Test 1 Flashcards
(191 cards)
1
Q
Alcohol abuse
A
recurrent use resulting in failure to fulfill major role obligations, recurrent use in hazardous situations, recurrent alcohol-related legal problems,
2
Q
alcohol use disorder
A
two or more of the following events in a year;
tolerance, withdrawal, important activities given up or reduced because of alcohol, drinking more or longer than attended
3
Q
at-risk drinking
A
Men: 14 or more drinks/week or 4 or more drinks/occasion
Women: 7 or more drinks/week or 3 or more drinks/occasion
4
Q
child emotional abuse
A
any pattern of behavior that harms a child’s emotional development or sense of self-worth.
ex: belittling, rejection, threats, and withholding love and support
5
Q
child neglect
A
failure to provide for a child’s basic needs(physical, educational, medical, and emotional)
6
Q
child physical abuse
A
physical injury resulting from punching, beating, kicking, biting, burning, shaking, or otherwise harming a child
7
Q
child sexual abuse
A
includes fondling a child’s genitals, incest, penetration, rape, sodomy, indecent exposure, and commercial exploitation through prostitution or the production of pornographic materials
8
Q
elder abuse
A
willful infliction of force that results in bodily harm, pain, and/or impairment of a person age 65 and older
Ex: pushing, slapping, hitting, shaking, burning, and rough handling
9
Q
elder neglect(physical)
A
physical harm (actual or potential) to a person 65 and older because of failure to provide for the person’s well being
10
Q
intimate partner violence (IPV)
A
physical and/or sexual violence (use of physical force) or threat of such violence, also psychological or emotional abuse and/or coercive tactics when there has been prior physical and/or sexual violenc
11
Q
who is involved intimate partner violence?
A
non-marital partners: dating, boyfriend, girlfriend
former spouses
12
Q
mandatory reporting of abuse
A
required by law to report abuse to a government agency
13
Q
psychological abuse
A
infliction of emotional and/or mental anguish by humiliation, coercion and threats and/or lack of social stimulation.
Ex: yelling, threats of harm, threats or withholding basic medical and/or personal care, leaving the person alone for a long period of time
14
Q
routine universal screening for intimate partner violence
A
asking all adult patients (usually female patients) each time they are in the health care system, no matter what their problem or concern, whether they have experience IPV
15
Q
assessment
A
the collection of data about an individual’s health state
16
Q
biomedical model
A
the western European/ North American tradition that views health as the absence of disease
17
Q
complete database
A
a complete health history and full physical examination
18
Q
critical thinking
A
simultaneously problem solving while self-improving one’s own thinking ability
19
Q
diagnostic reasoning
A
a method of collecting and analyzing clinical information
20
Q
emergency database
A
rapid collection of the database
21
Q
environment
A
the total of all the conditions and elements that make up the surroundings and influence the development of a person
22
Q
evidence-based practice
A
a systematic approach emphasizing the best research evidence, the clinical’s experience, patient preferences and values
23
Q
focused database
A
used for a limited or short-term problem; concerns mainly one problem, one cue complex, or one body system
24
Q
follow-up database
A
used in all settings to monitor progress of short term or chronic health problems
25
holistic health
the view that the mind, body, and spirit are interdependent and function as a whole withing the environment
26
medical diagnosis
used to evaluate the cause and etiology of disease; focus is on the function or malfunction of a specific organ system
27
nursing diagnosis
used to evaluate the response of the whole person to actual or potential health problems
28
prevention
any action directed toward promoting health and preventing the occurrence of disease
29
wellness
a dynamic process and view of health; move toward optimal functioning
30
acculturation
process of social and psychological exchanges with encounters between persons of different cultures, resulting in changes in either group
31
cultural and linguistic competence
a set of congruent behaviors, attitudes, and policies that come together in a system among professionals that enables work in cross-cultural situations
32
cultural care
professional health care that is culturally sensitive, appropriate and competent
33
culture
the nonphysical attributes of a person-the thoughts, communications, action, beliefs, values, and institutions of racial, ethnic, religious, or social groups
34
ethnicity
a social group within the social system that claims to possess variable traits such as a common geographical origin, migratory status, and religion
35
ethnocentrism
tendency to view your own way of life as the most desirable, acceptable, or best and to act superior to another culture's way of life
36
folk healer
lay healer in the person's culture apart from the biomedical or scientific health care system
37
health illness
the balance or imbalance of the person, both within one's being and in the outside world
38
religion
the belief is a divine or superhuman power or powers to be obeyed and worshiped as the creator and ruler of the universe and a system of beliefs, practices and ethical values
39
socialization
the process of being raised within a culture and acquiring the characteristics of that group
40
spirituality
a person's personal effort to find purpose and meaning in life
41
Civil rights act of 1964
federal law mandates that when someone with limited English proficiency seeks health care, you can't deny them
42
values
a desirable or undesirable state of affairs and a universal feature of all cultures
43
Ad hoc interpreter
using a patient's family member, friends or child as an interpreter
44
animism
imagining the inanimate objects come alive and have human characteristics
45
avoidance language
the use of euphemisms to avoid reality or to hide feelings
46
clarification
examiner's response used when the patient's word choice is ambiguous or confusing
47
closed questions
questions that ask for specific information
48
confrontation
response in which examiner gives honest feedback about what he or she has seen or felt after observing a certain patient action, feeling or statement
49
distancing
the use of impersonal speech to put space between one's self and a threat
50
elderspeak
infantilizing and demeaning language used by a health professional when speaking to an older adult
51
electronic health recording
direct computer entry of a patient's health records while in the patient's presence
52
empathy
viewing the world from the other person's inner frame of reference while remaining yourself
53
ethnocentrism
the tendency to view your own way of life as the most desirable, acceptable, or best and to act in a superior manner to another culture''s way of life
54
explanation
examiner's statement that inform the patient; examiner shares factual and objective information
55
facillitation
examiner's response that encourages the patient to say more, to continue with the story
56
geographic privacy
private room or space with only the examiner and patient present
57
interpretation
examiner's statement that is not based on direct observation, but is based on examiner's inference or conclusion; links events, make associations, or implies cause
58
interview
meeting between the examiner and patient with the goal of gathering a complete health history
59
jargon
medical vocabulary used with a patient in an exclusionary and paternalistic way
60
leading question
a question that implies that one answer would be better than another
61
nonverbal communication
message conveyed through body language: posture, gestures, facial expression, eye contact, touch, and were one places the chairs
62
open-ended question
asks for longer narrative information; unbiased; leaves the person free to answer in any way
63
reflection
examiner response the echoes the patient's words; repeats part of what the patient has just said
64
summary
final review of what the examiner understands of what the patient has said
65
telegraphic speech
speech used by the age 3 or 4 years in which three-or four word sentences contain only the essential words
66
verbal communication
messages sent through spoken words, vocalizations, or tone of voice
67
abstract reasoning
pondering a deeper meaning beyond the concrete and literal
68
attention
concentration, ability to focus on one specific thing
69
consciousness
being aware of one's own existence, feelings, and thoughts and being aware of the environment
70
delirium
an acute confusional change or loss of consciousness and perceptual disturbances that may accompany acute illness; usually resolves when the underlying cause is treated
71
dementia
a gradual progressive process, causing decreased cognitive function even though the person is fully conscious and awake, not reversible
72
language
using the voice to communicate one's thoughts and feelings
73
memory
ability to lay down and store experience and perceptions for later recall
74
mood
prolonged display of a person's feelings
75
orientation
awareness of the objective world in relation to the self
76
perception
awareness of objects through any of the five senses
77
thought content
what the person thinks-specific ideas, beliefs, the use of words
78
thought process
the way a person thinks, the logical train of thought
79
financial abuse
intentional misuse of elderly person's financial and material resources
80
financial neglect
failure to use elderly person's assets to provide needed services
81
what are some long term effects on child's development?
lead to change's in brain structure and chemistry, may lead to long-term physical psychological, and emotional, social and cognitive dysfunction
82
What are some risk factors that may contribute to child maltreatment?
family disorganization, substance abuse, parental stress, disabilities, mental retardation, social isolation
83
What is routine, universal screening for IPV or Intimate partner violence?
asking every woman at every health care encounter if she has been abused by a husband, boyfriend or other intimate partner or ex-partner?
84
What does is mean if a patient is alert?
they are awake or readily aroused, oriented, fully ware of external and internal stimuli
85
what does is mean if a patient is lethargic?
not fully alert, drifts in and out of sleep, can be aroused by name, responds appropriately
86
What does it mean if a patient is obtunded?
sleeps most of the time, difficult to arouse them, needs loud shout or vigorous shake
87
What does it mean if a patient is in a stupor or semi-coma?
spontaneously unconscious, responds only to persistent and vigorous shake or pain
88
What does it mean if a patient is in a coma?
completely unconscious , no response to pain or any external or internal stimuli
89
what do we need to look at medical history when looking at child abuse?
previous hospitalizations, injuries, and does he/she suffer from any chronic medical conditions
90
How do you check a patient's attention span?
note patient's ability to concentrate, (do the finish a thought with out wandering)
91
How do you check a patient's recent memory?
24 hour diet recall, ask when a patient arrived to the agency
92
How do you check a patient's remote memory?
ask verifiable past events, (first job, past health, anniversary)
93
How do you check a patient's new learning?
four unrelated words test; tell a patient four unrelated words and then ask them to repeat them to you then, in five minutes, 10 minutes, and 30 minutes
94
What is dysphonia?
disorder of the voice, difficulty or discomfort in talking
95
what is dysarthria?
disorder of articulation, distorted speech sounds
96
what is aphasia?
disorder or language comprehension and production of secondary to brain damage,
97
what does IPV stand for?
intimate partner violence
98
Do you need proof of elderly abuse/neglect?
No, you only need a suspicion
99
the concept of health and healing has evolved in recent years. Which is the best description of health?
A. health is the absence of disease
B. health is a dynamic process towards optimal functioning
C. health depends on an interaction of mind
D. health is the prevention of disease
C. health depends on an interaction of mind, body, and spirit within the environment
100
which would be included in the database for a new patient admission to a surgical unit?
A. all subjective and objective data gathered by a health practitioner from a patient
B. all objective data obtained from a patient through inspection, percussion, palpation, and auscultation
C. a summary of a patient's record, including laboratory studies
D. all subjective and objective, and data gathered from a patient and the results of any laboratory or diagnostic studies completed
D. all subjective and objective, and data gathered from a patient and the results of any laboratory or diagnostic studies completed
101
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you are reviewing assessment data of a 45-year-old male patient and note pain of 8 on a scale of 10, labored breathing, and pale skin color on the electronic health record. This documentation is an example of:
A. hypothetical reasoning
B. diagnostic reasoning
C. data cluster
D. signs and symptoms
```
C. data cluster
102
a patient is in the emergency department with nausea and vomiting. Which would you include in the database?
A. a complete health history and full physical examination
B. a diet and GI history
C. previously identified problems
D. start collection of data in conjunction with lifesaving measure
B. a diet and GI history
103
a patient has recently received health insurance and would like to know how often he should visit a provider. How do you respond?
A. " It would be most efficient if you visit on an annual basis"
B. "There is no recommendation for frequency of health care visits."
C. "your visits may vary, depending on your level of wellness"
D. "your visit will be based on your preference"
C. " Your visits may vary, depending on your level of wellness."
104
```
you are reviewing concepts related to steps in the nursing process for determining prioritization and developing patient outcomes. To what are these actions attributed?
A. Planning
B. Assessment
C. Implementation
D. Diagnosis
```
A. Planning
105
Which best describes evidence-based nursing practice?
A. combining clinical expertise with the use of nursing research to provide the best care for patients's values and circumstances
B. appraising and looking at the implications of one or two articles as they relate to the culture and ethnicity of the patient
C. completing a literature search to find relevant article that use nursing research to encourage nurses to use good practices
D. Finding value-based resources to justify nursing actions when working with patients of diverse cultural backgrounds
A. combining clinical expertise with the use of nursing research to provide the best care for patient's values and circumstances
106
what can be determined when the nurse clusters data as part of the critical-thinking process?
A. this step identifies problems that may be urgent and require immediate action
B. the step involves making assumptions in the data
C. the nurse recognizes relevant information among the data
D. risk factors can be determined so the nurse knows how to offer health teaching
C. the nurse recognizes relevant information among the data
107
```
a patient says she is very nervous and nauseated, and she feels like she will vomit. This data would be what type of data?
A. objective
B. reflective
C. subjective
D. introspective
```
C. subjective
108
```
the expert nurse differs from the novice nurse by acting without consciously thinking about the actions. This is referred to as:
A. deductive reasoning
B. intuition
C. the nursing process
D. focus assessment
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B. intuition
109
which would be considered a risk diagnosis?
A. identifying existing levels of wellness
B. evaluating previous problems and goals
C. identifying potential problems the individual may develop
D. focusing on strengths and reflecting an individual's transition to higher levels of wellness
C. identifying potential problems the individual may develop
110
which would be included in a holistic model of assessment?
A. nursing goals for the patient
B. anticipated growth and development patterns
C. a patient's perception of his or her health status
D. the nurse's perception of disease related to the patient
C. a patient's perception of his or her health status
111
the nurse uses health promotion activities with a new patient. what would this focus include?
A. the nurse would try to change the patient's perceptions of disease
B. the nurse would search for identification of biomedical model interventions
C. the nurse would help to identify negative health acts of the patient
D. the nurse would empower the patient to choose a healthier lifestyle
D. the nurse would empower the patient to choose a healthier lifestyle
112
```
Which is an example of objective data?
A. patient's history of allergies
B. patient's use of medications at home
C. last menstrual period 1 month ago
D. 2-x 5 cm scar present on the right lower forearm
```
2-x-5 cm scar present on the right lower forearm
113
during the evaluation phase of the nursing process, which action would be included?
A. validating the nursing diagnosis
B. establishing priorities related to patient care
C. providing information to the patient and family members
D. establishing a timeline for planed outcomes
C. providing information to the patient and family members
114
which statement best describes religion?
A. an organized system of beliefs concerning the cause, nature, and purpose of the universe
B. belief in a divine or superhuman spirit to be obeyed and worshiped
C. affiliation with one of the 1200 recognized religions in the United States
D. the following of established rituals, especially in conjunction with health-seeking behaviors
A. an organized system of beliefs concerning the cause, nature, and purpose of the right universe
115
the major factor contributing to the need for cultural care nursing is:
A. an increasing birth rate
B. limited access to health care services
C. demographic change
D. a decreasing rate of immigration
C. demographic change
116
the term culturally competent implies that the nurse:
A. is prepared is nursing
B. possesses knowledge of the tradition of diverse peoples
C. applies underlying knowledge to providing nursing care
D. understands the cultural context of the patient's situation
D. underlying the cultural context of the patient's situation
117
you are the triage nurse in the emergency department and perform the initial intake assessment on a patient who does not speak English. Based on your understanding of linguistic competence, which action would present as a barrier to effective communication?
A. maintaining a professional respectful demeanor
B. allowing for additional time to complete the process
C. providing the patient with a paper and pencil so he or she can write down the answers to the questions that you are going to ask
D. seeing if there are any family members present who may assist with the interview process
C. providing the patient with a paper and pencil so the patient can write down the answers to the questions that you are going to ask
118
```
which culture would describe illness as hot and cold imbalance?
A. Asian-american heritage
B. African-american heritage
C. Hispanic-american heritage
D. american Indian heritage
```
A. Asian-American heritage
119
```
of what does the patient believe that amulet is protective?
A. the evil eye
B. being kidnapped
C. exposure to bacterial infections
D. an unexpected fall
```
the evil eye
120
which statement best illustrates the difference between religion and spirituality?
A. religion reflects an individual's reaction to life events whereas spirituality is based on whether the individual attends religious services
B. religion is characterized by identification of a higher being shaping one's destiny while spirituality reflects an individual's perception of one's life having worth or meaning
C. religion is the expression of spiritual awakening whereas spirituality is based on belief in divine right
D. religion is the active interpretation of one's spirituality
B. religion is characterized by identification of a higher being shaping one's destiny while spirituality reflects an individual's perception of one's life having worth or meaning
121
the first step to cultural competency by a nurse is to:
A. identify the meaning of health to the patient
B. understand how a health care delivery systems work
C. develop a frame of reference to traditional health care practices
D. understand your own heritage and its basis in cultural values
D. understand your own heritage and its basis in cultural values
122
which statement is true in regard to pain?
A. nurse's attitudes toward their patients' pain are unrelated to their own experiences with pain
B. the cultural background of a patient is important in a nurse's assessment of that patient's pain
C. a nurse's area of clinical practice is most likely to determine his or her assessment of a patient's pain
D. a nurse's years of clinical experience and current position are a strong indicator of his or her response to patient pain
B. the cultural background of a patient is important in a nurse's assessment of that patient's pain
123
```
Which factor is identified as a priority influence on a patient's health status?
A. poverty
B. lifestyle factors
C. legislative action
D. occupational status
```
A. poverty
124
which statement is most appropriate to use when initiating as assessment of cultural beliefs with an older American Indian patient:
A. " Are you of the Christian faith?"
B. " Do you want to see medicine man?"
C. " how often do you seek help from medical providers?"
D. " what cultural or spiritual beliefs are important to you?"
D. what cultural or spiritual beliefs are important to you?
125
the practitioner, entering the examining room to meet a patient for the first time, states: " Hello, I'm M.M., and i'm here to gather some information from you and to perform your examination. This will take about 30 minutes. D.D. is a student working with me. If it's all right with you, she will remain during the examination. which of the following must be added to cover all aspects of the interview contract?
A. a statement regarding confidentiality patient costs, and the expectations of each person
B. the purpose of the interview and the role of the interviewer
C. time and place of the interview and a confidentiality statement
D. an explicit purpose of the interview and a description of the physical examination, including diagnostic studies
A. a statement regarding confidentiality, patient cost, and the expectations of each person
126
______ is exhibiting an accurate understanding of the other person's feelings within a communication context. A. empathy
B. liking others
C. facilitation
D. a nonverbal listening technique
A. empathy
127
you conduct an admission interview. Because you are expecting a phone call, you stand near the door. Which would be a more appropriate approach?
A. arrange to have someone page you so you can sit on the side of the bed
B. have someone else answer the phone so you can sit facing the patient
C. use this approach given the circumstance
D. arrange for a time free of interruptions after the initial physical examination is complete
B. have someone else answer the phone so you can sit facing the patient
128
```
a patient asks the nurse, "may I ask you a question?" this is an example of :
A. an open-ended question
B. a reflective question
C. a closed question
D. a double-barreled question
```
C. closed ended question
129
which statement best describes interpretation as a communication technique?
A. interpretation is the same as classification
B. interpretation is a summary of a statement made by a patient
C. interpretation is used to focus on a particular aspect of what the patient has just said
D. interpretation is based on the interview's inference from the data that have been presented
D. interpretation is based on the interview's inference from the data that have been presented
130
which demonstrates a good understanding of the interview process?
A. the nurse stops the patient each time something is said that is not understood
B. the nurse spends more time listening to the patient than talking
C. the nurse is consistently thinking of his or her next response to the patine will know they are understood
D. the nurse uses "why" questions to seek clarification of unusual symptoms or behavior
B. the nurse spends more time listening to the patient than talking
131
during an interview, a patient denies having any anxiety. the patient frequently changes position in the chair, holds his arms folded tight again his chest, and has little eye contact with the interviewer. The interviewer should:
A. use confrontation to bring the discrepancy between verbal and nonverbal behavior to the patient's attention
B. proceed with the interview. patients usually are truthful with a health care practitioner.
C. make a mental note to discuss the behavior after the physical examination is completed
D. proceed with the interview and examination as outlined on the agency assessment form. The patient's behavior is appropriate for the circumstances
A. use confrontation to bring the discrepancy between verbal and nonverbal behavior to the patient's attention
132
For what or with whom should touch be used during the interview?
A. only with individuals from a Western culture
B. as a routine way of establishing contact with the person and communicating empathy
C. only with patient of the same gender
D. only if the interviewer knows the person well
D. only if the interviewer knows the person well
133
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children usually come for health care with a parent. At about what age should the interviewer begin to question the child himself or herself regarding presenting symptoms?
A. 5 years
B. 7 years
C. 9 years
D. 11 years
```
B. 7 years
134
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because of adolescents' developmental level, not all interviewing techniques can be used with them. Which techniques should be avoided?
A. facilitation and clarification
B. confrontation and explanation
C. empathy and interpretation
D. silence and reflection
```
D. silence and reflection
135
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knowledge of the use of personal space is helpful for the health care provider. Personal distance is generally considered to be:
A. 0 to 1 1/2 feet
B. 1 1/2 to 4 feet
C. 4 to 12 feet
D. 12 or more feet
```
B. 1 1/2 to 4 feet
136
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Mr. B. tells you, " everyone here ignores me." You respond, "ignores you?" This technique is best described as:
A. clarification
B. selective listening
C. reflecting listening
D. validation
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C. reflecting
137
what does active listening NOT include?
A. taking detailed notes during the interview
B. watching for clues in body language
C. repeating statements back to the person to make sure you have understood
D. asking open-ended questions to explore the person's perspective
A. taking detailed notes during the interview
138
when interviewing a patient who does not speak English, the examiner should:
A. take advantage of family members who are readily available and willing to assist
B. use a qualified medical interpreter who is culturally literate
C. seek as much information as possible and then continue with the physical examination
D. wait until a qualified medical interpreter is available before starting the interview
B. use a qualified medical interpreter who is culturally literate
139
with older adults, how should the examiner proceed with the interview:
A. proceed in a more organized and concise manner
B. consider the fatigue of the older person and break the interview into shorter parts
C. ask a family member to complete some of the records while moving ahead with the interview
D. raise your voice if the patient does not appear to hear you
B. consider the fatigue of the older person and break the interview into shorter parts
140
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when reading a medical record, you see the following notation: Patient states, "i have had a cold for about a week, and now i am having difficulty breathing." this is an example of:
A. a past health history
B. a review of systems
C. a functional assessment
D. a reason for seeking care
```
D. a reason for seeking care
141
you have reason to question the reliability of the information being provided by a patient. One way to verify the reliability within the context of the interview is to:
A. rephrase the same questions later in the interview
B. review the patient's previous medical records
C. call the person identified as the emergency contact to verify the data
D. provide the patient with a printed history to complete and then compare the data
A. rephrase the same questions later in the interview
142
the statement "reason for seeking care" has replaced the "chief complaint" this change is significant because:
A. the "chief complaint" is really a diagnostic statement
B. the newer term allows another individual to supply the necessary information
C. the newer term incorporate wellness needs
D. the "reason for seeking care" can incorporate the history of the present illness
C. the newer term incorporate wellness needs
143
During an initial interview, the examiner says, " Mrs. J., tell me what you do when your headaches occur?" this is an example of which type of information?
A. the patient's perception of the problem
B. aggravating or relieving factors
C. the frequency of the problem
D. the severity of the problem
B. aggravating or relieving factors
144
which is an appropriate recording of a patient's reason for seeking health care?
A. angina pectoris, duration 2 hours
B. substernal pain radiation to the left axilla, 1 hour duration
C. "grabbing" chest pain for 2 hours
D. pleurisy, 2 days' duration
C. "grabbing" chest pain for 2 hours
145
a genogram is used for which reasons?
A. past history
B. past health history, specifically hospitalizations
C. family history
D. the 8 characteristics of presenting symptoms
C. family history
146
what is the best descriptions of "review of systems" as a part of the health history?
A. the evaluation of the past and present health state of each body system
B. a documentation of the problem as described by the patient
C. the recording of the objective findings of the practitioner
D. a statement that describes the overall health state of the patient
A. the evaluation of the past and present health state of each body system
147
which finding is considered to be subjective?
A. temperature of 101.2
B. pulse rate of 96 beats/min
C. measured weight loss of 20 pounds since the previous measurements
D. pain lasting 2 hours
D. pain lasting 2 hours
148
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when taking a health history for a child, what information, in addition to that for an adult, is usually obtained?
A. coping and stress management
B. a review of immunizations received
C. environmental hazards
D. hospitalization history
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B. a review of immunizations received
149
although a full mental status examination may not be required, you must be aware of the 4 main headings of the assessment while performing the interview and physical examination. These headings are:
A. mood, affect, consciousness, and orientation
B. memory, attention, thought content, and perceptions
C. language, orientation, attention, and abstract reasoning
D. appearance, behavior, cognition, and thought process
D. appearance, behavior, cognition, and thought process
150
select the finding that most accurately describes appearance of a patient.
A. a tense posture and restless activity. Clothing clean but not appropriate for season
B. oriented x 3. affect appropriate for circumstances
C. alert and responds to verbal stimuli. tearful when diagnosis discussed.
D. laughing inappropriately, oriented x 3
A. a tense posture and restless activity. Clothing clean but not appropriate for season
151
you are assessing short-term cognitive function. Which assessment shows the ability to lay down new memories?
A. nothing whether the patient completes a thought without wondering
B. a test of general knowledge
C. a description of past medical history
D. use of the four unrelated words test.
D. use of the four unrelated words test.
152
you are preparing the discharge plan for a patient with aphasia. What assessment should you include in the plan?
A. ask the patient to calculate serial 7's
B. ask the patient to name his or her grandchildren or their birthdays
C. ask the patient to demonstrate word comprehension by naming articles in the room or on the body as you point to them.
D. ask the patient to interpret a proverb
C. ask the patient to demonstrate word comprehension by naming articles in the room or on the body as you point to them.
153
during an interview with a patient diagnosed with a seizure disorder, the patient states, "I plan to be an airline pilot." If the patient continues to have this as a career goal after teaching regarding seizure disorders has been provided, you might question the patient's:
A. thought processes
C. ask the patient to demonstrate word comprehension by naming articles in the room or on the body as you point to them.
C. attention span
D. recent memory
C. ask the patient to demonstrate word comprehension by naming articles in the room or on the body as you point to them.
154
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on a patient's second day in an acute care hospital, the patient complains about the "bugs" on the bed. The bed is clean. This would be an example of altered:
A. thought processes
B. orientation
C. perception
D. higher intellectual function
```
C. perception
155
```
one way to assess cognitive function and to screen dementia is with:
A. the proverb interpretation test
B. the mini-cog
C. the denver II
D. the older adult behavioral checklist
```
B. the mini-cog
156
```
a major characteristic of dementia is:
A. impairment of short and long term memory
B. hallucinations
C. sudden onset of symptoms
D. substance-induced
```
A. impairment of short and long term memory
157
what statement is an example of a patient with dysarthria?
A. when asked a question, the patient responds fluently but uses words incorrectly or makes up words so that speech may be incomprehensible
B. the word choice and grammar are appropriate, but the sounds are distorted so the speech is unintelligible
C. the pitch and volume of words are difficult and the voice may be hoarse but the language is intact
D. comprehension is intact but there is difficulty is expressing thoughts, with nouns and verbs being the dominant word choices
B. the word choice and grammar are appropriate, but the sounds are distorted so the speech is unintelligible
158
```
you are leading a discussion of the planned activities for the day at an adult living center and state, "We will be having snacks at 9:30 and lunch will be at noon." one of the participants responds in a very monotone manner, "snacks at 9:30, lunch at noon". this patient is exhibiting signs of:
A. echolalia
B. confabulation
C. flight of ideas
D. neologisms
```
A. echolalia
159
you are performing a mental status examination. Which assessment would be most appropriate?
A. examining the patient's EEG
B. observing the patient as he or she takes an IQ test
C. observing the patient and inferring health or dysfunction
D. examining the patient's response to a specific set of questions
C. observing the patient and inferring health or dysfunction
160
when assessing mental status in children, what statement is true?
A. all aspects of mental status is children are interrelated
B. children are highly labile and unstable until the age of 2
C. children's mental status is largely a function of their parent's level of functioning until the age of 7
D. A child's mental status is impossible to assess until the child develops the ability to concentrate
A. all aspects of mental status is children are interrelated
161
you are assessing a 75-year-old man. What is an expected finding?
A. he will have no decrease in any of his abilities, including response time
B. he will have difficulty to tests of remote memory because this typically decreases with age
C. it may take him a little longer to respond but his general knowledge and abilities should not have declined
D. he will have had a decrease in his response time due to language loss and a decrease in general knowledge
C. it may take him a little longer to respond but his general knowledge and abilities should not have declined
162
```
what is a priority assessment for aging adults?
A. phobias
B. general intelligence
C. irrational thinking patterns
D. sensory perceptive abilities
```
D. sensory perceptive abilities
163
```
a phase of addiction characterized by tolerance, increasing time spend in substance related activities, unsuccessful attempts to quit, and continued use despite known harm is:
A. relief
B. withdrawal
C. dependency
D. preoccupation
```
C. dependency
164
```
the unpleasant effect that occurs when use of a drug is stopped is called:
A. potency
B. withdrawal
C. metabolism
D. threshold
```
B. withdrawal
165
```
the need for increasingly lager doses of a substance to achieve the same effect that was initially experienced from using is called:
A. tolerance
B. addiction
C. abuse
D. dependence
```
A. tolerance
166
Which health issue is NOT a result of prolonged heavy drinking?
A. kidney and liver damage
B. increased risk for oral cancer
C. increased resistance to pneumonia and other infectious diseases
D. damage to the brain and peripheral nervous system
C. increased resistance to pneumonia and other infectious diseases
167
```
how many drinks does a person consume in one sitting for it to be considered binge drinking?
A. 3
B. 5
C. 7
D. 8
```
B. 5
168
a pregnant woman explains that she does not intend to stop drinking because her friends continues to drink during pregnancy, and "nothing happened to them or their kids." how should the clinician respond to this statement?
A. while it is true that there is no scientific evidence that alcohol harm the fetus, abstinence is recommended because of the physical effect on your body.
B. no amount of alcohol has been determined to be safe for a pregnant woman so i would ask you to stop drinking alcohol completely,
C. maybe you could cut back on your alcohol intake, at least until you're in the third trimester, when the effects on the fetus are minimal
D. if you can limit yourself to only one drink per day, you will be helping yourself and your baby.
B. no amount of alcohol has been determined to be safe for a pregnant woman so i would ask you to stop drinking alcohol completely,
169
```
which is the most commonly used laboratory test to identify chronic alcohol drinking?
A. blood urea nitrogen
B. liver enzyme panel
C. gamma-glutamyl transferase
D. mean corpuscular volume
```
C. gamma-glutamyl transferase
170
```
the CAGE screening tool is used to assess:
A. sexual activity
B. depression
C. problem alcohol use
D. decreased mental status
```
C. problem alcohol use
171
while assessing a man during a physical examination for work, you suspect alcohol use. Which assessment tool is appropriate in this situation?
A. AUDIT screening tool
B. rapid eye test
C. mental status examination
D. Holmes social readjustment rating scale
A. AUDIT screening tool
172
you are screening patients for excessive alcohol consumption. which patient would be considered over the recommended limit?
A. a man who reports drinking 3 beers and 1 shot of whiskey each day
B. a woman who reports drinking 2 glasses of wine and 2 vodka martinis each day
C. the older adult man who reports drinking 1 glass of sherry before going to bed each night
D. the woman who reports drinking 1 glass of wine with lunch and dinner each day
B. a woman who reports drinking 2 glasses of wine and 2 vodka martinis each day
173
you are performing a sports physical on a 16-year old girl. which question would most likely yield an accurate substance use assessment?
A. many teenagers have tried street drugs. have you tried these drugs?
B. tell me which street drug your friend have offered you
C. do most or your friends drink alcohol or do street drugs?
D. your high school has a reputation for drug abuse. do you use drugs?
A. many teenagers have tried street drugs. have you tried these drugs?
174
```
during the assessment, you will observe for which problems in addition to alcohol withdrawal syndrome?
A. renal insufficiency
B. pancreatitis
C. irritable bowel syndrome
D. impaired glucose tolerance
```
B. pancreatitis
175
```
you are assessing a patient's cardiac risk factors secondary to chronic alcohol use. Which condition might this patient exhibit?
A. bradycardia
B. ventral fibrillation
C. hypertension
D. Hypotension
```
C. hypertension
176
you are assessing a male patient's alcohol consumption. Which statement would alert you to investigate further?
A. i drink at weddings and holidays
B. i enjoy a few beers on the weekend
C. no matter how much I drink I don't get drunk.
D. I drink a beer with dinner every day
C. no matter how much I drink I don't get drunk
177
which scenario is an example of intimate partner violence?
A. an ex-boyfriend stalks his ex-girlfriend
B. marital rape
C. hitting a date
D. all of the above
D. all of the above
178
Routine universal screening for domestic violence includes:
A. asking all women each time they come to the health care system they are abused
B. asking women who have injuries if they are abused
C. asking women who have symptoms of depression and PTSD if they are abused
D. asking women ages 18 to 30 years if they are abused
B. asking women who have injuries if they are abused
179
patients are at high risk for which mental health problem associated with intimate partner violence?
A. hallucination
B. suicidality
C. schizophrenia
D. attention-deficit/ hyperactivity disorder (ADHD)
B. suicidality
180
```
which gynecologic problem is not usually associated with intimate partner violence?
A. pelvic pain
B. ovarian cysts
C. STIs
D. vaginal tearing
```
B. ovarian cysts
181
risk factors for intimate partner homicide include:
A. abuse during pregnancy
B. victim substance abuse
C. victim unemployment
D. history of victim childhood sexual assault
A. abuse during pregnancy
182
elder abuse and neglect assessments include:
A. willful infliction of force
B. withholding prescription medications without medical orders
C. not replacing broken glasses
D. threatening to place someone in a nursing home
E. all of the above
E. all of the above
183
when assessing an injury on a child, which should be considered?
A. the child's developmental level
B. the child's medical and medication history
C. the history of how the injury occurred
D. all of the above
D. all of the above
184
what is a known risk factor for child maltreatment?
A. substances abuse
B. intimate partner violence
C. physical disability and/or mental retardation in the child
D. all of the above
D. all of the above
185
bruising on a nonwalking or noncruising child:
A. is a common finding from normal infant activity
B. needs to be further evaluated for either an abusive or medical explanation
C. is commonly seen on the buttocks
D. cannot be reported until after a full medical evaluation
B. needs to be further evaluated for either an abusive or medical explanation
186
```
which is a forensic term that is related to "purpura" but is not related to blunt force trauma?
A. wound
B. incision
C. ecchymosis
D. bruise
```
C. ecchymosis
187
which should be routinely included in evaluation a case of elder abuse?
A. corroborative interview from caregiver
B. baseline laboratory tests
C. testing of STIs
D. TB testing
B. baseline laboratory tests
188
```
during an examination, you notice a patterned injury on a patient's back. which is most likely?
A. a blunt force trauma
B. a friction rub
C. a stabbing
D. a welt from a leather belt
```
D. a welt from a leather belt
189
during an interview, a woman has answered "yes" to 3 of the abuse assessment screen questions. How should you proceed?
A. ask the patient if she has filed a restraining order
B. proceed by asking more questions about the items they answered no to
C. respond by confirming that the patient was abused
D.interview the woma's partner and compare notes
B. proceed by asking more questions about the items they answered no to
190
which clinical situation would require the examiner to report to the proper authorities
A. statements from the victim
B. statements from witnesses
C. proof of abuse and/or neglect
D. suspicion of elder abuse and/or neglect
D. suspicion of elder abuse and/or neglect
191
which would you include on the chart of the patient who has been the victim of abuse?
A. photographic documentation of injuries
B. a summary of the abused patient's statements
C. verbatim documentation of every statement made
D. a general description of injuries in the progress notes
A. photographic documentation of injuries
