NR 302 HEALTH ASSESSMENT FINAL EXAM EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS | 100% PASS (A+ CERTIFIED)

NR 302 HEALTH ASSESSMENT FINAL EXAM EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS | 100% PASS (A+ CERTIFIED) 1. The retinal structures viewed through the ophthalmoscope are optic disc, vessels, macula, background 2. "Positive consensual light reflex" means...: simultaneous constriction 3. The thickening and yellowing of the lens due to aging is described as cataract 4. Eye emergency sudden change in vision 5. Visual acuity is assessed with Snellen eye chart 6. The cover test is used to assess for muscle weakness 7. When using the ophthalmoscope, you would remove your own glasses and approach the patient's left eye with your left eye 8. The 6 eye muscles that control eye movement are innervated by cranial nerves III, IV, VI 9. Conjunctivitis redness of the conjunctiva 10. normal peripheral vision would see finger at 90 degrees 11. patient blind in left eye, what happens when light in right both constrict 12. interruption of red reflex happens when there is opacity of cornea or lens 13. One cause of visual impairment in aging adults is glaucoma 14. PERRLA pupils equal, round, reactive to light and accommodation 15. cause of red reflex light reflecting from the retina 16. color of tympanic membrane pearly gray 17. sensioneural hearing loss related to gradual nerve degeneration 18. Before ear exam, palate pinna, tragus, and mastoid process 19. Ear exam of 3 year old pull pinna down 20. ear exam of adult pull pinna up and back 21. darwin tubercle a congenital, painless nodule at the helix 22. when assessing patients ear tilt head away from examiner 23. The hearing receptors are located in the cochlea 24. The sensation of vertigo may indicate pathology in the semicircular canals 25. common cause of conductive hearing loss impacted cerumen 26. Signs of ear infection absent light reflex, red and bulging drum 27. Reducing risk of ear infection dont smoke in house or car 28. assessing hearing in babies watch for head turn when you call their name 29. patient w head injury has clear watery drainage from ear consider possible basal skull fracture, refer immediately 30. common site of nose bleeds kiesselbach plexus 31. Which sinuses can you assess through examination? frontal and maxillary 32. the frenulum is the midline fold of tissue that connects the tongue to the floor of the mouth 33. The largest salivary gland is located within the cheeks in front of the ear 34. old woman with dry mouth medication 35. find a deviated septum, what next document in case it needs suction 36. Oral malignancies are most likely to develop in the mucosal "gutter" under the tongue 37. tonsils 3+: tonsils touch the uvula 38. function of nasal turbinates warm the inhaled air 39. Opening of adult's parotid gland is opposite what? upper 2nd molar 40. A nasal polyp is distinguished from the nasal turbinates by 3 things moveable, pale/gray, nontender 41. The examiner notes small, round, white, shiny papules on the hard palate and gums of a 2-month-old infant. What is the significance of this finding? epstein pearls, normal 42. when assessing tongue palpate u shaped area under tongue 43. expected finding of 75 year old oral cavity decreased ability to identify odors 44. african american with flat, 3cm, nontender, gray/white lesion on bucal mucosa leukodema, normal 45. The manubriosternal angle is the articulation of the manubrium and the body of the sternum 46. description of left lung narrower than the right lung with two lobes 47. Documentation of cough productive cough for at least 3 months throughout the year, happens last two years 48. Confirm symmetric chest expansion -Place hands on posterior chest wall thumbs at T9 or T10 slide medially pinch up skin between thumbs 49. Auscultation of breath sounds Hold the diaphragm of the stethoscope against the chest wall; listen to one full respiration in each location, being sure to do side to side comparisons 50. Bronchiovesicular breath sounds medium-pitched, moderately loud sounds heard over the main- stem bronchi; inspiration = expiration 51. Fever, increased respiratory rate, chest expansion decresed on left side, dull to percussion over left low lobe, loud breath sounds w crackles on low left lobe lobar pneumonia 52. angle of nail is less than 160 and spongy, indicates-: congenital heart disease and COPD 53. Coarse and low pitched sound heard on inspiration and expiration and accompanied by pain with breathing.: Pleural friction rub 54. egophony test: patient says "eeee" when diaphragm moved 55. Examine for tactile fremitus palpate chest symmetrically 56. pulse oximetry measure arterial oxygen saturation of hemoglobin 57. pleural friction rub best detected by auscultation 58. A barrel-shaped chest is characterized by equal anteroposterior transverse diameter and ribs being horizontal 59. Apex 3 to 4cm above inner third of clavicles 60. base rests on diaphragm 61. Lateral left 6th rib, midclavicular line 62. lateral right fifth intercostal 63. posterior apex C7 64. normal chest Elliptic shape with an anteroposterior to transverse diameter in the ratio of 1:2 65. barrel chest: anteroposterior = transverse diameter 66. pectus excavatum: sunken sternum and adjacent cartilages 67. pectus carinatum: forward protrusion of the sternum 68. Scoliosis: abnormal lateral curvature of the spine 69. kyphosis: excessive outward curvature of the spine, causing hunching of the back. 70. the precordium is: the area on the anterior chest overlying the heart and great vessels 71. Description of Tricuspid Valve: right atrioventricular valve 72. function of pulmonic valve: protect the orifice between the right ventricle and the pulmonary artery 73. atrial systoles occurs during: ventricular diastole 74. second heart sound is result of: closing of the aortic and pulmonic valves 75. Abnormal finding of jugular venous pressure: patient elevated to 45 degrees , Internal jugular vein pulsation at 4 cm above sternal angle 76. normal sized apical impulse: 1 x 2 cm 77. Auscultation of Pulmonic Area: 2nd intercostal space 78. what differentiates a split s2 from s3: S3 is lower pitched and is heard at the apex 79. assessment to rule out pericardial friction rub: listen with diaphragm, patient sitting up and leaning forward, holding breath in expiration 80. First step in auscultating the heart: identify S1 and S2 81. You will hear a split S2 most clearly in which area?: pulmonic 82. bell should be pressed lightly against skin so that: is does not act as a diaphragm 83. A murmur heard after S1 and before S2 is classified as systolic, possibly benign 84. Assessment of carotid artery: palpate medial to sternomastoid muscle, one side at a time 85. S1 is best heard at the _____ of the heart, whereas S2 is loudest at the _____ of the heart. S1 coincides with the pulse in the _____ and coincides with the ______ wave if the patient is on an ECG monitor.: S1 heard at apex, S2 at base, S1 pulse coinsides with carotid artery and R wave 86. tough, fibrous, double-walled sac that surrounds and protects the heart: peri- cardium 87. thin layer of endothelial tissue that lines the inner surface of the heart chambers and valves: endocardium 88. reservoir for holding blood: atrium 89. ensures smooth, friction-free movement of the heart muscle: pericardial fluid 90. Muscular pumping chamber: ventricle 91. muscular wall of heart: myocardium 92. Biomedical model: the Western European/North American tradition that views health as the absence of disease 93. The concept of health and healing has evolved in recent years. Which is the best description of health?: Health depends on an interaction of mind, body, and spirit within the environment 94. What would be included in a database for a new patient admission to surgical unit?: All subjective and objective data, data gathered from patient, and results of any labs or imagine 95. You are reviewing assessment data of a 45 year old male patient and note pain of 8/10, labored breathing and pale. This documentation is an example of: data cluster 96. A patient is in the emergency department with nausea and vomiting. Which would you include in the database?: A diet and GI history 97. A patient has recently received health insurance and would like to know how often to see his provider. How do you respond?: Your visits may very, depending on your level of wellness 98. You are reviewing concepts related to steps in the nursing process for determining prioritization and developing patient outcomes. To what are these actions attributed?: planning 99. Which best describes evidence based practice?: Combining clinical expertise with the use of nursing research to provide the best care for patients while considering the patient's values and circumstances 100. What can be determined when the nurse clusters data as part of the criti- cal-thinking process?: The nurse recognizes relevant information among the data 101. A patient says she is very nervous and nauseated, and she feels as if she will vomit. This is what type of data?: Subjective 102. The expert nurse differs from the novice nurse by acting without consciously thinking about the actions. This is referred to as: intuition 103. Which would be considered a risk diagnosis?: Identifying potential problems the individual may develop 104. Which would be included in a holistic model of assessment?: A patient's perception of his or her health status 105. The nurse uses health promotion activities with a new patient. What would this focus include?: The nurse would empower the patient to choose a healthier lifestyle. 106. Which is an example of objective date? History Medications Last period 2- x 5cm scar present on R lower forearm: 2- x 5cm scar on R lover forearm 107. During the evaluation phase of the nursing process, which action would be included?: Including patient and family members 108. Acculturation: process of social and psychological exchanges with encounters between persons of different cultures, resulting in changes in either group 109. cultural and linguistic competence: a set of congruent behaviors, attitudes, and policies that come together in a system among professionals that enables work in cross cultural situations 110. folk healer: lay healer in the person's culture apart from the biomedical or scientific health care system 111. Title VII of the Civil Rights Act of 1964: a federal law that mandates that when people with limited english proficiency seek health care in health care settings can not be denied to them. 112. Which statement best described religion?: an organized system of beliefs concerning the cause, nature, and purpose of the universe 113. The major factor contributing to the need for cultural care nursing is demographic change