Download NSG6020 Final exam Questions With Complete Solutions and more Exams Nursing in PDF only on Docsity!
NSG6020 Final exam Questions With
Complete Solutions
Heberden's nodes are commonly found in which one of the following diseases? correct answer: Degenerative joint disease You are beginning the examination of the skin on a 25-year-old teacher. You have previously elicited that she came to the office for evaluation of fatigue, weight gain, and hair loss. You strongly suspect that she has hypothyroidism. What is the expected moisture and texture of the skin of the patient with hypothyroidism correct answer: dry and rough You are assessing a patient with joint pain and are trying to decide whether it is inflammatory or noninflammatory in nature. Which one of the following symptoms is consistent with an inflammatory process? correct answer: tenderness A 68-year-old retired farmer comes to your office for evaluation of a skin lesion. On the right temporal area of the forehead, you see a flattened papule the same color as his skin, covered by a dry scale that is round and feels hard. He has several more of these scattered on the forehead, arms and legs. Based on this description, what is your most likely diagnosis? correct answer: actinic keratosis A 28-year-old graduate student comes to your clinic for evaluation of pain "all over." With further questioning, she is able to relate that the pain is worse in the neck, shoulders, hands,
low back and knees. She denies swelling in her joints. She states that the pain is worse in the morning. There is no limitation in her range of motion. On physical examination, she has several points on the muscles of the neck, shoulders and back that are tender to palpation. Muscle strength and range of motion are normal. Which one of the following is likely the cause of her pain? correct answer: fibromyalgia A new patient is complaining of severe pruritus that is worse at night. Several family members also have the same symptoms. Upon examination, areas of excoriated papules are noted on some of the interdigital webs of both hands and on the axillae. This finding is most consistent with: correct answer: Scabies An obese 55-year-old woman went through menarche at age 16 and menopause 2 years ago. She is concerned because an aunt had severe osteoporosis. Which one of the following is a risk factor for osteoporosis? correct answer: Delayed menarche Ms. Whiting is a 68-year-old female who comes in for her usual follow-up visit. You notice a few flat red and purple lesions, about 6 centimeters in diameter, on the ulnar aspect of her forearms but nowhere else. She doesn't mention them. They are tender when you examine them. What should you do? correct answer: Ask how she acquired them. A 58-year-old man comes to your office complaining of bilateral back pain that now awakens him at night. This has been steadily increasing for the past 2 months. Which one of the following is the most reassuring in this patient with back pain? correct answer: Pain that is bilateral
and states that he hurts so bad he can't even urinate. He is nauseated and is throwing up. He denies any recent illness or fever. His past medical history is unremarkable. He denies any tobacco, alcohol, or drug use. His parents are both in good health. On examination, you see a young teenager lying on the bed with an emesis basin. He is very uncomfortable and keeps shifting his position. His blood pressure is 150/100, his pulse is 110, and his respirations are 24. On visualization of the penis, he is circumcised and there are no lesions and no discharge from the meatus. His scrotal skin is tense and red. Palpation of the left testicle causes severe pain and the patient begins to cry. His prostate examination is unremarkable. His cremasteric reflex is absent on the left but is normal on the right. By catheter you get a urine sample and the analysis is unremarkable. You send the boy with his mother to the emergency room for further workup. correct answer: Torsion of the spermatic cord Which is true of prostate cancer? correct answer: Ethnicity is a risk factor. Which of the following conditions involves a tight prepuce which, once retracted, cannot be returned? correct answer: Paraphimosis A 12-year-old is brought to your clinic by his father. He was taught in his health class at school to do monthly testicular self- examinations. Yesterday, when he felt his left testicle, it was enlarged and tender. He isn't sure if he has had burning with urination and he says he has never had sexual intercourse. He has had a sore throat, cough, and runny nose for the last three days. His past medical history is significant for a tonsillectomy
as a small child. His father has high blood pressure and his mother is healthy. On examination, you see a child in no acute distress. His temperature is 100.8 and his blood pressure and pulse are unremarkable. On visualization of his penis, he is uncircumcised and has no lesions or discharge. His scrotum is red and tense on the left and normal appearing on the right. Palpating his left testicle reveals a mildly sore swollen testicle. The right testicle is unremarkable. An examining finger is put through both inguinal rings, and there are no bulges with bearing down. His prostate examination is unremarkable. Urine analysis is also unremarkable. What abnormality of the testes does this child most likely have? correct answer: Acute orchitis The most common cause of cancer deaths in males is: correct answer: Colon cancer Important techniques in performing the rectal examination include which of the following? correct answer: All of the above Jim is a 47-year-old man who is having difficulties with sexual function. He is recently separated from his wife of 20 years. He notes that he has early morning erections but otherwise cannot function. Which of the following is a likely cause for his problem? correct answer: Psychological issues Which of the following is true of human papilloma virus (HPV) infection? correct answer: It commonly resolves spontaneously in one to two years.
A 30-year-old man notices a firm, 2-cm mass under his areola. He has no other symptoms and no diagnosis of breast cancer in his first-degree relatives. What is the most likely diagnosis? correct answer: Breast tissue Which of the following is true regarding breast self- examination? correct answer: A high proportion of breast masses are detected by breast self-examination. A 23-year-old computer programmer comes to your office for an annual examination. She has recently become sexually active and wants to be placed on birth control. Her only complaint is that the skin in her armpits has become darker. She states it looks like dirt, and she scrubs her skin nightly with soap and water but the color stays. Her past medical symptoms consist of acne and mild obesity. Her periods have been irregular for 3 years. Her mother has type 2 diabetes, and her father has high blood pressure. The patient denies using tobacco but has four to five drinks on Friday and Saturday nights. She denies any illegal drug use. On examination, you see a mildly obese female who is breathing comfortably. Her vital signs are unremarkable. Looking under her axilla, you see dark, velvet-like skin. Her annual examination is otherwise unremarkable. What disorder of the breast or axilla is she most likely to have? correct answer: Acanthosis nigricans Which of the following is true of women who have had a unilateral mastectomy? correct answer: They should be examined carefully along the surgical scar for masses.
A 76-year-old retired farmer comes to your office complaining of abdominal pain, constipation, and a low-grade fever for about three days. He denies any nausea, vomiting, or diarrhea. The only unusual thing he remembers eating is two bags of popcorn at the movies with his grandson, three days before his symptoms began. He denies any other recent illnesses. His past medical history is significant for coronary artery disease and high blood pressure. He has been married for over fifty years. He denies any tobacco, alcohol, or drug use. His mother died of colon cancer and his father had a stroke. On examination, he appears his stated age and is in no acute distress. His temperature is 100.9 degrees and his other vital signs are unremarkable. His head, cardiac, and pulmonary examinations are normal. He has normal bowel sounds and is tender over the left lower quadrant. He has no rebound or guarding. His rectal examination is unremarkable and his fecal occult blood test is negative. His prostate is slightly enlarged but his testicular, penile, and inguinal examinations are all normal. Blood work is pending. What diagnosis for abdominal pain best describes his symptoms and signs? correct answer: Acute diverticulitis Jim is a 60-year-old man who presents with vomiting. He denies seeing any blood with emesis, which has been occurring for two days. He does note a dark, granular substance resembling the coffee left in the filter after brewing. What do you suspect? correct answer: Bleeding from a peptic ulcer A 26-year-old sports store manager comes to your clinic, complaining of severe right-sided abdominal pain for twelve hours. He began having a stomachache yesterday, with a decreased appetite, but today the pain seems to be just on the
medications. During the review of systems (ROS), you note that she has felt fatigued, had some weight gain, has irregular periods, and has cold intolerance. Her past medical history is significant for one vaginal delivery and two cesarean sections. She is married, has three children, and owns a flower shop. She denies tobacco, alcohol, or drug use. Her mother has type 2 diabetes and her father has coronary artery disease. There is no family history of cancers. On examination, she appears her stated age. Her vital signs are normal. Her head, eyes, ears, nose, throat, and neck examinations are normal. Her cardiac, lung, and abdominal examinations are also unremarkable. Her rectal occult blood test is negative. Her deep tendon reflexes are delayed in response to a blow with the hammer, especially the Achilles tendons. What is the best choice for the cause of her constipation? correct answer: Hypothyroidism 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 sixteen, but 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? correct answer: Intermittent claudication 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? correct answer: Calf 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? correct answer: Radial pulse, brachial pulse Cody is a teenager with a history of leukemia and an enlarged spleen. Today he presents with fairly significant left upper quadrant (LUQ) pain. On examination of this area, a rough grating noise is heard. What is this sound? correct answer: It is a splenic rub. A 30-year-old woman with a history of mitral valve problems states that she has been "very tired." She has started waking up at night and feels like her "heart is pounding." During the assessment, the nurse practitioner palpates a thrill and lift at the fifth left intercostal space midclavicular line. In the same area the nurse practitioner also auscultates a blowing, swishing sound right after S1. These findings would be most consistent with: correct answer: mitral regurgitation. A patient presents with excruciating headache pain on one side of his head, especially around his eye, forehead, and cheek that lasts about 1/2 to 2 hours, occurring once or twice each day. The nurse practitioner suspects: correct answer: cluster headaches A patient complains that while studying for an examination he began to notice a severe headache in the frontotemporal area of his head that is throbbing and is somewhat relieved when he lies down. He tells the nurse practitioner that his mother also had
like quality of the sound across the quadrants. This type of sound indicates: correct answer: air-filled areas. A patient tells the nurse that he is allergic to penicillin. What would be the nurse practitioner's best response to this information? correct answer: Please describe what happens to you when you take penicillin." A patient's thyroid is enlarged, and the nurse practitioner is preparing to auscultate the thyroid for the presence of a bruit. A bruit is a: correct answer: soft, whooshing, pulsatile sound best heard with the bell of the stethoscope. After completing an initial assessment on a patient, the nurse practitioner has documented that his respirations are eupneic and his pulse is 58. This type of data would be: correct answer: objective A patient tells the nurse that she has had abdominal pain for the past week. What would be the best response by the nurse? correct answer: Can you point to where it hurts?" A teenage patient comes to the emergency department with complaints of an inability to "breathe and a sharp pain in my left chest." The assessment findings include the following: cyanosis, tachypnea, tracheal deviation to the right, decreased tactile fremitus on the left, hyperresonance on the left, and decreased breath sounds on the left. This description is consistent with: correct answer: a pneumothorax
The inspection phase of the physical assessment: correct answer: takes time and reveals a surprising amount of information The mother of a 2-year-old is concerned because her son has had three ear infections in the past year. What would be an appropriate response by the nurse practitioner? correct answer: "Your son's eustachian tube is shorter and wider than yours because of his age, which allows for infections to develop more easily." The nurse practitioner would use bimanual palpation technique in which situation? correct answer: Palpating the kidneys and uterus The patient's record, laboratory studies, objective data, and subjective data combine to form the: correct answer: database When preparing to perform a physical examination on an infant, the examiner should: correct answer: have the parent remove all clothing except the diaper on a boy. i The nurse practitioner notices that an infant has a large, soft lump on the side of his head and that his mother is very concerned. She tells the nurse practitioner that she noticed the lump about 8 hours after her baby's birth, and that it seems to be getting bigger. One possible explanation for this is: correct answer: cephalhematoma When examining an infant, the nurse practitioner should examine which area first? correct answer: Abdomen
132/85. How would you categorize this? correct answer: Prehypertension How should you determine whether a murmur is systolic or diastolic? correct answer: Palpate the carotid pulse. A 78-year-old retired seamstress comes to the office for a routine check-up. You obtain an electrocardiogram (ECG) because of her history of hypertension. You diagnose a previous myocardial infarction and ask her if she had any symptoms related to this. Which of the following symptoms would be more common in this patient's age group for an AMI? correct answer: Pain radiating into the jaw On examination, you find a bounding carotid pulse on a 62-year- old patient. Which murmur should you suspect? correct answer: Aortic insufficiency Which of the following correlates with a sustained, high- amplitude point of maximal impulse (PMI)? correct answer: Hypertension A 68-year-old woman with hypertension and diabetes is seen by the nurse practitioner for a dry cough that worsens at night when she lies in bed. She has shortness of breath, which worsens when she exerts herself. The patient's pulse rate is 90/min and regular. The patient has gained 6 lbs over the past two months. She is on a nitroglycerine patch and furosemide daily. The explanation for her symptoms is: correct answer: Congestive heart failure
When listening to a soft murmur or bruit, which of the following may be necessary? correct answer: All of the above. You notice a patient has a strong pulse and then a weak pulse. This pattern continues. Which of the following is likely? correct answer: Severe left heart failure A patient complains of shortness of breath for the past few days. On examination, you note late inspiratory crackles in the lower third of the chest that were not present a week ago. What is the most likely explanation for these? correct answer: Heart failure A sixty-year-old baker presents to your clinic, complaining of increasing shortness of breath and nonproductive cough over the last month. She feels like she can't do as much activity as she used to do without becoming tired. She even has to sleep upright in her recliner at night to be able to breathe comfortably. She denies any chest pain, nausea, or sweating. Her past medical history is significant for high blood pressure and coronary artery disease. She had a hysterectomy in her 40s for heavy vaginal bleeding. She is married and is retiring from the local bakery soon. She denies any tobacco, alcohol, or drug use. Her mother died of a stroke, and her father died from prostate cancer. She denies any recent upper respiratory illness, and she has had no other symptoms. On examination, she is in no acute distress. Her blood pressure is 160/100, and her pulse is 100. She is afebrile, and her respiratory rate is 16. With auscultation, she has distant air sounds and she has late inspiratory crackles in both lower lobes. On cardiac examination, the S1 and S2 are distant and an S3 is heard over the apex. correct answer: Left-sided heart failure
Which of the following is consistent with good percussion technique? correct answer: Strike the pleximeter over the distal interphalangeal joint.
