NURS-6512N-6/NURS-6512A-6-Advanced Health Assessment-2021-Fall-QTR-Term-wks-1-thru-11-(08/30/2021-11/14/2021)-PT27

NURS-6512N-6/NURS-6512A-6-Advanced Health Assessment-2021-Fall-QTR-Term-wks-1-thru-11-(08/30/2021-11/14/2021)-PT27

Question 1

A blood pressure cuff bladder should be long enough to:


cover 45% to 50% of the arm circumference.


cover 20% to 25% of the arm circumference.


completely encircle the arm.


cover 75% to 80% of the arm circumference.


Question 2

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


Attempt to convince the patient to accept institutional mores.


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


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


Ignore one’s own cultural beliefs.


The review of systems is a component of the:


physical examination.


health history.


past medical/surgical history.




Question 4

Subjective and symptomatic data are:


not mentioned in the legal chart.


documented with the examination findings.


placed in the history section.


recorded with the examination technique.


Question 5

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


Question 6

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


air conduction of sound.


mallear auditory ability.


bone versus air conduction.


lateralization of sound.


Question 7

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


upper right kidney ridge.


lower liver border.


descending aorta.


medial border of the spleen.


Question 8

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:


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


forego the examination for fear of violating cultural norms.


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


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



Question 9

Mrs. Raymonds is a 24-year-old patient who has presented for a routine concern over her current weight. In your patient teaching with her, you explain the importance of macronutrients. Which of the following is a macronutrient?










Question 10

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?


Consistent right lower quadrant (RLQ pain)


Rebound tenderness


Positive McBurney sign


Positive psoas sign


Question 11

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


help make the interview questions more pertinent.


form a sense of the patient.


form stereotypical categories.


draw conclusions regarding individual patient needs.


Question 12

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


buzzing or tingling sensations.


buzzing from bone conduction.


hearing range of normal speech.


noise above the threshold level.


Question 13

White, rounded, or oval ulcerations surrounded by a red halo and found on the oral mucosa are:


Fordyce spots.




aphthous ulcers.


Stensen ducts.


Question 14

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


glycogen storage in the liver.


myocardial cell function.


normal growth and development.


building and maintaining tissues.


Question 15

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.



Loss of high frequency



Results from cranial nerve VII



Bone conduction heard longer than air conduction



Unable to hear in a crowded room



Sounds may be garbled and difficult to localize



Progression is slow

A, D, E

Question 16

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










Question 17

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










Question 18

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


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


Avoid directly confronting the patient regarding your impression.


Ask whether the patient has considered self-harm.


Ask whether the patient would like to visit a psychiatrist.


Question 19

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


standing at the foot of the table.


walking around the table.


seated on the patient’s right.


standing at the patient’s left.


Question 20

Which question would be considered a leading question?


“You don’t get headaches often, do you?”


“What do you think is causing your headaches?”


“At what time of the day are your headaches the most severe?”


“On a scale of 1 to 10, how would you rate the severity of your headaches?”


Question 21

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




top of the head.


preauricular area.


mastoid bone.


Question 22

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:


percuss for ascites.


assess for rebound tenderness.


inspect for ecchymosis of the flank.


auscultate for abdominal bruits.


Question 23

Under normal circumstances, how much water is lost daily by the body?


3 to 4 L


2 to 2.5 L


5 to 6 L


1 to 1.5 L


Question 24

You are collecting a history from an 11-year-old girl. Her mother is sitting next to her in the examination room. When collecting history from older children or adolescents, they should be:


ignored while you address all questions to the parent.


given the opportunity to be interviewed without the parent at some point during the interview.


mailed a questionnaire in advance to avoid the need for her to talk.


allowed to direct the flow of the interview.


Question 25

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










Question 26

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


Objective information only


Subjective information only


All information


Diagnostic information only


Question 27

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




Dorsal surface


Ulnar surface


Finger pads


Question 28

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


ask him if he would like some time alone.


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


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


ask the patient what he is upset about.


Question 29

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


Fontanel sizes


Liver span


Thyroid position


Prostate size


Question 30

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):


progress note.


triage note.


accident report.


problem-oriented medical record.


Question 31

Mr. Mills is a 55-year-old patient who presents to the office for an initial visit for health promotion. A survey of mobility and activities of daily living (ADLs) is part of a(an):


ethnic assessment.


genetic examination.


social history.


functional assessment.


Question 32

Which of the following is the most vital nutrient?










Question 33

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


neck area.








Question 34

Mr. Black is a 44-year-old patient who presents to the clinic with complaints of neck pain that he thinks is from his job involving computer data entry. As the examiner, you are checking the range of motion in his neck and note the greatest degree of cervical mobility is at:


A. C1 to C2.


C. C3 to C4.


D. C4 to C5.


B. C2 to C3.


Question 35

The attitudes of the health care professional:


do not influence patient behavior.


are difficult for the patient to sense.


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


are culturally derived.


Question 36

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


exercise and eat more fiber.


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


come to the laboratory for a stool guaiac test.


eat six small meals a day.


Question 37

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


The gland is tender upon palpation.


Palpation of the gland becomes difficult.


A bruit is auscultated.


Inspection reveals a goiter.


Question 38

Mrs. Grace is a 58-year-old patient who has a diagnosis of pernicious anemia. Which B vitamin is deficient in patients with pernicious anemia?










Question 39

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


maxillary and frontal sinuses.


maxillary sinuses only.


sphenoid sinuses only.


sphenoid and frontal sinuses.


Question 40

When examining the skull of a 4-month-old baby, you should normally find:


C. ossification of all sutures.


B. closure of the posterior fontanel.


A. closure of the anterior fontanel.


D. overlap of cranial bones.


Question 41

A guideline for history taking is for caregivers to:


make notes sparingly so that patients can be observed during the history taking.


ask for a complete history at once so that data are not forgotten between meetings.


ask direct questions before open-ended questions so that data move from simple to complex.


write detailed information as stated by patients so that their priorities are reflected.


Question 42

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


differential diagnosis.


history of present illness.




general patient information section.


Question 43

Nasal symptoms that imply an allergic response include:


small, atrophied nasal membranes.


purulent nasal drainage.


bluish gray turbinates.


firm consistency of turbinates.


Question 44

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


B. under fluorescent lighting.


A. using an episcope.


C. with illumination provided by daylight.


D. using a Wood’s light.


Question 45

Pigmented, raised, warty lesions over the face and trunk should be assessed by an experienced practitioner who can distinguish:


B. furuncles from folliculitis.


C. sebaceous hyperplasia from eczema.


D. seborrheic keratoses from actinic keratoses.


A. cutaneous tags from lentigines.


Question 46

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










Question 47

Mrs. Tuber is a 36-year-old patient who comes into the health center with complaints that her fingernails are not growing. Which structure is the site of new nail growth?


A. Cuticle


D. Nail bed


C. Matrix


B. Perionychium


Question 48

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


allowing the clinician to catch up on documentation.


increasing the length of the visit.


promoting calmness.


providing time for reflection.


Question 49

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 having “green nasal discharge” for the past 72 hours.


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 “allergies.”


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


Question 50

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 51

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


Referral note


Brief SOAP note


Comprehensive health history


Progress note

Question 52

Tympanic thermometers measure body temperature when a probe is placed:


under the ear.


in the auditory canal.


anterior to the ear.


posterior to the ear.


Question 53

A flat, nonpalpable lesion is described as a macule if the diameter is:


3 cm exactly.


too irregular to measure.


greater than 1 cm.


less than 1 cm.


Question 54

Sweat glands, hair, and nails are all formed from:


D. papillae that penetrate the epidermis.


B. closely packed squamous cells.


A. basement membranes under cellular strata.


C. invaginations of epidermis into dermis.


Question 55

Nuchal rigidity is most commonly associated with:


D. cranial nerve V damage.


B. meningeal irritation.


A. thyroiditis.


C. Down syndrome.


Question 56

The most superior part of the stomach is the:




pyloric orifice.






Question 57

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 E


Vitamin D


Vitamin A


Question 58

Penicillin is considered a


“cold” herb.


“hot” medicine.


“cold” medicine.


“lukewarm” oil.


Question 59

Tangential lighting is best used for inspecting skin:










Question 60

Peritonitis produces bowel sounds that are:


high pitched








Question 61

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


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


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


Question 62

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




Cushing syndrome


Diabetes mellitus


Addison disease


Question 63

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


rectal examination.








Question 64

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 65

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 66

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.


personal and social history.


past medical history.


review of systems.


Question 67

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:


ask whether he would prefer to speak to the clinician.


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.


Question 68

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


history of present illness.


physical examination.


patient education.


review of systems.


Question 69

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:


fruit and vegetables.


lean meat and fish.


sandwiches and diet drinks.


pasta and chicken.


Question 70

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


chief complaint.


medical history.






Question 71

Before performing an abdominal examination, the examiner should:


have the patient empty his or her bladder.


ascertain the patient’s HIV status.


don double gloves.


completely disrobe the patient.


Question 72

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


Glasgow Coma Scale.


Miller Analogies Test.


PACES assessment.


CAGE questionnaire.


Question 73

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.


olive complexion.


repeated trauma or irritation to skin.


history of allergic reactions to sunscreen.


Question 74

Unusual white areas on the skin may be due to:


A. adrenal disease.


B. polycythemia.


C. vitiligo.


D. Down syndrome.


Question 75

In examining the neck of a 34-year-old female patient, you note that the uppermost ridge of the tracheal cartilage is at the:










Question 76

Differential diagnoses belong in the:




physical examination.






Question 77

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


less than 5 inches of the lower arm.


more than two-thirds of the upper arm.


less than one-half of the upper arm.


more than 4 inches of the lower arm.


Question 78

A 22-year-old female nurse is interviewing an 86-year-old male patient. The patient avoids eye contact and answers questions only by saying, “Yeah,” “No,” or “I guess so.” Which of the following is appropriate for the interviewer to say or ask?


It s hard for me to gather useful information because your answers are so short.


We will be able to communicate better if you will look at me.


Are you uncomfortable talking with me?


Does your religion make it hard for you to answer my questions?


Question 79

Fluorescing lesions are best distinguished using a(n):


incandescent lamp.




magnifying glass.


Wood’s lamp.


Question 80

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


“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.”


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


Question 81

The infant should be placed in which position to have his or her height or length measured?


Prone on a measuring board


Vertical, with the examiner’s hands under the infant’s axilla


In the lateral position with the toes against a measuring board


Supine on a measuring board


Question 82

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


most of the abdomen.


emphysemic lungs.


healthy lung tissue.


the liver.


Question 83

When assessing abdominal pain in a college-age woman, one must include:


the first day of the last menstrual period.


food likes and dislikes.


age at completion of toilet training.


history of interstate travel.


Question 84

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:


raise his or her head off the pillow.


hold his or her breath.


sit upright.


flex his or her knees.


Question 85

Which of the following occurs when firm pressure is used to apply the stethoscope’s bell end-piece to the skin?


It transmits low-pitched sounds.


Assessment findings are more accurate.


Most sounds are occluded.


It functionally converts to a diaphragm end-piece.


Question 86

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:


B. patch.


D. papule.


A. plaque.


C. macule.


Question 87

When are open-ended questions generally most useful?


During the initial part of the interview


During the review of systems


After several close-ended questions have been asked


While designing the genogram


Question 88

When taking a history, you should:


use a holistic and eclectic structure.


use a chronologic and sequential framework.


ask the patient to give you any information they can recall about their health.


start the interview with the patient’s family history.


Question 89

When assessing abdominal pain in a college-age woman, one must include:


age at completion of toilet training.


food likes and dislikes.


the first day of the last menstrual period.


history of interstate travel.


Question 90

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


need to do good for the patient.


care provider acting as a father or mother figure.


care provider knowing what is best for the patient.


need to avoid harming the patient.


Question 91

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:


assess for rebound tenderness.


assess for rebound tenderness.


inspect for ecchymosis of the flank.


percuss for ascites.


Question 92

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:


B. hyperthyroidism.


C. thyroid cancer.


A. hypothyroidism.


D. thyroid cyst.


Question 93

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 94

The adult recommended dietary fat intake should be _____ g/day.


Question 95

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 proper medical and technical terminology.


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


Question 96

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


are used for noting disease progression.


are ways for recording laboratory study results.


are methods for recording locations of findings.


should not be used in the legal record.


Question 97

You are palpating a patient’s thyroid and find that its broadest dimension measures 4 cm. The right lobe is 25% larger than the left. These data would indicate:


D. thyroiditis.


C. a normal thyroid gland.


B. a multinodular goiter.


A. a congenital anomaly.


Question 98

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


middle ear effusion.


healed tympanic membrane perforation.


repeated and prolonged crying cycles.


impacted cerumen in the canal.


Question 98

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


middle ear effusion.


healed tympanic membrane perforation.


repeated and prolonged crying cycles.


impacted cerumen in the canal.


Question 99

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:


C. Stensen duct stone.


D. thyroglossal duct cyst.


A. parotid gland tumor.


B. branchial cleft cyst.


Question 100

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?


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


“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.”


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


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