NR 565 Exam Questions And Answers With Complete
Solution( Know This And Finish Already)
During a post-hospital discharge visit, you notice your 71 year old female patient has been
diagnosed with a "new murmur" found by the hospitalist during their recent
hospitalization for CHF exacerbation. In evaluating the patient, during which phase of the
cardiac cycle would you anticipate auscultation of a S3 or S4 heart sound? - Diastole
The point of maximum impulse (PMI) is most often palpable in healthy adults when
positioned in the supine or left lateral decubitus position. Which one of the following
locations is most commonly described as the PMI in a healthy adult? - left 5th ICS, MCL
The nurse practitioner assessing the patient with a rapid cardiac rhythm may assess for a
pulse deficit by auscultating the patient's heart while watching the EKG rhythm. Where
would the S1 heart sound correlate with the electrocardiographic waves? - Peak of the R
wave
Michael, a 72 year old male patient who previously presented with stable cardiac-type
chest pain has underwent a stress test. He presents today to review the stress test results,
which show EKG findings of ST segment depression during the exam in leads V3 and V4 as
well as some concurrent chest discomfort. Based on these findings, which of the following
are NOT priority medical decisions?
*Prescribe metoprolol (Lopressor) 12.5mg PO BID
*Prescribe aspirin 81mg PO daily
*Refer to cardiology for angiography
• Check for thyroid dysfunction - Check for thyroid dysfunction
Your newly established patient states in the past year, they have progressively developed a
noticeable bump on their neck and when asked about symptoms, they report feeling very
anxious, have developed a tremor, and are commonly feeling palpitations in their chest.On
examination, you identify an enlarged thyroid gland suspicious for a goiter. Of the following
diagnoses, which is most likely for the patient to develop based on these findings above? -
thyrotoxicosis
Your patient has a diagnosis of Addison's disease. Which of the following might you expect
to find during examination? - low body temperature
Your patient with a diagnosis of autoimmune hepatitis is beingseen in your clinic for
routine liver serology and follow-up examination. Which of the following correctly
identifies the normal liver span when percussing the liver of a HEALTHY adult? - 6-12 cm in
the right midclavicular line.
The 19 year old male patient presents with acute symptomsof abdominal pain and a history
of intermittent heartburn and spicy foodintolerance, as well as anxiety due to his college
,athletic performance. You have a concern the patient may have a perforated gastric ulcer
and is experiencing peritonitis. Which of the following exam findings is NOT supportive of
this diagnosis? - Absence of pain with withdrawal of palpation.
Your new patient intake history of an elderly man includes a history of Ehlers-Danlos with
complications of retinal detachment treated with gas pneumopexy. In discussing this
history, you recall the transparent mass of gelatinous material where the gas pneumopexy
is performed can be found in which chamber(s) of the eye? - Anterior only
While assessing the patient, you covered their right eye while you covered your left eye,
then brought a set number of fingers or wiggling fingers into each quadrant of the patient's
visual field while you had them identify when they saw your fingers/movement. A normal
exam would be documented as which of the following? - Normal Confrontation
A patient of Mediterranean descent who presents with microcytic anemia with normal red
cell distribution width should be evaluated using gel electrophoresis to confirm which of
the following types of anemia? - Thalassemia
The 43 year old male patient with macrocytic anemia should be evaluated for which of the
following lab levels to help narrow down the etiology? - Vitamin B12
While examining a 53 year old female patient, you auscultate abnormal breath sounds over
all fields, and now assess transmission of voice sounds by having the patient say "ee" while
auscultating the chest with the diaphragm of your stethoscope. Normally, you should
auscultate a muffled "e" sound, however, you hear hear a nasally "a" sound. Which one of
the following will you document is present?*Positive stereognosis.*Positive for
egophony.*Negative for bronchophony.*Negative for egophony - Positive for egophony
While assessing the 19 year old patient for a new onset cough, the nurse practitioner may
inspect, auscultate, palpate, and/or percuss.How does performing percussion of the thorax
assist the provider during the physical examination?*To assist with the confirmation of
cardiac origin of angina.*To assess for deep-seated lesion and tumors.*To assess for any
pain or discomfort prior to palpitation of the chest wall.*To identify if underlying tissue are
air-filled, fluid-filled or consolidated - To identify if underlying tissue are air-filled, fluid-
filled or consolidated
Your 42 year old male patient has been referred to your clinic for establishing care and on
his intake survey, you note he has documented diagnosis of interstitial lung disease. You
have decided to perform a diaphragmatic excursion test on the patient. Which one of the
following results would you expect to see in this patient? - Approximately equal level of
change in the descent of the diaphragm bilaterally during maximal inspiration and
expiration. with a decreased overall inspiratory capacity
Your 50 year old Caucasian male patient has not seen a primary care giver in 20+ years and
is here for a history and physical examination. While examining the head and face, you see
your patient has nonpitting periorbital edema, particularly underneath their eyes and very
, dry, thinned hair, including the lateral third of eyebrows (as pictured below: Sparse
hairline, thin lateral eyebrows, Periobital edema). Which one of the folowing would you
expect to cause this finding? - Severe hypothyroidism
A40 year old, female, African American patient presents for history and physical. Upon
your initial assessment, you notice she has severe exophthalmos as pictured below. Which
one of the following diagnoses below would be the highest on your differential diagnose of
this physical examination finding? (eyes bulging out of her head) - Hyperthyroidism.
Your patient with a suspected diagnosis of COPD has been seen by pulmonology and has
underwent a pulmonary function test (PFT) with spirometry. As the patient's primary
healthcare provider, you have been asked to explain the findings of the PFT to the patient
in afollow-up visit at which time the patient asks what the study was evaluating. To
describe the PFT to the patient in more useful terms, you state that the large inspiration of
air to the furthest extent they could reasonably accomplish followed by a full exhalation is
referred to as which of the following measurements during the PFT? - Forced Vital
Capacity.
Your 32 year old female patient presented for a routine health exam states they have a
diagnoses of hyperthyroidism by anotherprovider a year ago. In addition to evaluation with
TSH and T4 labwork, which of the following represent typical signs of hyperthyroidism
expected on your exam of this patient? - tachycardia
The nurse practitioner's evaluation of a patient with Diabetes Mellitus type 2 should
include which of the folowing while evaluatingfor end organ dysfunction of the disease?
*Renal function panel.*Urinalysis.*Non-dilated eye exam.*All of these are appropriate
options. - All of these are appropriate options.
The 33 year old male patient presents with complaints of abdominal pain after a recent
birthday party where other guests alsosuspected food borne illness and gastroenteritis. To
elicit the most accurate evaluation of this patient, which is the order of assessment which
should be done for the abdomen? - Inspection, auscultation, palpation, percussion
Your 22 year old male patient states during his review of systems thathis scrotum is very
enlarged and feels like it is full a powerlifter and works as a trash collector. You suspect the
patient likely has which of the following diagnoses? - Varicocele
Your 22 year old female patient is seeing you for complaints of sinus pressure and
congestion. Which one of the following sinuses should be palpated during your
examination? - Frontal
Your 49 year old male patient presents with weight loss, night sweats, anhedonia, and a
CXR showing profoundly enlarged hilar adenopathy. Based on these findings, a diagnosis of
lymphoma would be in your working differential. Which one of the following assessment
findings when palpating lymph nodes would be INCONSISTENT with this diagnosis? - Non-
tender, minimally palpable anterior cervical chain node palpation.
Solution( Know This And Finish Already)
During a post-hospital discharge visit, you notice your 71 year old female patient has been
diagnosed with a "new murmur" found by the hospitalist during their recent
hospitalization for CHF exacerbation. In evaluating the patient, during which phase of the
cardiac cycle would you anticipate auscultation of a S3 or S4 heart sound? - Diastole
The point of maximum impulse (PMI) is most often palpable in healthy adults when
positioned in the supine or left lateral decubitus position. Which one of the following
locations is most commonly described as the PMI in a healthy adult? - left 5th ICS, MCL
The nurse practitioner assessing the patient with a rapid cardiac rhythm may assess for a
pulse deficit by auscultating the patient's heart while watching the EKG rhythm. Where
would the S1 heart sound correlate with the electrocardiographic waves? - Peak of the R
wave
Michael, a 72 year old male patient who previously presented with stable cardiac-type
chest pain has underwent a stress test. He presents today to review the stress test results,
which show EKG findings of ST segment depression during the exam in leads V3 and V4 as
well as some concurrent chest discomfort. Based on these findings, which of the following
are NOT priority medical decisions?
*Prescribe metoprolol (Lopressor) 12.5mg PO BID
*Prescribe aspirin 81mg PO daily
*Refer to cardiology for angiography
• Check for thyroid dysfunction - Check for thyroid dysfunction
Your newly established patient states in the past year, they have progressively developed a
noticeable bump on their neck and when asked about symptoms, they report feeling very
anxious, have developed a tremor, and are commonly feeling palpitations in their chest.On
examination, you identify an enlarged thyroid gland suspicious for a goiter. Of the following
diagnoses, which is most likely for the patient to develop based on these findings above? -
thyrotoxicosis
Your patient has a diagnosis of Addison's disease. Which of the following might you expect
to find during examination? - low body temperature
Your patient with a diagnosis of autoimmune hepatitis is beingseen in your clinic for
routine liver serology and follow-up examination. Which of the following correctly
identifies the normal liver span when percussing the liver of a HEALTHY adult? - 6-12 cm in
the right midclavicular line.
The 19 year old male patient presents with acute symptomsof abdominal pain and a history
of intermittent heartburn and spicy foodintolerance, as well as anxiety due to his college
,athletic performance. You have a concern the patient may have a perforated gastric ulcer
and is experiencing peritonitis. Which of the following exam findings is NOT supportive of
this diagnosis? - Absence of pain with withdrawal of palpation.
Your new patient intake history of an elderly man includes a history of Ehlers-Danlos with
complications of retinal detachment treated with gas pneumopexy. In discussing this
history, you recall the transparent mass of gelatinous material where the gas pneumopexy
is performed can be found in which chamber(s) of the eye? - Anterior only
While assessing the patient, you covered their right eye while you covered your left eye,
then brought a set number of fingers or wiggling fingers into each quadrant of the patient's
visual field while you had them identify when they saw your fingers/movement. A normal
exam would be documented as which of the following? - Normal Confrontation
A patient of Mediterranean descent who presents with microcytic anemia with normal red
cell distribution width should be evaluated using gel electrophoresis to confirm which of
the following types of anemia? - Thalassemia
The 43 year old male patient with macrocytic anemia should be evaluated for which of the
following lab levels to help narrow down the etiology? - Vitamin B12
While examining a 53 year old female patient, you auscultate abnormal breath sounds over
all fields, and now assess transmission of voice sounds by having the patient say "ee" while
auscultating the chest with the diaphragm of your stethoscope. Normally, you should
auscultate a muffled "e" sound, however, you hear hear a nasally "a" sound. Which one of
the following will you document is present?*Positive stereognosis.*Positive for
egophony.*Negative for bronchophony.*Negative for egophony - Positive for egophony
While assessing the 19 year old patient for a new onset cough, the nurse practitioner may
inspect, auscultate, palpate, and/or percuss.How does performing percussion of the thorax
assist the provider during the physical examination?*To assist with the confirmation of
cardiac origin of angina.*To assess for deep-seated lesion and tumors.*To assess for any
pain or discomfort prior to palpitation of the chest wall.*To identify if underlying tissue are
air-filled, fluid-filled or consolidated - To identify if underlying tissue are air-filled, fluid-
filled or consolidated
Your 42 year old male patient has been referred to your clinic for establishing care and on
his intake survey, you note he has documented diagnosis of interstitial lung disease. You
have decided to perform a diaphragmatic excursion test on the patient. Which one of the
following results would you expect to see in this patient? - Approximately equal level of
change in the descent of the diaphragm bilaterally during maximal inspiration and
expiration. with a decreased overall inspiratory capacity
Your 50 year old Caucasian male patient has not seen a primary care giver in 20+ years and
is here for a history and physical examination. While examining the head and face, you see
your patient has nonpitting periorbital edema, particularly underneath their eyes and very
, dry, thinned hair, including the lateral third of eyebrows (as pictured below: Sparse
hairline, thin lateral eyebrows, Periobital edema). Which one of the folowing would you
expect to cause this finding? - Severe hypothyroidism
A40 year old, female, African American patient presents for history and physical. Upon
your initial assessment, you notice she has severe exophthalmos as pictured below. Which
one of the following diagnoses below would be the highest on your differential diagnose of
this physical examination finding? (eyes bulging out of her head) - Hyperthyroidism.
Your patient with a suspected diagnosis of COPD has been seen by pulmonology and has
underwent a pulmonary function test (PFT) with spirometry. As the patient's primary
healthcare provider, you have been asked to explain the findings of the PFT to the patient
in afollow-up visit at which time the patient asks what the study was evaluating. To
describe the PFT to the patient in more useful terms, you state that the large inspiration of
air to the furthest extent they could reasonably accomplish followed by a full exhalation is
referred to as which of the following measurements during the PFT? - Forced Vital
Capacity.
Your 32 year old female patient presented for a routine health exam states they have a
diagnoses of hyperthyroidism by anotherprovider a year ago. In addition to evaluation with
TSH and T4 labwork, which of the following represent typical signs of hyperthyroidism
expected on your exam of this patient? - tachycardia
The nurse practitioner's evaluation of a patient with Diabetes Mellitus type 2 should
include which of the folowing while evaluatingfor end organ dysfunction of the disease?
*Renal function panel.*Urinalysis.*Non-dilated eye exam.*All of these are appropriate
options. - All of these are appropriate options.
The 33 year old male patient presents with complaints of abdominal pain after a recent
birthday party where other guests alsosuspected food borne illness and gastroenteritis. To
elicit the most accurate evaluation of this patient, which is the order of assessment which
should be done for the abdomen? - Inspection, auscultation, palpation, percussion
Your 22 year old male patient states during his review of systems thathis scrotum is very
enlarged and feels like it is full a powerlifter and works as a trash collector. You suspect the
patient likely has which of the following diagnoses? - Varicocele
Your 22 year old female patient is seeing you for complaints of sinus pressure and
congestion. Which one of the following sinuses should be palpated during your
examination? - Frontal
Your 49 year old male patient presents with weight loss, night sweats, anhedonia, and a
CXR showing profoundly enlarged hilar adenopathy. Based on these findings, a diagnosis of
lymphoma would be in your working differential. Which one of the following assessment
findings when palpating lymph nodes would be INCONSISTENT with this diagnosis? - Non-
tender, minimally palpable anterior cervical chain node palpation.
