2013 Exam Multichoice questions Flashcards Preview

168.123 Assessment and clinical decision making > 2013 Exam Multichoice questions > Flashcards

Flashcards in 2013 Exam Multichoice questions Deck (30):
1

1. When performing the physical assessment the examiner should:
a) examine tender or painful areas first to help relieve the patient's anxiety.
b) follow the same examination sequence regardless of the patient's age or condition.
c) organize the steps of the assessment so that the patient does not change positions too often.
d) perform the examination from the left side of the bed.

c) organize the steps of the assessment so that the patient does not change positions too often.

2

2. 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.

3

3. While counting the apical pulse on a 16-year-old patient, you note an irregular rhythm. His rate speeds up on inspiration and slows on expiration. What would be your response?
a) refer the patient to a cardiologist for further testing.
b) no further response needed as this is a normal finding.
c) talk with patient about his intake of caffeine.
d) do an electrocardiogram following the exam.

d) do an electrocardiogram following the exam.
a) refer the patient to a cardiologist for further testing.

4

4. You notice that your client’s pupils are not equal. Normal pupillary light reflex would show:
a) pupillary dilation when looking at far objects.
b) eyes converging and pupils constricting when looking at a near object.
c) constriction of both pupils occurs in response to bright light.
d) both eyes converge to focus on the light.

c) constriction of both pupils occurs in response to bright light.

Weber & Kelly Pg 272

5

5. When you ask your 68-year-old patient to stand with feet together and arms at his side with his eyes closed, he starts to sway and moves his feet further
apart. You would document this as a:
a) negative Homan's sign.
b) positive Romberg's sign.
c) ataxia.
d) negative Romberg's sign.

b) positive Romberg's sign.

Doesn't appear to be anything in Weber and Kelly on how to record this but found on internet

6

6. It is normal to palpate a few lymph nodes in the neck of a healthy person.
What are the characteristics of these nodes?
a) mobile, soft, non-tender.
b) large, clumped, tender.
c) matted, fixed, tender, hard.
d) soft , fixed, non-tender.

a) mobile, soft, non-tender.

Page 261 Weber and Kelly

7

7. 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.

8

8. In examining Mr. P., 70, you notice that he has bilateral gynaecomastia. Which of the following describes your best course of action?
a) ignore it, it is not unusual for men to have benign breast enlargement.
b) recommend that Mr. P. see his doctor for a mammogram.
c) explain that this condition may be the result of hormonal changes and recommend that he see his doctor.
d) tell Mr. P. that gynaecomastia in the male is usually associated with prostate enlargement and recommend that he be screened thoroughly.

c) explain that this condition may be the result of hormonal changes and recommend that he see his doctor.

Pg 381 Weber and Kelly
Not a normal finding - Gynaecomastia, a smooth, firm, moveable disc of glandular tissue may be seen in one breast in males for a temporary time. However it may also be seen in in hormonal imbalances, drug abuse, cirrhosis, leukaemia, and thyrotoxicosis. Irregular shaped, hard nodules occur in breast cancer.

9

9. Auscultation is the term used for?
a) Listening to the sounds produced by the body.
b) Listening to the sounds produced by palpation.
c) The sounds heard on percussion.
d) All of the above.

a) Listening to the sounds produced by the body.

10

10. Objective data in the assessment is obtained:
a) By what the patient says about themselves during the history.
b) During the initial interview.
c) From the nursing diagnosis.
d) By the nurse during the physical assessment

d) By the nurse during the physical assessment

11

11.When assessing an individual for their mental health status, there are four main headings of assessment. What are these?
a) Mood, affect, consciousness and orientation
b) Memory, attention, thought content and perception
c) Language, orientation, attention and abstract reasoning
d) Appearance, behaviour, cognition and thought process.

d) Appearance, behaviour, cognition and thought process.

Info from the forum from the Jarvis textbook

Weber & Kelly Pg 59 - Mental status refers to a persons level of cognitive and emotional functioning and stability

12

12. 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.

a) document findings before leaving the examination room.

13

13. 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.

Weber & Kelly Pg 37
Sonds and vibrations allow you to assess underlying structures. Percussion has several different assessment uses including:
Elicit pain
Determine location, size and shape
Determine density
Detect abnormal masses
Elicit reflexes

14

14. The Glasgow Coma Scale is divided into three areas. They include:
a) pupillary response, a reflex test and assessing pain.
b) eye opening, motor response to stimuli and verbal response.
c) response to fine touch, stereognosis and sense of position.
d) orientation, rapid alternating movements and Romberg test.

b) eye opening, motor response to stimuli and verbal response.

15

15. When assessing the spine you would ask the patient to:
a) Adduct and extend
b) Supinate evert and retract
c) Extend adduct invert and rotate
d) Flex, extend, rotate

d) Flex, extend, rotate

Also need to add lateral bends (side to side)

From Marlas Notes

16

16. Examination of the shoulder includes:
a) Forward flexion, internal rotation, abduction and external rotation
b) Abduction ,adduction ,pronation and supination
c) Circumduction, inversion, eversion and rotation
d) Eversion, retraction, protraction, and circumduction

a) Forward flexion, internal rotation, abduction and external rotation

From Marlas Notes
Also includes Hyperextension and adduction

17

17.When examining the apical pulse, the normal size of the impulse is?
a) < 1cm
b) about 2cm
c) 3cms
d) varies depending on the size of the person

d) varies depending on the size of the person

Normally 1 to 2cm but in patients with large breasts or who are obese apical pulse may not be palpable

Pg 405 Weber and Kelly

18

18. The absence of bowel sounds is established after listening for
a) 1 full minute
b) 3 full minutes
c) 5 full minutes
d) None of the above

c) 5 full minutes

19

19. Auscultation of the abdomen may reveal bruits of which arteries
a) Aortic, renal iliac and femoral
b) Jugular, aortic, carotid and femoral
c) Pulmonic, aortic and portal
d) Renal iliac internal jugular and femoral

a) Aortic, renal iliac and femoral

20

20. The largest salivary gland is located
a) Within the cheeks in front of the ear
b) Beneath the mandible at the angle of the jaw
c) Within the floor of the mouth under the tongue
d) As the base of the tongue

a) Within the cheeks in front of the ear

Three pairs of salivary glands are:
Parotid - below and in front of ears, empty through stensons ducts located in the cheek
Submandibular - in lower jaw, open under the tongue on either side of frenulum through Whartons ducts
Sublingual - under the tongue, open through several ducts located on the floor of the mouth

Page 313 Weber and Kelly

21

21. A common cause of conductive hearing loss is
a) Impacted cerumen
b) Acute rheumatic fever
c) A CVA
d) Otitis externa

a) Impacted cerumen

22

22. When auscultating the lungs of an adult patient, you note that over the posterior lower lobes you hear low pitched, soft breath sounds with inspiration
being longer than expiration. You know that these are:
a) bronchial breath sounds and are normal in that location.
b) bronchovesicular breath sounds and are normal in that location.
c) vesicular breath sounds and are normal in that location.
d) sounds normally auscultated over the trachea.

c) vesicular breath sounds and are normal in that location.

Bronchial - Trachea/Thorax; High pitch, Short inspiration & long expiration
Bronchiovesicular - Over sternum and between scapulae; Moderate pitch, Same length during inspiration and expiration
Vesicular - Peripheral lung fields; Low pitch; Long inspiration and short expiration

Page 355 Weber & Kelly

23

23. 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)

24

24. 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.

25

25. Positive consensual light reflex is when
a) The convergence of the axes of the eyeballs
b) The simultaneous constriction of the other pupil when one eye is exposed to bright light
c) A reflex direction of the eye towards an object attracting a person’s attention
d) The adaptation of the eye to near vision

b) The simultaneous constriction of the other pupil when one eye is exposed to bright light

26

26. 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

27

27. 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.

28

28. Tenderness on light palpation in the right lower quadrant could indicate a disorder of the:
a) spleen.
b) sigmoid.
c) gallbladder.
d) appendix.

d) appendix.

29

29. Upon percussion you note a dull sound at the midline in the pelvic region. You might suspect:
a) appendicitis.
b) distended bladder.
c) impaction.
d) renal calculi.

b) distended bladder.

If there is dull percussion on the flanks this may a dull percussion tone on the flanks

Page 472 Weber and Kelly

30

30. The most reliable indicator of pain in an adult is?
a. degree of physical functioning.
b. non verbal behaviours.
c. the family’s comments.
d. the client’s self report.

d. the client’s self report.