis C. Rheumatoid arthritis D. Intermittent claudication: Rheumatoid arthritis 19. When the FNP asks a 68-year-old patient to stand with feet together and arms at his side with his eyes closed he starts to sway and moves his feet farther apart. The FNP would document this finding as: A. Ataxia. B. Lack of coordination. C. Negative Homans sign. D. Positive Romberg sign.: Positive Romberg sign 20. During an assessment of the cranial nerves the FNP finds the following asymmetry when the patient smiles or frowns, uneven lifting of eyebrows, sagging of lower eyelids, and escape of air when the FNP presses against the right path cheek. This would indicate dysfunction of
D. "You really shouldn't drink so much alcohol; it may be causing your tremor.": Does the tremor change when you drink the alcohol?
23. During a history of a 78-year-old man, his wife states that "he occasionally has problems with short-term memory loss and confusion. He can't even remember how to button his shirt". In doing the assessment of his sensory system which action of the FNP's is most appropriate? A. The nurse would not do this part of the examination because the results would not be valid. B. The nurse would perform the tests, knowing that mental status does not affect sensory ability. C. The nurse would proceed with the explanations of each test. D. Before testing, the nurse would assess the patient s mental status and ability to follow directions at this time.: Before testing, the FNP would assess the patient's mental status and ability to follow directions at this time Ensure validity of sensory system testing by making sure the person is alert, cooperative, and comfortable and has an adequate attention span. Otherwise, you may get misleading and invalid results.
24. While obtaining a history of a 3 month old infant from the mother the FNP asks about the infants ability to suck and grasp the mother's finger. What is the FNP assessing? A. Reflexes B. Intelligence C. Cranial nerves D. Cerebral cortex function: Reflexes 25. The FNP is doing an assessment on a 29-year-old woman who visits the clinic complaining of always dropping things and falling down. While testing rapid alternating movements the FNP notices that the woman is unable to pat both her knees. Her response is very slow and she misses frequently. What should the FNP suspect? A. Vestibular disease B. Lesion of cranial nerve IX C. Dysfunction of the cerebellum D. Inability to understand directions: Dysfunction of the cerebellum 26. A mother brings her two-month-old daughter in for an examination says "my daughter rolled over against the wall and now I have noticed that she has
B. The trigeminal nerve C. Frostbite with resultant paresthesia to the cheeks D. Scleroderma.: The trigeminal nerve (CN V)
29. When examining the face, the FNP is aware that the two pairs of salivary gland's that are accessible to examination are the glands A. occipital and submental B. parotid and jugulodigastric C. parotid and submandibular D. submandibular and occipital: Parotid and submandibular Two pairs of salivary glands accessible to examination on the face are the parotid glands, which are in the cheeks over the mandible, anterior to and below the ear; and the submandibular glands, which are beneath the mandible at the angle of the jaw. The parotid glands are not normally palpable. 30. A patient comes to the clinic complaining of neck and shoulder pain and is unable to turn her head. The FNP suspects damage to cranial nerve and proceeds with the examination by :
A) XI; palpating the anterior and posterior triangles B) XI; asking the patient to shrug her shoulders against resistance C) XII; percussing the sternomastoid and submandibular neck muscles D) XII; assessing for a positive Romberg sign: CN XI; asking the patient to shrug her shoulders against resistance The major neck muscles are the sternomastoid and the trapezius. They are innervat- ed by CN XI, the spinal accessory. The innervated muscles assist with head rotation and head flexion, movement of the shoulders, and extension and turning of the head.
31. When examining a patient's cranial nerve function, the FNP remembers that the muscles in the neck that are innervated by CN XI (spinal accessory) are the: A) sternomastoid & trapezius B) Spinal accessory & omohyoid C) Trapezius & sternomandibular D) sternomandibular & spinal accessory: Sternomastoid and trapezius 32. The patient's laboratory data reveal an elevated thyroxine level. The FNP would proceed with an examination of the gland: A. Thyroid
35. The FNP is aware that the four areas in the body were lymph nodes accessible are the: A. Head, breasts, groin, and abdomen. B. Arms, breasts, inguinal area, and legs. C. Head and neck, arms, breasts, and axillae. D. Head and neck, arms, inguinal area, and axillae: Head and neck, arms, inguinal area, and axillae 36. A 52-year-old patient describes the presence of occasional floaters or spots moving in front of his eyes. The FNP should know that floaters are usually not significant and are caused by: A. Examine the retina to determine the number of floaters. B. Presume the patient has glaucoma and refer him for further testing. C. Consider these to be abnormal findings, and refer him to an ophthalmolo- gist. D. Know that floaters are usually insignificant and are caused by condensed vitreous fibers.: Caused by condensed vitreous fibers. Know that floaters are usually insignificant and are caused by condensed vitreous fibers. 37. The FNP is preparing to assess the visual acuity of a 16-year-old
patient. How should the FNP proceed? A. Perform the confrontation test. B. Ask the patient to read the print on a handheld Jaeger card. C. Use the Snellen chart positioned 20 feet away from the patient. D. Determine the patient's ability to read newsprint at a distance of 12 to 14 inches.: Use the Snellen chart position 20 feet away from the patient
38. A patient's vision is recorded as 20/30 when the Snellen eye chart is used. The FNP interprets these results to indicate that: A. At 30 feet the patient can read the entire chart. B. The patient can read at 20 feet what a person with normal vision can read at 30 feet. C. The patient can read the chart from 20 feet in the left eye and 30 feet in the right eye. D. The patient can read from 30 feet what a person with normal vision can read from 20 feet.: The patient can read at 20 feet what a person with normal vision can read at 30 feet
