NU 673 Assessment Midterm
1. A patient is suspected to have COPD. The APRN instructs the patient to take a deep breath in, and then with his mouth open,
breathe out as fast and completely as he can. For what is the APRN checking?
A. Whispered pectoriloquy
B. Forced expiratory time
C. Egophony
D. Tactile fremitus: B. Forced expiratory time
2. A pt presents to the clinic with severe right sided abdominal pain for 12 hours. He began having a "stomach ache" yesterday,
with decreased appetite, but today the pain seems to be just on the lower right side. He has had some nausea & vomiting, but no
constipation or diarrhea. His last BM was last night and was normal. He has had no fever or chills. He denies any recent illness or
injuries. His PMH is unremarkable. He denies any tobacco or drug use and drinks 4-6 beers/week. on exam, he appears ill and is
lying on his right side. His temp is 100.4 F and HR is 110. His bowel sounds are decreased and he has rebound pain and guarding
one third of the way between anterior superior iliac spine and the umbilicus in the right lower quadrant. What is the most likely
cause of his pain?
A. Acute appendicitis
B. Mesenteric ischemia
C. Acute mechanical intestinal obstruction
D. Acute cholecystitis: A. Acute appendicitis
3. An APRN notes a 12 mm Hg difference in systolic BP during inspiration. How should the APRN document this finding?
A. Acute stenosis
B. Carotid arterial disease
C. Paradoxical pulse
D. Pulsus alternans: C. Paradoxical pulse
4. Which of the following percussion notes is obtained over a gastric bubble?
A. Flatness
B. Hyperresonance
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, NU 673 Assessment Midterm
C. Tympany
D. Resonance: C. Tympany
5. The APRN is performing a cardiac exam on a pt with SOB and palpitations.
She listens to the heart with the pt sitting upright, then has the pt change
to a supine position, and finally she has the pt turn onto the left side in the left lateral decubitus position. Which of the following
valvular defects is best heard in this position?
A. Mitral
B. Aortic
C. Tricuspid
D. Pulmonic: A. Mitral
6. A 20 year old male has a history of leukemia and an enlarged spleen. Today he presents with a fairly significant left upper
quadrant pain. On exam of the area a rough grating noise is heard. What is this sound known as?
A. It is a variant of bowel noise
B. It is a splenic rub
C. Vascular noise
D. It represents borborygmi: B. It is a splenic rub
7. An elderly pt with a history of smoking 2 packs/day for 50 years reports to the APRN prolonged shortness of breath. On cardiac
exam, the APRN feels the most prominent palpable impulse to be in the xiphoid area. This is most likely a result of what
condition?
A. COPD
B. Aortic stenosis
C. Mitral regurgitation
D. Pulmonary hypertension: D. Pulmonary hypertension
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1. A patient is suspected to have COPD. The APRN instructs the patient to take a deep breath in, and then with his mouth open,
breathe out as fast and completely as he can. For what is the APRN checking?
A. Whispered pectoriloquy
B. Forced expiratory time
C. Egophony
D. Tactile fremitus: B. Forced expiratory time
2. A pt presents to the clinic with severe right sided abdominal pain for 12 hours. He began having a "stomach ache" yesterday,
with decreased appetite, but today the pain seems to be just on the lower right side. He has had some nausea & vomiting, but no
constipation or diarrhea. His last BM was last night and was normal. He has had no fever or chills. He denies any recent illness or
injuries. His PMH is unremarkable. He denies any tobacco or drug use and drinks 4-6 beers/week. on exam, he appears ill and is
lying on his right side. His temp is 100.4 F and HR is 110. His bowel sounds are decreased and he has rebound pain and guarding
one third of the way between anterior superior iliac spine and the umbilicus in the right lower quadrant. What is the most likely
cause of his pain?
A. Acute appendicitis
B. Mesenteric ischemia
C. Acute mechanical intestinal obstruction
D. Acute cholecystitis: A. Acute appendicitis
3. An APRN notes a 12 mm Hg difference in systolic BP during inspiration. How should the APRN document this finding?
A. Acute stenosis
B. Carotid arterial disease
C. Paradoxical pulse
D. Pulsus alternans: C. Paradoxical pulse
4. Which of the following percussion notes is obtained over a gastric bubble?
A. Flatness
B. Hyperresonance
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, NU 673 Assessment Midterm
C. Tympany
D. Resonance: C. Tympany
5. The APRN is performing a cardiac exam on a pt with SOB and palpitations.
She listens to the heart with the pt sitting upright, then has the pt change
to a supine position, and finally she has the pt turn onto the left side in the left lateral decubitus position. Which of the following
valvular defects is best heard in this position?
A. Mitral
B. Aortic
C. Tricuspid
D. Pulmonic: A. Mitral
6. A 20 year old male has a history of leukemia and an enlarged spleen. Today he presents with a fairly significant left upper
quadrant pain. On exam of the area a rough grating noise is heard. What is this sound known as?
A. It is a variant of bowel noise
B. It is a splenic rub
C. Vascular noise
D. It represents borborygmi: B. It is a splenic rub
7. An elderly pt with a history of smoking 2 packs/day for 50 years reports to the APRN prolonged shortness of breath. On cardiac
exam, the APRN feels the most prominent palpable impulse to be in the xiphoid area. This is most likely a result of what
condition?
A. COPD
B. Aortic stenosis
C. Mitral regurgitation
D. Pulmonary hypertension: D. Pulmonary hypertension
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