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NU 650 Exam 3 Questions With
Complete Solutions
When percussing the abdomen in a patient with constipation, which of the following sounds would you expect to find in the LLQ? A. Tympanic B. Dull C. Resonant D. Hyperresonant correct answer: B Which of the following represents the proper position for the NP to assess the patient's abdomen? A. Stand at the patient's left side and proceed in a systematic fashion. B. Stand at the patient's left side and assess any problem areas first C. Stand at the patient's right side and process in a systemic fashion D. Stand at the patient's right side and assess any problem areas first correct answer: C The NP will demonstrate the correct order of examination for the abdomen by using examination techniques that follows:
- Auscultation
- Inspection
- Palpation
- Percussion
A. 1-2-3-
B. 2-3-4-
C. 3-4-1-
D. 2-1-3-4 correct answer: D The NP will use which of the following examination techniques to determine muscular resistance, superficial organs and masses in the abdomen A. inspection B. light palpation C. deep palpation D. percussion correct answer: B The NP will use which of the following methods to help the patient relax during the abdominal exam? A. ask the patient to hold their breath B. Palpate the abdomen after inspiration C. palpate the abdomen after expiration D. Palpate the abdomen using quick short movements correct answer: C When percussing the abdomen, you would document the normal finding of percussion over the intestines as: A. Tympanic B. Dull C. Resonant D. Hyperresonant correct answer: A The NP will use her third finger to strike or deliver a rapid tap or blow against another finger placed against the surface of the
The liver border can be palpated normally below the costal margin at the:A. Left mid-clavicular lineB. Right mid-axillary lineC. Right mid-calvicular lineD. Left mid-axillary line correct answer: C The NP will recognize which of the following subjective or objective findings as worrisome for an abdominal aortic aneurysm?A. aortic width of 2.8 cmB. 25 pack-year smoking historyC. age of 60D. Female gender correct answer: B The NP will use which of the following examination techniques to determine muscular resistance, superficial organs and masses in the abdomenA. inspectionB. light palpationC. deep palpationD. percussion correct answer: B The parents of a 4-month-old infant share concern about their child's umbilical hernia at a well-child visit. The NP will correctly inform them that:A. Most umbilical hernias disappear by 12 months of ageB. The hernia can be surgically repaired before the child reaches adolescenceC. This finding indicates that their child is at high risk for other herniasD. There is a strong familial history for umbilical hernias correct answer: A Which of the following abdominal exam findings would prompt the NP to consider cholecystitis as a differential diagnosis?A. Positive psoas signB. Positive Rovsing's signC. Positive Obturator signD. Positive murphy's sign correct answer: D Which of the following symptoms would you expect from a young adolescent in the early phase of appendicitis?A. Abdominal pain two hours after eatingB. CVA tendernessC.
Severe RLQ pain with pallor and sweatingD. Constipation correct answer: C 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 claudicationB) Chest pressure with exertionC) Shortness of breathD) Knee pain correct answer: A 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 fingerB) Radial surface of the forearm and hand, thumb and index fingers, and radial middle fingerC) Ulnar surface of the forearm and hand; second, third, and fourth fingersD) Radial surface of the forearm and hand; second, third, and fourth fingers correct answer: A Mr. E 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 legsB) Relief of the pain with bending at the waistC) Color changes of the skinD) Swelling with tenderness of the skin correct answer: B Which of the following pairs of ischemic symptoms versus vascular supply is correct?A) Lower calf/superficial femoralB)
A 28-year-old housewife presents to your office for a 6-week postpartum checkup. She complains of fatigue greater than expected and palpitations. Her hair is falling out as well. She denies sadness or depression symptoms. Before this, she had not had any medical problems. She is breastfeeding her child and is not on any birth control. She had her first period since giving birth last week. A pregnancy test done in the office is negative. What is your most likely diagnosis?(A) Thyroiditis(B) Iron- deficiency anemia(C) Addison's disease(D) Sheehan's syndrome correct answer: A Which of the following percussion notes would you obtain over the gastric bubble?A) ResonanceB) TympanyC) HyperresonanceD) Flatness correct answer: B A 38-year-old accountant comes to your clinic for evaluation of a headache. The throbbing sensation is located in the right temporal region and is an 8 on a scale of 1 to 10. It started a few hours ago, and she has noted nausea with sensitivity to light; she has had headaches like this in the past, < 1/wk, but not as severe. She does not know of any inciting factors. There has been no change in the frequency of her headaches. She usually takes an over-the counter analgesic and this results in resolution of the headache. Based on this description, what is the most likely diagnosis of the type of headache?A) TensionB) MigraineC) ClusterD) Analgesic rebound correct answer: B A 29-year-old computer programmer comes to your office for evaluation of a headache. The tightening sensation is located all over the head and is of moderate intensity. It used to last
minutes, but this time it has lasted for 5 days. He denies photophobia and nausea. He spends several hours each day at a computer monitor/keyboard. He has tried over-the-counter medication; it has dulled the pain but not taken it away. Based on this description, what is your most likely diagnosis?A) TensionB) MigraineC) ClusterD) Analgesic rebound correct answer: A A 49-year-old administrative assistant comes to your office for eval of dizziness. You elicit the information that the dizziness is a spinning sensation of sudden onset, worse with head position changes. The episodes last a few seconds and then go away, and they are accompanied by intense nausea. Vomiting x1. She denies tinnitus. You perform a physical exam of the head and neck and note that the patient's hearing is intact to Weber and Rinne and that there is nystagmus. Her gait is normal. Based on this description, what is the most likely diagnosis?A) Benign positional vertigoB) Vestibular neuronitisC) Ménière's diseaseD) Acoustic neuroma correct answer: A A 55-year-old bank teller comes to your office for persistent episodes of dizziness. The first episode started suddenly and lasted 3 to 4 hours. He experienced a lot of nausea with vomiting; the episode resolved spontaneously. He has had five episodes in the past 1½ weeks. He does note some tinnitus that comes and goes. Upon physical examination, you note that he has a normal gait. The Weber localizes to the right side and the air conduction is equal to the bone conduction in the right ear. Nystagmus is present. Based on this description, what is the most likely diagnosis?A) Benign positional vertigoB) Vestibular
correct answer: Associated deficit indicating neurological involvement When testing for carpal tunnel syndrome, numbness or tingling in the distribution of the median nerve (palmar surface of thumb, index, middle and medial 4th finger) when hands are pressed together in acute flexion for 60 seconds is a positive correct answer: Phalen's sign Which of the following areas of musculoskeletal examination tests joint function and stability correct answer: Range of motion Which test is used to detect an injury or tear or the medial or lateral collateral ligament correct answer: Stress test (abduction/adduction) The area of the body surface innervated by a particular spinal nerve is called a correct answer: dermatome Two of the most common symptoms patients with neurologic disorders describe are correct answer: generalized weakness and pain One way to test cranial nerves IX and X correct answer: assess gag reflex Cranial nerves III, IV, and VI are all related to correct answer: ocular movement
One way to test cranial nerve XI is correct answer: Ask the patient to shrug shoulders against resistant pressure of examiner's hands One way to test cranial nerve VIII is correct answer: weber test The best test to assess cranial nerve II is correct answer: snellen chart and reading newspaper print Cranial nerve VII assesses nerves associated with correct answer: the face, facial movement One way to test cranial nerve XII correct answer: ask patient to stick out tongue One way to test cranial nerve V is correct answer: check for facial sensation The best test for assessing cranial nerve I is correct answer: Ask the patient to sniff vanilla The ability to identify a number or letter written on the palm of your hand correct answer: graphesthesia A test to evaluate position sense correct answer: Romberg test The ability to identify an object by feeling it (tactile sensation) correct answer: stereognosis Mark is a 35 year old police officer who is seeing you for his annual check up. When taking his sexual history it is important
with her. When documenting her office visit the best choice for a differential diagnosis is: correct answer: oligomenorrhea Which of the following findings on a urine dipstick is indicative of an infection correct answer: Positive leukocytes, nitrites and blood Dullness noted during percussion of the abdomen could indicate all of the following Except: correct answer: air filled intestines When performing a genital exam on a 25-year-old man, the nurse notices deeply pigmented, wrinkled scrotal skin with large sebaceous follicles. On the basis of this information, the practitioner would correct answer: Consider this a normal finding and proceed with the examination A 22 year old woman is being seen at the clinic for problems with vulvar pain, dysuria, and fever. On physical examination, the practitioner notices clusters of small shallower vesicles with surrounding erythema on the labia. There is also inguinal lymphadenopathy present. The most likely cause of these lesions is correct answer: Herpes simplex virus type 2 When performing the bimanual examination, the practitioner notices that the cervix feels smooth and firm, is round, and is fixed in place (does not move). When cervical palpation is performed, the patient complains of some pain. The nurse practitioner's interpretation of these results should be which of these? correct answer: The cervix should move when palpated; an immobile cervix may indicate malignancy
It is important to ask your patient about their sexual history. Why? Select all that apply. correct answer: 1. To assess their risk for potential pregnancy in females of childbearing age2. It is important to know their sexual preferences3. So that you can provide patient centered sex education4. To learn their potential risk for sexually transmitted infection The NP will use which of the following examination techniques to determine muscular resistance, superficial organs and masses in the abdomenA. inspectionB. light palpationC. deep palpationD. percussion correct answer: B Which of the following abdominal exam findings would prompt the NP to consider cholecystitis as a differential diagnosis?A. Positive psoas signB. Positive Rovsing's signC. Positive Obturator signD. Positive murphy's sign correct answer: D Problem with balance/unsteady gait; represents a disturbance in correct answer: cerebellum function One week old: Touch cheek lightly and head turn correct answer: rooting reflex Rapid alternating movements are used to assess correct answer: balance, coordination 6 month old Well visit should still have this reflex present correct answer: parachute reflex Normal average reflex score correct answer: 2+
6-year female patient; position to exam her genitalia correct answer: supine, frog-leg position Normal palpitation of ovaries correct answer: They are smooth, firm, mobile, and almond shape Proper order of examining the female genitalia correct answer: Speculum examination, bimanual examination, rectovaginal examination Swelling around the inguinal ring alongside the pubic hair that is not painful and reduces without difficulty when in the supine position correct answer: A direct inguinal hernia Breast palpation that is most suggestive of cancer correct answer: Firm, nontender lump that is fixed to underlying tissue To prepare female patient for a pelvic exam and pap smear correct answer: Assure the woman that she can stop the exam at anytime she feels discomfort Associated with increased breast cancer risk correct answer: Heavy alcohol usefirst degree relative with breast canceradvancing age Assessment of normal prostate correct answer: It is heart shaped with a palpable grooveIt surface is smoothIt has a elasticity, rubbery consistency
To determine the patient's gender identity the NP should correct answer: Incorporate open-ended, neutral questions into the sexual history Normal testicular exam correct answer: Testes that feel ovoid and mobile, and slight sensation is felt by the patient upon compression Rectal examination = firm, irregularly shaped mass correct answer: Report the finding and refer the patient to GI for further examination. Pelvic Inflammatory Disease correct answer: Cervical Motion Tenderness (CMT)
