2012 Exam Multichoice questions Flashcards Preview

168.123 Assessment and clinical decision making > 2012 Exam Multichoice questions > Flashcards

Flashcards in 2012 Exam Multichoice questions Deck (30):
1

1. Your patient tells you he is allergic to penicillin. What would be your next response?
a) "Are you allergic to any other drugs?"
b) "I'll write your allergy on your medication chart so you won't receive any."
c) "Would you describe what happens to you when you take penicillin?"
d) "How often have you received penicillin?"

c) "Would you describe what happens to you when you take penicillin?"

2

2. The force or strength of the pulse:
a) is a reflection of the heart's stroke volume.
b) reflects the blood volume in the arteries during diastole.
c) demonstrates elasticity of the vessel wall.
d) is usually recorded on a 0-2 scale.

a) is a reflection of the heart's stroke volume.

From lecture notes

3

3. What should the examiner palpate for tenderness prior to examining the ear with the otoscope?
a) helix, external auditory meatus and lobule.
b) mastoid process, tympanic membrane and malleus.
c) pinna, pars flaccida and antitragus.
d) pinna, tragus and mastoid process.

d) pinna, tragus and mastoid process.

Refer to lecture notes for this information

4

4. In the Rinne test, the 2 to 1 ratio refers to:
a) the loudness of the tone heard by the two ears.
b) the length of time until the patient stops hearing the tone by air conduction and by bone conduction.
c) the length of time until the patient no longer hears the tone and the examiner no longer hears the tone.
d) the examiner hearing the tone twice as long as the patient hears it.

b) the length of time until the patient stops hearing the tone by air conduction and by bone conduction.

Using the tuning forks to test air and bone conduction for sounds. Air conduction is twice as long as bone conduction for a normal. In sensorineural loss air conduction is longer than bone conduction but NOT twice as long

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5

5. The left lung:
a) is shorter than the right because of the underlying stomach.
b) consists of two lobes.
c) consists primarily of an upper lobe on the posterior chest.
d) is divided by the percardial fissure.

b) consists of two lobes.

6

6. The first heart sound (S1) is the result of:
a) aortic and pulmonic valve closure.
b) aortic and mitral valve closure.
c) mitral and tricuspid valve closure.
d) tricuspid and pulmonic valve closure.

c) mitral and tricuspid valve closure.

S1 is lub and first sound of heart beat, S1 Starts systole - where blood is ejected from the ventricles (ventricular contraction)

7

7. The valve closures that can BEST be heard at the base of the heart are:
a) aortic, pulmonic
b) mitral, tricuspid
c) mitral, pulmonic
d) tricuspid, aortic

a) aortic, pulmonic

Aortic area - 2nd intercostal at right sternal border (base of the heart)
Pulmonic area - 2nd intercostal at the left sternal border (base of the heart)

Erbs point - 3rd to 5th intercostal space at the left sternal border
Mitral (apical) - 5th intercostal space near the midclavicular line (the apex of the heart)
Tricuspid area - 4th or 5th intercostal space at the lower left sternal border

Page 396 Weber & Kelly

8

8. To assess the dorsalis pedis artery, you would palpate:
a) in the groove behind the medial malleolus.
b) lateral to the extensor tendon of the great toe.
c) over the lateral malleolus.
d) behind the knee.

b) lateral to the extensor tendon of the great toe.

Dorsiflex the patients foot and apply light pressure lateral to and along the side of the extensor tendon of the big toe.

Assess amplitude bilaterally

Page 437 Weber and Kelly

9

9. Joe is being assessed for range of joint movement. You ask him to move his arm in towards the center of his body. This movement is called:
a) flexion.
b) extension.
c) adduction.
d) abduction.

c) adduction.

10

10. In assessing the tonsils of a 30-year-old, you note they are involuted, granular in appearance, and appear to have deep crypts. What would be your response to these findings?
a) Nothing, this is the appearance of normal tonsils.
b) Obtain a throat culture on the patient for possible strep infection.
c) Refer patient to a throat specialist.
d) Continue with assessment looking for any other abnormal findings.

a) Nothing, this is the appearance of normal tonsils.

Check this answer? from quizlet

Tonsilitis (detecting and grading)
1+ Tonsils are visible
2+ Tonsils are midway between tonsillar pillars and uvula
3+ Tonsils touch the uvula
4+ Tonsils touch each other

11

11. Select the sequence of techniques used during an examination of the abdomen.
a) Percussion, inspection, palpation, auscultation.
b) Inspection, palpation, percussion, auscultation.
c) Inspection, auscultation, percussion, palpation.
d) Auscultation, inspection, palpation, percussion.

c) Inspection, auscultation, percussion, palpation.

12

12. You are obtaining a history from a 30-year-old male and are concerned about health promotion activities. Which of the following questions would you ask?
a) "Have you ever noticed any pain in your testicles?"
b) "Do you perform testicular self exams?"
c) "Do you have any history of sexually transmitted infections?"
d) "Have you had any problems with passing your urine?"

b) "Do you perform testicular self exams?"

13

13. Which of the following statements is true regarding the diaphragm of the stethoscope?
a) Use the diaphragm to listen for high-pitched sounds.
b) Use the diaphragm to listen for low-pitched sounds.
c) Hold the diaphragm lightly against the person's skin to listen for extra heart sounds and murmurs.
d) Hold the diaphragm lightly against the person's skin to block out the low-pitched sounds.

a) Use the diaphragm to listen for high-pitched sounds.

14

14. During the examination, it is often appropriate to offer some brief teaching about the patient's body or your findings. Which of the following statements is most appropriate?
a) "You have pitting oedema and mild varicosities."
b) "Your hypertension is under control."
c) "I'm using my stethoscope to listen for any adventitious sounds."
d) "Your pulse is 80 beats per minute; this is within the normal range."

d) "Your pulse is 80 beats per minute; this is within the normal range."

15

15. In assessing the radial pulse of a patient, you would:
a) count the pulse for 15 seconds and multiply by 4, if the rhythm is regular.
b) count the pulse for 1 minute if the rhythm is irregular.
c) count the initial pulse for a full 2 minutes to detect any variation in amplitude.
d) count the pulse for 10 seconds and multiply by 6, if the patient has no history of cardiac abnormalities.

b) count the pulse for 1 minute if the rhythm is irregular.

16

16. During an initial interview, the nurse asks, “Mrs. J., tell me what you do when your headaches occur.” With this question, the nurse is seeking information
about:
a) the client’s perception of the problem.
b) aggravating or relieving factors.
c) the frequency of the problem.
d) the severity of the problem.

a) the client’s perception of the problem.

17

17. At the conclusion of the examination, the examiner should:
a) document findings before leaving the examination room.
b) have findings confirmed by another practitioner.
c) relate objective findings to the subjective findings for accuracy.
d) summarise findings to the patient.

/

18

18. The purpose of percussion is to:
a) assess underlying tissue consistency.
b) assess underlying tissue texture.
c) assess underlying structures.
d) assess underlying tissue turgor.

c) assess underlying structures.

Percussion - Elicits pain; Determines location, size and shape ; Determines density ; Detects abnormal masses and Elicits reflexes (tendon hammer)

Three types - direct (onto patient) , indirect (through finger) and blunt (fist through hand)

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19

19. The nurse must ensure that the earpieces of the stethoscope are placed so that the alignment fits the contour of the ear canal. In which direction should they be placed?
a) pointing upward.
b) pointing downward.
c) pointing forward.
d) pointing backward.

b) pointing downward.

20

20. You are measuring the initial blood pressure on a 72 year-old client is being admitted for hypertension. How would you proceed?
a) Place the cuff on the client’s arm and inflate it 30 mmHg above the client’s pulse rate.
b) Inflate the cuff to 200 mmHg in an attempt to obtain the most accurate systolic reading.
c) Inflate the blood pressure cuff 30 mmHg above the point at which the palpated pulse disappeared.
d) Look at the client’s past blood pressure readings, and inflate the cuff 30 mmHg above the highest systolic reading recorded.

c) Inflate the blood pressure cuff 30 mmHg above the point at which the palpated pulse disappeared.

21

21. The capillary bed should refill after being depressed in
a) less than 1 second.
b) more than 2 seconds.
c) 1 – 2 seconds.
d) time is not significant as long as colour returns.

c) 1 – 2 seconds.

22

22. Which of the following is an expected normal finding when performing the diagnostic positions test?
a) Nystagmus in extreme superior gaze.
b) A slight amount of lid lag when moving the eyes from a superior to inferior position.
c) Parallel tracking of object with both eyes.
d) Convergence and accommodation of the eyes.

/

23

23. A patient has a normal pupillary light reflex. What does this mean?
a) The eye focuses the image in the centre of the pupil.
b) Constriction of both pupils occurs in response to bright light.
c) The eyes converge to focus on the light.
d) Light is reflected at the same spot in both eyes.

b) Constriction of both pupils occurs in response to bright light.

Pupillary light reflex causes pupils to immediately constrict when exposed to light.
Direct reflex - only eye exposed to light constricts OR
Indirect/Consensual reflex - opposite eye exposed to light constricts.

Page 272 Weber and Kelly

24

24. The tympanic membrane should appear:
a) whitish with a small fleck of light in superior portion.
b) pearly grey and slightly concave.
c) pulled in at the base of the cone of light.
d) light pink with a slight bulge.

b) pearly grey and slightly concave.

25

25. The most important technique when progressing from one auscultatory site on the thorax to another is:
a) top to bottom comparison.
b) side to side comparison.
c) posterior to anterior comparison.
d) interspace by interspace comparison.

b) side to side comparison.

26

26. In your assessment of a healthy adult, where would you expect to palpate the apical impulse?
a) third left intercostal space at the midclavicular line.
b) fifth left intercostal space at the midclavicular line.
c) fourth left intercostal space at the sternal border.
d) fourth left intercostal space at the anterior axillary line.

b) fifth left intercostal space at the midclavicular line.

Use palmer of hand to palpate intercostal spaces and will find the apical pulse in the mitral area. Use one finger pad for more accurate palpation.

Not always possible to palpate, consider patient sitting upright and leaning forward or on their lateral left side

Page 405 Weber and Kelly

27

27. Bradycardia is the term given for?
a) a heart rate above 60 beats per minute (b.p.m)
b) a heart rate below 60 bpm
c) an irregular heart rate
d) the normal variation of heart rate related to inspiration and expiration

b) a heart rate below 60 bpm

28

28. In the patient’s medical record their tonsils are graded as 3+. On assessment the tonsils would be?
a) visible.
b) half way between the tonsilar pillars and uvula.
c) touching the uvula.
d) touching each other.

c) touching the uvula.

Tonsilitis (detecting and grading)
1+ Tonsils are visible
2+ Tonsils are midway between tonsillar pillars and uvula
3+ Tonsils touch the uvula
4+ Tonsils touch each other

29

29. The sinuses that are accessible to examination are the:
a) ethmoid and sphenoid.
b) frontal and ethhmoid.
c) maxillary and sphenoid.
d) frontal and maxillary .

d) frontal and maxillary .

Frontal sinus - above the eyes
Maxillary - in the jaw
Ethmoid and Sphenoid sinuses are deeper in the skull.

30

30. Visual acuity is assessed with:
a) the Snellen Eye Chart.
b) an ophthalmoscope.
c) the Confrontation Test.
d) the Hirschberg Test.

a) the Snellen Eye Chart.

Used for distant (6 metres) and close (35cm handheld) testing

Patient stands 6 metres from the chart, covers one eye with a card and reads each letter.

Recorded as a fraction. Top number is always 6 (distance from chart) and bottom number refers to the last full line patient could read. Last line on chart (smallest letters is usually 6/6). If any letters are missed record and then deduct number of letters eg 6/9 - 2

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