NSG 3160 Health Assessment Exam 2
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While counting the apical pulse on a 16-year-old patient, the nurse notices an irregular
rhythm. His rate speeds up on inspiration and slows on expiration. What would be the
nurse's response?
A) Talk with the patient about his intake of caffeine.
B) Refer the patient to a cardiologist for further testing.
C) No further response is needed because this is a normal variation.
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D) Perform an echocardiogram after the examination. –
Correct Answer :C) No further response is needed because this is a normal variation.
The rhythm should be regular, although sinus arrhythmia occurs normally in young adults
and children. With sinus arrhythmia, the rhythm varies with the person's breathing.
Increasing at the peak of inspiration and slowing with expiration (Bates, p401).
Which of following is not found in the upper left quadrant of the abdomen?
A) spleen
B) left kidney
C) pancreas
D) gallbladder –
Correct Answer :D) gallbladder
All except the gallbladder are found in the upper left abdominal quadrant. (Bates, p450-451)
What is the correct way to perform the Whisper test to assess hearing?
A) whisper a combination of 3 letters and numbers out of the patient's sight while occluding
the other ear and have them repeat it, then test the other side.
B) whisper, "Can you hear me?"
C) have someone whisper a sentence outside the exam room door and have the patient
repeat it
D) whisper a sentence of 5 words and have the patient repeat it. –
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Correct Answer :A) whisper a combination of 3 letters and numbers out of the patient's sight
while occluding the other ear and have them repeat it, then test the other side.
The Whisper test is recommended to be a combination of 3 letters and numbers while
occluding the other ear. Have the patient repeat it, then test the other ear. (Bates, p246-247)
Macular degeration effects:
A) lateral vision
B) peripheral vision
C) central vision
D) none of the above –
Correct Answer :C) central vision
Bates, p 242
Which of the following is not an ABCDE screening for melanoma?
A) asymmetry
B) borders
C) clarity
D) diameter –
Correct Answer :C) clarity
Asymmetry, Border, Color, Diameter, and Evolution are the ABCDE for melanoma detection.
(Bates, p179)
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Ms. Jones complains of visible blood in her urine. This is called:
A) hematochezia
B) melena
C) gross hematuria
D) microscopic hematuria –
Correct Answer :C) gross hematuria
Blood visible in urine with the naked eye is called gross hematuria. If the blood is not visible
with the human eye and only when examined with a microscope, it is microscopic
hematuria. (Bates, p463)
Hepatitis A is transmitted via:
A) IV drug use
B) sexual contact
C) fecal-oral route
D) blood and body fluids –
Correct Answer :C) fecal-oral route
Bates, p466
Which of the following is the most common bloodborne pathogen in the United States?
A) Hepatitis C
B) HIV
C) Hepatitis A
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