Health Assessment Exam 1 Flashcards
(224 cards)
1
Q
Which statement is true regarding the relationship of physical characteristics and culture?
a. Physical characteristics should be used to identify members of cultural groups.
b. There is a difference between distinguishing cultural characteristics and
distinguishing physical characteristics.
c. To be a member of a specific culture, an individual must have certain identifiable
physical characteristics.
d. Gender and race are the two essential physical characteristics used to identify
cultural groups.
A
There is a difference between distinguishing cultural characteristics and
distinguishing physical characteristics.
2
Q
An image of any group that rejects its potential for originality or individuality is known as a(n)
a. acculturation
b. norm.
c. stereotype.
d. ethnos.
A
c. stereotype.
3
Q
- Mr. L presents to the clinic with severe groin pain and a history of kidney stones. Mr. L’s son tells you that for religious reasons, his father wishes to keep any stone that is passed into the urine filter that he has been using. What is your most appropriate response?
a. ―With your father’s permission, we will examine the stone and request that it be
returned to him.‖
b. ―The stone must be sent to the lab for examination and therefore cannot be kept.‖
c. ―We cannot let him keep his stone because it violates our infection control policy.‖
d. ―We don’t know yet if your father has another kidney stone, so we must analyze
this one
A
a. ―With your father’s permission, we will examine the stone and request that it be
returned to him.
4
Q
- The motivation of the healthcare professional to ―want to engage in the process of becoming culturally competent, not ―have to, is called
a. cultural knowledge.
b. cultural awareness.
c. cultural desire.
d. cultural skill.
A
c. cultural desire.
5
Q
- Mr. Marks is a 66-year-old patient who presents for a physical examination to the clinic. Which question has the most potential for exploring a patient’s cultural beliefs related to a health problem?
a. ―How often do you have medical examinations?‖
b. ―What is your age, race, and educational level?‖
c. ―What types of symptoms have you been having?‖
d. ―Why do you think you are having these symptoms?
A
d. ―Why do you think you are having these symptoms?
6
Q
- The definition of ill or sick is based on a
a. stereotype.
b. cultural behavior.
c. belief system.
d. cultural attitude.
A
c. belief system.
7
Q
- A 22-year-old female nurse is interviewing an 86-year-old male patient. The patient avoids eye contact and answers questions only by saying, ―Yeah,―No, or ―I guess so. Which of the following is appropriate for the interviewer to say or ask?
a. ―We will be able to communicate better if you look at me.‖
b. ―It’s hard for me to gather useful information because your answers are so short.‖
c. ―Are you uncomfortable talking with me?‖
d. ―Does your religion make it hard for you to answer my questions?
A
c. ―Are you uncomfortable talking with me?
8
Q
- As you explain your patient’s condition to her husband, you notice that he is leaning toward you and pointedly blinking his eyes. Knowing that he is from England, your most appropriate response to this behavior is to
a. tell him that you understand his need to be alone.
b. ask whether he has any questions.
c. ask whether he would prefer to speak to the clinician.
d. tell him that it is all right to be angry.
A
b. ask whether he has any questions.
9
Q
- An aspect of traditional Western medicine that may be troublesome to many Hispanics, Native Americans, Asians, and Middle Eastern groups is Western medicine’s attempts to
a. use a holistic approach that views a particular medical problem as part of a bigger
picture.
b. determine a specific cause for every problem in a precise way.
c. establish harmony between a person and the entire cosmos
d. restore balance in an individual’s life.
A
b. determine a specific cause for every problem in a precise way.
10
Q
- The attitudes of the healthcare professional
a. are largely irrelevant to the success of relationships with the patient.
b. do not influence patient behavior.
c. are difficult for the patient to sense.
d. are culturally derived.
A
d. are culturally derived.
11
Q
- Mr. Sanchez is a 45-year-old gentleman who has presented to the office for a physical examination to establish a new primary care healthcare provider. Which of the following describes a physical, not a cultural, differentiator?
a. Race
b. Rite
c. Ritual
d. Norm
A
a. Race
12
Q
- Mr. Abdul is a 40-year-old Middle Eastern man who presents to the office for a first visit with the complaint of new abdominal pain. You are concerned about violating a cultural prohibition when you prepare to do his rectal examination. The best tactic would be to
a. forego the examination for fear of violating cultural norms.
b. ask a colleague from the same geographic area if this examination is acceptable.
c. inform the patient of the reason for the examination and ask if it is acceptable to
him.
d. refer the patient to a provider more knowledgeable about cultural differences.
A
c. inform the patient of the reason for the examination and ask if it is acceptable to
him.
13
Q
- Mr. Jones is a 45-year-old patient who presents to the office. A person’s definition of illness is likely to be most influenced by
a. race.
b. socioeconomic class.
c. enculturation.
d. age group.
A
c. enculturation.
14
Q
- As the healthcare provider, you are informing a patient that he or she has a terminal illness. This discussion is most likely to be discouraged in which cultural group?
a. Navajo Native Americans
b. Dominant Americans
c. First-generation African descendants
d. First-generation European descendants
A
a. Navajo Native Americans
15
Q
- Because of common cultural food preferences, avoidance of monosodium glutamate (MSG) is likely to be most problematic for the hypertensive patient of which group?
a. Native Americans
b. Hispanics
c. Chinese
d. Italians
A
c. Chinese
16
Q
. An example of a cold condition is
a. a fever.
b. a rash.
c. tuberculosis.
d. an ulcer.
A
c. tuberculosis.
17
Q
- Which variables can intrude on successful communication? (Select all that apply.)
a. Social class
b. Gender
c. Stereotype
d. Phenotype
e. Age
A
a. Social class
b. Gender
e. Age
18
Q
- Campinha-Bacote’s Process of Cultural Competence Model includes which cultural constructs? (Select all that apply.)
a. Desire
b. Awareness
c. Thought processes
d. Skill
e. Language
A
a. Desire
b. Awareness
d. Skill
19
Q
- Which question would be considered a ―leading question?
a. ―What do you think is causing your headaches?
b. ―You don’t get headaches often, do you?
c. ―On a scale of 1 to 10, how would you rate the severity of your headaches?
d. ―At what time of the day are your headaches the most severe?
A
b. ―You don’t get headaches often, do you?
20
Q
- When are open-ended questions generally most useful?
a. During sensitive area part of the interview
b. After several closed-ended questions have been asked
c. While designing the genogram
d. During the review of systems
A
a. During sensitive area part of the interview
21
Q
- Periods of silence during the interview can serve important purposes, such as
a. allowing the clinician to catch up on documentation.
b. promoting calm.
c. providing time for reflection.
d. increasing the length of the visit.
A
c. providing time for reflection.
22
Q
- Mr. Franklin is speaking with you, the healthcare provider, about his respiratory problem. Mr. Franklin says, ―I’ve had this cough for 3 days, and it’s getting worse. You reply, ―Tell me more about your cough. Mr. Franklin states, ―I wish I could tell you more. That’s why I’m here. You tell me what’s wrong! Which caregiver response would be most appropriate for enhancing communication?
a. ―After 3 days, you’re tired of coughing. Have you had a fever?
b. ―I’d like to hear more about your experiences. Where were you born?
c. ―I don’t know what’s wrong. You could have almost any disease.
d. ―I’ll examine you and figure out later what the problem is.
A
a. ―After 3 days, you’re tired of coughing. Have you had a fever?
23
Q
- After you ask a patient about her family history, she says, ―Tell me about your family now.‖ Which response is generally most appropriate?
a. Ignore the patient’s comment and continue with the interview.
b. Give a brief, undetailed answer.
c. Ask the patient why she needs to know.
d. Tell the patient that you do not discuss your family with patients.
A
b. Give a brief, undetailed answer.
24
Q
- A 36-year-old woman complains that she has had crushing chest pain for the past 2 days. She seems nervous as she speaks to you. An appropriate response is to
a. continue to collect information regarding the chief complaint in an unhurried manner.
b. finish the interview as rapidly as possible.
c. ask the patient to take a deep breath and calm down.
d. ask the patient if she wants to wait until another day to talk to you.
A
a. continue to collect information regarding the chief complaint in an unhurried
manner.
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7. Ms. A states, ―My life is just too painful. It isn’t worth it.‖ She appears depressed. Which one of the following statements is the most appropriate caregiver response?
a. ―Try to think about the good things in life.
b. ―What in life is causing you pain?
c. ―You can’t mean what you’re saying.
d. ―If you think about it, nothing is worth getting this upset about.
b. ―What in life is causing you pain?
26
8. You are collecting a history from a 16-year-old girl. Her mother is sitting next to her in the examination room. When collecting history from older children or adolescents, they should be
a. given the opportunity to be interviewed without the parent at some point during the
interview.
b. mailed a questionnaire in advance to avoid the need for them to talk.
c. ignored while you address all questions to the parent.
d. allowed to direct the flow of the interview.
a. given the opportunity to be interviewed without the parent at some point during the
interview.
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9. Information that is needed during the initial interview of a pregnant woman includes all the following except
a. the gender that the woman hopes the baby will be.
b. past medical history.
c. healthcare practices.
d. the woman’s remembering (knowledge) about pregnancy.
a. the gender that the woman hopes the baby will be.
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10. When interviewing older adults, the examiner should
a. speak extremely loudly, because most older adults have significant hearing
impairment.
b. provide a written questionnaire in place of an interview.
c. position himself or herself facing the patient.
d. dim the lights to decrease anxiety.
c. position himself or herself facing the patient.
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11. To what extent should the patient with a physical disability or emotional disorder be involved in providing health history information to the health professional?
a. The patient should be present during information collection but should not be
addressed directly.
b. All information should be collected from past records and family members while
the patient is in another room.
c. The patient should be involved only when you sense that he or she may feel
ignored.
d. The patient should be fully involved to the limit of his or her ability.
d. The patient should be fully involved to the limit of his or her ability.
30
12. When taking a history, the nurse should
a. ask the patient to give you any information he or she can recall about his or her
health.
b. start the interview with the patient’s family history.
c. use a chronologic and sequential framework.
d. use a holistic and eclectic structure.
c. use a chronologic and sequential framework.
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13. When questioning the patient regarding his or her sexual history, which question should be asked initially?
a. ―Do you have any particular sexual likes or dislikes?
b. ―Do you have any worries or concerns regarding your sexual life?
c. ―How often do you have intercourse and with whom?
d. ―Do you have any reason to think you may have been exposed to a sexually
transmitted infection?
b. ―Do you have any worries or concerns regarding your sexual life?
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14. A guideline for history taking is for caregivers to
a. ask direct questions before open-ended questions so that data move from simple to complex.
b. ask for a complete history at once so that data are not forgotten between meetings.
c. make notes sparingly so that the patient can be observed during the history taking.
d. write detailed information as stated by patients so that their priorities are reflected.
c. make notes sparingly so that the patient can be observed during the history taking.
33
15. Mr. D complains of a headache. During the history, he mentions his use of alcohol and illicit drugs. This information would most likely belong in the
a. chief complaint.
b. past medical history.
c. personal and social history.
d. review of systems.
c. personal and social history.
34
16. Direct questioning about domestic violence in the home should be
a. a routine component of history taking with all patients.
b. avoided for fear of offending the patient’s partner.
c. conducted only in cases in which there is a history of abuse.
d. used only when the patient is obviously being victimized.
a. a routine component of history taking with all patients.
35
17. A tool used to screen adolescents for alcoholism is the
a. CAGE.
b. CRAFFT.
c. PACES.
d. HITS.
b. CRAFFT.
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18. Tom is a 16-year-old diabetic who does not follow his diet. He enjoys his dirt bike and seems unconcerned about any consequences of his activities. Which factor is typical of adolescence and pertinent to Tom’s health?
a. Attachment to parents
b. High self-esteem
c. Low peer support needs
d. Propensity for risk taking
d. Propensity for risk taking
37
19. Mr. Mills is a 55-year-old patient who presents to the office for an initial visit for health promotion. A survey of mobility and activities of daily living (ADL) is part of a(n)
a. ethnic assessment.
b. functional assessment.
c. genetic examination.
d. social history.
b. functional assessment.
38
20. Constitutional symptoms in the ROS refer to
a. height, weight, and body mass index.
b. fever, chills, fatigue, and malaise.
c. hearing loss, tinnitus, and diplopia.
d. rashes, skin turgor, and temperature.
b. fever, chills, fatigue, and malaise.
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21. JM has been seen in your clinic for 5 years. She presents today with signs and symptoms of acute sinusitis. The type of history that is warranted is a(n) _________ history.
a. complete
b. inventory
c. problem or focused
d. interim
c. problem or focused
40
1. Which are appropriate for the interview setting with a patient? (Select all that apply.)
a. Playing music in the background
b. Ensuring comfort for all involved
c. Maintaining eye contact
d. Using a conversational tone
e. Keeping the door open
f. Removing physical barriers
b. Ensuring comfort for all involved
c. Maintaining eye contact
d. Using a conversational tone
f. Removing physical barriers
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1. According to the guidelines for Standard Precautions, the caregiver’s hands should be washed
a. only after touching body fluids with ungloved hands and between patient contacts.
b. only after touching blood products with ungloved hands and after caring for
infectious patients.
c. only after working with patients who are thought to be infectious.
d. after touching any body fluids or contaminated items, regardless of whether gloves are worn.
d. after touching any body fluids or contaminated items, regardless of whether gloves
are worn.
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2. Which patient is at the highest risk for developing latex allergy?
a. The new patient who has no chronic illness and has never been hospitalized
b. The patient who has had multiple procedures or surgeries
c. The patient who is a vegetarian
d. The patient who is allergic to contrast dye
b. The patient who has had multiple procedures or surgeries
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3. Which initial action, in a patient with autonomic dysreflexia, would aid in lowering blood pressure?
a. Have the patient lie on the left side.
b. Assist the patient to remove any tight clothing.
c. Recheck the blood pressure after 5 minutes.
d. Perform an EKG.
b. Assist the patient to remove any tight clothing.
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4. . The use of secondary, tangential lighting is most helpful in the detection of
a. variations in skin color.
b. enlarged tonsils.
c. foreign objects in the nose or ear.
d. variations in contour of the body surface.
d. variations in contour of the body surface.
45
5. You are caring for a nonambulatory 80-year-old male patient and he tells you, a female nurse, that he feels like he is having drainage from his rectum. Which initial nursing action is appropriate?
a. Drape the patient and observe the rectal area.
b. Tell the patient that his doctor will be notified of his problem.
c. Tell the patient that you will ask the male nurse on the next shift to check on the
problem.
d. Give the patient an ice pack to apply to the area.
a. Drape the patient and observe the rectal area.
46
6. You are planning to palpate the abdomen of your patient. Which part of the examiner’s hand is best for palpating vibration?
a. Dorsal surface
b. Finger pads
c. Fingertips
d. Ulnar surface
d. Ulnar surface
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7. The dorsal surface of the hand is most often used for the assessment of
a. crepitus.
b. temperature.
c. texture.
d. vibration.
b. temperature
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8. Mrs. Berger is a 39-year-old woman who presents with a complaint of epigastric abdominal pain. You have completed the inspection of the abdomen. What is your next step in the assessment process?
a. Light palpation
b. Deep palpation
c. Percussion
d. Auscultation
d. Auscultation
49
9. The degree of percussion tone is determined by the density of the medium through which the sound waves travel. Which statement is true regarding the relationship between density of the medium and percussion tone?
a. The more dense the medium, the louder the percussion tone.
b. The less dense the medium, the louder the percussion tone.
c. The more hollow the area percussed, the quieter the percussion tone.
d. Percussion over muscle areas produces the loudest percussion tones.
b. The less dense the medium, the louder the percussion tone.
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10. Expected normal percussion tones include
a. dullness over the lungs.
b. hyperresonance over the lungs.
c. tympany over an empty stomach.
d. flatness over an empty stomach.
c. tympany over an empty stomach.
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11. During percussion, a dull tone is expected to be heard over
a. healthy lung tissue.
b. emphysemic lungs.
c. the liver.
d. most of the abdomen.
c. the liver.
52
12. When using mediate or indirect percussion, which technique is appropriate?
a. Place the palmar surface of the nondominant hand on the body surface, with the fingers held together.
b. Place the palmar surface of the nondominant hand on the body surface, with the fingers slightly spread apart.
c. Place the ulnar surface of the nondominant hand on the body surface, with the fingers together.
d. Place the ulnar surface of the nondominant hand on the body surface, with the fingers slightly spread apart.
b. Place the palmar surface of the nondominant hand on the body surface, with the
fingers slightly spread apart.
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13. During percussion, the downward snap of the striking fingers should originate from the
a. shoulder.
b. forearm.
c. wrist.
d. interphalangeal joint.
c. wrist.
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15. During auscultation, you can limit your perceptual field best by
a. asking patients to describe their symptoms.
b. closing your eyes.
c. performing auscultation before percussion.
d. using an aneroid manometer.
b. closing your eyes.
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16. You are auscultating a patient’s chest. The sounds are not clear, and you are having difficulty distinguishing between respirations and heartbeats. Which technique can you use to facilitate your assessment?
a. Anticipate the next sounds.
b. Isolate each cycle segment.
c. Listen to all sounds together.
d. Move the stethoscope clockwise.
b. Isolate each cycle segment.
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17. Auscultation should be carried out last, except when examining the
a. neck area
b. heart.
c. lungs.
d. abdomen
d. abdomen
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18. Tympanic thermometers measure body temperature when a probe is placed
a. anterior to the ear.
b. posterior to the ear.
c. under the ear.
d. in the auditory canal.
d. in the auditory canal.
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19. A scale used to assess patients’ weight should be calibrated
a. only by the manufacturer.
b. by a qualified technician at regularly scheduled intervals.
c. each time it is used.
d. when necessary, with the patient standing on the scale.
c. each time it is used.
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20. The height-measuring attachment of the standing platform scale should be pulled up
a. before the patient steps on the scale.
b. before the scale is balanced.
c. after the patient steps on the scale.
d. only after weight has been assessed.
a. before the patient steps on the scale.
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21. The infant should be placed in which position to have his or her height or length measured?
a. Vertically, with the examiner’s hands under the infant’s axillae
b. Supine on a measuring board
c. Prone on a measuring board
d. In the lateral position, with the toes against a measuring board
b. Supine on a measuring board
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22. You are using an ophthalmoscope to examine a patient’s inner eye. You rotate the lens selector clockwise and then counterclockwise to compensate for
a. amblyopia.
b. astigmatism.
c. myopia.
d. strabismus.
c. myopia.
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23. The pneumatic attachment for the otoscope is used to evaluate
a. ear canal patency.
b. eardrum landmarks.
c. hearing acuity.
d. tympanic membrane movement.
d. tympanic membrane movement.
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24. Mr. Walters, a 32-year-old patient, tells you that his ears are ―stopped up. An objective assessment of this complaint is achieved by using the
a. tuning fork.
b. reflex hammer.
c. otoscope with pneumatic attachment.
d. tympanometer.
d. tympanometer.
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25. Tuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure
a. buzzing or tingling sensations.
b. buzzing from bone conduction.
c. hearing range of normal speech.
d. noise above the threshold level.
c. hearing range of normal speech.
65
6. To perform a deep tendon reflex measurement, you should
a. briskly tap the tendon with the rubber end of the hammer.
b. place the hammer firmly on the tendon for 3 to 5 seconds.
c. tap the silver end of the hammer on the tendon.
d. use the needle implement to determine sensory perception
a. briskly tap the tendon with the rubber end of the hammer.
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27. A variant of the percussion hammer is the neurologic hammer, which is equipped with which of the following?
a. Brush and needle
b. Tuning fork and cotton swab
c. Penlight and goniometer
d. Ruler and bell
a. Brush and needle
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28. Transillumination functions on the principle that
a. air, fluid, and tissue transmit light differentially.
b. black light causes certain substances to fluoresce.
c. converging and diverging light brings structures into focus.
d. tangential light casts shadows that illuminate contours.
a. air, fluid, and tissue transmit light differentially.
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1. Which of the following are the causes of hyperreflexia? (Select all that apply.)
a. Cold stirrups
b. Standard scale
c. Insertion of a speculum
d. Fever
e. Pressure during bimanual examination
a. Cold stirrups
c. Insertion of a speculum
e. Pressure during bimanual examination
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1. After the subjective and objective data have been prioritized, the next step is to
a. order laboratory tests.
b. formulate a problem list.
c. initiate appropriate referrals.
d. initiate therapy.
b. formulate a problem list.
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2. New findings of unknown causes are
a. problems to be noted on the problem list.
b. deferred for subsequent visits.
c. diagnosed before physical examination.
d. reserved for specialists.
a. problems to be noted on the problem list.
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3. Which is an accepted method of making a diagnosis?
a. Relying on intuition
b. Making maximal use of laboratory tests
c. Using first assumptions
d. Using algorithms
d. Using algorithms
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4. The adage that ―common problems occur commonly advises the practitioner to
a. always diagnose the patient’s problem in terms of what their practice usually sees.
b. refer any uncommon complaints to specialists as soon as possible.
c. not consider more than one diagnosis unless necessary.
d. examine uncommon problems critically before assuming that the issue is an unusual presentation of a common problem.
c. not consider more than one diagnosis unless necessary.
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5. The most important guide to sequencing actions should be
a. probability and utility.
b. assumption and intuition.
c. costs and risks of procedures.
d. reimbursement potential and patient acceptance.
a. probability and utility.
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6. Utilitarianism can be described as
a. balancing interests.
b. preventing harm.
c. choosing wisely.
d. doing good.
c. choosing wisely.
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7. Positive outcomes depend on the
a. number of laboratory tests ordered.
b. quality of decisions made.
c. use of pharmacologic modalities.
d. time saved by the use of ancillary personnel.
b. quality of decisions made.
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8. Self-analysis assists providers in giving proper context to
a. history and physical findings.
b. therapeutic options.
c. attitudes, values, and feelings.
d. differential diagnoses.
c. attitudes, values, and feelings.
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9. Medical decision making requires a balance between
a. trust and suspicion.
b. ethical and unethical behavior.
c. remembering and superstition.
d. mechanism and probabilism.
d. mechanism and probabilism.
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10. A valid history and physical examination can serve to
a. create higher healthcare costs.
b. limit the indiscriminate use of diagnostics.
c. threaten patient satisfaction.
d. increase the risk of liability.
b. limit the indiscriminate use of diagnostics.
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11. A specific test is one that has the ability to
a. correctly identify those who have the disease.
b. correctly identify those who do not have the disease.
c. be exclusively used to make a diagnosis.
d. exclude competing explanations for another test finding.
OBJ:Nursing process—diagnosis
b. correctly identify those who do not have the disease.
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12. Mr. Johnson actually has streptococcal pharyngitis; however, the throat culture is initially read as negative. This situation describes a test with a
a. low sensitivity.
b. high sensitivity.
c. high specificity.
d. low specificity.
a. low sensitivity.
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3. Which of the following is not a component of a management plan?
a. Presumptive diagnosis
b. Patient education
c. Diet modification
d. Physical therapy
a. Presumptive diagnosis
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14. When determining actions for the management plan, the practitioner should first address
a. problems in the order of their chronologic development.
b. the patient’s concern about a particular problem.
c. the patient’s social and economic circumstances.
d. the most urgent problem.
d. the most urgent problem.
83
1. When utilizing a joint approach with the patient, which factors are likely to be considered? (Select all that apply.)
a. Consultations
b. Laboratory studies
c. Assistive technology
d. Patient education
e. Practitioner background
a. Consultations
b. Laboratory studies
c. Assistive technology
84
1. Which part of the information contained in the patient’s record may be used in court?
a. Subjective information only
b. Objective information only
c. Diagnostic information only
d. All information
d. All information
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2. Ms. S reports that she is concerned about her loss of appetite. During the history, you learn that her last child recently moved out of her house to go to college. Rather than infer the cause of Ms. S’s loss of appetite, it would be better to
a. defer or omit her comments.
b. have her husband call you.
c. quote her concerns verbatim.
d. refer her for psychiatric treatment.
c. quote her concerns verbatim.
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3. Which is an effective adjunct to document the location of findings during the recording of the physical examination?
a. Relationship to anatomic landmarks
b. Computer graphics
c. Comparison with other patients of same gender and size
d. Comparison to previous examinations using light pen markings
a. Relationship to anatomic landmarks
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4. The position on a clock, topographic notations, and anatomic landmarks
a. are methods for recording locations of findings.
b. are used for noting disease progression.
c. are ways for recording laboratory study results.
d. should not be used in the legal record.
a. are methods for recording locations of findings.
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5. Regardless of the origin, discharge is described by noting
a. a grading scale of 0 to 4.
b. color and consistency.
c. demographic data and risk factors.
d. associated symptoms in alphabetic order.
b. color and consistency.
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6. Drawing of stick figures is most useful to
a. compare findings in extremities.
b. demonstrate radiation of pain.
c. indicate consistency of lymph nodes.
d. indicate mobility of masses.
a. compare findings in extremities.
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7. Which is an example of a problem that requires recording on the patient’s problem list?
a. Common age variations
b. Expected findings
c. Problems needing further evaluation
d. Minor variations
c. Problems needing further evaluation
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8. A problem may be defined as anything that will require
a. evaluation.
b. medication.
c. surgery.
d. treatment.
a. evaluation.
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9. Differential diagnoses belong in the
a. history.
b. physical examination.
c. assessment.
d. plan.
c. assessment.
93
10. Which of the following is not a component of the plan portion of the problem-oriented medical record?
a. Diagnostics ordered
b. Therapeutics
c. Patient education
d. Differential diagnosis
d. Differential diagnosis
94
11. Your patient returns for a blood pressure check 2 weeks after a visit during which you performed a complete history and physical examination. This visit would be documented by creating a(n)
a. progress note.
b. accident report.
c. problem-oriented medical record.
d. triage note.
a. progress note.
95
12. A detailed description of the symptoms related to the chief complaint is presented in the
a. history of present illness.
b. differential diagnosis.
c. assessment.
d. general patient information section.
a. history of present illness.
96
13. The effect of the chief complaint on the patient’s lifestyle is recorded in which section of the medical record?
a. Chief complaint
b. History of present illness
c. Past medical history
d. Social history
b. History of present illness
97
14. The patient’s perceived disabilities and functional limitations are recorded in the
a. problem list.
b. general patient information.
c. social history.
d. history of present illness.
d. history of present illness.
98
15. The review of systems is a component of the
a. physical examination.
b. health history.
c. assessment.
d. past medical-surgical history.
b. health history.
99
16. Allergies to drugs and foods are generally listed in which section of the medical record?
a. History of present illness
b. Past medical history
c. Social history
d. Problem list
b. Past medical history
100
17. Information recorded about an infant differs from that recorded about an adult, mainly because of the infant’s
a. attention span.
b. developmental status.
c. nutritional differences.
d. source of information.
b. developmental status.
101
18. Which finding is unique to the documentation of a physical examination of an infant?
a. Fontanel size
b. Liver span
c. Prostate size
d. Thyroid position
a. Fontanel size
102
19. Data relevant to the social history of older adults includes information on
a. family support systems.
b. previous healthcare visits.
c. over-the-counter medication intake.
d. date of last cancer screening.
a. family support systems.
103
20. A SOAP note is used in which type of recording system?
a. Preventive care
b. Problem oriented
c. Systems review
d. Traditional treatment
b. Problem oriented
104
21. The examiner’s evaluation of a patient’s mental status belongs in the
a. history of present illness.
b. review of systems.
c. physical examination.
d. patient education.
c. physical examination.
105
22. Which format would be used for visits that address problems not yet identified in the problem-oriented medical record (POMR)?
a. Brief SOAP note
b. Comprehensive health history
c. Progress note
d. Referral note
a. Brief SOAP note
106
23. George Michaels, a 22-year-old patient, tells the nurse that he is here today to ―check his allergies.‖ He has been having ―green nasal discharge‖ for the last 72 hours. How would the nurse document his reason for seeking care?
a. GM is a 22-year-old male here for ―allergies.
b. GM came into the clinic complaining of green discharge for the past 72 hours.
c. GM, a 22-year-old male, states that he has allergies and wants them checked.
d. GM is a 22-year-old male here for having ―green nasal discharge for the past 72 hours.
d. GM is a 22-year-old male here for having ―green nasal discharge for the past 72 hours.
107
1. The pyrexia response is triggered by the production and release of
a. prostaglandins.
b. endogenous pyrogens.
c. hypothalamic enzymes.
d. thyroid hormones.
a. prostaglandins.
108
2. During expiration, the internal intercostals
a. increase the force of muscular contraction.
b. decrease the lateral diameter during expiration.
c. decrease the intrathoracic space.
d. increase elastic recoil during expiration.
b. decrease the lateral diameter during expiration.
109
3. . The fifth vital sign is
a. pain.
b. orientation.
c. waist-to-hip ratio.
d. body mass index (BMI).
a. pain
110
4. The Joint Commission (TJC) requires that
a. pain be assessed on all discharges.
b. repeated assessment of pain be limited to those patients who complain of pain.
c. repeated intensity documentation be made of the course of pain relief for all
patients.
d. pain be assessed on surgical patients.
c. repeated intensity documentation be made of the course of pain relief for all
patients.
111
5. The perception of pain
a. is the same across cultures.
b. can be easily assessed in neonates.
c. is predictable with the same circumstances.
d. is affected by emotions and quality of sleep.
d. is affected by emotions and quality of sleep.
112
6. The most frequent cause of serious hypertension in children is
a. heart disease.
b. liver failure.
c. renal disease.
d. rheumatic fever.
c. renal disease.
113
7. Underestimation of blood pressure will occur if the cuff’s width covers
a. less than half of the upper arm.
b. less than 5 inches of the lower arm.
c. more than two-thirds of the upper arm.
d. more than 4 inches of the lower arm.
c. more than two-thirds of the upper arm.
114
8. Which pulse characteristic in the neonate may indicate infection?
a. Bounding pulse rate
b. Regular pulse rate
c. Sustained high pulse rate
d. Intermittent slow pulse rate
c. Sustained high pulse rate
115
9. Infants delivered by Cesarean section demonstrate which respiratory characteristic in comparison to infants delivered vaginally?
a. Slower respiratory rate
b. Faster respiratory rate
c. Shallower respirations
d. Deeper respirations
b. Faster respiratory rate
116
1. Which occurs with malignant hypertension? (Select all that apply.)
a. Blurred vision
b. Sleep disturbance
c. Tachycardia
d. Dyspnea
e. Encephalopathy
a. Blurred vision
d. Dyspnea
e. Encephalopathy
117
2. In a syndrome in which regional pain extends beyond this specific peripheral nerve injury, you would notice which of the following? (Select all that apply.)
a. Allodynia
b. Sleep disturbance
c. Blood flow changes
d. Numbness
e. Edema
a. Allodynia
c. Blood flow changes
d. Numbness
e. Edema
118
1. When is the mental status portion of the neurologic system examination performed?
a. During the history-taking process
b. During assessment of cranial nerves and deep tendon reflexes
c. During the time when questions related to memory are asked
d. Continually, throughout the entire interaction with a patient
d. Continually, throughout the entire interaction with a patient
119
2. A 69-year-old truck driver presents with a sudden loss of the ability to understand spoken language. This indicates a lesion in the
a. temporal lobe.
b. Broca area.
c. frontal cortex.
d. cerebellum.
a. temporal lobe.
120
3. The ability for abstract thinking normally develops during
a. infancy.
b. early childhood.
c. adolescence.
d. adulthood.
c. adolescence.
121
4. The Mini-Mental State Examination (MMSE) may be used to
a. estimate cognitive changes quantitatively.
b. estimate personality disorders qualitatively.
c. diagnose neurologic disorders.
d. determine the cause of memory loss.
a. estimate cognitive changes quantitatively.
122
5. Assessing orientation to person, place, and time helps determine
a. ability to understand analogies.
b. abstract reasoning.
c. attention span.
d. state of consciousness.
d. state of consciousness.
123
6. When you ask the patient to tell you the meaning of a proverb or metaphor, you are assessing which of the following?
a. Level of consciousness
b. Abstract reasoning
c. Emotional stability
d. Memory
b. Abstract reasoning
124
7. Impairment of arithmetic skills is often the result of
a. impaired execution of motor skills.
b. impaired judgment.
c. perceptual distortions.
d. depression.
d. depression.
125
8. Peripheral neuropathy is most likely to be manifested by
a. impaired memory.
b. impaired abstract reasoning.
c. impaired writing ability.
d. hallucinations.
c. impaired writing ability.
126
9. Recent memory may be tested by
a. asking the patient to name the past four presidents.
b. asking the patient to listen to and repeat a series of numbers.
c. showing the patient four items and asking him or her to list the items about 10
minutes later.
d. asking the patient about verifiable information, such as his or her mother’s maiden
name.
c. showing the patient four items and asking him or her to list the items about 10
minutes later.
127
10. Loss of immediate and recent memory with retention of remote memory suggests
a. attention-deficit/hyperactivity disorder (ADHD).
b. impaired judgment.
c. stupor.
d. dementia
d. dementia.
128
11. You ask the patient to follow a series of short commands to assess
a. judgment.
b. attention span.
c. arithmetic calculations.
d. abstract reasoning.
b. attention span.
129
12. Which observation would be most significant when assessing the condition of a patient who has judgment impairment?
a. Repeated failure to fulfill family obligations
b. Forgetting family members’ birth dates
c. Going to church three times a week
d. Planning for retirement in 20 years
a. Repeated failure to fulfill family obligations
130
13. Appropriateness of logic, sequence, cohesion, and relevance to topics are markers for the assessment of
a. mood and feelings.
b. attention span.
c. thought process and content.
d. abstract reasoning.
c. thought process and content.
131
14. Which type of hallucination is most commonly associated with alcohol withdrawal
a. Olfactory
b. Visual
c. Auditory
d. Tactile
d. Tactile
132
15. Flight of ideas or loosening of associations is associated with
a. aphasia.
b. dysphonia.
c. multiple sclerosis.
d. psychiatric disorders.
d. psychiatric disorders.
133
16. The Glasgow Coma Scale is used to
a. determine the cause of decreased consciousness.
b. diagnose disorders that alter level of consciousness.
c. quantify consciousness.
d. predict response to stimulant medications.
c. quantify consciousness.
134
17. Which condition is considered progressive rather than reversible?
a. Delirium
b. Dementia
c. Depression
d. Anxiety
b. Dementia
135
18. A clinical syndrome of failing memory and impairment of other intellectual functions, usually related to obvious structural diseases of the brain, describes
a. delirium.
b. dementia.
c. depression.
d. anxiety.
b. dementia.
136
19. Mrs. Griffiths, a 28-year-old patient, presents to your office to discuss her attention-deficit/hyperactivity disorder (ADHD). Which statement is true in regard to ADHD?
a. It occurs before 7 years of age.
b. It is usually related to mental retardation.
c. It is usually related to dementia.
d. It is manifested by prolonged periods of catatonic behavior.
a. It occurs before 7 years of age.
137
20. An aversion to touch or being held, along with delayed or absent language development, is characteristic of
a. attention-deficit/hyperactivity disorder.
b. autism.
c. dementia.
d. mental retardation.
b. autism.
138
21. You are interviewing a 20-year-old patient with a new-onset psychotic disorder. The patient is apathetic and has disturbed thoughts and language patterns. The nurse recognizes this behavior pattern as consistent with a diagnosis of
a. depression.
b. autistic disorder.
c. mania.
d. schizophrenia.
d. schizophrenia.
139
22. While interviewing a patient, you ask him to explain the ―Lion and the Mouse‖ to assess
a. reading comprehension.
b. attention span.
c. mood and feeling.
d. reasoning skills.
d. reasoning skills.
140
23. The Mini-Mental State Examination (MMSE) should be administered for the patient who
a. gets lost in her neighborhood.
b. sleeps an excessive amount of time.
c. has repetitive ritualistic behaviors.
d. uses illegal hallucinogenic drugs.
a. gets lost in her neighborhood.
141
1. Which clinical assessments test attention span? (Select all that apply.)
a. Spell WORLD backward.
b. Draw a clock.
c. Say the days of the week.
d. Do arithmetic calculations.
e. Explain ―a stitch in time saves nine.
a. Spell WORLD backward.
c. Say the days of the week.
d. Do arithmetic calculations.
142
2. Which are signs and symptoms of dementia? (Select all that apply.)
a. Aphasia
b. Apathy
c. Odd behaviors
d. Disintegration of personality
e. Lack of awareness of others
a. Aphasia
b. Apathy
d. Disintegration of personality
143
. Under most conditions, adult patients should be able to repeat forward a series of _____________ numbers.
ANS:
five to eight (or) 5 to 8
five to eight
5 to 8
144
2. The examiner should be concerned about neurologic competence if a social smile cannot be elicited by the time a child is _________ old.
ANS:
2 to 3 months
two to three months
2- to 3-months
A social smile is expected in the 2- to 3-month-old infant. If it is difficult or impossible to elicit a social smile by 3 months, the infant may not be neurologically intact.
145
1. The gonads begin to secrete estrogen and testosterone during
a. infancy.
b. puberty.
c. pregnancy.
d. early adulthood
b. puberty.
146
2. Developmental changes of puberty are caused mainly by the interaction of the pituitary gland, gonads, and
a. hypothalamus.
b. islet cells.
c. thalamus.
d. thymus.
a. hypothalamus.
147
3. After 50 years of age, stature
a. becomes fixed.
b. begins a barely perceptible secondary increase.
c. increases at a rate of 0.5 cm/year.
d. declines.
d. declines.
148
4. By 10 to 12 years of age, lymphatic tissues are about
a. 25% of adult size.
b. 50% of adult size.
c. the same as adult size.
d. twice the size of those in the adult.
d. twice the size of those in the adult.
149
5. During adolescence, the head size normally increases as a result of
a. sinus development.
b. brain mass increase.
c. evolution of lymphatic tissue.
d. hypertrophy of myelin.
a. sinus development.
150
6. Gender-specific skeletal differences first occur during
a. the second stage of fetal development.
b. late infancy.
c. early childhood.
d. adolescence.
d. adolescence.
151
7. Mrs. Layton is a 33-year-old patient who is obese. Most adult obesity begins
a. in adolescence.
b. in childhood.
c. after the skeletal growth is completed.
d. once sexual maturation is complete.
a. in adolescence.
152
8. The legs are the fastest growing body part during
a. early infancy.
b. late infancy.
c. childhood.
d. early adulthood.
c. childhood.
153
9. Skeletal mass and organ systems double in size during
a. infancy.
b. early childhood.
c. adolescence.
d. early adulthood.
c. adolescence.
154
10. Optimal infant birth weight is difficult for pregnant adolescents to obtain because
a. they have not completed their own growth spurt.
b. there are insufficient uterine supporting structures.
c. the amniotic fluid is variable in pregnant adolescents.
d. blood volume has not reached adult proportions.
a. they have not completed their own growth spurt.
155
11. How much of the weight gained during a normal pregnancy is accounted for by the fetus?
a. Less than 5 pounds
b. 6 to 8 pounds
c. 9 to 12 pounds
d. 13 to 30 pounds
b. 6 to 8 pounds
156
12. The rate of weight gain during pregnancy is expected to be
a. greatest in the first trimester.
b. greatest in the second trimester.
c. greatest in the third trimester.
d. about the same in each trimester.
b. greatest in the second trimester.
157
13. During a preventive healthcare visit, Ms. G, an older patient, states that she is getting shorter. She says that her son mentioned that her change in stature became noticeable to him during his last visit with her. Her posture appears straight and aligned. When addressing Ms. G.’s present concerns, it is most important to inquire about
a. the number of pregnancies.
b. her parents’ heights.
c. a history of scoliosis.
d. her usual height and weight.
d. her usual height and weight.
158
14. Over the past 2 decades, there has been a trend toward
a. increased osteoporosis.
b. preservation of height.
c. obesity in older adults.
d. preservation of muscle mass.
c. obesity in older adults.
159
15. Milestone achievements are data most likely to appear in the history of
a. adolescents.
b. infants.
c. school-age children.
d. young adults.
b. infants.
160
16. To estimate an individual’s frame size, the examiner should measure
a. skull circumference.
b. the length from the olecranon process to the acromion process.
c. elbow breadth.
d. hip circumference.
c. elbow breadth.
161
17. Healthy term babies generally double their birth weight by what age?
a. 3 months
b. 5 months
c. 9 months
d. 12 months
b. 5 months
162
18. Infants born to the same parents are normally within which range of weight of each other?
a. 6 ounces
b. 12 ounces
c. 1 pound
d. 2 pounds
a. 6 ounces
163
19. To measure head circumference, the tape is wrapped snugly around the child’s head at the occipital protuberance and the
a. supraorbital prominence.
b. brow line.
c. nasal bridge.
d. chin.
a. supraorbital prominence.
164
20. Between 5 and 24 months of life, the infant’s chest circumference is normally
a. about equal to the head circumference.
b. greater than head circumference by 2 inches.
c. smaller than head circumference by about 4 inches.
d. at least 2 inches smaller than head circumference.
a. about equal to the head circumference.
165
21. In clinical practice, the Ballard Assessment Tool is used to assess a newborn’s
a. length.
b. weight.
c. lung maturity.
d. gestational age.
d. gestational age.
166
22. Which situation poses the most concern?
a. The child whose weight and height ratios have remained at the 50th percentile
b. The child whose weight and height ratios have stayed between the 90th and 95th
percentiles
c. The child whose weight and height ratios have never been above the 50th
percentile
d. The child whose weight and height ratios have dropped 15 percentiles since the last visit
d. The child whose weight and height ratios have dropped 15 percentiles since the last visit
167
23. The upper-to-lower segment ratio should be calculated
a. bimonthly for the first year of life.
b. annually for the first 5 years.
c. only when a child is suspected of having a growth problem or unusual body proportions.
d. in children of first-generation immigrants.
c. only when a child is suspected of having a growth problem or unusual body
proportions.
168
24. Which statement regarding female pubertal changes is true?
a. Most adolescent girls will develop breasts before they develop pubic hair.
b. Peak height velocity should occur after menarche.
c. Breast asymmetry is an abnormal finding.
d. Menarche should occur by Tanner breast stage 2
a. Most adolescent girls will develop breasts before they develop pubic hair.
169
25. What is the youngest age at which pubic hair growth in the male may be considered normal?
a. 7 years
b. 8 years
c. 9 years
d. 10 years
c. 9 years
170
26. A pregnant woman of normal prepregnancy weight should be expected to gain how much weight per week during the second and third trimesters of pregnancy?
a. 1 pound
b. 3 pounds
c. 2 pounds
d. 4 pounds
a. 1 pound
171
27. A prominent forehead, large nose, large jaw, and elongation of the facial bones and extremities are signs of
a. infantile hydrocephalus.
b. acromegaly.
c. Cushing syndrome.
d. achondroplasia.
b. acromegaly.
172
28. Round face, preauricular fat, hyperpigmentation, and ―buffalo hump‖ in the posterior cervical area are associated with
a. infantile hydrocephalus.
b. acromegaly.
c. Cushing syndrome.
d. achondroplasia.
c. Cushing syndrome.
173
29. Mrs. Raymonds is a 24-year-old patient who has presented for a routine concern over her current weight. In your patient teaching with her, you explain the importance of macronutrients. Which of the following is a macronutrient?
a. Iron
b. Thiamin
c. Calcium
d. Fat
d. Fat
174
30. Which is the most vital nutrient?
a. Protein
b. Carbohydrate
c. Fat
d. Water
d. Water
175
31. Which of the following is the most accurate reflection of an individual’s food intake?
a. 24-hour diet recall
b. Food diary
c. Computerized nutrient analysis
d. Serum protein assay
b. Food diary
176
32. Mrs. Hartzell is a 34-year-old patient who has presented for nutritional counseling because she is a vegetarian. Deficiency of which of the following is a concern in the vegetarian diet?
a. Ascorbic acid
b. Vitamin B12
c. Folate
d. Fiber
b. Vitamin B12
177
33. Ms. Otten is a 45-year-old patient who presents with a complaint of weight gain. Which medication is frequently associated with weight gain?
a. Diuretics
b. Oral hypoglycemics
c. Laxatives
d. Steroids
d. Steroids
178
34. Ms. Davis is a 27-year-old patient with a BMI of 33. Based on her BMI, your diagnosis would be
a. normal body weight.
b. overweight.
c. obese.
d. extremely obese.
c. obese.
179
35. A 17-year-old girl presents to the clinic for a sports physical. Physical examination findings reveal bradycardia, multiple erosions of tooth enamel, and scars on her knuckles. She appears healthy otherwise. You should ask her if she
a. binges and vomits.
b. has regular menstrual periods.
c. has constipation frequently.
d. is cold intolerant.
a. binges and vomits.
180
1. Which are signs and symptoms of hydrocephalus? (Select all that apply.)
a. Early closed suture lines
b. Hyperreflexia
c. Irritable, poor feeding
d. Does not meet expected height and weight
e. Difficulty holding head up
f. Rapidly increasing head circumference
b. Hyperreflexia
c. Irritable, poor feeding
e. Difficulty holding head up
f. Rapidly increasing head circumferenc
181
1. . An 11-year-old boy is brought in for an annual physical examination by his mother. The boy’s height is 60 inches. You suspect Marfan syndrome because the boy’s arm span is greater than _______________ inches.
ANS: 60
182
2. Infants normally increase their birth length by ____% during the first year of life.
50
183
3. The term large for gestational age (LGA) indicates that an infant is larger than ____% of infants born at the same number of weeks’ gestation.
90
184
1. The autonomic nervous system coordinates which of the following?
a. High-level cognitive function
b. Balance and affect
c. Internal organs of the body
d. Balance and equilibrium
c. Internal organs of the body
185
2. The major function of the sympathetic nervous system is to
a. orchestrate the stress response.
b. coordinate fine motor movement.
c. determine proprioception.
d. perceive stereognosis.
a. orchestrate the stress response.
186
3. The parasympathetic nervous system maintains the day-to-day function of
a. digestion.
b. response to stress.
c. lymphatic supply to the brain.
d. lymphatic drainage of the brain.
a. digestion
187
4. Cerebrospinal fluid serves as a
a. nerve impulse transmitter.
b. red blood cell conveyer.
c. shock absorber.
d. mediator of voluntary skeletal movement.
c. shock absorber.
188
5. Diabetic peripheral neuropathy will likely produce
a. hyperactive ankle reflexes.
b. diminished pain sensation.
c. exaggerated vibratory sense.
d. hypersensitive temperature perception.
b. diminished pain sensation.
189
6. The thalamus is the major integration center for the perception of
a. speech.
b. olfaction.
c. pain.
d. thoughts.
c. pain.
190
7. The awareness of body position is known as
a. proprioception.
b. graphesthesia.
c. stereognosis.
d. two-point discrimination.
a. proprioception.
191
8. Which area of the brain maintains temperature control?
a. Epithalamus
b. Thalamus
c. Abducens
d. Hypothalamus
d. Hypothalamus
192
9. If a patient cannot shrug his or her shoulders against resistance, which cranial nerve (CN) requires further evaluation?
a. CN I, olfactory
b. CN V, trigeminal
c. CN IX, glossopharyngeal
d. CN XI, spinal accessory
d. CN XI, spinal accessory
193
10. Motor maturation proceeds in an orderly progression from
a. peripheral to central.
b. head to toe.
c. lateral to medial.
d. pedal to cephalic.
b. head to toe.
194
11. Normal changes of the aging brain include
a. increased velocity of nerve conduction.
b. diminished perception of touch.
c. increased total number of neurons.
d. diminished intelligence quotient.
b. diminished perception of touch.
195
12. The area of body surface innervated by a particular spinal nerve is called a
a. dermatome.
b. nerve pathway.
c. spinal accessory area.
d. cutaneous zone.
a. dermatome.
196
13. A neurologic past medical history should include data about
a. allergies.
b. circulatory problems.
c. educational level.
d. immunizations.
b. circulatory problems.
197
14. Which is the technique most often used for evaluating the neurologic system?
a. Auscultation
b. Inspection
c. Palpation
d. Percussion
b. Inspection
198
15. When assessing superficial pain, touch, vibration, and position perceptions, you are testing
a. cerebellar function.
b. emotional status.
c. sensory function.
d. tendon reflexes.
c. sensory function.
199
16. You are initially evaluating the equilibrium of Ms. Q. You ask her to stand, with her feet together and arms at her sides. She loses her balance. Ms. Q has a positive
a. Kernig sign.
b. Homan sign.
c. McMurray test.
d. Romberg sign.
d. Romberg sign.
200
17. The finger to nose test allows assessment of
a. coordination and fine motor function.
b. point location.
c. sensory function.
d. stereognosis.
a. coordination and fine motor function.
201
18. You are performing a two-point discrimination test as part of a well physical examination. The area with the ability to discern two points in the shortest distance is the
a. back.
b. palms.
c. fingertips.
d. upper arms.
c. fingertips.
202
19. As Mr. B enters the room, you observe that his gait is wide-based and he staggers from side to side while swaying his trunk. You would document Mr. B’s pattern as
a. dystonic ataxia.
b. cerebellar ataxia.
c. steppage gait.
d. tabetic stamping.
b. cerebellar ataxia.
203
20. Deep pressure tests are used mostly for patients who are experiencing
a. absent superficial pain sensation.
b. gait and stepping disturbances.
c. lordosis, osteoporosis, or arthritis.
d. tonic neck or torso spasms.
a. absent superficial pain sensation.
204
21. Vibratory sensory testing should be routinely done for the patient with
a. Parkinson disease.
b. diabetes.
c. cerebral palsy.
d. Guillain-Barré syndrome.
b. diabetes.
205
22. To assess a cremasteric reflex, the nurse strokes the
a. sole of the foot and observes whether the toes fan down and out.
b. abdomen and observes whether the umbilicus moves away from the stimulus.
c. inner thigh and observes whether the testicle and scrotum rise on the stroked side.
d. palm and observes whether the fingers attempt to grasp.
c. inner thigh and observes whether the testicle and scrotum rise on the stroked side.
206
23. When you ask a patient to close his or her eyes and identify an object placed in the hand, you are evaluating
a. stereognosis.
b. graphesthesia.
c. vibratory sensation.
d. extinction phenomenon.
a. stereognosis.
207
24. The ability to recognize a number traced on the skin is called
a. stereognosis.
b. graphesthesia.
c. an extinction phenomenon.
d. two-point discrimination.
b. graphesthesia.
208
25. Which condition is consistent with Brown-Séquard syndrome?
a. Central sensory loss that is generalized
b. Motor paralysis on the lesion side of the body
c. Multiple peripheral neuropathy of the joints
d. Spinal root paralysis below the umbilicus
b. Motor paralysis on the lesion side of the body
209
26. To assess spinal levels L2, L3, and L4, which deep tendon reflex should be tested?
a. Triceps
b. Patellar
c. Biceps
d. Achilles
b. Patellar
210
27. When using a monofilament to assess sensory function, the nurse
a. uses two simultaneous monofilaments on similar bilateral points and then
compares results.
b. applies both a monofilament and a pin on similar bilateral points and then
compares results.
c. applies pressure to the monofilament until the filament bends.
d. strokes the monofilament along the skin from proximal to distal areas.
c. applies pressure to the monofilament until the filament bends.
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28. Visible or palpable extension of the elbow is caused by reflex contraction of which muscle?
a. Achilles
b. Biceps
c. Patellar
d. Triceps
d. Triceps
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29. It is especially important to test for ankle clonus if
a. deep tendon reflexes are hyperactive.
b. deep tendon reflexes are hypoactive.
c. the Romberg sign is positive.
d. the patient has peripheral neuropathy.
a. deep tendon reflexes are hyperactive.
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30. On a scale of 1+ to 4+, which deep tendon reflex score is appropriate for a finding of clonus in a patient?
a. 1+
b. 2+
c. 3+
d. 4+
d. 4+
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31. Which sign is associated with meningitis and intracranial hemorrhage?
a. Babinski sign
b. Asymmetric tonic neck reflex
c. Doll’s eye movement
d. Nuchal rigidity
d. Nuchal rigidity
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32. Cranial nerve XII may be assessed in an infant by
a. watching the infant’s facial expressions when crying.
b. observing the infant suck and swallow.
c. clapping hands and watching the infant blink.
d. observing the infant’s rooting reflex.
b. observing the infant suck and swallow.
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33. You are most concerned for the infant who has a
a. weak palmar grasp at 3 months.
b. strong stepping reflex at 2 months.
c. weak plantar reflex at 9 months.
d. strong tonic neck at 6 months.
d. strong tonic neck at 6 months.
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34. At what age should the infant begin to transfer objects from hand to hand?
a. 2 months
b. 4 months
c. 7 months
d. 10 months
c. 7 months
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35. An acute polyneuropathy that commonly follows a nonspecific infection occurring 10 to 14 days earlier and that primarily affects the motor and autonomic peripheral nerves in an ascending pattern is
a. cerebral palsy.
b. HIV encephalopathy.
c. Guillain-Barré syndrome.
d. Rett syndrome.
c. Guillain-Barré syndrome.
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36. Which is a concern, rather than an expected finding, in older adults?
a. Reduced ability to differentiate colors
b. Bilateral pillrolling of the fingers
c. Absent plantar reflex
d. Reduction in upward gaze
b. Bilateral pillrolling of the fingers
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37. Which condition is potentially life-threatening if not treated expeditiously with antibiotics?
a. HIV encephalopathy
b. Dementia
c. Parkinson disease
d. Bacterial meningitis
d. Bacterial meningitis
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38. Ipsilateral Horner syndrome indicates a cerebrovascular accident (CVA) occurring in the
a. anterior portion of the pons.
b. internal or middle cerebral artery.
c. posterior inferior cerebellar artery.
d. vertebral or basilar arteries.
c. posterior inferior cerebellar artery.
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39. The immune system attacks the synaptic junction between the nerve and muscle fibers, blocking acetylcholine receptor sites in
a. myasthenia gravis.
b. encephalitis.
c. multiple sclerosis.
d. cerebral palsy.
a. myasthenia gravis.
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40. Persons with Parkinson disease have an altered gait characterized by
a. short shuffling steps.
b. the trunk in a backward position.
c. exaggerated swinging of the arms.
d. lifting the legs in a high-stepping fashion.
a. short shuffling steps.
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1. The tests for cortical sensory function include which of the following? (Select all that apply.)
a. Two-point discrimination
b. Extinction phenomenon
c. Superficial pain
d. Stereognosis
e. Touch
which of the following? (Select all that apply.)
a. Two-point discrimination
b. Extinction phenomenon
d. Stereognosis
