NRS 202 Exam #3

Question 1

Contour of Abdomen

Answer 1

Scaphoid, Flat, Rounded, Protuberant

Question 2

Liver Span technique

Answer 2

Up to down is resonant to dull

Down to up is tympany to dull

Question 3

LIVER

Answer 3

RUQ 5th intercostal

Question 4

SPLEEN

Answer 4

LUQ 9-11th intercostal

Question 5

Costovertebral Angle Tenderness

Answer 5

Indirect fist percussion on the back side of the patient to percuss kidneys. 12th rib. Tissues vibrate instead of making a sound.

Question 6

Shifting Dullness

Answer 6

Test for ascites. Percuss down the side of the abdomen and if fluid is present then the note will change from tympany to dull when you reach it.

Question 7

Rebound Tenderness

Answer 7

AKA Blumberg Sign. Push hand down at 90 degrees slowly and deep. When you let go there will be sudden rebound. Normal or negative result is no pain.

Question 8

Inspiratory Arrest

Answer 8

AKA Murphy Sign. Specific to the gallbladder. Put fingers under the liver border and have patient take a deep breath. Patient should not have pain.

Question 9

Iliopsas Muscle Test

Answer 9

To test for appendicitis. Lay supine, lift right leg straight up. RN pushes down on right thigh. If there is pain, then there is appendicitis.

Question 10

Romberg Test

Answer 10

Person stands with feet together and arm at the sides, with eyes closed for 20 seconds. Person should not lose balance.

Question 11

Spinothalamic Tract

Answer 11

pain, temperature, and light touch

Question 12

Posterior Column Tract

Answer 12

Vibration, Position, Tactile discrimination (fine touch)

Question 13

Tacticle Discrimination Tests

Answer 13

Stereogenesis, Grapesthesia, two-point discrimination, extinction, point location

Question 14

Extinction

Answer 14

Close eyes, touch opposite sides of the body and patient will tell you where you are touching

Question 15

Point Location

Answer 15

simulataneous touch patient’s body and they tell you where

Question 16

Reflex Grading Scale

Answer 16

0 = absent
1 = diminished
2 = normal
3 = brisker than average
4 = very brisk, hyperactive

Question 17

Clonus

Answer 17

Short, jerky contractions, not controllable

Question 18

Biceps Reflex

Answer 18

Flexion

Question 19

Triceps Reflex

Answer 19

Extension

Question 20

Brachioradialis Reflex

Answer 20

Flexion and supination

Question 21

Quadriceps Reflex

Answer 21

Extension

Question 22

Achilles Reflex AKA Ankle Jerk

Answer 22

Plantar flexion

Question 23

Plantar Reflex

Answer 23

Inversion and flexion

Fanning of the toes is for infants and is a positive Babinski sign

Question 24

Benign Breast Disease

Answer 24

Multiple tender masses - about 50% of women have a form of this disease

Question 25

Cancer

Answer 25

Solitary, unilateral, nontender mass - hard, dense, and fixed and underlying tissue

Question 26

Fibroadenoma

Answer 26

Benign tumors, solitary nontender mass that is solid, firm, rubbery and elastic - freely movable

Question 27

Order of Muskuloskeletal Exam

Answer 27

Inspect Palpate ROM Muscle Testing

Question 28

Dislocation

Answer 28

Complete loss of contact between bones in a joint

Question 29

Subluxation

Answer 29

2 bones in a joint stay in contact but their alignment is off

Question 30

contracture

Answer 30

shortening of a muscle, limits ROM

Question 31

Ankylosis

Answer 31

stiffness or fixation of a joint

Question 32

Muscle Test Grading Scale

Answer 32

``` 0 = no contraction 1 = slight contraction 2 = full ROM with gravity eliminated (passive motion) 3 = full ROM with gravity 4 = full ROM against gravity, some resistance 5 = full ROM against gravity, full resistance ```

Question 33

Phalen Test

Answer 33

Hold both hands back to back while flexing wrists 90 degrees. People with carpal tunnel will have numbness and burning

Question 34

Tinels Sign

Answer 34

Direct percussion of the median nerve at the wrist - burning and tingling is a sign of carpal tunnel

Question 35

Bulge Sign

Answer 35

Confirms presence of small amounts of liquid as you try to move the fluid from 1 side of the joint to the other

Question 36

Ballottement of Patella

Answer 36

When larger amounts of fluid are present - compress suprapatellar pouch to move fluid into knee joint, push patella against femur - if no fluid is present then the patella is already against the femur

Question 37

McMurray Test

Answer 37

Test for meniscal tears - place patient supine, hold heel and flex knee and hip and rotate leg in and out, externally rotate leg - in you hear or feel a click the the test is positive for a meniscal tear

Question 38

Osteoarthritis

Answer 38

noninflammatory, localized progressive disorder involving deterioration of articular cartilages and subchondral bone

Question 39

Osteoporosis

Answer 39

Decrease in skeletal bone mass occurring when rate of bone resorption is greater than that of bone formation

Question 40

Dyschezia

Answer 40

pain due to a local condition (hemarrhoid, fissure) or constipation

Question 41

Melena

Answer 41

Black stools

Question 42

steatorrhea

Answer 42

excessive fat in the stool, malabsorption of fat

Question 43

Pap smear

Answer 43

screens for cervical cancer, NOT endometrial or ovarian cancer

Question 44

Location of Breasts

Answer 44

Between 2 and 6th ribs. Anterior to the pectoralis major and serratus anterior muscle

Question 45

Montgomery Glands

Answer 45

small elevated sebaceous glands on the areola

Question 46

Cervix

Answer 46

Smooth, firm, evenly rounded, somewhat mobile