NR 509 Advanced Physical Assessments (Spring 2022) LATEST NR 509 Shadow Health UPDATED QUESTIONS AND ANSWERS

NR 509 Advanced Physical Assessments (Spring 2022) LATEST NR 509 Shadow Health UPDATED QUESTIONS AND ANSWERS 1. NR 509 Week 2 Shadow Health: HEENT Physical Assessment 2. NR 509 Week 2 Shadow Health: Respiratory Physical Assessment 3. NR 509 Week 3 Shadow Health: Musculoskeletal Physical Assessment 4. NR 509 Week 3 Shadow Health: Neurological Physical Assessment 5. NR 509 Week 4 Shadow Health: Cardiovascular Physical Assessment 6. NR 509 Week 5 Shadow Health: Gastrointestinal Physical Assessment 7. NR 509 Week 6 Shadow Health: Mental Health Physical Assessment NR 509 Week 2 Shadow Health: HEENT Physical Assessment – Suppose you had found that Tina’s pupils were reactive to both direct and consensual light, yet unequal in size. Which condition would you suspect? Imagine that, during your physical exam with Tina, you had palpated an enlarged left supraclavicular lymph node. What would this finding have indicated? If you had observed Arteriovenous (AV) nicking during the retinal exam on Tina, what would you have seen? Suppose that you had detected a click while palpating Tina’s temporomandibular joint (TMJ). What could have been the cause? If Tina had reported new onset ear pain, what would have been the most useful finding to determine otitis media? Imagine that you inspected Tina’s throat and noted that her tonsils touched each other. How would you grade her tonsils on the tonsillar hypertrophy grading scale? NR 509 Week 2 Shadow Health: Respiratory Physical Assessment If Tina had mentioned that she was just diagnosed with pneumonia, what would you have expected to find during percussion? If the results of Tina’s pulse oximetry had been 97%, which of the following would have been true? Suppose that, during your lung exam on Tina, you had heard bronchial breath sounds in the left lower lung posteriorly. What would you have suspected based on this finding? Suppose that while auscultating, you assessed a few scattered expiratory wheezes. Why would this … an expected finding for a patient with Tina’s history? When you observe a patient like Tina throughout an exam, there are many ways to determine whether a patient is experiencing respiratory distress. Identify one indicator of respiratory distress that can … assessed through observation alone. Describe how you would assess Tina for dyspnea. NR 509 Week 3 Shadow Health: Musculoskeletal Physical Assessment If you were assessing range of motion (ROM) for a healthy 28-year-old woman with no known joint issues, which of the following would indicate limited ankle ROM? When palpating joints in a musculoskeletal exam, crepitus indicates: Imagine that Tina has hard painless bumps on the dorsolateral aspects of the distal interphalangeal joints that had limit flexion during a range of motion test. How would you have documented these abnormalities? Describe the major differences in acute versus passive range of motion (ROM) when distinguishing between an articular and nonarticular joint issue. What would be some of the ways in which you could assess Tina for suspected lumbar radiculopathy? Explain the difference between a sprain and a strain NR 509 Week 3 Shadow Health: Neurological Physical Assessment To assess spinal levels L2, L3 and L4 in Tina, which deep tendon reflexes would have to … tested? Imagine that you were preparing to irrigate a Foley catheter of a patient with a spinal cord injury at T4 in a urology clinic. Upon moving the leg bag, the patient became suddenly flushed and diaphoretic above the nipple line. What would you suspect was happening? Which of the following is not a common symptom of Parkinson’s disease? Name at least three ways to assess cerebellar function during a physical exam If Tina had a fever and photophobia, you would have had to test for meningitis. Describe how you would have tested for the Kernig’s sign Suppose you assessed pain sensation over Tina’s left foot, and noticed that she had decreased sensation. How would you have proceeded with your exam? NR 509 Week 4 Shadow Health: Cardiovascular Physical Assessment In order to determine which heart sound is S1, which of the following should you assess? The assessment of Jugular Venous Pressure (JVP) correlates with: Tina had brisk capillary refill (less than 3 seconds). What does this mean? Describe where on the body and when in the cardiac cycle you are most likely to auscultate a murmur caused by mitral valve prolapse. Imagine you had heard a murmur on Tina. Why would it have been important to ask Tina to change positions while auscultating the heart? You decide to order an arterial blood gas on Tina. Which physical exam test should you perform before drawing blood from the radial artery? NR 509 Week 5 Shadow Health: Gastrointestinal Physical Assessment Which of the following physical exam tests could … used if you suspected cholecystitis in Tina? Suppose that you were concerned that Tina may have had an enlarged spleen. How would you have proceeded? During a gastrointestinal exam, the purpose of light palpation of the abdomen is to: If you had heard bowel sounds occurring about 15 times per minute in 1-2 quadrants while examining Tina, what would have been the significance of this finding? Imagine that you had heard a swishing sound while auscultating Tina’s epigastric region. Identify where this bruit would have been likely to originate. Suppose that after examining Tina, you were concerned she may have peritonitis. How would you have assessed Tina to confirm your diagnosis? NR 509 Week 6 Shadow Health: Mental Health Physical Assessment If you had asked Tina to tell you the meaning of the proverb “Don’t cry over spilled milk,” what would you have been assessing? Suppose that Tina had been unable to identify the pen you were holding. What is the name of this symptom? Which of the following is a component of assessing cognition? Distinguish between inappropriate affect and appropriate affect, and provide an example of each. Identify the components (domains) of a comprehensive mental status exam. Imagine that Tina’s family member reported to you that she had been acting confused on and off for the last two days. Identify at least two key features of delirium. Describe why you would assess for delirium.