NU 650 through Midterm Exam

NU 650 through Midterm Exam A patient is seen in the office for amenorrhea, for which you obtain a urine pregnancy test in the office that returns negative. You would document this finding in which of the following sections of the encounter? A. HPI B. CC C. Subjective Data D. Objective Data D: Objective data A patient you are seeing for the first time in your office, brings their previous medical records for the review. you would document a summer of the previous medical records in which of the following sections of the encounter note? A. HPI B. CC C. Subjective Data D. Objective Data C: Subjective data The most effective process to elicit the ROS is for the NP to: A. Limit the ROS to systems related to the CC B. Follow the patients lead regarding the order of symptoms C. incorporate the ROS during the physical exam, stopping to make notes as necessary D. Start with general questions on each of the different body systems D The NP can determine higher cognitive function by asking the patient to perform which of the following tasks? A. Explain the meaning of a proverb B. Identify the day of the week, month, season, date and year C. Recall details of historical events D. Spell a five-letter word such as WORLD backward A The NP will ask the patient which of the following questions to assess for depression? A. have you ever been annoyed by other criticizing your alcohol use? B. Over the past two weeks have you felt little interest or pleasure in doing things? C. Over the past two weeks have you been unable to stop or control worrying? D. How often do you have contact with those that you care about or care about you? B The NP will document the reason for visit in which of the following sections of the encounter? A. HPI B. CC C. Subjective Data D. Objective Data B The primary care provider will anticipate that what percent of outpatients have mental health disorders? A. 10% B. 15 % C. 20% D. 25% C Which of the following actions by the NP demonstrations patient-centered interviewing techniques? A. Determine the personal context of the patients symptoms B. Focus on symptoms to identify a disease or condition C. Offer his or her perspective to lead the patients response D. Solicit information from the patients significant others A Which of the following strategies is most effective when dealing with an angry or disruptive patient? A. Allow the patient to disrupt the setting as needed to alleviate their anger B. Ask the patient to lower their voice and remain calm throughout the interview C. Reinforce the patients criticisms of other clinicians or the facility D. Validate the patients feelings without agreeing with their reasons. D Which of the following variables should have the greatest affect as to how the NP will conduct the H & PE of a child? A. The child's developmental level B. the child's chronological age C. The expected head to toe format and order of examination techniques D. The child's birth history A Match the primary skin lesion to the description A. Macule 1. Lesion is raised B. Papule 2. Lesion is raised 1 cm & fluid filled C. Plaque 3. Lesion is flat D. Vesicle 4. Lesion is raised, 1cm but not fluid filled E. Bullae 5. Lesion is raised Macule -- Lesion is Flat Papule -- lesion is raised Plaque -- lesion is raised, 1 cm but not fluid filled Vesicle -- lesion is raised Bullae -- lesion is raised, 1 cm and fluid filled A linear arrangement along a nerve distribution is a description of which type of skin lesion? A. Annular B. Zosteriform C. Keratitis D. Linear B A wood's lamp is especially useful in diagnosing __________ A. tine versicolor B. herpes zoster C. contact dermatitis D. All of the above A. tine versicolor (woods lamp helps diagnosis yeast infections) Mr. P. has had a "terrible itch" for several months that he has been scratching continuously. Upon examination, the nurse might expect to find: A. a keloid B. a fissue C. keratosis D. Lichenification D The NP has identified a solid, elevated, circumscribed lesion that is less than 1 cm in diameter and palpable into the dermis. This NP will correctly document this finding as a _________ A. bulla B. wheal C. nodule D. papule D Which of the following objective findings would alert the NP to consider skin cancer in the list of differential diagnoses? A. Annular and symmetrical lesions B. Blurred edges to a raised lesion C. solid red raised lesion D. Diameter of 5 mm B Which of the following secondary lesions is usually the result of a self-inflicted abrasion? A. Excoriation B. Scale C. Lichenification D. Atrophy A You have just read in the patient's chart that she has a lesion that is confluent in nature. On exam, you would expect to find: A. lesions that run together B. Angular lesions that have grown together C. Lesions arranged in a line along a nerve route D. Lesions that are grouped or clustered together A Which of the following represents the proper position for the NP to assess the patient's abdomen? A. Stand at the patient's left side and proceed in a systematic fashion. B. Stand at the patient's left side and assess any problem areas first C. Stand at the patient's right side and process in a systemic fashion D. Stand at the patient's right side and assess any problem areas first C The NP will demonstrate the correct order of examination for the abdomen by using examination techniques that follows: 1. Auscultation 2. Inspection 3. Palpation 4. Percussion A. 1-2-3-4 B. 2-3-4-1 C. 3-4-1-2 D. 2-1-3-4 D A 36-year-old female patient is seen in the clinic for a reported fever and back pain. She complained of pain when the NP percussed over the left CVA angle. This finding supports which of the following differential diagnosis? A. Pyelonephritis B. Left lower lobe pneumonia C. Splenomegaly D. Cholecystitis A The liver border can be palpated normally below the costal margin at the: A. Left mid-clavicular line B. Right mid-axillary line C. Right mid-calvicular line D. Left mid-axillary line C The NP will recognize which of the following subjective or objective findings as worrisome for an abdominal aortic aneurysm? A. aortic width of 2.8 cm B. 25 pack-year smoking history C. age of 60 D. Female gender B The NP will use which of the following examination techniques to determine muscular resistance, superficial organs and masses in the abdomen A. inspection B. light palpation C. deep palpation D. percussion B The NP will use which of the following methods to help the patient relax during the abdominal exam? A. ask the patient to hold their breath B. Palpate the abdomen after inspiration C. palpate the abdomen after expiration D. Palpate the abdomen using quick short movements C The parents of a 4-month-old infant share concern about their child's umbilical hernia at a well-child visit. The NP will correctly inform them that: A. Most umbilical hernias disappear by 12 months of age B. The hernia can be surgically repaired before the child reaches adolescence C. This finding indicates that their child is at high risk for other hernias D. There is a strong familial history for umbilical hernias A When percussing the abdomen in a patient with constipation, which of the following sounds would you expect to find in the LLQ? A. Tympanic B. Dull C. Resonant D. Hyperresonant B When percussing the abdomen, you would document the normal finding of percussion over the intestines as: A. Tympanic B. Dull C. Resonant D. Hyperresonant A Which of the following abdominal exam findings would prompt the NP to consider cholecystitis as a differential diagnosis? A. Positive psoas sign B. Positive Rovsing's sign C. Positive Obturator sign D. Positive murphy's sign D Which of the following symptoms would you expect from a young adolescent in the early phase of appendicitis? A. Abdominal pain two hours after eating B. CVA tenderness C. Severe RLQ pain with pallor and sweating D. Constipation C A 40 year old male patient presents with sinus pain, pressure and yellow nasal discharge. Your exam would include palpation of: A. Ethmoid and frontal sinuses B. Maxillary and sphenoid sinuses C. Frontal and maxillary sinuses D. Sphenoid and ethmoid sinuses C A 60 y.o presents with a 3-day history of left eye irritation. Which of the following findings should be recorded in the ROS? A. Patient denies eye pain or change in vision B. Vision is 20/20 by Snellen Chary C. Yellow crust is visible at the inner canthus of the left eye D. all of the above A During a physical exam of the throat, which of the following structures of the mouth/throat should rise when the patient says "aah"? A. Hard palate B. Soft palate C. Lingual frenulum D. Buccal mucosa B In conductive type hearing loss, you would expect: A. sound lateralizes to the good ear when the weber test is used B. sound lateralizes to the affected (bad) ear when the weber test is used C. The weber test remains unaltered with conductive type hearing loss and sound will be heard equally in both ears D. The weber test can cause discomfort in a patient with conductive type hearing loss and should not be used in this situation B On exam of the posterior pharynx, you are able to visualize the tonsils bilaterally extending just past the anterior and posterior pillars. According to the Friedman Scale, how would you document this finding in your note? A. tonsils noted to be normal B. Tonsils visualized grade 3 C. Tonsils visualized grade 1 D. Tonsils visualized grade 2 C The NP will assess visual acuity using which of the following tests? A. Snellen test B. Cover test C. Accommodation test D. Confrontation test A The NP will recognize which of the following findings when assessing the lymph nodes in the head and neck as worrisome, warranting further workup? A. Tender tonsillar and submandibular nodes in the presence of a streptococcal infection B. Any lymph node that the NP is able to roll in two directions: up and down, side to side C. Enlarged supraclavicular nodes D. Deep cervical chain nodes that are inaccessible to exam C When conducting an ophthalmoscopic exam, the NP will differentiate arteries from veins by noting: A. Larger size of arteries