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NURS 5220 EXAM 1 2025 | ALL QUESTIONS AND
CORRECT ANSWERS WITH RATIONALES
(ALREADY GRADED A+) | LATEST EXAM |
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Mr. Javed is an Arab gentleman who is experiencing a sore throat. He is most likely to treat this with: A. meditations and prayer. B. ginger root, a "hot" medicine. C. barley water, a "cold" food. D. no treatment at all. ---------CORRECT ANSWER-----------------C: CorrectBarley water is an example of a cold treatment. It is applicable because the condition would be considered a hot condition. In the naturalistic or holistic approach, which of the following statements accurately reflect the naturalist belief? A. External factors must be kept in perfect balance. B. A person eats and uses only naturally grown foods. C. Restoring a disturbed balance requires well-heated foods. D. All prescribed medications are considered "cold." ---------CORRECT ANSWER-----------------A: CorrectA more naturalistic or "holistic" approach broadens the context. It views our lives as part of a much greater whole (the entire cosmos) that must be in harmony. If the balance is disturbed, illness can result. The goal, then, is to retrieve balance and harmony. Cultural groups have different value orientations. Choose the statement that best reflects the past-oriented value orientation. A. A diabetic patient believes that the reason he has diabetes is because of his past eating habits. B. An Asian woman with cancer sees her herbalist for treatment.
C. People who have come from a low socioeconomic status have fewer health problems. D. Environmental factors are the rationale behind past value choices. ------- --CORRECT ANSWER-----------------B: CorrectAnswer b is the best choice. Past-oriented value orientation cultures maintain traditions that were meaningful in the past and/or worship ancestors. Cultural beliefs and behaviors that will have an effect on your assessment of the patient include which of the following? A. Diet and nutritional practices. B. The nature of relationships within a family C. Modes of communication: the uses of speech, body language, and space D. All of the above ---------CORRECT ANSWER-----------------D: CorrectCultural beliefs, behaviors, and practices make up one's culture, which broadly reflects the whole of human behavior, including ideas and attitudes; ways of relating to one another; manners of speaking; the material products of physical effort, ingenuity, and imagination. Language is a part of culture. So, too, are the abstract systems of belief, etiquette, law, morals, entertainment, and education. A patient presents with multiple raised lesions on her skin. What instrument can help examine these lesions? A. Calipers B. Ruler C. Tympanometer D. Transilluminator ---------CORRECT ANSWER-----------------B:CorrectThe ruler, which can be used to measure skin lesions, is among other devices you should personally own because it will be used the most often. The examiner notes an obvious odor to the patient when they first meet. Which examination technique is being applied?
A. nutritional history. B. chief complaint. C. prenatal information. D. personal social information. ---------CORRECT ANSWER----------------- C:CorrectFor older infants, record information as for adults; however, for newborns, include the details of the mother's pregnancy and any untoward events occurring since birth. Which issue has most recently challenged the health care system in regard to the accuracy of patient records? A. Inclusion of detailed family and background data B. Access to the record by multiple health care professionals C. EMR recording errors by students in the health care delivery area D. Inappropriate use of the CPCF function ---------CORRECT ANSWER----- ------------D:CorrectAlthough potentially being a very effective tool, the ability to easily copy and paste or carry forward (CPCF) text from one note to another has become the latest hazard in electronic medical documentation. Whereas legibility is no longer an issue with electronic medical records (EMRs), copy and paste is now looming as a patient safety, legal, and regulatory challenge for EMRs. When CPCF is used inappropriately, it can affect patient safety by rendering meaningless an essential communication tool relied on at the point of care. The OLDCARTS mnemonic is a guide to the: A. history of the present illness. B. review of systems. C. family history. D. personal and social history. ---------CORRECT ANSWER----------------- A:CorrectThe OLDCARTS mnemonic helps make sure all characteristics of a problem are described in the history of present illness to ensure a comprehensive presentation.
Mrs. Harris is a 46-year-old patient who presents to your office for a routine physical examination. During the history and physical, you note expected Rinne and Weber test results. This would be documented: A. objective data. B. subjective data. C. systematic data. D. functional data. ---------CORRECT ANSWER-----------------A: CorrectObjective data are the findings resulting from direct observation— what you see, hear, and touch. Record the objective data by body systems and anatomic location. How does the APSO patient record format differ from the SOAP format? A. Categories of information B. Sequence of information C. Amount of detail D. Level of specificity ---------CORRECT ANSWER----------------- B:CorrectThe problem-oriented medical record (POMR) with SOAP (Subjective, Objective, Assessment, and Plan) notes is one system for organizing documentation. The POMR can also be created in the APSO (Assessment, Plan, Subjective, and Objective) format. When recording data into the patient's record, the health care provider must remember that the record is a: A. patient's personal and private record. B. legal document that may be used in court and other legal proceedings. C. health care organization's record that can only be used for medical treatment within that organization. D. public document that is available to those who are affiliated with the health care organization. ---------CORRECT ANSWER----------------- B:CorrectThe patient's record is a legal document, and any information contained in it may be used in court and in other legal proceedings, as well as to make health care payment determinations.
Incremental grading is often used for recording which examination finding? A. Size of lymph nodes B. Tenderness related to pain perception C. Deep tendon reflexes D. Amount of discharge visible from an orifice ---------CORRECT ANSWER- ----------------C:CorrectFindings that vary by degrees are customarily graded or recorded in an incremental scale format. Pulse amplitude, heart murmur intensity, muscle strength, and deep tendon reflexes are findings often recorded in this manner. For structures that have a round shape, such as the tympanic membrane, an effective way to document location of an alteration is to relate its location to the: A. numbers on the face of a clock. B. degrees in a circle. C. divisions on a chronometer. D. spokes on a wheel. ---------CORRECT ANSWER----------------- A:CorrectIn some cases, location of a finding on or near a specific structure (e.g., tympanic membrane, rectum, vaginal vestibule) may be described by its position on a clock. Which is an example of a resolution to a problem? A. The problem has been inactive for the past five office visits. B. The patient denies that the problem exists. C. The problem has been corrected surgically. D. The manifestations of the problem have disappeared. ---------CORRECT ANSWER-----------------C:CorrectWhen a problem is resolved, the date of resolution should be entered and this item can then be removed from the active problem list. Surgical correction of a condition and recovery from an acute infectious process are examples of resolved problems.
The plan is divided into which three sections? A. Diagnostics, therapeutics, and medicritics B. Therapeutics, diacritics, and education C. Diagnostics, diacritics, and education D. Therapeutics, diagnostics, and education ---------CORRECT ANSWER--- --------------D:CorrectThe plan is divided into three sections: diagnostics, therapeutics (if known), and patient education. Mrs. Wolf brings her newborn in for a routine infant checkup. In the newborn examination, the focus is on: A. developmental disabilities. B. the transition to extrauterine life and congenital anomalies. C. the prenatal care of the mother and birth trauma. D. the medical history of the mother. ---------CORRECT ANSWER------------- ----B:CorrectWith newborns the focus is on their transition to extrauterine life and the detection of any congenital anomalies. Which is an advantage of the APSO patient record format as opposed to the SOAP format? A. Patient record is shorter B. Record contains more data C. Clinically useful data are more accessible D. Can be used for all types of patients ---------CORRECT ANSWER--------- --------C:CorrectWith the APSO format, the assessment and plan is moved to the beginning of the document, with all remaining data available in the remainder of the note. Use of the phrase "patient denies" in recording the nonexistence of symptoms has a negative connotation and may imply that the individual is: A. noncompliant.
D. Just before term ---------CORRECT ANSWER----------------- B:CorrectDuring pregnancy, blood pressure commonly decreases beginning at about 8 weeks' gestation, gradually falling until a low point is reached at mid-pregnancy. During an initial interview with your patient, you ask the patient, "Can you describe that for me?" Which statement best describes the question? A. It is the most risky type of question because the patient can say anything. B.The question is asking for specific information. C. The patient has discretion about the extent of the answer. D. The answer can lead the interviewer away from the purpose of the interview. ---------CORRECT ANSWER-----------------C: The open-ended question gives the patient discretion about the extent of an answer. This is an example of a question carefully formulated to illicit an enhanced patient response. The answer can lead the interviewer away from the purpose of the interview. Because an adolescent is often reluctant to talk during an interview, it is best to: A. tell the patient that you must have straight answers to your questions. B. ensure confidentiality regarding the information discussed. C. inform the patient that adolescents have trouble expressing their feelings. D. obtain the history from a parent or other family member. --------- CORRECT ANSWER-----------------C: CorrectAdolescents may be reluctant to talk and have a clear need for confidentiality. All adolescent patients
should be given the opportunity to discuss their concerns with you privately. It is wise to let parents or other caregivers know you will be asking them to step out of the room to provide this important opportunity for the adolescent. For which age group is a functional assessment most critical? A. Children B. Adolescents C. Adults D. Older adults ---------CORRECT ANSWER-----------------D: CorrectQuite simply, functional assessment is an attempt to understand a patient's ability to achieve the basic activities of daily living. This assessment should be made for all older adults and for any person limited by disease or disability, acute or chronic. Which of the following will best facilitate an interview with a deaf person? A. Speaking loudly B. Using gestures C. Sitting or standing at eye level D. Sitting to the side of the patient ---------CORRECT ANSWER----------------
- c: CorrectPersons with impaired hearing often read, write, sign, and/or read lips, but you must speak slowly and enunciate each word clearly and in full view. Sitting or standing at eye level allows for full view. Which of the following questions may lead to an inaccurate response? A. "Where do you feel the pain?" B. "How does this situation make you feel?" C. "What happened after you noticed your injury?" D. "That was a horrible experience, wasn't it?" ---------CORRECT ANSWER-----------------D: CorrectAnswer d is an example of a leading question. The leading question is the most risky because it may limit the information provided to what the patient thinks you want to know. Questions a, b, and c are examples of direct and open-ended questions.
D. encouraging more detail. ---------CORRECT ANSWER-----------------D: CorrectWhen you repeat a patient's answer, you are engaging in reflecting. Reflecting encourages patients to provide more detail. While interviewing an angry patient, you start to become annoyed and are beginning to dislike the patient. The best way to resolve this is to: A. spend the least amount of time possible with the patient. B. displace your annoyance toward the patient on an inanimate object. C. ignore the feelings and remain neutral in your interactions. D. express concern and explore the problem with the patient. --------- CORRECT ANSWER-----------------D: CorrectWhen dealing with the angry patient, it is appropriate to confront or acknowledge the anger and explore the potential issue. Answer d is the best example in the scenario given. Which of the following behaviors is most important in establishing a connection with the patient? A. Documenting data from the history using direct patient quotes B. Phrasing questions so that they are clear and explicit C. Avoiding the trap of giving advice during an interview D. Listening intently while observing nonverbal cues ---------CORRECT ANSWER-----------------D: CorrectEstablishing a connection with the patient is essential to good communication. Being a skilled listener and being alert to patients' nonverbal communication help establish meaningful connection. During an interview, the patient describes problems associated with an illness and begins to cry. The best action in this situation is to: A. stop the interview and reschedule for another time. B. allow the patient to cry, then resume when the patient is ready. C. change the topic to something less upsetting.
D. continue the interview while the patient cries in order to get through it quickly. ---------CORRECT ANSWER-----------------B:CorrectPeople will cry. Let the emotion proceed at the patient's pace. Resume your questioning only when the patient is ready. If you suspect a patient is holding back, give permission. Offer a tissue or simply say, "It seems like you're feeling bad. It's okay to cry." Name the emotion. Be direct about such a tender circumstance, but gently, not too aggressively or insistently. Which statement best describes the chief complaint? A.General health and illness B. The reason the individual is seeking care C. Information to make the diagnosis D. Concerns about confidentiality and trust ---------CORRECT ANSWER----- ------------B: CorrectThe chief complaint is the main reason the person is seeking care or the chief concern. The other answers are parts of the history and physical or review of symptoms. A woman presents to a women's health clinic stating that she has had a positive home pregnancy test and desires prenatal care. You would conduct a(n): A. complete history. B. focused history. C. problem-oriented history. D. interim history. ---------CORRECT ANSWER-----------------A:CorrectThe examiner would conduct a complete history because the complete history allows the examiner to become thoroughly familiar with the patient. Most often, this history is recorded the first time you see the patient. The other answers are used when something is already known about the patient or an established relationship exists. You are responding to a patient who has behaved toward you in a seductive manner. Which of the following is most appropriate?
A 45-year-old patient presents with a complaint of anxiety related to his wife's criticism of his drinking. During the history you ask several of the CAGE model questions and the patient tells you that he wants to cut down on his drinking. Which conclusion would you draw about this patient? A. He is an alcoholic. B. His drinking is caused by anxiety. C. He may be an alcohol abuser. D. He should be examined for symptoms of withdrawal. ---------CORRECT ANSWER-----------------C:CorrectThe CAGE questionnaire is one model for discussing the use of alcohol. CAGE is an acronym for Cutting down, Annoyed by criticism, Guilty feeling, Eye-openers. Its use does not ensure absolute sensitivity in the detection of a problem. There is a difference between a screening and an assessment interview. The goal of screening is to find out if a problem exists. This is particularly true of CAGE, CRAFFT, and TACE screening tools. They are effective, but they are only the start, and assessment goes on from there. A conversation with a parent concerning a 5-year-old child: A. violates the child's need for privacy. B. is inappropriate because the child is able to talk with you. C. provides significant information about family dynamics. D. causes distrust in the child toward the examiner. ---------CORRECT ANSWER-----------------C: CorrectFamily dynamics become evident during history taking and may even lead to clues that a parent is in need. Your responsibility goes beyond that for the child. Answers a, b, and d may apply to the adolescent child. Mr. Sandstrom has come for his routine appointment for his hypertension. He is not experiencing medication side effects or other health problems. Which of the following questions is most appropriate to ask when you begin the interview?
A. "How have you been doing since your last visit?" B. "Have you been taking your medications?" C. "What brings you to the office today?" D. "How are you doing with your hypertension?" ---------CORRECT ANSWER-----------------A:CorrectAt the start, greet the patient and those with the patient. Begin by asking open-ended questions ("How have you been feeling since we last met?" "What questions would you like to discuss?" "What do you want to make sure we cover in today's visit?"). During an interview, a patient admits to feeling worthless and having a sleep disturbance for the last 3 weeks. These clues warrant exploring the possibility of: A. altered cognition. B. suicidal ideation or plan. C. substance abuse. D. panic attacks. ---------CORRECT ANSWER-----------------B:CorrectA sense of sluggishness in the daily experience; disturbances in sleeping, eating, and social contact; and feelings of loss of self-worth can be clues for depression. When questioning a patient regarding a sensitive issue such as drug use, it is best to: A. begin by describing the effects of drug abuse on health. B. be direct, firm, and to the point. C. explain that only health care workers will share the information. D. explain that only health care workers will share the information. --------- CORRECT ANSWER-----------------B: CorrectSensitive issues, which may be difficult to discuss but are important to address, include sex, drug or alcohol use, or concerns about death. Being direct, firm, and to the point are successful techniques used in these types of interviews. Answers a, c, and d, have proven to be ineffective techniques in these situations.
B. an inability of the patient to communicate. C. a reluctance of the patient to verbalize information. D. a need to terminate the interview because of the decreased attention of the patient. ---------CORRECT ANSWER-----------------C: CorrectSometimes intimidated by silence, many clinicians feel the urge to break it. Be patient. Do not force the conversation. You may have to move the moment along with an open-ended question or a mild nudge. Remember, though, that silence allows the patient a moment of reflection or time to summon courage. Some issues can be so painful and sensitive that silence becomes necessary and should be allowed. Most people will talk when they are ready. Interviewers should identify and assess their own feelings, such as hostility and prejudice, in order to: A. avoid inappropriate behavior. B. explain their biases to patients. C. express personal idiosyncrasies. D. promote self-awareness. ---------CORRECT ANSWER-----------------A: CorrectYour own beliefs, attitudes, and values cannot be discarded, but you do have to discipline them. You have to be aware of your cultural beliefs, faith, and conscience so that they do not inappropriately intrude as you discuss with patients a variety of issues. That means knowing yourself. You will better control possible barriers to a successful outcome. J.F. shares with you that he has an uncle and a brother with sickle cell disease. Where would this information best be documented? A. Chief complaint B. Medical history C. Social history D. Family history ---------CORRECT ANSWER-----------------D:CorrectThe pathway to detecting risk is the family history. Blood relatives in the immediate or extended family with illnesses with features similar to the patient's are an immediate concern. If a disease "runs in the family," such
as sickle cell disease, ask about everyone from grandparents to cousins. A thorough and well-done family history is the essence of genomic medicine. A mother runs into the emergency department with her 6-year-old son. She says that her son fell 15 feet from a tree. The child is screaming and has an open fracture of the left forearm. You would conduct a(n): A. complete history. B. focused history.. C. problem-oriented history. D. interim history. ---------CORRECT ANSWER-----------------B:CorrectThe focused history is taken when the problem is acute, possibly life threatening, and requiring immediate attention so that only the need of the moment is given full attention A patient with diabetes comes into the medical clinic, stating that he has noticed a sore on his foot for the last week. You note that his last visit was 2 months ago. You would conduct a(n): A. complete history. B. focused history. C. problem-oriented history. D. interim history. ---------CORRECT ANSWER-----------------D: CorrectThe interim history is designed to chronicle events that have occurred since your last meeting with the patient. Its substance is determined by the nature of the problem and the need of the moment. The interim history should always be complemented by the patient's previous record. Which behavior is least likely to facilitate an interview with a patient who is dissembling? A. Allow the topic to be changed. B. State "I noticed that you changed the topic." C. Use gentle questioning to help the patient explore the topic.
