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Which statement about the apices of the lungs is true? The apices of the lungs: A Are at the level of the second rib anteriorly. B Extend 3 to 4 cm above the inner third of the clavicles. C Are located at the sixth rib anteriorly and the eighth rib laterally. D Rest on the diaphragm at the fifth intercostal space in the midclavicular line (MCL). ---------CORRECT ANSWER-----------------B During an examination of the anterior thorax, the nurse is aware that the trachea bifurcates anteriorly at the: a Costal angle. B Sternal angle. C Xiphoid process. D Suprasternal notch. ---------CORRECT ANSWER-----------------B During an assessment, the nurse knows that expected assessment findings in the normal adult lung include the presence of: a Adventitious sounds and limited chest expansion.
b Increased tactile fremitus and dull percussion tones. c Muffled voice sounds and symmetric tactile fremitus. d Absent voice sounds and hyperresonant percussion tones. ---------CORRECT ANSWER-----------------C The primary muscles of respiration include the: A Diaphragm and intercostals. B Sternomastoids and scaleni. C Trapezii and rectus abdominis. d External obliques and pectoralis major. ---------CORRECT ANSWER-----------------A A 65-year-old patient with a history of heart failure comes to the clinic with complaints of being awakened from sleep with shortness of breath. Which action by the nurse is most appropriate? A Obtaining a detailed health history of the patients allergies and a history of asthma b Telling the patient to sleep on his or her right side to facilitate ease of respirations c Assessing for other signs and symptoms of paroxysmal nocturnal dyspnea d Assuring the patient that paroxysmal nocturnal dyspnea is normal and will probably resolve within the next week ---------CORRECT ANSWER-----------------C
The nurse is observing the auscultation technique of another nurse. The correct method to use when progressing from one auscultatory site on the thorax to another is comparison. A Side-to-side B Top-to-bottom C Posterior-to-anterior D Interspace-by-interspace ---------CORRECT ANSWER-----------------A When auscultating the lungs of an adult patient, the nurse notes that low-pitched, soft breath sounds are heard over the posterior lower lobes, with inspiration being longer than expiration. The nurse interprets that these sounds are: A Normally auscultated over the trachea. B Bronchial breath sounds and normal in that location. C Vesicular breath sounds and normal in that location. D Bronchovesicular breath sounds and normal in that location. ---------CORRECT ANSWER-----------------C The nurse is auscultating the chest in an adult. Which technique is correct? A Instructing the patient to take deep, rapid breaths B Instructing the patient to breathe in and out through his or her nose C Firmly holding the diaphragm of the stethoscope against the chest D Lightly holding the bell of the stethoscope against the chest to avoid friction ---- -----CORRECT ANSWER-----------------C
The nurse is percussing over the lungs of a patient with pneumonia. The nurse knows that percussion over an area of atelectasis in the lungs will reveal: a Dullness. B Tympany. C Resonance. D Hyperresonance. ---------CORRECT ANSWER-----------------A During auscultation of the lungs, the nurse expects decreased breath sounds to be heard in which situation? A When the bronchial tree is obstructed B When adventitious sounds are present C In conjunction with whispered pectoriloquy D In conditions of consolidation, such as pneumonia ---------CORRECT ANSWER----- ------------A A woman in her second trimester of pregnancy complains of heartburn and indigestion. When discussing this with the woman, the nurse considers which explanation for these problems? a Tone and motility of the gastrointestinal tract increase during the second trimester. b Sluggish emptying of the gallbladder, resulting from the effects of progesterone, often causes heartburn. c Lower blood pressure at this time decreases blood flow to the stomach and
A woman who is 28 weeks pregnant has bilateral edema in her lower legs after working 8 hours a day as a cashier at a local grocery store. She is worried about her legs. What is the nurses best response? A You will be at risk for development of varicose veins when your legs are edematous. B I would like to listen to your heart sounds. Edema can indicate a problem with your heart. C Edema is usually the result of too much salt and fluids in your diet. You may need to cut down on salty foods. d As your baby grows, it slows blood return from your legs, causing the swelling. This often occurs with prolonged standing. ---------CORRECT ANSWER----------------- D When assessing a woman who is in her third trimester of pregnancy, the nurse looks for the classic symptoms associated with preeclampsia, which include: a Edema, headaches, and seizures. B Elevated blood pressure and proteinuria. C Elevated liver enzymes and high platelet counts. D Decreased blood pressure and edema. ---------CORRECT ANSWER-----------------B The nurse knows that the best time to assess a womans blood pressure during an initial prenatal visit is: a At the end of the examination when she will be the most relaxed.
B At the beginning of the interview as a nonthreatening method of gaining rapport. C During the middle of the physical examination when she is the most comfortable. D Before beginning the pelvic examination because her blood pressure will be higher after the pelvic examination. ---------CORRECT ANSWER-----------------A When examining the face of a woman who is 28 weeks pregnant, the nurse notices the presence of a butterfly-shaped increase in pigmentation on the face. The proper term for this finding in the documentation is: a Striae. B Chloasma. C Linea nigra. D Mask of pregnancy. ---------CORRECT ANSWER-----------------B Which finding is considered normal and expected when the nurse is performing a physical examination on a pregnant woman? A Palpable, full thyroid B Edema in one lower leg C Significant diffuse enlargement of the thyroid D Pale mucous membranes of the mouth ---------CORRECT ANSWER-----------------A
likely need to be surgically repaired. C The possibility that the woman has a hernia attributable to the increased pressure within the abdomen from the pregnancy should be suspected. D The woman should be told that she may have a difficult time with delivery because of the weakness in her abdominal muscles. ---------CORRECT ANSWER----- ------------A The nurse is palpating the fundus of a pregnant woman. Which statement about palpation of the fundus is true? A The fundus should be hard and slightly tender to palpation during the first trimester. B Fetal movement may not be felt by the examiner until the end of the second trimester. C After 20 weeks gestation, the number of centimeters should approximate the number of weeks gestation. D Fundal height is usually less than the number of weeks gestation, unless an abnormal condition such as excessive amniotic fluid is present. ---------CORRECT ANSWER-----------------C The nurse is palpating the abdomen of a woman who is 35 weeks pregnant and notices that the fetal head is facing downward toward the pelvis. The nurse would document this as fetal: a Lie. b Variety.
c Attitude. d Presentation. ---------CORRECT ANSWER-----------------D The nurse is palpating the uterus of a woman who is 8 weeks pregnant. Which finding would be considered to be most consistent with this stage of pregnancy? A The uterus seems slightly enlarged and softened. B It reaches the pelvic brim and is approximately the size of a grapefruit. C The uterus rises above the pelvic brim and is approximately the size of a cantaloupe. D It is about the size of an avocado, approximately 8 cm across the fundus. --------- CORRECT ANSWER-----------------D Which of these correctly describes the average length of pregnancy? A 38 weeks B 9 lunar months C m280 days from the last day of the last menstrual period D 280 days from the first day of the last menstrual period ---------CORRECT ANSWER-----------------D A patients pregnancy test is positive, and she wants to know when the baby is due. The first day of her last menstrual period was June 14, and that period ended June 20. Using the Ngele rule, what is her expected date of delivery? a March 7
During a health history interview, a 38-year-old woman shares that she is thinking about having another baby. The nurse knows which statement to be true regarding pregnancy after 35 years of age? a Fertility does not start to decline until age 40 years. B Occurrence of Down syndrome is significantly more frequent after the age of 35 years. C Genetic counseling and prenatal screening are not routine until after age 40 years. D Women older than 35 years who are pregnant have the same rate of pregnancyrelated complications as those who are younger than 35 years. --------- CORRECT ANSWER-----------------B Which of the following changes are expected in vision as part of the normal aging process? A) Cataracts B) Glaucoma C) Macular degeneration D) Blurring of near vision ---------CORRECT ANSWER-----------------D A 72-year-old retired truck driver comes to the clinic with his wife for evaluation of hearing loss. He has noticed some decreased ability to hear what his wife and grandchildren are saying to him. He admits to lip-reading more. He has a history of noise exposure in his young adult years: He worked as a sound engineer at a local arena and had to attend a lot of concerts. Based on this information, what is the most likely finding regarding his hearing acuity? A) Loss of acuity for middle-range sounds
B) Increase of acuity for low-range sounds C) Loss of acuity for high-range sounds D) Increase of acuity for high-range sounds ---------CORRECT ANSWER----------------- A A 79-year-old retired banker comes to your office for evaluation of difficulty with urination; he gets up five to six times per night to urinate and has to go at least that often in the daytime. He does not feel as if his bladder empties completely; the strength of the urinary stream is diminished. He denies dysuria or hematuria. This problem has been present for several years but has worsened over the last 8 months. You palpate his prostate. What is your expected physical examination finding, based on this description? A) Normal size, smooth B) Normal size, boggy C) Enlarged size, smooth D) Enlarged size, boggy ---------CORRECT ANSWER-----------------C A 70-year-old retired auto mechanic comes to your office because his neighbor is concerned about his memory. The patient himself admits to misplacing his keys more often and forgets what he is supposed to buy from the grocery store and where he has parked the car. He denies getting lost in familiar places. Upon further questioning, he states that his wife of 40 years died 8 months ago; his three children live in three different states; and he has limited his activities because the people he interacted with were "his wife's friends, not his." He drinks a six-pack of beer daily; he does not smoke or use illicit drugs. You perform a mini- mental state examination and obtain a total score of 24 out of 28. Based on this information, what is your most likely diagnosis?
An 88-year-old retired piano teacher comes for evaluation of fatigue. You notice that her clothes are hanging loosely off her frame and that she has lost 15 pounds. She is unaware of this. Her husband of 63 years died a few months ago. You ask the patient to complete a Rapid Screen for Dietary Intake. Which of the following statements is considered to be part of this rapid screen? A) I eat more than two meals per day. B) I drink one glass of alcohol every day. C) Without wanting to, I have lost or gained 10 pounds in the last 6 months. D) I eat with at least one other person most of the time. ---------CORRECT ANSWER-----------------C An 89-year-old retired school principal comes for an annual check-up. She would like to know whether or not she should undergo a screening colonoscopy. She has never done this before. Which of the following factors should not be considered when discussing whether she should go for this screening test? A) Life expectancy B) Time interval until benefit from screening accrues C) Patient preference D) Current age of patient ---------CORRECT ANSWER-----------------D Which of the following booster immunizations is recommended in the older adult population? A) Tetanus
B) Diphtheria C) Measles D) Mumps ---------CORRECT ANSWER-----------------A You are asked to perform a home safety assessment for an 87-year-old retired farmer who lives by himself. Which of the following is not considered to be an increased risk for falls? A) Loose electrical cords B) Slippery or irregular surfaces C) Chairs at awkward angles D) Bright lighting ---------CORRECT ANSWER-----------------D A 73-year-old retired accountant comes to your office for her annual examination. She has incontinence of urine when she coughs or sneezes. She takes several medications for control of hypertension and diabetes. You use the DIAPERS mnemonic to assess the cause of her incontinence. All of the following are items represented by the mnemonic except for: A) Atrophic vaginitis B) Depression C) Pharmaceuticals D) Restricted mobility ---------CORRECT ANSWER-----------------B Which of the following brief screening measures is useful in assessing memory?
A) Isolated elevation of the diastolic BP B) Narrow pulse pressure C) Elevation of the systolic BP D) Elevation of the BP with standing ---------CORRECT ANSWER-----------------C Which of the following represents age-related changes in the lungs? A) Decrease in chest wall compliance B) Speed of expiration increases C) Increase in respiratory muscle strength D) Increased elastic recoil of lung tissue ---------CORRECT ANSWER-----------------A Mrs. Stanton is a 79-year-old widow who presents to your office for a routine BP visit. You note a new pulsatile mass in the right neck at the carotid artery. Which of the following is the most likely cause for this? A) Anxiety B) Carotid artery aneurysm C) Kinking of the artery D) Tortuous aorta ---------CORRECT ANSWER-----------------C Mr. Chin is an 82-year-old man who comes to your office for a routine check. On examination, you notice a somewhat high-pitched murmur in the second right intercostal space during systole. It does not radiate and the rest of his
examination is normal for his age. Which istrue of the most likely cause of this murmur? A) It often decreases carotid upstroke. B) It carries with it increased risk for cardiovascular disease. C) It is usually accompanied by an S3 gallop. D) It is found in 10% of otherwise normal elderly patients. ---------CORRECT ANSWER-----------------B Mrs. Buckley is a 75-year-old widow who wants you to look at her teeth because over the past 2 weeks she has had right-sided jaw pain when eating. It does not occur otherwise. She also has had a headache. Which of the following should be considered? A) Palpation of her temples B) Dental referral C) Ultrasound of the gallbladder D) Inquiry about anosmia ---------CORRECT ANSWER-----------------A Which of the following is commonly seen in aging men? A) Erectile dysfunction in 20% of all men B) Testicles ride higher within the scrotum C) Strong response to visual erotic cues D) Persistent sexual interest ---------CORRECT ANSWER-----------------D
