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at Arlington -NURS 5334
A young woman undergoes cranial nerve testing. On touching the soft
palate, her uvula deviates to the left. Which of the following is likely?
A) CN IX lesion on the left
B) CN X lesion on the left
C) CN IX lesion on the right
D) CN X lesion on the right
D) CN X lesion on the right
In cranial nerve X paralysis, the soft palate fails to rise and the uvula
deviates to the opposite side.
When performing posterior palpation of the thyroid gland, you should
do all fo the following, EXCEPT:
A) Have the patient tip his or her head forward and slightly to the side.
B) Place your index fingers above the cricoid cartilage.
C) Palpate between the sternocleidomastoid muscle and the trachea for
the lobes of the thyroid.
D) Move your fingers laterally to palpate for the thyroid lobes.
B) Place your index fingers above the cricoid cartilage.
Place the fingers of both hands on the patient's neck so that your index
fingers are just BELOW the cricoid cartilage.
,You are interviewing an elderly woman in the ambulatory setting and
trying to get more information about her urinary symptoms. Which of
the following techniques is NOT a component of guided questioning?
A) Reassuring the patient that the urinary symptoms are benign and that
she doesn't need to worry about it being a sign of cancer.
B) Offering the patient multiple choices in order to clarify the character
of the urinary symptoms she is experiencing.
C) Asking her to tell you what she means when she states that she has a
urinary tract infection.
D) Directed questioning starting with the general and proceeding to the
specific in a manner that does not make the patient give a yes/no
answer.
A) Reassuring the patient that the urinary symptoms are benign and that
she doesn't need to worry about it being a sign of cancer.
Bates p 59, 69-71
,Mrs. T. comes for her regular visit to the clinic. She is on your schedule
because her regular provider is on vacation and she wanted to be seen.
You have heard about her many times from your colleague and are
aware that she is a very talkative person. Which of the following is a
helpful technique to improve the quality of the interview for both the
provider and the patient?
A) Allow the patient to speak uninterrupted for the duration of the
appointment.
B) Briefly summarize what you heard from the patient in the first 5
minutes and then try to have her focus on one aspect of what she told
you.
C) Set the time limit at the beginning of the interview and stick with it, no
matter what occurs in the course of the interview.
D) Allow your impatience to show so that the patient picks up on your
nonverbal cue that the appointment needs to end.
B) Briefly summarize what you heard from the patient in the first 5
minutes and then try to have her focus on one aspect of what she told
you.
Give the patient free rein for the first 5-10 minutes, listening closely to
the conversation. Focus on what seems most important to the patient.
Learn to set limits when needed. A brief summary may help you change
the subject yet validate any concerns. Do no show your impatience.
, Which of the following will help to optimize success from a pediatric
examination?
A) Doing the examination out of order if necessary to take advantage of
quiet periods for auscultation, etc.
B) Being very orderly, so as not to miss a portion of the examination.
C) Using firmness throughout your examination, letting the child know
you are in charge.
D) Making sure to place the infant on the table during the examination
while Mom watches close by.
A) Doing the examination out of order if necessary to take advantage of
quiet periods for auscultation, etc.
With certain exceptions, physical examination does not require use of
the examining table, or with the child in a parent's lap. Plan the
examination to start with the least distressing procedures and end with
the most distressing, usually involving the throat and ears. Patience,
distraction, play flexibility in the order of the examination, and caring but
firm approach are all key to successfully examining the young child.