NURS 6512N Midterm Exam 1 -

Underestimation of blood pressure will occur if the blood pressure cuff's width covers: COVERS: MORE THAN TWO THIRDS OF THE UPPER ARM. Mrs. Hartzell is a 34-year-old patient who has presented for nutritional counseling because she is a vegetarian. Deficiency of which of the following is a concern in the vegetarian diet? PROTEINS, CALCIUM, IRON, B12, AND VITAMIN D The most superior part of the stomach is the: FUNDUS When recording physical findings, which data are recorded first for all systems? INSPECTION Mr. Kevin Marks is a new health care provider. What is the best method to develop cultural competence? REALIZE THE CULTURAL VALUES ARE DIFFICULT TO CHANGE AND MUST BE RESPECTED To perform the Rinne test, place the tuning fork on the: MASTOID When are open-ended questions generally most useful? DURING THE INITIAL PART OF THE INTERVIEW The review of systems is a component of the: PERSONAL AND SOCIAL HISTORY Fluorescing lesions are best distinguished using a(n): WOODSLAMP Pigmented, raised, warty lesions over the face and trunk should be assessed by an experienced practitioner who can distinguish: SEBORRHEIC KERATOSES FROM ACTINIC KERATOSES. Mr. Franklin is speaking with you, the health care provider, about his respiratory problem. Mr. Franklin says, "I've had this cough for 3 days, and it's getting worse." You reply, "Tell me more about your cough." Mr. Franklin states, "I wish I could tell you more. That's why I'm here. You tell me what's wrong!" Which caregiver response would be most appropriate for enhancing communication? AFTER 3 DAYS, YOU'RE TIRED OF COUGHING. HAVE YOU HAD A FEVER?" The term denoting the caregiver's need to do no harm to the patient is: DEONTOLOGIC IMPERATIVES. Recommended carbohydrate content of total dietary intake (% total calories) is %. 50% Mr. Abdul is a 40-year-old Middle Eastern man who presents to the office for a first visit with the complaint of new abdominal pain. You are concerned about violating a cultural prohibition when you prepare to do his rectal examination. The best tactic would be to: INFORM THE PATIENT OF THE REASON FOR THE EXAM AND ASK IF IT IS ACCEPTABLE TO HIM Your patient is complaining of acute, intense sharp epigastric pain that radiates to the back and left scapula with nausea and vomiting. Based on this history, your prioritized physical examination should be to: INSPECT FOR ECCHYMOSIS OF THE FLANK. When examining the skull of a 4-month-old baby, you should normally find: CLOSURE OF THE POSTERIOR FONTANEL Ms. G. is being seen for her routine physical examination. She is a college graduate and president of a research firm. Although her exact salary is unknown, she has adequate health insurance. Most of the above information is part of Ms. G.'s history. PERSONAL AND SOCIAL During an interview, tears appear in the patient's eyes and his voice becomes shaky. Initially, you should: KEEP THE INTERVIEW MOVING TO DISTRACT THE PATIENT Before performing an abdominal examination, the examiner should: HAVE THE PATIENT EMPTY HIS OR HER BLADDER The adult recommended dietary fat intake should be 35 g/day. Nuchal rigidity is most commonly associated with: MENINGITIS A serous membrane that lines the abdominal cavity and forms a protective cover for many abdominal structures is the: PERITONEUM A flat, nonpalpable lesion is described as a macule if the diameter is: LESS THAN 1CM Bulging of an amber tympanic membrane without mobility is most often associated with: MIDDLE EAR EFFUSION The position on a clock, topographic notations, and anatomic landmarks: METHODS FOR RECORDING LOCATIONS OF FINDINGS When assessing abdominal pain in a college-age woman, one must include: THE FIRST DAY OF THE LAST MENSTRUAL PERIOD. The infant should be placed in which position to have his or her height or length measured? SUPINE ON A MEASURING BOARD A fixed image of any group that rejects its potential for originality or individuality is known as a(n): STEREOTYPE Sweat glands, hair, and nails are all formed from: INVAGINATION OF EPIDERMIS INTO DERMIS MR. WALTERS, A 32-YEAR-OLD PATIENT, TELLS YOU THAT HIS EARS ARE "STOPPED UP." AN OBJECTIVE ASSESSMENT OF THIS COMPLAINT IS ACHIEVED BY USING THE: TYMPANOMETER Ms. Davis is a 27-year-old patient with a BMI of 33. Based on her BMI, your diagnosis would be: OBESE (over 30) Tracheal tug suggests the presence of a(n): AORTIC ANEURYSM Mr. Black is a 44-year-old patient who presents to the clinic with complaints of neck pain that he thinks is from his job involving computer data entry. As the examiner, you are checking the range of motion in his neck and note the greatest degree of cervical mobility is at: C 4 TO C 5: C4 AND C5 OR C5 AND C 6 PROVIDE THE GREATEST HORIZONTAL MOBILITY IN ADULTS The most common form of birth trauma of the scalp is: CAPUT SUCCEDANEUM Which question would be considered a leading question? YOU DON'T GET HEADACHES OFTEN, DO YOU?" A brief statement of the reason the patient is seeking health care is called the: CHIEF CONCERN Your patient is complaining of acute, intense sharp epigastric pain that radiates to the back and left scapula with nausea and vomiting. Based on this history, your prioritized physical examination should be to: INSPECT FOR ECCHYMOSIS OF THE FLANK. A tool used to screen adolescents for alcoholism is the: CRAFFT INCREASED TERMINAL HAIR FOLLICLES TO THE TRAGUS OF MEN'S EARS. (NOTE: TERMINAL HAIR IS LONG, THICK AND DARK) Mr. Johnson presents with a freely movable cystic mass in the midline of the high neck region at the base of the tongue. This is most likely a: THYROGLOSSAL DUCT CYST. When hearing is evaluated, which cranial nerve is being tested? CN VIII Mrs. Grace is a 58-year-old patient who has a diagnosis of pernicious anemia. Which B vitamin is deficient in patients with pernicious anemia? B12 Mr. Marks is a 66-year-old patient who presents for a physical examination to the clinic. Which question has the most potential for exploring a patient's cultural beliefs related to a health problem? "WHY DO YOU THINK YOU ARE HAVING THESE SYMPTOMS?" You are examining a pregnant patient and have noted a vascular lesion. When you blanche over the vascular lesion, the site blanches and refills evenly from the center outward. The nurse documents this lesion as a: TELANGIECTASIA A blood pressure cuff bladder should be long enough to: COVER 75% TO 80% OF THE ARM CIRCUMFERENCE A college student comes to the student health center complaining of difficulty in concentrating during class and while studying. The diet that would contribute to this problem is one that consumes mostly: CARBOHYDRATES ARE THE ONLY SOURCE OF FUEL FOR THE BRAIN AND CENTRAL NERVOUS SYSTEM. After thorough inspection of the abdomen, the next assessment step is: AUSCULTATION Mr. Mathews is a 47-year-old patient who presents for a routine physical examination. On examination, you have noted a bruit heard over the thyroid. This is suggestive of: HYPERTHYROIDISM During percussion, a dull tone is expected to be heard over: LIVER Which of the following occurs when firm pressure is used to apply the stethoscope's bell end-piece to the skin? IT FUNCTIONALLY CONVERTS TO A DIAPHRAGM END- PIECE. When communicating with older children and teenagers, you should be sensitive to their: TYPICAL RELUCTANCE TO TALK To approximate vocal frequencies, which tuning fork should be used to assess hearing? 500 TO 1000 HZ You are palpating a patient's thyroid and find that its broadest dimension measures 4 cm. The right lobe is 25% larger than the left. These data would indicate: THE DESCRIPTION IS MOST LIKELY A NORMAL FINDING When you are questioning a patient regarding alcohol intake, she tells you that she is only a social drinker. Which initial response is appropriate? WHAT AMOUNT AND WHAT KIND OF ALCOHOL DO YOU DRINK IN A WEEK? Expected normal percussion tones include: NORMAL LINGS PRODUCE RENAISSANCE PERCUSSION TONES Subjective and symptomatic data are: PLACED IN THE HISTORY SECTIONS You are collecting a history from an 11-year-old girl. Her mother is sitting next to her in the examination room. When collecting history from older children or adolescents, they should be: ALLOWED TO INTERVIEW W/O PARENT PRESENT. Which technique is most likely to result in the patient's understanding of questions? USE THE PATIENT'S OWN TERMS IF POSSIBLE. Mr. and Mrs. Johnson have presented to the office with their infant son with complaints of ear drainage. When examining an infant's middle ear, the nurse should use one hand to stabilize the otoscope against the head while using the other hand to: PULL THE AURICLE DOWN AND BACK IN AN EFFORT TO STRAIGHTEN THE UPWARD CURVATURE OF THE CANAL Unusual white areas on the skin may be due to: VITILIGO George Michaels, a 22-year-old patient, tells the nurse that he is here today to "check his allergies." He has been having "green nasal discharge" for the last 72 hours. How would the nurse document his reason for seeking care? GM IS A 22-YEAR-OLD MALE HERE FOR HAVING "GREEN NASAL DISCHARGE" FOR THE PAST 72 HOURS. To correctly document absent bowel sounds, one must listen continuously for: 5 MINUTES Which of the following formats would be used for visits that address problems not yet identified in the problem-oriented medical record (POMR)? BRIEF SOAP NOTE Which type of speculum should be used to examine a patient's tympanic membrane? THE LARGEST SPECULUM THAT WILL FIT COMFORTABLY IN EAR Ms. Jones is a 31-year-old female patient who presents for a routine physical examination. Which examination technique will be used first? INSPECTION In counseling a client regarding nutrition education, you explain that linoleic acid, a major fatty acid, is thought to be essential for: LINOLEIC ACID, FOUND ABUNDANTLY IN MILK AND DAIRY FAT, IS REQUIRED FOR NORMAL GROWTH AND DEVELOPMENT, IT HAS BEEN SUGGESTED THAT IT CAN REDUCE BODY FAT IN OVERWEIGHT PATIENT Mr. D. complains of a headache. During the history, he mentions his use of alcohol and illicit drugs. This information would most likely belong in the: PERSONAL AND SOCIAL HISTORY Peritonitis produces bowel sounds that are: DECREASED/HYPOACTIVE The recommended minimum daily protein requirement for the normal adult is . 14% TO 20% OF TOTAL CALORIES. As part of your health promotion education for a new patient, you explain that the risk factors for skin cancer include: FAIR-SKINNED PERSONS WITH LIGHT EYES WITH REPEATED TRAUMA OR SKIN IRRITATION HAVE HIGHER RISK FACTORS FOR SKIN CANCER DEVELOPMENT. Which is the best way to position a patient's neck for palpation of the thyroid? FLEXED TOWARD THE SIDE BEING EXAMINED When taking a history, you should: USE A CHRONOLOGIC AND SEQUENTIAL FRAMEWORK. Ms. Otten is a 45-year-old patient who presents with a complaint of weight gain. Which medication is frequently associated with weight gain? MEDICATIONS THAT CONTRIBUTE TO WEIGHT GAIN INCLUDE STEROIDS, ORAL CONTRACEPTIVES, ANTIDEPRESSANTS, AND INSULIN. Which of the following is an expected change in the assessment of the thyroid during pregnancy? A BRUIT IS AUSCULTATED D/T INCREASED VASCULARITY Brittle nails are typical findings in: OLDER ADULTS Regardless of the origin, discharge is described by noting: COLOR AND CONSISTENCY Nasal symptoms that imply an allergic response include: BLUISH GRAY TURBINATES. ("TURBINATES THAT APPEAR BLUISH GRAY OR PALE PINK WITH A SWOLLEN, BOGGY CONSISTENCY MAY INDICATE ALLERGIES" Mrs. Britton brings her 16-year-old son in with a complaint that he is not developing correctly into adolescence. Which structures disproportionately enlarge in the male during adolescence? IN THE MALE ADOLESCENT, THE NOSE AND THYROID CARTILAGE ENLARGE, AND FACIAL HAIR DEVELOPS, EMERGING FIRST ON THE UPPER LIP, THEN THE CHEEKS, LOWER LIP AND CHIN. Mr. Mills is a 55-year-old patient who presents to the office for an initial visit for health promotion. A survey of mobility and activities of daily living (ADLs) is part of a(an): FUNCTIONAL ASSESSMENT. Tangential lighting is best used for inspecting skin: CONTOUR A 5-year-old child presents with nasal congestion and a headache. To assess for sinus tenderness you should palpate over the: MAXILLARY SINUSES ONLY Tuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure: HEARING RANGE OF NORMAL SPEECH Which statement is true regarding the relationship of physical characteristics and culture? THERE IS A DIFFERENCE BETWEEN DISTINGUISHING CULTURAL CHARACTERISTICS AND DISTINGUISHING PHYSICAL CHARACTERISTICS. A guideline for history taking is for caregivers to: MAKE NOTES SPARINGLY SO THAT PATIENTS CAN BE OBSERVED DURING THE HISTORY TAKING A 17-year-old girl presents to the clinic for a sports physical. Physical examination findings reveal bradycardia, multiple erosions of tooth enamel, and scars on her knuckles. She appears healthy otherwise. You should ask her if she: BINGES AND VOMITS During an interview, you have the impression that a patient may be considering suicide. Which action is essential? KEEP THE INTERVIEW MOVING TO DISTRACT THE PATIENT Mrs. Leonard brings her newborn infant into the pediatrician's office for a first well- baby visit. As the health care provider, you teach her that newborns are more vulnerable to hypothermia due to: A POORLY DEVELOPED SUBCUTANEOUS FAT LAYER. Your patient returns for a blood pressure check 2 weeks after a visit during which you performed a complete history and physical. This visit would be documented by creating a(n): PROGRESS NOTE You are planning to palpate the abdomen of your patient. Which part of the examiner's hand is best for palpating vibration? ULNAR SURFACE In examining the neck of a 34-year-old female patient, you note that the uppermost ridge of the tracheal cartilage is at the: CRICOID You are using an ophthalmoscope to examine a patient's inner eye. You rotate the lens selector clockwise, then counterclockwise to compensate for: MYOPIA Your patient presents with symptoms that lead you to suspect acute appendicitis. Which assessment finding is least likely to be associated with this condition early in its course? CONSISTENT RIGHT LOWER QUADRANT PAIN Under normal circumstances, how much water is lost daily by the body? UNDER NORMAL CIRCUMSTANCES, APPROXIMATELY 2 TO 2.5 LITERS OF WATER IS LOST DAILY Tympanic thermometers measure body temperature when a probe is placed: EARDRUM (IN THE EAR) Which cranial nerves innervate the face? 5 AND 7 Which of the following is an "ABCD" characteristic of malignant melanoma? ASYMMETRIC BORDERS Mrs. Tuber is a 36-year-old patient who comes into the health center with complaints that her fingernails are not growing. Which structure is the site of new nail growth? MATRIX Which of the following is the most accurate reflection of an individual's food intake? FOOD DIARY A 51-year-old woman calls with complaints of weight loss and constipation. She reports enlarged hemorrhoids and rectal bleeding. You advise her to: COME TO THE LABORATORY FOR A STOOL GUAIAC TEST. White, rounded, or oval ulcerations surrounded by a red halo and found on the oral mucosa are: APHTHOUS ULCERS (CANKER SORES) When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? Saturday, October 6, 2018 8:53:52 PM EDT