NSG 6020 Final Exam 2022
A 65-year-old patient remarks that she just can’t believe that her breasts
sag so much. She states it must be from lack of exercise. What
explanation should the nurse offer her?
After menopause, the glandular and fat tissue atrophies, causing breast
size and elasticity to diminish, resulting in breasts that sag.
The mother of a 10-year-old boy asks the nurse to discuss the recognition
of puberty. The nurse should reply by saying:
“Puberty usually begins about age fifteen.”
“The first sign of puberty is enlargement of the testes.”
“Penis size does not increase until about the age of sixteen.”
"The development of pubic hair precedes testicular or penis enlargement.”
A patient has bilateral pitting edema of the feet. While assessing the
peripheral vascular system, the nurse's primary focus should be:
The correct answer is: Venous function of the lower extremities
During an examination, the nurse notes severe nystagmus in both eyes of
a patient. Which of the following conclusions is correct?
1. This is a normal occurrence.
2. This may indicate disease of the cerebellum or brainstem.
3. This is a sign that the patient is nervous about the examination.
,4. This indicates a visual problem and a referral to an ophthalmologist is
indicated.
End-point nystagmus at an extreme lateral gaze occurs normally. Assess
any other nystagmus carefully. Severe nystagmus occurs with disease of
the vestibular system, cerebellum, or brainstem.
When performing a musculoskeletal assessment, the nurse knows the
correct approach for the examination should be:
proximal to distal
A 43-year-old woman is at the clinic for a routine examination. She
reports that she has had a breast lump in her right breast for years.
Recently, it has begun to change in consistency and is becoming harder.
She reports that 5 years ago her physician evaluated the lump and
determined that it “was nothing to worry about.” The examination
validates the presence of a mass in the right upper outer quadrant at 1
o’clock, approximately 5 cm from the nipple. It is firm, mobile,
nontender, with borders that are not well defined.
The nurse’s recommendation to her is:
“Because of the change in consistency of the lump, it should be further
evaluated by a physician.”
The nurse practitioner is examining a 3-month-old infant. While holding
the thumbs on the infant's inner–mid-thighs and the fingers outside on
the hips, touching the greater trochanter, the nurse practitioner adducts
, the legs until the nurse practitioner's thumbs touch and then abducts the
legs until the infant's knees touch the table. The nurse practitioner does
not note any "clunking" sounds and is confident to record a:
Negative Ortolani's sign.
A patient's mother has noticed that her son, who has been to a new
babysitter, has some blisters and scabs on his face and buttocks. On
examination, the nurse notices moist, thin-roofed vesicles with a thin
erythematous base and suspects:
Impetigo
The nurse is testing superficial reflexes on an adult patient. When
stroking up the lateral side of the sole and across the ball of the foot, the
nurse notices the plantar flexion of the toes. How would the nurse
document this finding?
1.Positive Babinski sign
2.Plantar reflex abnormal
3.Plantar reflex present
4.Plantar reflex “2+” on a scale from “0 to 4+”
With the same instrument, draw a light stroke up the lateral side of the sole
of the foot and across the ball of the foot, like an upside-down “J.” The
normal response is plantar flexion of the toes and sometimes of the whole
foot.
A 65-year-old patient remarks that she just can’t believe that her breasts
sag so much. She states it must be from lack of exercise. What
explanation should the nurse offer her?
After menopause, the glandular and fat tissue atrophies, causing breast
size and elasticity to diminish, resulting in breasts that sag.
The mother of a 10-year-old boy asks the nurse to discuss the recognition
of puberty. The nurse should reply by saying:
“Puberty usually begins about age fifteen.”
“The first sign of puberty is enlargement of the testes.”
“Penis size does not increase until about the age of sixteen.”
"The development of pubic hair precedes testicular or penis enlargement.”
A patient has bilateral pitting edema of the feet. While assessing the
peripheral vascular system, the nurse's primary focus should be:
The correct answer is: Venous function of the lower extremities
During an examination, the nurse notes severe nystagmus in both eyes of
a patient. Which of the following conclusions is correct?
1. This is a normal occurrence.
2. This may indicate disease of the cerebellum or brainstem.
3. This is a sign that the patient is nervous about the examination.
,4. This indicates a visual problem and a referral to an ophthalmologist is
indicated.
End-point nystagmus at an extreme lateral gaze occurs normally. Assess
any other nystagmus carefully. Severe nystagmus occurs with disease of
the vestibular system, cerebellum, or brainstem.
When performing a musculoskeletal assessment, the nurse knows the
correct approach for the examination should be:
proximal to distal
A 43-year-old woman is at the clinic for a routine examination. She
reports that she has had a breast lump in her right breast for years.
Recently, it has begun to change in consistency and is becoming harder.
She reports that 5 years ago her physician evaluated the lump and
determined that it “was nothing to worry about.” The examination
validates the presence of a mass in the right upper outer quadrant at 1
o’clock, approximately 5 cm from the nipple. It is firm, mobile,
nontender, with borders that are not well defined.
The nurse’s recommendation to her is:
“Because of the change in consistency of the lump, it should be further
evaluated by a physician.”
The nurse practitioner is examining a 3-month-old infant. While holding
the thumbs on the infant's inner–mid-thighs and the fingers outside on
the hips, touching the greater trochanter, the nurse practitioner adducts
, the legs until the nurse practitioner's thumbs touch and then abducts the
legs until the infant's knees touch the table. The nurse practitioner does
not note any "clunking" sounds and is confident to record a:
Negative Ortolani's sign.
A patient's mother has noticed that her son, who has been to a new
babysitter, has some blisters and scabs on his face and buttocks. On
examination, the nurse notices moist, thin-roofed vesicles with a thin
erythematous base and suspects:
Impetigo
The nurse is testing superficial reflexes on an adult patient. When
stroking up the lateral side of the sole and across the ball of the foot, the
nurse notices the plantar flexion of the toes. How would the nurse
document this finding?
1.Positive Babinski sign
2.Plantar reflex abnormal
3.Plantar reflex present
4.Plantar reflex “2+” on a scale from “0 to 4+”
With the same instrument, draw a light stroke up the lateral side of the sole
of the foot and across the ball of the foot, like an upside-down “J.” The
normal response is plantar flexion of the toes and sometimes of the whole
foot.
