Exam 4: NR414 Flashcards
Objective Findings for Osteoarthritis
- Limited ROM in the affected joint
- fluid iseasily moved around the joint space
*
3 areas of the Glasgow Coma Scale
- eye opening
- motor response to stimuli
- verbal response
higher motor system that permits very skilled and purposeful movements such as writing.
corticospinal tract.
A murmur heard after S1 and before S2 is classified as
systolic (possibly benign)
During a visit for a school physical the 13 year old questions the asymmetry of her breasts. What is your best response?
“One breast may grow faster than the other during development”
During assessment of the spine, what do you ask the patient?
- Flex
- Extend
- Abduct
- Rotate
During examination of the breasts of a pregnant woman, what are the expected findings?
A blue vascular pattern over both breasts
moving a limb away from the midline of the body
Abduction
Melena
really dark stools b/c of blood
fibrous bands running directly from one bone to another.
ligaments
a partial or incomplete paralysis
paresis
an abnormal sensation such as burning or tingling.
parastesia
What is the sequence used during examination of the abdomen?
- Inspect
- Auscultate
- Percuss
- Palpate
all ascending and descending fiber tracts; it has vital autonomic centers for respiration, heart, and gastrointestinal function as well as nuclei for cranial nerves VIII through XII.
Medulla
What would cause a false positive fecal occult test?
red meat
When is the bulbourethral gland assessed
exam of a male patient
What does a “normal” tympanic membrane look like?
Shiny, translucent, pearly grey
a medical condition in which the bones become brittle and fragile from loss of tissue, typically as a result of hormonal changes, or deficiency of calcium or vitamin D.
osteoporosis
Bundles of muscle fibers that compose skeletal muscle are identified as:
fasciculi
the landau reflex in an infant is seen when
the baby raises the head and arches the back as in a swan dive
Automatic associated movements of the body are under the control and regulation of:
basal ganglia
When do we start Colorectal Exam?
- 50, every 5-10 years
- colostomy
- ocult blood test
What 4 areas do you auscultate when listening to the heart?
- Aortic, Pulmonic, Tricuspid, Mitral
What is the time frame for full breast development?
1.5 - 6 years
Average age for breast development in african americans?
8 to 9 years
A 78 year old male comes into the office and the nurse assesses that he has a greying/white arc/circle around his cornea with no vision loss. She should conclude that the patient has:
Arcus Senillis
describe the anal canal
- 3.8 cm long long outlet of the GI tract
skin normal findings seen mostly in infants? x3
- Cafe Au Lait Spot
- Mongolian Spot
- Lanugo
Describe the Left Lung
- narrower than the right w/ 2 lobes
A positive babinski sign is
dorsifelxion of the big toe and fanning of all toes
Each half of the cerebrum is a
hemisphere
a person hears and comprehends words but is unable to speak correctly; incoherent words are substituted for intended words.
paraphasia
Older Adult Expected Finding During Breast Exam
- lactiferous ducts are more palpable
- feel firm and stringy b/c of fibrosis and calcification.
How common is prostate cancer
1/6
The test where you place a coin on a person’s hand and ask him or her to indentify it
stereognosis
How do we detect Prostate Cancer early?
- Blood for prostate specific antigen (PSA)
- Digital Rectal Examination (DRE)
style of speech for a person with parkinsons
slow monotonous
How do you examine the trigeminal nerve in an infant
offer the baby a bottle
The best exercises to maintain bone health are
Weight bearing exercises
Straightening a limb at a joint
extension
Normal stool characteristics
Softs, brown, BM daily
An area of the body that is supplied mainly from one spinal segment through a particular spinal nerve is identified as a:
dermatone
When is a baseline mammogram recommened for women?
Between 35 and 39 yrs
The knee joint is the articulation of three bones, the:
- femur,
- tibia
- patella.
slow, writhing, continuous, and involuntary movements of the extremities.
Athetosis
When is the best time to perform a breast self examination?
on the 4th - 7th day of the cycle
occurs with diabetes, epilepsy, and alcoholic liver disease. Chronic hyperplasia of the palmar fascia causes flexion contractures of the digits.
Dupuytren contracture
Turning the forearm so the palm is up
supination
Clonus that may be seen when testing deep tendon reflexes is characterized by a(n):
- a set of rapid, rhythmic contractions of the same muscle.
Swan-neck, boutonnière deformity, and ulnar deviation are conditions associated with
rheumatoid arthritis
Anterior and Posterior Stability are provided to the knee joint by the
- anterior/posterior cruciate ligaments
Turning the forearm so the palm is out
Pronation
n impaired ability to coordinate movement, often characterized by a staggering gait and postural imbalance.
ataxia
Where is the most common site for breast tumors
upper outer quadrant
What is a symptom of internal hemorroids?
frequent constipation, rectal bleeding and pain. No mass at anal opening
An expected postmenopausal breast change includes:
- glandular tissue atrophy.
- increased fibrous connective tissue.
- fat tissue atrophy.
- Decrease Breast Size
Subjective Data for Osteoarthritis
- Pain (worse later in the day)
- stiffness
- reported limited ROM
Crepitation is an audible sound that is produced by:
roughened articular surfaces moving over each other
What is a findiing that indicated prostate cancer in the prostate gland?
diffuse hardness
Which of the following options is not a change that comes with menopause?
- The vaginal pH becomes more alkalotic
- The vagina becomes shorter and narrower
- The cervix shrinks
- The ovaries hypertrophy
localized uncoordinated, uncontrollable twitching of a single muscle group innervated by a single motor nerve fiber or filament.
Fasciculation
How do you elicit Babinski Reflex
stroke the lateral aspect of the sole of the foot from heel to the ball
A known risk factor for breast cancer includes:
Early Menarche, or Late Menopause (after 55)
During neurologic examination the tendon reflex fails to appear. Before striking the tendon again, the examiner might use what type of technique?
reinforcement
strong fibrous cords that attach skeletal muscles to bones.
tendons
which cultural group has the lowest incidence of osteoporosis?
African Americans
Broca Means
difficulty speaking
Cranial Nerve Mneumonic Sensory, Motor or Both
- Some Say Marry Money But My Brother Says Bad Business Marry Money
Cranial Nerve Mneumonic
Oh Oh Oh To Touch And Feel Very Good Velvet AH!
- Olfactoryoptic
- Oculomotor
- Trochlear
- Trigeminal
- Abducens
- Facial
- Vestibulocochlear
- Glossopharyngeal
- Vagus
- Accessory
- Hypoglossal
The number of lobes within the breast ranges between:
15 and 20
Malignant Breast Lump Characteristics
- Irregular Shape
- Tenderness
Why are children more at risk for ear infections?
They have shorter, wider, more horizontal Eustachian tubes
Define Supernumary nipple
A normal and common variation. An extra nipple on the thorax or abdomen. It is usually 5 to 6 cm below the breast near the midline and has no glandular tissue.
The production of red blood cells in the bone marrow is called:
hematopoiesis.
What is a gynecomastia
- enlargement of the male breast, due to hormone imbalance or hormone therapy.
- liver cirrhosis.
s a feature of the nerve tracts; the left cerebral cortex receives sensory information from and controls motor function to the right side of body, whereas the right cerebral cortex likewise interacts with the left side of the body.
Crossed Represenation
What is steatorhhea
frothy, foul smelling stools that float at the surface
Rectum is how long
12 cm. most distal portion of lg intestine
What assessments should be performed last on a 4-week-old infant?
Otoscopic examination of the tympanic membrane
moving the sole of the foot inward at the ankle
inversion
To assess for a spinal curvature
- the person will bend over and touch the toes with the knee in extension
Influences Body Temperature
Diurnal Cycle
when is a cremasteric response positive?
when the ipsilateral testicle elevates upon stroking of the inner aspect of the thigh
The group of axillary lymph nodes that drains the other three groups of nodes is the:
Central Nodes
A newborn’s nail beds may be blue (cyanotic) for the first few hours of life, then they turn what color?
pink
the cutaneous distribution of the various spinal nerves.
Dermal segmentation
Positive Phalen Test and Tinel Signs are indicative of?
carpal tunnel syndrome
Superficial reflexes include
- abdominal,
- cremasteric,
- plantar (or Babinski) reflexes.
control of body temperature
hypothalamus
Muscle extension can be assessed by
- instructing the person to rise from a squatting position without using the hands for support.
What is the cause of a neonate with large breasts, secreting clear/white fluid?
maternal estrogen, which crossed the placenta
Name the reservoirs for storing milk in the breasts?
Lactiferous Sinuses
The musculoskeletal system functions include:
- provide support to stand erect
- allow movement; to encase and protect the inner vital organs
- produce RBCS in the bone marrow
- reservoir for storage of essential minerals
Benign Prostatic Hypertrophy (BPH) is highest in this group?
African americans
Striae which occur when elastic fibers in the reticular layers of the skin are broken after rapid or prolonged stretching, have a distinct color when of long duration. What is this color?
Silvery White
s where sensory pathways of the spinal cord, cerebellum, and brain stem form synapses on their way to the cerebral cortex.
thalamus
Moving the body part forward and parallel to the ground
protraction
The extrapyramidal system is located in the:
basal ganglia.
Bending a limb at a joint
flexion
What is a symptom of a benign prostatic hypertrophy
difficulty urinating and weak stream
Which cranial nerves control the extraocular muscles (EOM)?
- Oculomotor (II),
- Abducens (VI),
- Trochlear (IV)
Testing the deep tendon reflexes gives the examiner information regarding the intactness of the:
reflex arc at specific levels in the spinal cord
Pronation and supination of the hand and forearm are hte result of the articulation of the
- Radius
- Ulna
A patient comes into the ER reporting he is in pain, what factors are related to pain
- guarding
- diaphoresis
- increased heart rate
- change in appetitie
Assessments for EOM
- Corneal Light Reflex
- 6 Cardinal Positions
- Confrontation Test
- CN 3,4,6
degeneration of joint cartilage and the underlying bone, most common from middle age onward. It causes pain and stiffness, especially in the hip, knee, and thumb joints.
Osteoarthritis
he relative proportion of glandular, fibrous, and fatty tissue depends on…x5
- age,
- cycle
- pregnancy
- lactation
- nutritional state.
Cerebellar function is assesed by which of the following tests?
coordination, hop on one foot
moving the arm in a circle around the shoulder
circumduction
During the examination of an infant, use a cotton tipped applicator to stimulate the anal sphincter. The absence of a response suggests a lesion of
S2
When assessing the abdomen, what position do you put the patient?
Supine with knees flexed
Superficial reflexes test
- the sensory receptor in the skin;
- motor response is a localized muscle contraction
moving a body part backward and parallel to the ground
retraction
Which of the following vital signs are characteristic of an aging adult?
- Decreased temperature
- Decreased sweating
- Increased risk of orthostatic hypotension
What is the best position for inspecting the breasts for retraction?
Sitting with hand pushing onto hips
the sense of balance.
Vestibular function
characterized by hard, nontender nodules, 2 to 3 mm or more
Osteoarthritis
To assess range of motion
the leg should be abducted and adducted with the knee extended.
An ER nurse is assessing a female patient who has a blunt injury to the chest wall, what would be a sign of pneumothorax
diminished breath sounds
Define the Romberg Test
- A positive Romberg sign is loss of balance that occurs when closing the eyes
- occurs with cerebellar ataxia, loss of proprioception, and loss of vestibular function.
An Area not commonly associated with pain
inramuscular
The presence of primitive reflexes in a newborn infant is indicative of:
immaturity of the nervous system.
moving the sole of the foot outward at the ankle
eversion
Often seen with history of trauma or obesity, and can be genetic
osteoarthritis
Average Age for breast development in Caucasians?
10 years
Nutrition to reduce risk of colon cancer
high fiber
What is the gastrocolic Reflex
a peristaltic wave
Benign Breast Characteristics
- Soft
- Well Defined Margins
- Freely moveable
in the temporal lobe is associated with language comprehension
Wernicke’s Area
How long does Breast development precede after menstruation?
2 years
How often should males 15 y/o+ do a testicular self exam?
Once a month
The divisions of the spinal vertebrae include:
- Cervical,
- thoracic,
- lumbar,
- sacral,
- coccygeal.
The nurse assess a patient with osteoarthritis, what would be an expected sign/symptom?
- stiff knees, hips, fingers, and vertebrae
weak, soft, and flabby; lacking normal muscle tone.
flaccidity
When testing for muscle strength, the examiner should:
- apply an opposing force when the individual puts a joint in flexion or extension.
How often should a women age 40-49 get a mammogram?
Every Year
