Midterm Exam Flashcards
A 35-year-old man is seen in the clinic for an infection in his left foot. Which of these findings should the FNP expect to see during an assessment of this patient?
Enlarged and tender inguinal nodes
The direction of blood flow through the heart is best described by which of these
Right atrium > right ventricle > pulmonary artery > lungs > pulmonary vein > left atrium > left ventricle
In assessing the carotid artery’s of an older patient with cardiovascular disease, the FNP would
Listen with the bell of the stethoscope to assess for bruit
When listening to heart sounds the FNP knows that the valve closures that can be heard best at the base of the heart are
Aortic and pulmonic
The sack that surrounds and protects the heart is called the
Pericardium
When assessing a newborn infant who is five minutes old the FNP knows that which of these statements would be true?
There is an opening in the atrial septum were blood can flow into the left side of the heart
The FNP is performing an assessment on an adult. The adults vital signs are normal and capillary refill is five seconds. What should the FNP do next?
Consider this a delayed capillary refill time investigate further
During an assessment of an older adult the FNP should expect to notice which finding as normal physiologic change associated with aging process?
Peripheral blood vessels growing more rigid with age producing a rise in systolic blood pressure
The mother of a three-month-old infant states that her baby has not been gaining weight. With further questioning the FNP finds that the infant falls asleep after nursing and wakes up after a short amount of time hungry again. What other information with the FNP want to have?
Presence of dyspnea or diaphoresis one sucking
In assessing a patient’s major risk factors for heart disease which would the FNP want to include when taking a history?
Smoking, hypertension, obesity, diabetes, high cholesterol
A teenage girl has arrived complaining of pain in her left wrist. She was playing basketball when
she fell and landed on her left hand. The FNP examined her hand and will expect a fracture if the
girl complains:
Of sharp pain that increases with movement
A patient has been diagnosed with osteoporosis and asked the FNP “what is osteoporosis?” The
FNP explains to the patient that osteoporosis is defined as:
Loss of bone density
Patient states, “I can hear a crunching or grating sound when I kneel”. She also states “that it is
very difficult to get out of bed in the morning because of stiffness and pain in my joints”. The FNP
should assess for signs of what problem?
Crepitation
When taking the history on a patient with a seizure disorder the FNP assesses whether the
patient has an aura. Which of these would be the best question for obtaining this information?
Do you have any warning signs before you receive your starts?
The FNP is teaching a class on osteoporosis prevention to a group of post-menopausal women. A participant shows that she needs more instruction when she states I will:
“Start swimming to increase my weight bearing exercise”
The FNP is performing a neurological assessment on a 41-year-old woman with a history of
diabetes. When testing her ability to feel the vibrations of a tuning fork the FNP notices that the
patient is unable to feel vibrations on the great toe or ankle bilaterally, but she is able to feel
vibrations on both patellae. Given this information what would the FNP suspect?
Peripheral neuropathy
An 80-year-old woman is visiting the clinic for a checkup. She states “I can’t walk as much as I
used to”. The FNP is observing from motor dysfunction in her hip and should have her:
Abduct her hip while she is lying on her back
The FNP is testing the function of cranial nerve XI. Which of these best describes the response
the FNP should expect if the nerve is intact? The patient
Moves the head and shoulders against resistance with equal strength
A 50-year-old woman is in a clinic for weakness in her left arm and leg that she noticed for the
past week. The FNP should perform which type of neurologic examination?
Complete neurologic examination
During the neurological assessment of a healthy 35-year-old patient the FNP asks him to relax his
muscles completely. The FNP then moves each extremity through full range of motion. Which of
these results would the FNP expect to find?
Mild, even resistance to movement
A woman who is 8 months pregnant comments that she has noticed a change in posture and is
having lower back pain. The FNP tells her that during pregnancy women have a posture shift to
compensate for the enlarging fetus. This shift and posture are known as:
Lordosis
A patient is able to flex his right arm forward without difficulty or pain but is unable to abduct his
arm because of pain and muscle spasms. The FNP should suspect
Rotator cuff lesions
A professional tennis player comes into the clinic complaining of a sore elbow. The FNP will
assess for tenderness at the:
Medial and lateral epicondyle
The FNP suspect that a patient has carpal tunnel syndrome and wants to perform the Phalen’s
test. To perform this task the FNP should instruct the patient to:
Hold both hands back-to-back while flexing the wrists 90 degrees for 60 seconds
During the history a patient tells the FNP that “it feels like the room is spinning around me”. The
FNP would document this as:
Vertigo
The assessment of a 60-year-old patient has taken longer than anticipated. In testing his pain
perception the FNP decides to complete the test as quickly as possible. When the FNP applies
the sharp point of a pin on his arm several times he is only able to identify these as one very
sharp prick. What would be the most accurate explanation for this?
This is most likely the result of the summation effect
An 85-year-old patient comments during his annual physical that “he seems to be getting shorter
as he ages”. The FNP should explain that decrease height occurs with aging because:
Of the shortening of the vertebral column
A patient is complaining of pain in his joints that is worse in the morning, is better after he has
moved around for a while, and then gets worse again if he sits for long periods of time. The FNP
should assess for other signs of what problem?
Rheumatoid arthritis
When the FNP asks a 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 farther apart. The FNP would document this
finding as:
Positive Romberg sign
During an assessment of the cranial nerves the FNP finds the following asymmetry when the
patient smiles or frowns, uneven lifting of eyebrows, sagging of lower eyelids, and escape of air
when the FNP presses against the right path cheek. This would indicate dysfunction of which of
these cranial nerves?
Motor component of VII
The FNP is teaching a class on osteoporosis prevention to a group of postmenopausal women which of these actions is the best way to prevent or delay bone loss in this group?
Taking calcium and Vitamin D supplements
In obtaining a history on a 74-year-old patient the FNP notes that he drinks alcohol daily and that
he has noticed a tremor in his hands that affects his ability to hold thing. With this information
what should the FNP’s response be?
Does the tremor change when you drink the alcohol?
During a history of a 78-year-old man his wife states that “he occasionally has problems with
short-term memory loss and confusion. He can’t even remember how to button his shirt”. In
doing the assessment of his sensory system which action of the FNP’s is most appropriate?
Before testing, the FNP would assess the patient’s mental status and ability to follow directions at this time
While obtaining a history of a 3-month-old infant from the mother the FNP asks about the infants
ability to suck and grass the mother’s finger. What is the FNP assessing?
Reflexes
