Nursing 507- Exam 2 Q's Flashcards
You have been employed as an FNP at a family practice clinic which sees mostly women & children. Today your 1st pt., Michael is a 2 y/o boy whose mother states “he has a weeping lesion on his face that is covered with a honey colored crust.” (Use Michaels scenario for the next Q)
Based on your knowledge of children, what is the most likely dx?
A. Contact dermatitis
B. Allergic dermatitis
C. Impetigo
D. Herpes simplex infection
C. Impetigo
Your physical exam with Michael will include (use Michaels scenario)
A. Perform a complete HEENT exam (includes everything you can do in this system)
B. Inspection of the skin on face & arms & palpation of lymph nodes in neck & arms
C. inspection of the skin on face & arms, palpation of the lympth nodes in neck & arms, auscultation of heart & lungs
D. complete HEENT exam, inspection of the skin, palpation of the lympth nodes in neck & arm
B. Inspection of the skin on face & arms & palpation of lymph nodes in neck & arms
Mary Smith is a 37 y/o white female present to your office with complaints of intermittent chest pain. She has been well up until 1 month ago, when she had a “bad cold which settled in my chest” She c/o a frequent cough, scant white sputum & a bad pain with coughing. She denies smoking, h/o bronchitis, asthma, fever, chills, diaphoresis, sob, & hemoptysis. Her PMH is unremarkable (use mary’s scenario for the next 2 q’s)
The most important component of the history in the eval of chest pain is?
A. characteristics of pain
B. pt’s previous med history
C. family history
D. pt’s age
A. characteristics of pain
When taking Mary’s history of the pain, it is vital to elicit the (use of Mary’s scenario)
A. duration of chest pain
B. location of the chest pain
C. subjective description of the chest pain
D. all of the above
D. all of the above
chest pain that is reproducible with putting pressure to the chest wall during palpation (you or her) is most consistent with the dx of? (use of mary’s scenario)
A. angina
B. pericarditis
C. costochondritis
D. gastroesophageal reflux
C. costochondritis
your pt. james c/o intermittent wheezing SOB for the past 18 months. These sx’s have become more severe over the past 2 months & he has decided to seek healthcare. He is a smoker for 14 year & has 3 unsuccessful attempts to quit in the past 2 yrs. He denies a productive cough. ETOH, or illicit drug use. Physical exam reveals BP 108/74, R 22 min & use of accessory muscles to breath (use James scenario for 2 Q’s)
What further history is important to obtain from James? (need to ask first)
A. surgical history
B. social history
C. family history
D. psychosocial history
C. family history
You have decided that james has emphysema. While auscultating the lungs you realize that the expected breath sounds for James would be (James scenario)
A. vesicular breath sounds
B. bronchial over involved area
C. obscured by wheezes
D. decreased to absent
D. decreased to absent
If you were to percuss Jame’s lungs, what would the expected result be? (james scenario)
A. dull
B. hyperresonant
C. tympanic
D. flat
B. hyperresonant
Valerie a 42 y/o waitress presents to your office for eval of SOB. she has had a fever as high as 103 F for the past 3 days & has a productive cough with green sputum (use vals scenario for the next 2 q’s)
On physical exam you hear crackles in her lungs. A chest radiograph reveals a consolidation in the left lower lobe. You dx her with lobar pneumonia. When you perform tactile fremitus on theleft lower thorax, you would expect fremitus to be?
A. decreased
B. increased
C. unchanged from expected
D. displaced
B. increased
When you percuss Valerie’s left lower thorax, you would expect the percussion sound to be? (use vals scenario)
A. dull
B. resonant
C. flat
D. hyperresonant
A. dull
When you perform the test for egophony on this pt you would expect to hear (use vals scenario)
A. eee
B aay
C. whispered pectoriology
D. oooo
B aay
As an FNP in a cardiovascular clinic your job is to perform a complete history & physical on all clients who are scheduled for testing. During the history on Bob, a 45 y/o, he tells you that in the past he has felt his heart racing. (use bobs scenario for the next question)
This info belongs in the:
A. chief complaint
B. family history
C. Review of systems (ROS)
D. objective data with the lung assessment
C. Review of systems (ROS)
To get more info from Bob who states he sometimes has a “racing heartbeat” you ask all the following q’s except? (use Bob’s scenario)
A. Did you turn pale during the attack
B. What meds are you taking
C. Is there anything that sets the attacks off?
D. Is the heartbeat regular or irregular during the racing?
A. Did you turn pale during the attack
Brandon a 15 y/o member of the high school marching badn comes to your clinic for eval of hearing loss. He has multiple hearing infections as an infant and toddler, & had myringotomy tubes inserted in his ears. Additionally, he suffers from many allergies. His hearing is diminished in his right ear. When you place a vibrating tuning fork on the top if his head, the sound laterlized to the right ear. The name of this test is?
A. webers test
B. rinne’s test
C. whisper test
D. romberg test
A. webers test
Next u place a vibrating tuning fork on Brandon’s right mastoid process, asking him to tell you when he can no longer hear the sound; then you immediately place that same tuning fork near his right ear. He tells you he can hear the sound equally in air as against bone. The name of this test is?
A. weber’s test
B. Rinne’s test
C. whisper test
D. romberg test
B. Rinne’s test
Melanie is an 18 y/o pt who presents to your office with c/o fever, yellowish- green nasal discharge, intermittent sore throat & dull h/a (use mels scenario for 2 q’s)
Which of the following 2 q’s is the least important to ask mel?
A. ask about onset, duration & location
B. ask about seasonal allergies
C. ask if able to eat or drink anything
D. ask melanie to describe the sore throat & what aggravates it
C. ask if able to eat or drink anything
with c/o fever, yellowish- green nasal discharge, intermittent sore throat & dull h/a
Using your knowledge of the human body & ailments you realize that for Mel possible differential dx include all of the following except (mels scenario)
A. cluster/migraine h/a
B. allergic rhinitis
C. sinusitis
D. bronchiolitis
A. cluster/migraine h/a
For Mel, the most comprehensive but appropriate plan includes the following: (Mels scenario)
A. appropriate antibiotic, saline gargles, tylenol
B. advise her to use a humidifier, increase fluid intake, avoidance of swimming or driving. tylenol antihistamine
C. advise using a humidifier, increase fluid intake, avoidance of air travel, appropriate antihistamine, antibiotic & tylenol
D. utilizing nasal steroid, tyelonal & appropriate antibiotic
C. advise using a humidifier, increase fluid intake, avoidance of air travel, appropriate antihistamine, antibiotic & tylenol
Joshua, a 55 y/o male accountant presents with central chest pain on exertion, which 1st started when he was climbing stairs at his office. The chest pain is central, retrosternal, with some radiation to neck & arms. It goes away rapidly when he rests & tends to be worse in cold weather or after a heavy metal. He smokes 10 cigs/day. His father died of MI at the age of 60 y/o (use Josh’s scenario for the next q)
A. How much ETOH do you drink in a week?
B. Any siblings with heart problems?
C. Do you have a similar pain if you get excited or upset?
D. A & C
E. B & C
E. B & C
Joshua, a 55 y/o male accountant presents with central chest pain on exertion, which 1st started when he was climbing stairs at his office. The chest pain is central, retrosternal, with some radiation to neck & arms. It goes away rapidly when he rests & tends to be worse in cold weather or after a heavy metal. He smokes 10 cigs/day. His father died of MI at the age of 60 y/o
Josh’s most likely dx is?
A. MI
B. Pericarditis
C. Musculoskeletal pain
D. Angina
D. Angina
