Nursing 507-Exam 1 Q's

Question 1

John B is a 16 y/o male who present to your office for a camp physical. He is accompanied by his mother. He denies any acute problems or allergies. He denies drug, alcohol or tobacco use. He states that he is an average student. He enjoys participating in sports, especially competitive bike racing. (John will be the pt. for the next 3 Q’s).

When performing a physical exam of John, u must include?

A. Tanner staging, scoliosis screening, height & weight eval, BP, vision & hearing screen, instructions for testicular self-exam

B. Tanner staging, height & weight eval, complete neuro exam

C. scoliosis screening, vision & hearing screen, & BP eval

D. Scoliosis screening & instruction in testicular self-exam

Answer 1

A. Tanner staging, scoliosis screening, height & weight eval, BP, vision & hearing screen, instructions for testicular self exam

Question 2

Your interview with John B should include Q’s regarding the following topics:

A. Home, education, activities, alcohol use, tobacco use, & recent injuries

B. Home, school, religion, diet, & sexual practices

C. Home, education, activities drug use, sexuality, & suicide (suicidal thoughts)

D. Education, diet, drug use, participation in sports, BC practices

Answer 2

C. Home, education, activities drug use, sexuality, & suicide (suicidal thoughts)

Question 3

What are the principles of interviewing that you should use when obtaining a history from John?

A. The adolescent & his mother should be interviewed together & separately

B. The adolescent should be interviewed aloe to ensure confidentiality of the interview

C. The adolescent & parent should determine the interview procedure

D. There should not be any discussion of findings or health recommendations with the parent

Answer 3

C. The adolescent & parent should determine the interview procedure

Question 4

Health promotion guidance for John should include?

A. Development, nutrition, dental health, physical activity, injury prevention, sun exposure, smoking, alcohol, illicit drugs, sexual behavior, & safe sex practices

B. Diet, injuries & poisons, oral health, tobacco, & family planning

C. Physical activity, alcohol, sexual practice, sun exposure

D. Balanced diet, exercise, stress management, injury prevention, smoking, weight control, & safe sex practices

Answer 4

A. Development, nutrition, dental health, physical activity, injury prevention, sun exposure, smoking, alcohol, illicit drugs, sexual behavior, & safe sex practices

Question 5

John B is a 20 y/o college student who presents to the student health center for an annual visit. She denies any med, drug, alcohol use & reports no acute problems. She admits to a recent 18 lb weight loss.
She c/o of recent cessation of menses for 3 months, fatigue & dry skin. She denies a family h/o depression or mood disorders. She admits to a decrease in food intake. Her history is negative for obesity. (Jane will be the pt. in 2 Q’s)

Routine screening exams is appropriate for Jane should include?

A. Height & weight, BP, pelvic exam, & clinical breast exam

B. Height & weight, temp, & clinical breast exam

C. Cardiac assess, pulse, respiration, & pelvic exam

D. pulmonary asess, BP, & pelvic exam

Answer 5

A. Height & weight, BP, pelvic exam, & clinical breast exam

Question 6

When taking Jane B’s deit history, the following info should be obtained?

A. daily intake, dietary restrictions, nutritional supplements, & caffeine intake

B. Daily intake, frequency of meals, food preferences, & fluid intake

C. Dietary preferences, diet restrictions, & caffeine intake

D. Dietary needs, use of vitamins & herbs, fluid intake

Answer 6

A. daily intake, dietary restrictions, nutritional supplements, & caffeine intake

Question 7

Alex is a 28 y/o editor who presents to the clinic with abd pain. The pain is dull ache, located in the right upper quadrant, that she rates as a 3 at the least & an 8 at the worst. The pain started a few weeks ago, it lasts for 2-3 hours at a time, it comes & goes, & it seems to be worse a couple of hours after eating. She has noticed that it starts after eating greasy foods, so she has cut down on these as much as she can. Initially it occurred once a week, but now it is occurring every day. Nothing makes it better. From this description which of the 7 attributes of a symptom has been omitted?

A. Setting in which the sx’s occur

B. Associated manifestations (signs & sx’s)

C. Quality

D. Timing

Answer 7

B. Associated manifestations (signs & sx’s)

Question 8

What is the best way to approach a child age 1-4 years who ma be fearful of healthcare providers?

A. Take the health history from the parent as the child plays nearby fully clothed.

B. Talk firmly to a crying child & complete the exam

C. Talk with the child & parent while the child is undressed on the exam table

D. Talk firmly to the child & discuss methods of discipline with the parent

Answer 8

A. Take the health history from the parent as the child plays nearby fully clothed.

Question 9

For which reason does a clinician examine an older sibling if both children are being seen together?

A. The older child’s exam will take longer; besides the younger child has less to examine & the exam will go quicker in the end

B. The older child wants to get finished & join her friends in the waiting room.

C. The younger child will be less apprehensive when she sees the older child is alright during the exam

D. The younger child is crying so examining the older child first will give the younger child time to compose herself.

Answer 9

C. The younger child will be less apprehensive when she sees the older child is alright during the exam

Question 10

The importance of asking history questions about the patients daily life (under the psychosocial history) is to gather data on all of the following except:

A. Usual coping mechanisms

B. Presence of an apathetic life-style

C. Presence of realistic daily goals

D. Health of current family members

Answer 10

D. Health of current family members

Question 11

What is the name given to the multiple blackish blue areas on the buttocks & lower lumbar regions common in Native American, Asian & African American children

A. port wine stains

B. physiologic jaundice

C. mongolian spots

D. cutis marmorata

Answer 11

C. mongolian spots

Question 12

Which of the following is a rough test of intelligence & one that tests the higher cognitive functions by asking the name of the president, vice president or governor?

A. Information & vocab

B. Calculating ability

C. Proverbs

D. Constructional ability

Answer 12

A. Information & vocab

Question 13

Which of the following is the best technique for assessing the eyes of the infant?

A. open the eyes using the index finger & thumb

B. wait until the infant opens eyes & assess them quickly

C. hold infant in extended arms & rotate self & infant together

D. have the parent hold the eyes open for assessment

Answer 13

A. open the eyes using the index finger & thumb

Question 14

Adam is a very successful 15 y/o student & athlete. His mother brings him to your office today because he no longer studies, works out, or sees his friends. This has gone on for a month & a half. When you speak with him alone in the room he states it “would be better if I am not here what would you do next?

A. Tell him that he has a very promising career in anything he chooses & son he will feel better

B. Tell him that he needs an antidepressant & it will take about 4 weeks to work

C. speak with his mother about getting him together more with his friends

D. Assess his suicide risk

Answer 14

D. Assess his suicide risk

Question 15

What could be the cause of the following symptoms: generalized weakness, fatigue, weight loss, low grade fever, tender, warm, stiff joints in the morning?

A. Gout

B. Fibromyaligia syndrome

C. Rheumatoid arthritis

D. Oseoarthritis

Answer 15

C. Rheumatoid arthritis

Question 16

Which part of the history gives a clear, chronological account of how the symptoms developed?

A. Chief complaint

B. History if present illness

C. Past medical history

D. Review of systems

Answer 16

B. History if present illness

Question 17

Height, growth & body build are charted on a graph beginning at birth through adolescence. The adolescent growth spurt can readily be seen. What other general changes occur in this growth spurt?

A. The spine becomes somewhat stooped

B. The abd muscles weaken

C. Fat tends to concentrate around the hips

D. Boys shoulders increase more than girls

Answer 17

D. Boys shoulders increase more than girls

Question 18

Which of the following will help to optimize yield from a pediatric exam?

A. doing the exam out of order if necessary to take advantage of quiet periods for auscultation

B. being very orderly so as not to miss a portion of the exam

C. using firmness as needed to make it though your first exam

D. making sure to place the infant on the table during the exam while mom watches close by

Answer 18

A. doing the exam out of order if necessary to take advantage of quiet periods for auscultation

Question 19

Which bone should be palpated to determine the presence of a common fracture because of a difficult shoulder or arm extraction during delivery?

A. Clavicle

B. Humerus

C. Radius

D. Ulna

Answer 19

A. Clavicle

Question 20

Which of the following is an important physical exam guideline?

A. The exam length should be the same for every pt. regardless of the presenting problem

B. The periodic physical exam to detect & prevent disease in asymptomatic individuals is a must

C. The sequence of the exam is designed to minimize the pts need to change position & maximize the clinicians effficiency

D. The clinician must do enough physical exam on a regular basis to gain efficiency & maintain skills

Answer 20

C. The sequence of the exam is designed to minimize the pts need to change position & maximize the clinicians effficiency

Question 21

The physical exam of a pt. who complains of sore ribs on her right side for 2 days & has pain with deep breathing, revealed tenderness on light palpation. Which of the following questions would you ask if abuse were suspected?

A. Have you had any upper respiratory infections in the last month?

B. Is there a family history of heart disease?

C. Have you had past injuries like this one?

D. What is your occupation?

Answer 21

C. Have you had past injuries like this one?

Question 22

A pt. who had a left popliteal bypass has scratched the area near the surgical incision site covered with adhesive tape and now has a rash three times the original size. This rash is?

A. considered a new problem because she has not sought health care help before; make an entry in her chart

B. a minimal problem change the type of tape and don’t worry about it

C. considered a new problem but minimal assess the rash but there is no need to notify the physician

D. a new problem, change the type of tape, assess the rash, notify the physician because this may interfere with the healing process at the surgical site

Answer 22

D. a new problem, change the type of tape, assess the rash, notify the physician because this may interfere with the healing process at the surgical site

Question 23

You ask a mother when her child began to roll from front to back to front by herself. what type of info do you want to evaluate?

A. family development

B. social development

C. developmental milestone

D. prenatal history

Answer 23

C. developmental milestone

Question 24

To what does the general health statement section under physical exam refer?

A. The clinicians assessment of the patients health status

B. the patients perception of health

C. documentation of previous charting

D. chief complaint

Answer 24

A. The clinicians assessment of the patients health status

Question 25

Under current medications section of the history, which drugs should be included?

A. only prescription meds

B. OTC meds except vitamins

C. all meds including OTC meds

D. drug dosages & frequency of use

B/

Answer 25

C. all meds including OTC meds

Question 26

The review of systems data is considered part of the?

A. subjective data

B. objective data

C. analysis data

D. none of the above

Answer 26

A. subjective data

Question 27

Which of the following is evidence that during the teenage years, the ability to think abstractly & weigh consequences of actions is developed?

A. making correct career decisions

B. using or abusing ETOH or drugs

C. having the ability to resist peer pressure

D. having the ability to control impulses

Answer 27

B. using or abusing ETOH or drugs

Question 28

While taking a history of a pt. with chest pain what observations are made?

A. level of consciousness, posture, affect & characteristics of speech

B. level of consciousness, degree of aphasia, affect, & associated movements

C. level of consciousness, gait, symmetry, posture

D. unknown

Answer 28

A. level of consciousness, posture, affect & characteristics of speech

Question 29

What might be indicated in an infant whose femoral pulses were barely palpable as compared to the brachioradialis pulses?

A. umbilical hernia

B. coarctation of the aorta

C. aortic aneurysm

D. aortic stenosis

Answer 29

B. coarctation of the aorta

Question 30

As a family NP, you realize you will encounter various types of patients. To develop cultural sensitivity you must:

A. Recognize cultural diversity exists

B. Recognize & accept that cultural values are deeply ingrained & are very difficult to change

C. Be willing to modify health care to be congruent with the patients cultural background

D. Identify & examine your own cultural beliefs

E. all of the above

Answer 30

E. all of the above

Question 31

A pt. presents for eval of a sharp, aching chest pain which increases with breathing. Which anatomic area would you localize the symptom to?

A. Musculoskeletal

B. Reproductive

C. Urinary

D. Endocrine

Answer 31

A. Musculoskeletal

Question 32

Observation of the parent-infant/parent child interactions may identify which of the following?

A. childhood illness

B. failure to thrive & developmental delay

C. parental abuse & neglect

D. intelligence & language ability

Answer 32

C. parental abuse & neglect

Question 33

Which of the following offers proper instruction to the parents of a toddler with bowlegs?

A. call the orthopedic surgeon & plan for consultation visit

B. Do not do anything as bowlegs are normal in many children & they usually outgrow it

C. Gently twist the legs to show the muscles how to grow

D. Pin the diapers tighter to pull the legs in

Answer 33

B. Do not do anything as bowlegs are normal in many children & they usually outgrow it

Question 34

What action does a clinician take t ease the anxious, vulnerable, & exposed feelings many parents may have during a physical exam?

A. skips part of the exam to get through faster

B. listens, inspects, & palpates every region of the body that does not cause discomfort

C. examines in a gentle manner but is not afraid to cause discomfort if required

D. performs the exam in a sequence & does not deviate

Answer 34

B. listens, inspects, & palpates every region of the body that does not cause discomfort

Question 35

Which of the following would facilitate the history process & diminish undue stress on a pt. during an episode of acute chest pain?

A. ask questions as you auscultate the pt’s heart & lungs

B. take vitals signs as you ask questions on the characteristics of the chest pain

C. ask about the health history without the review of systems & wait until the episode of chest pain is over

D. Ask a few essential questions but obtain as much history as possible from the pt’s spouse who is in the waiting room

Answer 35

B. take vitals signs as you ask questions on the characteristics of the chest pain

Question 36

Mrs. Hyatt, a 35 y/o african american female cmes to your clinic with c/o weight loss, urinary frequency, & fatigue. In order to care for Mrs. Hyatt you will need to begin to generate a dx. Which of the following will be most helpful in determining the correct dx?

A. develop the database & develop your plan

B. record the findings & cluster the data

C. develop the database, cluster the data, select the most central finding

D. look over general info, obtain the history, do the physical exam, & develop a plan

Answer 36

C. develop the database, cluster the data, select the most central finding

Question 37

Which of the following cues may indicate a dysfunctional parent-child relationship?

A. The parent & child are having fun together in the exam room while the clinician takes the health history

B. The child stands close to the parent while the clinician is in the room

C. The parent & child have been separated for a long time without either showing concern

D. The child responding appropriately to conversation & questions from the parent

Answer 37

C. The parent & child have been separated for a long time without either showing concern

Question 38

Pt. strengths are identified & charted under analysis when SOAP charting is used?

A. True

B. False

Answer 38

A. True

Question 39

A skilled clinician will integrate, during the history, the gathering of data on mental status. Which of the following data are NOT necessary for a mental status assessment?

A. inspection of general appearance & affect

B. inspection of ability to pay attention & stay focused

C. questioning about edu & cultural background

D. palpation of the abd & peripheral pulses

Answer 39

D. palpation of the abd & peripheral pulses

Question 40

The components of the health history include all of the following except which one?

A. Review of systems

B. Thorax & lungs

C. History of present illness

D. personal & social items

Answer 40

B. Thorax & lungs

Question 41

For which of the following pt’s would a comprehensive health history be appropriate?

A. A new pt with a chief complaint of “I sprained my ankle.”

B. An established pt. with a chief complaint of “I have an upper resp infection.”

C. A new pt. with a chief complaint of “I am here to establish care.”

D. A new pt. wit a chief complaint of “I cut my hand.”

Answer 41

C. A new pt. with a chief complaint of “I am here to establish care.”

Question 42

The adolescent period is a time of cognitive development & intellectual maturation. Which of the following is true about the maturational process?

A. The individual matures by successfully finishingone stage &/ moving to the next

B. The process varies in its time of onset, duration, & is irrespective of chronological age

C. The individual moves through the process at a steady rate

D. The process is completed around 12 years of age

Answer 42

B. The process varies in its time of onset, duration, & is irrespective of chronological age

Question 43

A pt. tells the nurse that she is very uncomfortable with the itching she is experiencing. Which of the following describes this info given by the pt.?

A. subjective data

B. objective data

C. secondary data

D. systemtatic data

Answer 43

A. subjective data

Question 44

Which part of the exam is started at the beginning of the history & continues through the entire physical exam?

A. Resp assessment

B. Vital signs

C. General survey

D. neurological assessment

Answer 44

C. General survey

Question 45

As a NP in a pediatric setting, your highest educational priority in the plan is?

A. always interacting with the child

B. providing anticipatory guidance

C. prescribing appropriate antibiotics

D. documentation of the parent-child relationship

Answer 45

B. providing anticipatory guidance

Question 46

A 66 y/o man with a known history of COPD presents to your clinic for eval of progressive SOB. He had an upper resp infection (URI) 2 weeks ago & the sx’s have gotten worse. On physical exam, you discover that he is having an acute exacerbation of his COPD. On the general survey of the pt. you would expect to see him?

A. sitting up & leaning forward with his arms braced

B. supine with arms comfortably at his side

C. laying on his left side

D. standing

Answer 46

A. sitting up & leaning forward with his arms braced

Question 47

Which of the following statements concerning the elderly is true?

A. depression is a normal part of aging

B. although their motor responses may be slow, their ability to perform complex tasks is impaired

C. difficulty recalling the name of people or names of objects signifies the beginning of alzheimers disease

D. most men & women adapt well to aging & maintain activities that are appropriate to their abilities

Answer 47

D. most men & women adapt well to aging & maintain activities that are appropriate to their abilities

Question 48

Which type of history is gathered for an acute problem & requires tha only this need is met?

A. complete history

B. inventory history

C. episodic history

D. osteoarthritis

Answer 48

C. episodic history

Question 49

A parent has had a headache for 3 days. He denies a history of migraines & states “life is good for me.” However, he has a dull affect. Which history question would you ask if you suspected a dx of depression?

A. what meds do you take for your h/a

B. what do you see in the future for yourself

C. What thoughts are you keeping out of your mind?

D. What meaning do you attach to your headaches?

Answer 49

B. what do you see in the future for yourself

Question 50

Which of the following shows insensitivity toward the elderly when taking a health history?

A. The elderly person may be hearing impaired & need the healthcare provider to speak more slowly using a lower voice

B. The elderly person may not report embarrassing sx’s

C. The elderly person has a slower reaction & needs a longer time to respond to the question

D. The elderly person may feel less anxious if the name Grandpa is used for the healthcare provider

Answer 50

D. The elderly person may feel less anxious if the name Grandpa is used for the healthcare provider