NUR 634 Advanced Health Assessment Midterm
+ Dunphy sign Correct Answers (sharp pain in RLQ elicited by
voluntary cough)
+ Obturator Sign Correct Answers right hypogastric pain,
irritation of obturator muscle by inflamed appendix: flex pt's
right thigh, bend knee, rotate leg internally to stretch obturator
muscle.
+ Psoas Sign: Correct Answers irritation of psoas muscle by
inflamed appendix, place hand above pt's right knee, ask pt to
raise thigh against hand, or flex leg at hip=pain.
+ Rovsing Sign: Correct Answers rebound tenderness in RLQ
during LLQ quick palpation.
5A's: assesses pt's readiness to quit smoking. Correct Answers
o Ask about tobacco use
o Advise to quit
o Assess willingness to attempt to quit
o Assist in quitting attempt
o Arrange follow up
Abducens (CNVI) Correct Answers Movement of lateral rectus
muscle, moves eye laterally.
Achalasia Correct Answers LES does not open during
swallowing.
,Actinic keratosis: Correct Answers precancerous scaly
erythematous papules 2-5mm come and go on sun- exposed
areas, tx: Cryotherapy. May progress to nonmelanoma skin
cancer.
Actinic Purpura: Correct Answers purple patches or macules
on back of hands & forearms in elderly-fade over time.
Acute Iririts Correct Answers deep aching pain in eye, small,
irregular pupil, decreased vision, photophobia, caused by Herpes
Zoster or tb.
Acute symptomatic seizures: Correct Answers caused by head
trauma, alcohol, cocaine, withdrawal from alcohol,
benzodiazepines, barbiturates, hypoglycemia, hypocalcemia,
hyponatremia, stroke, encephalitis or meningitis.
Allen Test: Correct Answers compares patency of ulnar &
radial arteries. Ask pt to make fist, compress both radial & ulnar
artery, ask pt to open hand, palm is now pale, release pressure
over ulnar artery, if artery is patent, hand turns red in 3 seconds.
Alopecia Areata: Correct Answers sudden onset, clearly
demarcated, localized oval patches of hair loss leaving smooth
skin, no scaling or erythema.
Amblyopia Correct Answers Reduction in vision causing loss
of binocular vision from cataracts or untreated strabismus
(cross-eyed detected with cover-uncover test or Hirschberg Test-
will show asymmetric light reflex, pt c/o diplopia).
,Anemia of Chronic Disease: Correct Answers normochromic,
normocytic, caused by chronic systemic infection, inflammation,
or malignancy, or decreased erythropoietin in kidney failure.
RDW: normal, MCV: normal.
Angina Pectoris (stable angina): Correct Answers temporary
myocardial ischemia from coronary atherosclerosis, retrosternal
pain or across chest radiating to lower jaw, neck, epigastric,
pressing, squeezing, heavy, lasting 3-10 min, worse w/ exertion
or stress, alleviated by rest and nitro.
Angry patient Correct Answers acknowledge situation, try to
make amends, avoid reinforcing criticism of other clinicians, do
not make them lower voice at first, hear them 1st.
Anxiety: Correct Answers Generalized Anxiety Disorder-
excessive worry over 6-months, social phobia- anticipatory
anxiety in social situations, panic disorder-panic attacks, PTSD-
re- experiencing traumatic event, avoidance, or persistent
negative mood.
Aortic Regurgitation: Correct Answers high pitched,
decrescendo, LSB, "crushing" angina, dyspnea, bounding
pulses.
Aortic Stenosis: Correct Answers systolic ejection @ URSB,
crescendo-decrescendo best
heard leaning forward.
APETM Correct Answers Aortic: right 2nd intercostal space.
Pulmonic: left 2nd intercostal space
, Erbs: left 3rd intercostal space
Tricuspid: near left lower sternal border, 4th intercostal space
Mitral: PMI, 5th intercostal space, midclavicular line.
Aphasia: Correct Answers unable to speak or understand. If
Wernicke=temporal lobe lesion, unable to
understand/comprehend, speak fluently. Brocas=frontal lobe
lesion, unable to speak, speech is nonfluent, slow w/few words.
Aphonia Correct Answers loss of voice r/t laryngitis or CN X
paralysis.
Appendicitis: Correct Answers Inflammation of appendix
w/distention or obstruction, poorly localized periumbilical pain
migrating to RLQ at McBurney's Point: between umbilicus &
anterior superior iliac spine, if pain subsides=perforation, N/V
from pain.
Asteatosis: Correct Answers Dry, flaky, rough, itchy skin.
Asthma: Correct Answers reversible airflow obstruction w/
bronchial hyperresponsiveness & inflammation.
Percussion=resonant to diffusely hyperresonant, breath
sounds=wheezes or possible crackles, tactile fremitus decreased.
S/S: expiratory wheezing, chest tightness, dry cough, hx:
allergies.
Athetosis: Correct Answers slow/twisting movements of hands
from spasticity or cerebral palsy.
+ Dunphy sign Correct Answers (sharp pain in RLQ elicited by
voluntary cough)
+ Obturator Sign Correct Answers right hypogastric pain,
irritation of obturator muscle by inflamed appendix: flex pt's
right thigh, bend knee, rotate leg internally to stretch obturator
muscle.
+ Psoas Sign: Correct Answers irritation of psoas muscle by
inflamed appendix, place hand above pt's right knee, ask pt to
raise thigh against hand, or flex leg at hip=pain.
+ Rovsing Sign: Correct Answers rebound tenderness in RLQ
during LLQ quick palpation.
5A's: assesses pt's readiness to quit smoking. Correct Answers
o Ask about tobacco use
o Advise to quit
o Assess willingness to attempt to quit
o Assist in quitting attempt
o Arrange follow up
Abducens (CNVI) Correct Answers Movement of lateral rectus
muscle, moves eye laterally.
Achalasia Correct Answers LES does not open during
swallowing.
,Actinic keratosis: Correct Answers precancerous scaly
erythematous papules 2-5mm come and go on sun- exposed
areas, tx: Cryotherapy. May progress to nonmelanoma skin
cancer.
Actinic Purpura: Correct Answers purple patches or macules
on back of hands & forearms in elderly-fade over time.
Acute Iririts Correct Answers deep aching pain in eye, small,
irregular pupil, decreased vision, photophobia, caused by Herpes
Zoster or tb.
Acute symptomatic seizures: Correct Answers caused by head
trauma, alcohol, cocaine, withdrawal from alcohol,
benzodiazepines, barbiturates, hypoglycemia, hypocalcemia,
hyponatremia, stroke, encephalitis or meningitis.
Allen Test: Correct Answers compares patency of ulnar &
radial arteries. Ask pt to make fist, compress both radial & ulnar
artery, ask pt to open hand, palm is now pale, release pressure
over ulnar artery, if artery is patent, hand turns red in 3 seconds.
Alopecia Areata: Correct Answers sudden onset, clearly
demarcated, localized oval patches of hair loss leaving smooth
skin, no scaling or erythema.
Amblyopia Correct Answers Reduction in vision causing loss
of binocular vision from cataracts or untreated strabismus
(cross-eyed detected with cover-uncover test or Hirschberg Test-
will show asymmetric light reflex, pt c/o diplopia).
,Anemia of Chronic Disease: Correct Answers normochromic,
normocytic, caused by chronic systemic infection, inflammation,
or malignancy, or decreased erythropoietin in kidney failure.
RDW: normal, MCV: normal.
Angina Pectoris (stable angina): Correct Answers temporary
myocardial ischemia from coronary atherosclerosis, retrosternal
pain or across chest radiating to lower jaw, neck, epigastric,
pressing, squeezing, heavy, lasting 3-10 min, worse w/ exertion
or stress, alleviated by rest and nitro.
Angry patient Correct Answers acknowledge situation, try to
make amends, avoid reinforcing criticism of other clinicians, do
not make them lower voice at first, hear them 1st.
Anxiety: Correct Answers Generalized Anxiety Disorder-
excessive worry over 6-months, social phobia- anticipatory
anxiety in social situations, panic disorder-panic attacks, PTSD-
re- experiencing traumatic event, avoidance, or persistent
negative mood.
Aortic Regurgitation: Correct Answers high pitched,
decrescendo, LSB, "crushing" angina, dyspnea, bounding
pulses.
Aortic Stenosis: Correct Answers systolic ejection @ URSB,
crescendo-decrescendo best
heard leaning forward.
APETM Correct Answers Aortic: right 2nd intercostal space.
Pulmonic: left 2nd intercostal space
, Erbs: left 3rd intercostal space
Tricuspid: near left lower sternal border, 4th intercostal space
Mitral: PMI, 5th intercostal space, midclavicular line.
Aphasia: Correct Answers unable to speak or understand. If
Wernicke=temporal lobe lesion, unable to
understand/comprehend, speak fluently. Brocas=frontal lobe
lesion, unable to speak, speech is nonfluent, slow w/few words.
Aphonia Correct Answers loss of voice r/t laryngitis or CN X
paralysis.
Appendicitis: Correct Answers Inflammation of appendix
w/distention or obstruction, poorly localized periumbilical pain
migrating to RLQ at McBurney's Point: between umbilicus &
anterior superior iliac spine, if pain subsides=perforation, N/V
from pain.
Asteatosis: Correct Answers Dry, flaky, rough, itchy skin.
Asthma: Correct Answers reversible airflow obstruction w/
bronchial hyperresponsiveness & inflammation.
Percussion=resonant to diffusely hyperresonant, breath
sounds=wheezes or possible crackles, tactile fremitus decreased.
S/S: expiratory wheezing, chest tightness, dry cough, hx:
allergies.
Athetosis: Correct Answers slow/twisting movements of hands
from spasticity or cerebral palsy.
