NRNP-6552-14-Advanced Nursing Practice Reproductive Health

NURS-6512N-48-Advanced Health Assessment-2021-Fall-QTR-Term-wks-1-thru-11-(08/30/2021-11/14/2021)-PT2

NURS-6512N-48-Advanced Health Assessment-2021-Fall-QTR-Term-wks-1-thru-11-(08/30/2021-11/14/2021)-PT2

Question 1

Subjective and symptomatic data are:


documented with the examination findings.


not mentioned in the legal chart.


recorded with the examination technique.


placed in the history section.


Question 2

Mr. Mathews is a 47-year-old patient who presents for a routine physical examination. On examination, you have noted a bruit heard over the thyroid. This is suggestive of:


D. thyroid cyst.


A. hypothyroidism.


C. thyroid cancer.


B. hyperthyroidism.


Question 3

Mr. Jones is a 45-year-old patient who presents for a physical examination. On examination, you note costochondral beading, enlarged skull, and bowed legs and diagnose him with rickets. A deficiency of which fat-soluble micronutrient can result in rickets?


Vitamin  K


Vitamin D


Vitamin E


Vitamin A


Question 4

During an interview, tears appear in the patient’s eyes and his voice becomes shaky. Initially, you should:


offer a tissue and let him know it is all right to cry.


explain to the patient that you will be able to help him more if he can control his emotions.


ask the patient what he is upset about.


ask him if he would like some time alone.


Question 5

Mr. L. presents to the clinic with severe groin pain and a history of kidney stones. Mr. L.’s son tells you that, for religious reasons, his father wishes to keep any stone that is passed into the urine filter that he has been using. What is your most appropriate response?


“We don’t know yet if your father has another kidney stone, so we must analyze this one.”


“With your father’s permission, we will examine the stone and request that it be returned to him.”


“We cannot let him keep his stone because it violates our infection control policy.”


“The stone must be sent to the lab for examination and therefore cannot be kept.”


Question 6

Tuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure:


buzzing or tingling sensations.


noise above the threshold level.


buzzing from bone conduction.


hearing range of normal speech.


Question 7

When palpating the abdomen, you should note whether the liver is enlarged in the:


left lower quadrant.


periumbilical area.


midepigastric region.


right upper quadrant.


Question 8

Mrs. Britton is a 34-year-old patient who presents to the office with complaints of skin rashes. You have noted a 4′ 3-cm, rough, elevated area of psoriasis. This is an example of a:


C. macule.


A. plaque.


D. papule.


B. patch.


Question 9

Which of the following organs is part of the alimentary tract?










Question 10

After thorough inspection of the abdomen, the next assessment step is:




rectal examination.






Question 11

Mrs. Hartzell is a 34-year-old patient who has presented for nutritional counseling because she is a vegetarian. Deficiency of which of the following is a concern in the vegetarian diet?


Vitamin B12 




Ascorbic acid




Question 12

Which of the following is the most accurate reflection of an individual’s food intake?


Serum protein assays


Computerized nutrient analysis


Twenty-four-hour diet recall


Food diary


Question 13

Percussing at the right midclavicular line, below the umbilicus, and continuing upward is the correct technique for locating the:


medial border of the spleen.


lower liver border.


upper right kidney ridge.


descending aorta.


Question 14

Mrs. G. reports an increase in her alcohol intake over the past 5 years. To screen her for problem drinking, you would use the:


CAGE questionnaire.


Miller Analogies Test.


Glasgow Coma Scale.


PACES assessment.


Question 15

A 5-year-old child presents with nasal congestion and a headache. To assess for sinus tenderness you should palpate over the:


sphenoid and frontal sinuses.


sphenoid sinuses only.


maxillary sinuses only.


maxillary and frontal sinuses.


Question 16

The examiner’s evaluation of a patient’s mental status belongs in the:


physical examination.


review of systems.


patient education.


history of present illness.


Question 17

When you are questioning a patient regarding alcohol intake, she tells you that she is only a social drinker. Which initial response is appropriate?


“Do the other people in your household consume alcohol?”


“I’m glad that you are a responsible drinker.”


“What amount and what kind of alcohol do you drink in a week?”


“If you only drink socially, you won t need to worry about always having a designated driver.”


Question 18

Mrs. Leonard brings her newborn infant into the pediatrician’s office for a first well-baby visit. As the health care provider, you teach her that newborns are more vulnerable to hypothermia due to:


A. the presence of coarse terminal hair.


B. desquamation of the stratum corneum.


C. their covering of vernix caseosa.


D. a poorly developed subcutaneous fat layer.


Question 19

Mr. Akins is a 78-year-old patient who presents to the clinic with complaints of hearing loss. Which of the following are changes in hearing that occur in the elderly? Select all that apply.



Results from cranial nerve VII



Sounds may be garbled and difficult to localize



Bone conduction heard longer than air conduction



Progression is slow



Unable to hear in a crowded room



Loss of high frequency

B, E, F

Question 20

Which is the best way to position a patient’s neck for palpation of the thyroid?


A. Flexed away from the side being examined


B. Flexed directly forward


D. Hyperextended directly backward


C. Flexed toward the side being examined


Question 21

You are using an ophthalmoscope to examine a patient’s inner eye. You rotate the lens selector clockwise, then counterclockwise to compensate for:










Question 22

Mr. Johnson presents with a freely movable cystic mass in the midline of the high neck region at the base of the tongue. This is most likely a:


B. branchial cleft cyst.


C. Stensen duct stone.


D. thyroglossal duct cyst.


A. parotid gland tumor.


Question 23

Mrs. Webb is a 38-year-old patient who has been changing her lifestyle to eat in a healthy way and lose weight. During your health promotion education regarding her nutritional status, you explain the function of dietary protein as:


synthesizing and regulating hormones.


providing energy source for brain.


building and maintaining tissues.


participating in specific detoxifying metabolic pathways.


Question 24

Mrs. Kinder is a 39-year-old patient who presents to the office with complaints of an earache. In explaining to the patient about the function of her ears, which ear structure would you tell her is responsible for equalizing atmospheric pressure when swallowing, sneezing, or yawning?


Eustachian tube


Inner ear


Pars flaccida


Triangular fossa


Question 25

Ms. Otten is a 45-year-old patient who presents with a complaint of weight gain. Which medication is frequently associated with weight gain?






Oral hypoglycemics




Question 26

Before performing an abdominal examination, the examiner should:


have the patient empty his or her bladder.


completely disrobe the patient.


ascertain the patient’s HIV status.


don double gloves.


Question 27

When are open-ended questions generally most useful?


During the review of systems


After several close-ended questions have been asked


During the initial part of the interview


While designing the genogram


Question 28

Mrs. Britton brings her 16-year-old son in with a complaint that he is not developing correctly into adolescence. Which structures disproportionately enlarge in the male during adolescence?


A. Coronal sutures


D. Nose and thyroid cartilages


B. Hyoid and cricoid cartilages


C. Mandible and maxilla bones


Question 29

Cherry angiomas are a common finding in:


adults older than 30 years.


pregnant women.






Question 30

During percussion, a dull tone is expected to be heard over:


healthy lung tissue.


emphysemic lungs.


most of the abdomen.


the liver.


Question 31

The recommended minimum daily protein requirement for the normal adult is ______.

14-20% of total calories

Question 32

A detailed description of the symptoms related to the chief complaint is presented in the:


general patient information section.




history of present illness.


differential diagnosis.


Question 33

A brief statement of the reason the patient is seeking health care is called the:




chief complaint.




medical history.


Question 34

Peritonitis produces bowel sounds that are:




high pitched.






Question 35

Macronutrients are so named because they:


are required in large amounts.


form long chemical chains.


have high molecular weights.


tend to increase waist measurements.


Question 36

A patient presents to the emergency room with an open laceration from a dog bite. Pt states the incident occurred 2 days ago but the wound will not stop bleeding. What is the appropriate time frame to suture the site for adequate healing when sutures are needed? 


at least 24 hours


at least 48 hours


at least 36 hours


at least 1 week


Question 37

Recommended carbohydrate content of total dietary intake (% total calories) is ____%.

Question 38

During an interview, you have the impression that a patient may be considering suicide. Which action is essential?


Ask whether the patient would like to visit a psychiatrist.


Ask whether the patient has considered self-harm.


Avoid directly confronting the patient regarding your impression.


Record the impression in the patient’s chart and refer the patient for hospitalization.


Question 39

Which of the following is an “ABCD” characteristic of malignant melanoma?


Asymmetric borders


Borders well demarcated


Diameter less than 6 mm


Color of lesion is uniform


Question 40

Bulging of an amber tympanic membrane without mobility is most often associated with:


repeated and prolonged crying cycles.


middle ear effusion.


impacted cerumen in the canal.


healed tympanic membrane perforation.


Question 41

Which technique is most likely to result in the patient’s understanding of questions?


Use the simplest language possible.


Use the patient’s own terms if possible.


Use phrases that are commonly used by other patients in the area.


Use proper medical and technical terminology.


Question 42

When hearing is evaluated, which cranial nerve is being tested?










Question 43

Fluorescing lesions are best distinguished using a(n):


incandescent lamp.




magnifying glass.


Wood’s lamp.


Question 44

Differential diagnoses belong in the:






physical examination.




Question 45

Your patient returns for a blood pressure check 2 weeks after a visit during which you performed a complete history and physical. This visit would be documented by creating a(n):


triage note.


accident report.


problem-oriented medical record.


progress note.


Question 46

As part of your health promotion education for a new patient, you explain that the risk factors for skin cancer include:


dark eyes and hair.


history of allergic reactions to sunscreen.


repeated trauma or irritation to skin.


olive complexion.


Question 47

Which of the following formats would be used for visits that address problems not yet identified in the problem-oriented medical record (POMR)?


Comprehensive health history


Brief SOAP note


Referral note


Progress note


Question 48

Your patient presents with symptoms that lead you to suspect acute appendicitis. Which assessment finding is least likely to be associated with this condition early in its course?


Positive McBurney sign


Consistent right lower quadrant (RLQ pain)


Positive psoas sign


Rebound tenderness


Question 49

Spasmodic muscular contractions of the head, face, or neck are called:


C. dimpling.


D. webbing.


A. torticollis.


B. tics.


Question 50

Your patient is complaining of acute, intense sharp epigastric pain that radiates to the back and left scapula with nausea and vomiting. Based on this history, your prioritized physical examination should be to:


inspect for ecchymosis of the flank.


assess for rebound tenderness.


assess for rebound tenderness.


percuss for ascites.


Question 51

Mr. Sanchez is a 45-year-old gentleman who has presented to the office for a physical examination to establish a new primary care health care provider. Which of the following describes a physical, not a cultural, differentiator?










Question 52

Mr. Williams, age 25, has recovered recently from an upper and lower respiratory infection. He describes a long-standing nasal dripping. He is seeking treatment for a mild hearing loss that has not gone away. Information concerning his chronic postnasal drip should be documented within which section of his history?


Social history


Age-specific data


Past medical data


Past surgical data


Question 53

To approximate vocal frequencies, which tuning fork should be used to assess hearing?


100 to 300 Hz


1500 to 2000 Hz


500 to 1000 Hz


200 to 400 Hz


Question 54

A 51-year-old woman calls with complaints of weight loss and constipation. She reports enlarged hemorrhoids and rectal bleeding. You advise her to:


eat six small meals a day.


come to the laboratory for a stool guaiac test.


use topical over-the-counter hemorrhoid treatment for 1 week.


exercise and eat more fiber.


Question 55

Unusual white areas on the skin may be due to:


C. vitiligo.


D. Down syndrome.


B. polycythemia.


A. adrenal disease.


Question 56

Expected hair distribution changes in older adults include:


more prominent peripheral extremity hair production.


increased terminal hair follicles on the scalp.


increased terminal hair follicles to the tragus of men’s ears.


more prominent axillary and pubic hair production.


Question 58

When communicating with older children and teenagers, you should be sensitive to their:


natural urge to communicate.


need for verbal instructions.


desire for adult companionship.


typical reluctance to talk.


Question 59

A college student comes to the student health center complaining of difficulty in concentrating during class and while studying. The diet that would contribute to this problem is one that consumes mostly:


lean meat and fish.


sandwiches and diet drinks.


fruit and vegetables.


pasta and chicken.


Question 60

Placing the base of a vibrating tuning fork on the midline vertex of the patient’s head is a test for:


mallear auditory ability.


bone versus air conduction.


lateralization of sound.


air conduction of sound.


Question 61

You are completing a general physical examination on Mr. Rock, a 39-year-old man with complaints of constipation. When examining a patient with tense abdominal musculature, a helpful technique is to have the patient:


hold his or her breath.


sit upright.


flex his or her knees.


raise his or her head off the pillow.


Question 62

In issues surrounding ethical decision making, beneficence refers to the:


care provider knowing what is best for the patient.


care provider acting as a father or mother figure.


need to do good for the patient.


need to avoid harming the patient.


Question 63

You have just completed a skin assessment on Mr. Baker. During your assessment, you have transilluminated a skin lesion. During the physical examination, you know that skin lesions are transilluminated to distinguish:


C. fluid-filled from solid cysts or masses.


A. vascular from nonvascular lesions.


B. furuncles from folliculitis lesions.


D. herpes zoster from varicella.


Question 64

Before performing an abdominal examination, the examiner should:


ascertain the patient’s HIV status.


don double gloves.


have the patient empty his or her bladder.


completely disrobe the patient.


Question 65

Regardless of the origin, discharge is described by noting:


demographic data and risk factors.


associated symptoms in alphabetic order.


a grading scale of 0 to 4.


color and consistency.


Question 66

A serous membrane that lines the abdominal cavity and forms a protective cover for many abdominal structures is the:










Question 67

Which statement is true regarding the relationship of physical characteristics and culture?


There is a difference between distinguishing cultural characteristics and distinguishing physical characteristics.


Gender and race are the two essential physical characteristics used to identify cultural groups.


Physical characteristics should be used to identify members of cultural groups.


To be a member of a specific culture, an individual must have certain identifiable physical characteristics.


Question 68

The most common form of birth trauma of the scalp is:


cranial bossing.






caput succedaneum.


Question 69

A tool used to screen adolescents for alcoholism is the:










Question 70

Brittle nails are typical findings in:


B. infants.


D. older adults.


C. pregnant women.


A. adolescents.


Question 71

Mr. Abdul is a 40-year-old Middle Eastern man who presents to the office for a first visit with the complaint of new abdominal pain. You are concerned about violating a cultural prohibition when you prepare to do his rectal examination. The best tactic would be to:


inform the patient of the reason for the examination and ask if it is acceptable to him.


forego the examination for fear of violating cultural norms.


ask a colleague from the same geographic area if this examination is acceptable.


refer the patient to a provider more knowledgeable about cultural differences.


Question 72

Inspection of the abdomen should begin with the patient supine and the examiner:


standing at the foot of the table.


standing at the patient’s left.


seated on the patient’s right.


walking around the table.


Question 73

The term denoting the caregiver’s need to do no harm to the patient is:










Question 74

Coarse, dry, and brittle hair is associated with which metabolic disorder?


Addison disease


Cushing syndrome


Diabetes mellitus




Question 75

Your patient is complaining of acute, intense sharp epigastric pain that radiates to the back and left scapula with nausea and vomiting. Based on this history, your prioritized physical examination should be to:


auscultate for abdominal bruits.


assess for rebound tenderness.


inspect for ecchymosis of the flank.


percuss for ascites.


Question 76

Auscultation should be carried out last, except when examining the:






neck area.




Question 77

What finding is unique to the documentation of a physical examination of an infant?


Liver span


Thyroid position


Prostate size


Fontanel sizes


Question 78

To perform the Rinne test, place the tuning fork on the:


mastoid bone.


top of the head.


preauricular area.




Question 79

The position on a clock, topographic notations, and anatomic landmarks:


should not be used in the legal record.


are ways for recording laboratory study results.


are methods for recording locations of findings.


are used for noting disease progression.


Question 80

The review of systems is a component of the:


health history.




physical examination.


past medical/surgical history.


Question 81

Peritonitis produces bowel sounds that are:






high pitched




Question 82

A blood pressure cuff bladder should be long enough to:


completely encircle the arm.


cover 45% to 50% of the arm circumference.


cover 20% to 25% of the arm circumference.


cover 75% to 80% of the arm circumference.


Question 83

During physical examination of a 30-year-old Chinese man, you notice slight asymmetry of his face. The cranial nerve examination is normal. Your best action is to:


A. ask the patient if this characteristic runs in his family.


B. perform monofilament testing on the face.


C. consult with the physician regarding laboratory tests needed.


D. record the finding in the patient’s chart.


Question 84

Mr. Kevin Marks is a new health care provider. What is the best method to develop cultural competence?


Realize that cultural values are difficult to change and must be respected.


Ignore one’s own cultural beliefs.


Attempt to convince the patient to accept institutional mores.


Realize that all members of a cultural group behave in the same way.


Question 85

Mr. Donalds is a 45-year-old roofer. Your inspection to determine color variations of the skin is best conducted:


C. with illumination provided by daylight.


D. using a Wood’s light.


A. using an episcope.


B. under fluorescent lighting.


Question 86

Knowledge of the culture or cultures represented by the patient should be used to:


form a sense of the patient.


draw conclusions regarding individual patient needs.


help make the interview questions more pertinent.


form stereotypical categories.


Question 87

Periods of silence during the interview can serve important purposes, such as:


promoting calmness.


allowing the clinician to catch up on documentation.


providing time for reflection.


increasing the length of the visit.


Question 88

Which of the following is an expected change in the assessment of the thyroid during pregnancy?


Inspection reveals a goiter.


Palpation of the gland becomes difficult.


The gland is tender upon palpation.


A bruit is auscultated.


Question 89

Mr. D. complains of a headache. During the history, he mentions his use of alcohol and illicit drugs. This information would most likely belong in the:


chief complaint.


review of systems.


personal and social history.


past medical history.


Question 90

As you explain your patient’s condition to her husband, you notice that he is leaning toward you and pointedly blinking his eyes. Knowing that he is from England, your most appropriate response to this behavior is to:


tell him that you understand his need to be alone.


tell him that it is all right to be angry.


ask whether he has any questions.


ask whether he would prefer to speak to the clinician.


Question 91

The attitudes of the health care professional:


are culturally derived.


are difficult for the patient to sense.


are largely irrelevant to the success of relationships with the patient.


do not influence patient behavior.


Question 92

Nuchal rigidity is most commonly associated with:


C. Down syndrome.


D. cranial nerve V damage.


A. thyroiditis.


B. meningeal irritation.


Question 93

In counseling a client regarding nutrition education, you explain that linoleic acid, a major fatty acid, is thought to be essential for:


building and maintaining tissues.


myocardial cell function.


glycogen storage in the liver.


normal growth and development.


Question 94

George Michaels, a 22-year-old patient, tells the nurse that he is here today to “check his allergies.” He has been having “green nasal discharge” for the last 72 hours. How would the nurse document his reason for seeking care?


G. M. is a 22-year-old male here for “allergies.”


G. M., a 22-year-old male, states he has allergies and wants them checked.


G.M. is a 22-year-old male here for having “green nasal discharge” for the past 72 hours.


G. M. came into the clinic complaining of green discharge for the past 72 hours.


Question 95

You are planning to palpate the abdomen of your patient. Which part of the examiner’s hand is best for palpating vibration?


Ulnar surface


Dorsal surface




Finger pads


Question 96

Which part of the information contained in the patient’s record may be used in court?


Diagnostic information only


All information


Subjective information only


Objective information only


Question 97

Which of the following is the most vital nutrient?










Question 98

Expected normal percussion tones include:


tympany over an empty stomach.


dullness over the lungs.


hyperresonance over the lungs.


flatness over an empty stomach.


Question 99

Underestimation of blood pressure will occur if the blood pressure cuff’s width covers:


more than 4 inches of the lower arm.


less than 5 inches of the lower arm.


less than one-half of the upper arm.


more than two-thirds of the upper arm.

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