NSG 6020 Advanced Health and Physical End of Semester 1 Exam 2026

NSG 6020 NSG 6020 NSG 6020 Advanced Health and Physical End of Semester 1 Exam 2026 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 patient's laboratory data reveal an elevated thyroxine level. The nurse would proceed with an examination of the - Correct Answer-Thyroid A 6-month-old infant has been brought to the well-child clinic for a check-up. She is currently sleeping. What should the examiner do first? - Correct Answer-Auscultate the lungs and heart while the infant is still sleeping When preparing to examine a 6-year-old child, which action is most appropriate? - Correct Answer-Start with the thorax, abdomen, and genitalia before examining the head. Avoid talking about the equipment being used because it may increase the child's anxiety. Keep in mind that a child this age will have a sense of modesty. Have the child undress from the waist up. 68-year-old woman is in the eye clinic for a checkup. She tells the nurse that she has been having trouble with reading the paper, sewing, and even seeing the faces of her grandchildren. On examination, the nurse notes that she has some loss of central vision but her peripheral vision is normal. These findings suggest that: - Correct Answer-She may have macular degeneration In assessing a patient's major risk factors for heart disease, which would the nurse want to include when taking a history? 1.Family history, hypertension, stress, age 2.Personality type, high cholesterol, diabetes, smoking 3.Smoking, hypertension, obesity, diabetes, high cholesterol 4.Alcohol consumption, obesity, diabetes, stress, high cholesterol - Correct Answer-3. Smoking, hypertension, obesity, diabetes, high cholesterol A teenage patient comes to the emergency department with complaints of an inability to breathe and a sharp pain in the left side of his chest. The assessment findings include cyanosis, tachypnea, tracheal deviation to the right, decreased tactile fremitus on the left, hyperresonance on the left, and decreased breath sounds on the left. The nurse interprets that these assessment findings are consistent with: - Correct Answer-a pneumothorax During a hearing assessment the nurse practitioner finds that sound lateralizes to the patient's left ear with the Weber test. What can the nurse practitioner conclude from NSG 6020 NSG 6020 this? - Correct Answer-The patient has a conductive hearing loss in the right ear. Lateralization is a normal finding with the Weber test. The patient could have either a sensorineural or a conductive loss. A mistake has occurred; the test must be repeated. The most important reason to share information and offer brief teaching while performing the physical examination is to help: examiner feel more comfortable and gain control of the situation. rapport and increase the patient's confidence in the examiner. patient understand his or her disease process and treatment modalities. patient identify questions about his or her disease and potential areas of patient education. - Correct Answer-2. build rapport and increase the patient's confidence in the examiner. In assessing the sclera of a black patient, which of the following would be an expected finding? - Correct Answer-The presence of small brown macules on the sclera During an examination, the nurse knows that the best way to palpate the lymph nodes in the neck is described by which statement? - Correct Answer-Using gentle pressure, palpate with both hands to compare the two sides. The nurse is obtaining a history from a 30-year-old male patient and is concerned about health promotion activities. Which of the following questions would be appropriate to use to assess health promotion activities for this patient? 1. "Do you perform testicular self-exams?" 2. "Have you ever noticed any pain in your testicles?" 3. "Have you had any problems with passing your urine?" 4. "Do you have any history of sexually transmitted disease?" - Correct Answer-1. "Do you perform testicular self-exams?" When examining a 16-year-old male teenager, the examiner should: - Correct Answer provide feedback that his body is developing normally and discuss the wide variation among teenagers on the rate of growth and development. Which of the following statements regarding the aging adult and abdominal assessment is true? - Correct Answer-the abdominal musculature is thinner In recording the childhood illnesses of a patient who denies having had any, which of the following notes by the nurse would be most accurate? 1. Patient denies usual childhood illnesses. 2. Patient states he was a "very healthy" child. 3. Patient states sister had measles, but he didn't. 4. Patient denies measles, mumps, rubella, chickenpox, pertussis, or strep throat. - Correct Answer-4. Patient denies measles, mumps, rubella, chickenpox, pertussis, or strep throat. NSG 6020 NSG 6020 A patient's thyroid is enlarged, and the nurse 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. During an examination, the nurse knows that Paget's disease would be indicated by which of the following findings? - Correct Answer-Paget's disease occurs more often in males and is characterized by bowed, long bones, sudden fractures, and enlarging skull bones that press on cranial nerves causing symptoms of headache, vertigo, tinnitus, and progressive deafness. A patient is unable to read the 20/100 line on the Snellen chart. The nurse practitioner would - Correct Answer-refer the patient to an ophthalmologist or optometrist for further evaluation. Which technique of assessment is used to determine the presence of crepitus, swelling, and pulsations? - Correct Answer-Palpation During a cardiac assessment on an adult patient in the hospital for "chest pain," the nurse finds the following: jugular vein pulsations 4 cm above sternal angle when he is elevated at 45 degrees, BP 98/60, HR 130; ankle edema; difficulty in breathing when supine; and an S3 on auscultation. Which of the following best explains the cause of these findings? 1.Fluid overload 2.Atrial septal defect 3.Myocardial infarction 4.Heart failure - Correct Answer-4. heart failure Primary muscles of respiration include: - Correct Answer-diaphragm & intercostals A patient comes into the clinic complaining of pain in her right eye. On examination, the nurse sees a pustule at the lid margin that is painful to touch, red, and swollen. The nurse recognizes that this is - Correct Answer-a hordeolum (stye). During an examination of a patient's abdomen, the nurse practitioner notes that the abdomen is rounded and firm to the touch. During percussion, the nurse practitioner notes a drum-like quality of the sound across the quadrants. This type of sound indicates: - Correct Answer-air-filled areas. In preforming auscultation of heart sunds, which sequence would the nurse use? - Correct Answer-aortic area -- pulmonic area -- erb's point -- tricuspid -- mitral A patient comes into the emergency department after an accident at work. A machine blew dust into his eyes and he was not wearing safety glasses. The nurse examines his corneas by shining a light from the side across the cornea. What findings would suggest that he has suffered a corneal abrasion? - Correct Answer-A shattered look to the light rays reflecting off the cornea NSG 6020 NSG 6020 During a hearing assessment the nurse practitioner finds that sound lateralizes to the patient's left ear with the Weber test. What can the nurse practitioner conclude from this? - Correct Answer-The patient could have either a sensorineural or a conductive loss. During an examination of a female patient, the nurse practitioner notes lymphadenopathy and suspects an acute infection. Acutely infected lymph nodes would be: - Correct Answer-firm but freely moveable Which of the following statements best describes the purpose of a health history? - Correct Answer-The purpose of the health history is to collect subjective data—what the person says about him or herself. The physician reports that a patient has a tracheal shift. The nurse practitioner is aware that this means that the patient's trachea is: - Correct Answer-The trachea is pushed to the unaffected side with an aortic aneurysm, a tumor, unilateral thyroid lobe enlargement, and pneumothorax. The nurse practitioner is examining a 2-year-old child and asks, "May I listen to your heart now?" Which critique of her technique is most accurate? - Correct Answer Children at this age like to say "No." The examiner should not offer a choice when there is none. A patient tells the nurse practitioner that he is very nervous, that he is nauseated, and that he "feels hot." This type of data would be: - Correct Answer-Subjective During a hearing assessment the nurse practitioner finds that sound lateralizes to the patient's left ear with the Weber test. What can the nurse practitioner conclude from this? - Correct Answer-the patient has conductive hearing loss in the right ear During an admission assessment, the nurse practitioner notices that a male patient has an enlarged and rather thick skull. The nurse practitioner suspects acromegaly and would further assess for - Correct Answer-coarse facial features While performing a well-child assessment on a 5-year-old, the nurse practitioner notes the presence of palpable, bilateral, cervical, and inguinal lymph nodes. They are approximately 0.5 cm in size, round, mobile, and nontender. The nurse practitioner suspects that this: - Correct Answer-normal finding During an examination of a patient in her third trimester of pregnancy, the nurse practitioner notices that the patient's thyroid gland is slightly enlarged. No enlargement had been noted previously. The nurse practitioner suspects that - Correct Answer-The thyroid gland enlarges slightly during pregnancy owing to hyperplasia of the tissue and increased vascularity. NSG 6020 NSG 6020 What is responsible for the inspiratory splitting of S2? - Correct Answer-Closure of aortic, then pulmonic valves A 25-year-old optical technician comes to your clinic for evaluation of fatigue. As part of your physical examination, you listen to her heart and hear a murmur only at the cardiac apex. Which valve is most likely to be involved, based on the location of the murmur? - Correct Answer-Mitral A 58-year-old teacher presents to your clinic with a complaint of breathlessness with activity. The patient has no chronic conditions and does not take any medications, herbs, or supplements. Which of the following symptoms is appropriate to ask about in the cardiovascular review of systems? - Correct Answer-Orthopnea You are screening people at the mall as part of a health fair. The first person who comes for screening has a blood pressure of 132/85. How would you categorize this? - Correct Answer-Prehypertension You are evaluating a 40-year-old banker for coronary heart disease risk factors. He has a history of hypertension, which is well-controlled on his current medications. He does not smoke; he does 45 minutes of aerobic exercise five times weekly. You are calculating his 10-year coronary heart disease risk. Which of the following conditions is considered to be a coronary heart disease risk equivalent? - Correct Answer-Peripheral arterial disease You are conducting a workshop on the measurement of jugular venous pulsation. As part of your instruction, you tell the students to make sure that they can distinguish between the jugular venous pulsation and the carotid pulse. Which one of the following characteristics is typical of the carotid pulse? - Correct Answer-Palpable A 68-year-old mechanic presents to the emergency room for shortness of breath. You are concerned about a cardiac cause and measure his jugular venous pressure (JVP). It is elevated. Which one of the following conditions is a potential cause of elevated JVP? - Correct Answer-Constrictive pericarditis You are palpating the apical impulse in a patient with heart disease and find that the amplitude is diffuse and increased. Which of the following conditions could be a potential cause of an increase in the amplitude of the impulse? - Correct Answer-Aortic stenosis, with pressure overload of the left ventricle You are performing a cardiac examination on a patient with shortness of breath and palpitations. You listen to the heart with the patient sitting upright, then have him change to a supine position, and finally have him turn onto his left side in the left lateral decubitus position. Which of the following valvular defects is best heard in this position? - Correct Answer-Mitral NSG 6020 NSG 6020 You are concerned that a patient has an aortic regurgitation murmur. Which is the best position to accentuate the murmur? - Correct Answer-Upright, but leaning forward Where is the point of maximal impulse (PMI) normally located? - Correct Answer-In the left 5th intercostal space, 7 to 9 cm lateral to the sternum Which of the following events occurs at the start of diastole? - Correct Answer-Closure of the aortic valve Which is true of a third heart sound (S3)? - Correct Answer-It is caused by rapid deceleration of blood against the ventricular wall. Which is true of splitting of the second heart sound? - Correct Answer-It is best heard over the pulmonic area with the bell of the stethoscope In healthy adults over 20, how often should blood pressure, body mass index, waist circumference, and pulse be assessed, according to American Heart Association guidelines? - Correct Answer-Every 2 years You find a bounding carotid pulse on a 62-year-old patient. Which murmur should you search out? - Correct Answer-Aortic insufficiency To hear a soft murmur or bruit, which of the following may be necessary? - Correct Answer-Asking the patient to hold her breath Make sure the room is quiet when you perform the assessment Checking your stethoscope for air leaks (ALL) Which of the following may be missed unless the patient is placed in the left lateral decubitus position and auscultated with the bell? - Correct Answer-Mitral stenosis murmur Opening snap of the mitral valve S3 and S4 gallops (all) How should you determine whether a murmur is systolic or diastolic? - Correct Answer Palpate the carotid pulse. You are listening carefully for S2 splitting. Which of the following will help? - Correct Answer-Using the bell with light pressure over the 2nd left intercostal space A 78-year-old retired seamstress comes to the office for a routine check-up. She was obtained an ECG (electrocardiogram) because of her history of hypertension. She was diagnosed of a myocardial infarction, You 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 myocardial infarction? - Correct Answer-Syncope A patient comes to the emergency room for evaluation of shortness of breath. To which anatomic region would you assign the symptom? - Correct Answer-Cardiac NSG 6020 NSG 6020 patient presents for evaluation of a cough. Which of the following anatomic regions can be responsible for a cough? - Correct Answer-Cardiac 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 19-year-old college sophomore comes to the clinic for evaluation of joint pains. The student has been back from spring break for 2 weeks; during her holiday, she went camping. She notes that she had a red spot, shaped like a target, but then it started spreading, and then the joint pains started. She used insect repellant but was in an area known to have ticks. She has never been sick and takes no medications routinely; she has never been sexually active. What is the most likely cause of her joint pain? - Correct Answer-Lyme disease 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 of the following is likely the cause of her pain? - Correct Answer-Fibromyalgia A high school soccer player "blew out his knee" when the opposing goalie's head and shoulder struck his flexed knee while the goalie was diving for the ball. All of the following structures were involved in some way in his injury, but which of the following is actually an extra-articular structure? - Correct Answer-Tendons Louise, a 60-year-old, complains of left knee pain associated with tenderness throughout, redness, and warmth over the joint. Which of the following is least helpful in determining if a joint problem is inflammatory? - Correct Answer-Pain An infant presents with a heart rate of 180, a respiratory rate of 68, and an enlarged liver. What diagnosis does this suggest? - Correct Answer-Heart failure You are assessing an infant and notice that his nares flare, he has a soft grunt with each breath, and the skin between his ribs is pulled inward with inhalation. What is the significance of these findings? - Correct Answer-These are indicative of respiratory distress. 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. NSG 6020 NSG 6020 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 During a routine physical exam of a 90 year old woman, a low-pitched diastolic murmur grade II/VI is auscultated. It is located on the fifth intercostal space on the left side of the midclavicular line. Which is the following is the correct diagnosis? - Correct Answer Mitral stenosis You are performing a cardiac examination on a patient with shortness of breath and palpitations. You have the patient turn onto his left side in the left lateral decubitus position to listen to the heart. Which of the following valvular defects is best heard in this position? - Correct Answer-Mitral A 78-year-old retired seamstress comes to the office for a routine check-up. You obtain an ECG (electrocardiogram) 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 acute myocardial infarction? - Correct Answer-Syncope The nurse is participating in a health fair and performing cholesterol screens. One person has hypercholesterolemia. She is concerned about her risk for developing heart disease. Which of the following factors is used to estimate the 10-year risk of developing coronary heart disease - Correct Answer-Gender - men have a higher risk than women Excess fluid in pericardial cavity - caused by blunt trauma, pericarditis, myocardial rupture; life-threatening - Correct Answer-cardiac tamponade Radiological findings with severe left heart failure - Correct Answer-cardiomegaly, pulmonary artery engorgement, interstitial pulmonary edema, bat's wings pattern, and pleural effusion Mitral regurgitation - Correct Answer-Systolic murmur