NURS 7470 Exam 3 Practice Questions | Verified Answers, Complete Solutions

NURS 7470 Exam 3 Practice Questions | Verified Answers, Complete Solutions Which cranial nerve is not routinely tested unless a problem is suspected? a. I b. II c. V d. XI The patient is able to touch each finger to his thumb in rapid sequence. What does this finding mean? The patient has: a. Intact trochlear and abducens cranial nerves b. Appropriate cerebellar fx c. An intact spinal accessory nerve d. Appropriate kinesthetic sensation A patient makes the following statement: I sometimes feels as if the whole room is spinning. What type of neurologic dysfunction should the examiner suspect? a. Peripheral neuropathy dysfunction b. Increased intracranial pressure from a brain tumor c. Inner ear dysfunction affecting the acoustic nerve d. Lesion affecting the frontal lobe The examiner asks the patient to close her eyes then places a vibrating tuning fork of the patient's ankle and asks her to indicate what is felt. What is being assessed? a. Peripheral nerve sensory function b. Cranial nerve sensory fx c. Primary sensory fx d. Level of consciousness An older patient tells the examiner, I have a hard time finding the right words when I am talking this symptom may be a. A precursor to a seizure disorder b. An early sx of Parkinson disease c. An indication of a dysfunction of the temporal lobe d. Associated with a problem of the vestibular apparatus What response should occur when a patient's field of gaze moves from a distant object to one close to his or her fact? a. Rapid eye movement b. Ptosis of the eye c. Constriction of the pupil d. Dilation of the iris A patient demonstrates impaired pain sensation. Which additional test is appropriate to further evaluate this finding a. Heat and cold sensation b. Ultrasonic perception c. Deep tendon reflex d. Transillumination of the involved area The examiner squeezes the patient's biceps muscle as part of an exam. Which of the following responses verbalized by the patient is considered normal? a. That makes my arm tingle b. That makes a burning sensation go up my arm c. That is uncomfortable d. My arm is twitching Which of the following findings is associated with an increased risk for skin breakdown and injury? a. Inability to feel pressure applied by a monofilament b. Inability to identify a familiar object by touch c. Inability to identify a letter drawn in the palm of the hand d. 3+ deep tendon reflexes Which question asked by the examiner may help determine prevention strategies for seizures that a patient has been experiencing? a. Where do your seizures typically begin b. How do you feel after the seizure c. What goes thru your mind during the seizure d. Are there any factors or activities that seem to start the seizures? Jack is a 52-year old obese man with a 40 year pack smoking history and he has a history of poorly controlled diabetes. Which of the following assessment findings would likely be present given Jack's history? a. Slow and uncoordinated movement with finger-nose test b. Asymmetry of the face when asked to smile and puff out his cheeks c. Instability to discern superficial touch or two-point discrimination on the legs d. Reduced muscle tone on the left side of face During the neurological assessment, you determine the patellar deep tendon reflex is 3+. Which statement best describes this finding? a. diminished; low normal b. very brisk, hyperactive with clonus c. average; normal d. brisker than average, not necessarily indicative of disease How can an examiner best gain the cooperation of a child to perform a neurologic exam? a. Ask a parent to perform the exam while the examiner observes the response b. Ask the mother or father to step out of the room c. Promise the child a toy or treat if they do what you ask d. Create a game from various aspects of the neuro exam Sensory neurologic testing is not usually done with children until they are: a. Preschool age b. Kindergarten age c. Middle school age d. High school age When testing the plantar reflex of a 10 year old male, you note a dorsiflexion and extension of the great toe and fanning of the other toes. This finding is: a. indication the boy is left side dominant b. normal c. indicative of muscle spasms d. indication of disease of the pyramidal tract When testing the brachioradialis reflex, what is the expected response? a. pronation of the forearm and flexion of the elbow b. flexion of the hand c. flexion and supination of the forearm d. extension of the forearm/elbow Which of the following findings should an examiner consider a normal finding if associated with pregnancy? a. decreased gag reflex b. mild seizures c. change in balance d. 4+ deep tendon reflexes The musculoskeletal examination should begin when: a. when joint mobility is assessed b. the patient enters the examination room after obtaining Ht and Wt c. the remainder of the physical examination is completed d. during the collection of subjective data Which assessment technique/test is used to assess the integrity of the anterior cruciate ligament? a. Lachman test b. Valgus stress test c. Straight leg raise d. Thomas test A finding that is indicative of osteoarthritis is (are): a. swan neck deformities b. Bouchard nodes c. ganglions d. Heberden nodes A common finding in markedly obese patients and pregnant women is: a. kyphosis b. lordosis c. paraphimosis d. scoliosis. When assessing for carpal tunnel syndrome, Tinel's sign can be performed by tapping the: a. Radial artery b. Median nerve c. Volar carpal ligament d. Dorsal aspect of the wrist Which of the following questions asked by the examiner would be most helpful in understanding a patient complaining of acute back pain? a. "Was there any activity or injury that occurred prior to the onset of the pain?" b. "What medication do you currently take?" c. "Have you recently lost weight?" d. "Were you born with any congenital deformities of the spine?" Which spinal finding would be considered normal for a 72-year old patient? a. Scoliosis b. Kyphosis c. Meningocele d. Myelomeningocele A 3-year-old child brought to the clinic complaining of a painful right elbow. He is holding the right arm slightly flexed and pronated and refuses to move it. The mother states that symptoms started right after his older brother had been swinging him around by his arms. This presentation best supports a presentation of: a. radial head subluxation b. femoral anteversion c. osteomyelitis d. Osgood-Schlatter disease The examiner sees two 9-month old babies on the same day. Jeremy is a black 9 & 1/2-month old who pulls himself to a standing position and holds onto a chair while standing. Nathan is a white 9 & 1/2-month old who sits alone on the floor using hands for support; his mother states he is not yet scooting or creeping on the floor. What conclusion is appropriate for the examiner to make? a. Jeremy is athletically gifted compared to Nathan b. Jeremy is advanced for his age c. Both findings are within the "normal" range and should just be noted in the medical record d. Nathan may have a developmental delay Which of the following would be considered back pain red flags that potentially may indicate significant pathology? a. History of cancer b. Immunosuppression c. Pain longer than 1 month d. Saddle anesthesia e. Pain for 3 days after heavy lifting A 40 year old male with a BMI of 42. Three weeks ago he started a high protein, low carbohydrate, diet to lose weight. Today he presents with a red, hot swollen left big toe that started about 48 hours prior. The toe is extremely painful to move or touch. He denies any known trauma. What is the most likely condition these findings should lead you to suspect? a. Bursitis b. Trauma c. Tenosynovitis d. Gout Bones around a joint are held together by: a. muscles b. synovial membranes c. Ligaments d. tendons For which type of problem does a family history have significance? a. Rheumatoid arthritis b. Dislocation of the radius c. Lumbosacral radiculopathy d. Bursitis What is a goniometer used to assess? a. bone maturity b. muscle strength c. joint proportions d. range of motion Strength of the trapezius muscle is best evaluated by having the patient: a. straighten her leg with examiner opposition b. adduct the arm c. push her head against the examiner's hand d. clench her teeth during muscle palpation A patient complains of pain and a clicking noise with jaw movement. The pain extends into the face. These symptoms are suggestive of what condition? a. Temporomandibular joint syndrome b. Rheumatoid arthritis of the jaw c. Gout in the jaw d. Bursitis of the temporomandibular joint Harry was painting the ceiling in his house when his right shoulder pain started. This is indicative of pain with which range of motion of the shoulder? a. Forward flexion b. circumduction c. Adduction d. Hyperextension Café au lait patches are numbered with each assessment of infants and young children because: a. the numbers are expected to increase each year b. coalescent lesions are a more serious finding c. the presence of more than five patches suggests neurofibromatosis d. decreasing numbers are expected with growth. Which nerve associated with patellar reflex? L3 & L4 Which of the following infant reflex responses is considered normal? a. An 8-month old infant demonstrates a positive Moro reflex when startled b. A 13-month old baby toes fan in response to stroking the lateral surface of the infant's sole c. A 2-month old infant's legs flex up against the body when the infant is held in an upright position, and the dorsal side of the foot touches the table d. A 3-month year old infant's fingers fan when the examiner's finger is placed in the infant's hand During the examination of the extremities of the pregnant female, why is it important to elicit the knee and ankle deep tendon reflexes? a. Abnormal reflexes may indicate early signs of DVT. b. Abnormal reflexes, specifically, hyperreflexia may signal cortical irritability from eclampsia. c. Abnormal reflexes, specifically, hyporeflexia with proteinuria are associated with preeclampsia. d. Hyporeflexia is indicative of Gestational Diabetes Preeclampsia is associated with pregnancy induced hypertension and proteinuria. Other symptoms of preeclampsia are increased protein:creatinine ratio, impaired liver function, renal insufficiency, pulmonary edema, and cerebral or visual symptoms. Valgus Stress Test (knee) Positive test indicated by excess valgus movement and may be indicative of MCL sprain. A positive test with knee in full extension may be indicative of damage to MCL, PCL, posterior oblique ligament, posteromedial capsule Classic carpal tunnel syndrome would result in: reduced abduction of the thumb Which of the following is considered a normal finding for a woman in her eighth month of pregnancy? Lordosis To assess muscle strength of the temporalis and masseter muscles, the examiner will ask the patient to: a. Push the jaw forward while the examiner applies counterforce b. Attempt to open the mouth while the examiner applies counterforce c. Clench the teeth while the examiner palpates the contracted muscles d. Clench the teeth together while the examiner attempts to open the mouth with a tongue blade While examining range of motion (ROM) on a patient, the examiner should remember that: a. reverse tailor position is encouraged in adults with limited ROM to the hip b. active ROM is used to assess extremities with complete paralysis c. full muscle strength can be maintained with up to 75% of ROM to the related joint. d. passive ROM is normally 5 degrees greater than active ROM. When the patient's head is rotated to the left and right, what is the examiner assessing? sternocleidomastoid muscle Injuries to long bones and joints are more likely to result in fractures than in sprains until: adolescence While the client is supine, you have him fully extend one leg flat. You then flex the other knee to his chest. You notice the extended leg rising off the examining table. What is this test called? Thomas test The spine of a newborn infant should be palpated with the examiner noting the shape of each spinal process. If a split is noted in one of the spinal processes, which problem is suspected a. Bifid defect b. Lordosis c. Down syndrome d. Spina bifida To assess spinal level C6, C7, and C8, which deep tendon reflex should be tested? Tricep The examiner is conducting an interview with the mother of an infant as part of the neurologic system examination. Which of the following responses made by the mother may indicate a need for further evaluation? a. "My baby sometimes falls asleep when I am feeding her." b. "My baby seems to jump when there is a loud noise in the room." c. "I drank a glass of wine about once a week while I was pregnant." d. "I had problems with hypertension the entire time I was pregnant." Which cranial nerve is responsible for sensation of the gag reflex and taste of the posterior one third of the tongue? IX, X A woman complains of weakness in the lower extremities. She is 2 days postpartum. Which of the following problems should the examiner consider? a. depression b. obstetric palsy c. encephalitis d. postpartum stroke The examiner observes a 6-month-old infant. Which of the following observations should be considered an expected finding at this age? The infant: a. walks around the room holding onto objects b. feeds self with cup and spoon c. holds a rattle or spoon d. sits without support. What Grade would be indicated or documented for "Normal" muscle strength? 5 When palpating joints, crepitus may occur when: a. irregular bony surfaces rub together b. supporting muscles are excessively spastic c. joints are excessively lax d. there is excess fluid within the synovial membrane. Crepitus is felt or heard when irregular bony surfaces rub together, when two rough edges of a broken bone rub together, or with the movement of tendon inside the tendon sheath when tenosynovitis is present Sam, is a 15 year old soccer player with pain and swelling in ins left knee. You suspect a torn meniscus in the left knee, what test would be performed to further confirm this diagnosis? McMurray Test During the primary assessment, the examiner asks the patient, "Can you tell me who you are?" This question assesses: a. Airway and orientation b. Disability and exposure c. Breathing and circulation d. Exposure and circulation What technique will most likely facilitate the exam of a small frightened child? a. Promise the child you won't hurt her b. Tell the child a story in order to distract her c. Use restraints to hold the child, but tell her you are playing a game with her d. Tell the child you will give her a toy or treat if she does not cry Why do we develop a differential diagnosis list? a. A differential diagnosis list enables appropriate testing to promote consideration of competing diagnoses, rule out possibilities and confirm a final diagnosis. b. A differential diagnosis list ensures that the most common possible diagnoses are considered and that rare and unusual diagnoses are not considered. c. A differential diagnosis list ensures that laboratory tests, biopsy, diagnostic imaging, or other investigations are done in a timely manner. d. As a list of credible disease processes that may cause the patient's problem, a differential diagnosis list allows the practitioner to maximize patient's charges. Which of the following should be used to test for near vision? a. rosenbaum chart b. snellen e chart c. confrontation test d. cover-uncover test Choose all of the correct clinical pearls related to lymph node assessment. a. Slow nodal enlargement over weeks and months are suggestive of benign processes; rapid enlargement without inflammation is suggestive of malignancy. b. The harder the node and more discreet, the more likely it is to be benign. c. The more tender the node, the more likely it is inflammation. d. If you detect a bruit, you are most likely assessing a blood vessel rather than a lymph node. e. Lymph nodes that are soft are significant for pathology, those that are rubbery classically indicate malignancy & granulomatous infection, and hard non-tender nodes are classically an indication of lymphoma. Which of the following techniques is incorrect and affects the accuracy of auscultation? a. Placing the stethoscope firmly on the surface to be auscultated b. Auscultating through clothing c. Isolating one sound at a time during auscultation d. Listening for sound characteristics Order of examination is important, when examining the newborn and infant which technique should the examiner begin with? a. percussion b. auscultation c. palpation d. inspection Mr. C's visual acuity is 20/70. What does this designation mean? a. can see 70% of what the average person can see at 20 feet b. he can see 20% of the letters on the chart's 20/70 line c. is legally blind d. can read letters while standing 20 feet away from the chart what the average person can see standing 70 feet away from the chart While assessing hearing, you time the client's hearing of the tuning fork sounds when the fork is on the mastoid process and when the fork is in front of the ear. What is the purpose of this test? a. It produces lateralization of sound in the good ear. b. It determines bone conduction of sound. c. It produces a comparison of air to bone conduction. d. It determines air conduction of sound. When performing a physical examination, you should consider the examination to begin: a. After the vital signs are taken b. After the patient has put on an exam gown c. As soon as you meet the patient d. After you explain to the patient everything that you are going to so The nurse is assessing a client's tonsils and note that they touch the uvula. The nurse would document this finding as which of the following? a. 1+ b. 2+ c. 3+ d. 4+ Which of the following best describes how the collection of a history should be done?