Texas NURS5352 Test 1

Texas NURS5352 Test 1

Question 1 In children what is a common cause of hair loss?

Endrocrine disorders

Tinea capitis

fetal alcohol syndrome

genetic disorders

Question 2 Which of the following benign condition is characterized by bright red blood in a sharply defined area surrounded by healthy appearing conjunctiva?

Hemorrhagic conjunctivis

Subconjunctival hemorrhage

allergic conjuctivitis

bacterial conjuctivitis

Question 3 Peripheral vision is assessed by which test?

Confrontation

Pupillary reaction

Accomodation

Snellen E chart

Question 4 Nasal symptoms that imply an allergic response include:

Deviated septum

Bluish grey or pale pink turbinates

Purulent nasal discharge

Small atrophied nasal mucous membranes

Question 5 Intense pain with movement of the pinna is most closely associated with:

Otitis media with effusion

Otitis externa

Temporomandibular joint syndrome

Bacterial otitis media

Question  6 A smooth red tongue with a slick appearance may indicate:

Fungal infection

Niacin or B12   deficiency

Recent use of antibiotics

Geographic tongue

Question 7Bulging of an amber tympanic membrane with decreased mobility is consistent with:

Healed tympanic membrane perforation

Impacted cerumen in the external auditory canal

Pseudomonas infection of the external auditory canal

Middle ear effusion

Question 8 The head and chest circumference should be about the same on a patient until what age?

6 years

2 years

4 years

1 year

Question  9 A 29­year­old white woman presents to the clinic for evaluation. She is concerned because her skin, palms and soles of her feet are really yellow. You order blood work including LFTs and a hepatitis profile. The results of all her blood work are negative for hepatitis and her LFTs are within normal limits. With this in mind, what would the nurse practitioner want to ask this patient to explore other differential diagnoses, since hepatitis and other forms of liver disease are ruled out?

If she takes a lot of Iron?

If she has a history of diabetes mellitus

If she eats a lot of yellow and orange vegetables

Whether she has unusual bleeding problems

Question  10 Well­circumscribed silvery plaques on the trunk and extensor surfaces of the body is most consistent with which skin disorder?

Psoriasis

Pityriasis Rosea

Tinea

Eczema

Question 11 A 17­year­old student complains of a "rash for 3 days." After a complete history and ROS, the patient admits that there was a solitary oval plaque (Known as a "Herald Patch") on his upper chest about a week prior to the onset of this rash. Upon examination, you note pale, erythematous oval plaques over the trunk. They have fine scales and are arranged in a "christmas tree" pattern on his trunk. What is highest on your list of differential diagnoses?

Tinea

Contact Dermatitis

Seborrheic Dermatitis

Pityriasis Rosea

Question 12 A shiny, elevated nodule that is pearly or translucent, with tiny blood vessels noted on the surface describes this most common cutaneous neoplasm. What is the name of this lesion?

Malignant melanoma.

Squamous cell carcinoma

Seborrheic keratosis.

 Basal cell carcinoma.

Question 13 A 5­year­old child presents with discrete cloudy vesicles on an erythematous base (dew drops on a rose petal appearance) that began near her scalp and are spreading to the trunk. There are some vesicles that are umbilicated and others that are beginning to crust over. The child has a low­grade fever and feels tired. What common childhood illness is most consistent with these findings?

Rubeola

Varicella

Acne Vulgaris.

Impetigo

Question 14 You are seeing a 5 year old boy in the clinic. The mother states that her son developed a small red bump on his upper lip 3 days ago, with increase in size and drainage. He has also been complaining of intense itching. Your inspection reveals crusted over vesicles with honey­colored exudate on his nares, and upper lip. Which condition is consistent with the above findings?

Drug eruption

Acne Vulgaris

Chicken Pox

Impetigo

Question 15 A 24 year old male is brought in to the emergency room for evaluation. He was reportedly mumbling incoherently, and telling bystanders that he hears voices of people who are following him. His physical appearance is unkempt, with poor hygiene, and he is pacing in the exam room while you are talking with him. What disorder would BEST fit this description?

Obsessive/Compulsive Disorder

Schizophrenia.

Attention­Deficit/Hyperactivity Disorder (ADHD)

Expressive Aphasia

Question 16 The nurse practitioner asks the patient to draw a clock and place the time at "ten minutes after eleven o'clock." What is the purpose of this exam?

to determine the patient's level of mental retardation.

to detect disturbances in the norepinephrine and serotonin neurotransmitters.

To measure function of the parietal lobe of the brain

to measure cognitive, motor, and perceptual function

Question 17A wise practitioner will never assume a psychiatric diagnosis, until all physical causes are ruled out. The mnemonic THINCMED is useful when evaluating for underlying medical conditions. The "T" in this mnemonic stands for:

Tumor

Thyroid

Trauma

Thrombosis

Question 18 A 22­year­old female nurse is interviewing an 86­year­old 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?

 “Why are you so depressed?”

 “It’s hard for me to gather useful information because your answers are so short.”

 “Does your religion make it hard for you to answer my questions?”

 “Are you uncomfortable talking with me?”

Question 19 An aspect of traditional Western medicine that may be troublesome to many Hispanics, Native Americans/American Indians, Asians, and Arabs is Western medicine's attempts to:

use a "holistic" approach that views a particular medical problem as part of the bigger picture.

retrieve balance in an individual's life.

establish harmony between a person and the entire cosmos.

Oriented.

Question 20 A naturalistic or holistic approach to health care often assumes:

a reductionist view that looks to a very narrow cause and effect.

there are supernatural forces that determine one's fate.

there are external factors that must be kept in balance.

that “hot” conditions require treatment with a “hot” remedy.

Question 21 The attitudes of the health care professional are largely:

enculturated and cannot be changed.

difficult for the patient to sense.

uninfluenced by patient behavior.

culturally derived.

Question 22 The Rosenbaum card is used to measure:

A. distance perception.

B. near vision.

C. the ability to identify colors.

D. peripheral distortion.

Question 23 Which type of speculum should be used to examine a patient's tympanic membrane?

1. The smallest speculum that will illuminate the ear

2. The largest speculum that will fit comfortably in the ear

3. The shortest speculum available

4. Any speculum that will fit the otoscope head

Question 24 The nurse practitioner notes a number of important physical findings when conducting the physical examination. In which section of the record should these findings be recorded?

in the objective section

in the subjective section

in the assessment section

in the section designated for the plan

Question 25 A detailed description of the symptoms related to the chief complaint is presented in the:

Personal and Social History

Past Medical History.

General Patient Information

History of Present Illness.

Question 26 Which question would be considered a "leading question?"

 “What do you think is causing your headaches?”

 “You don’t get headaches often do you?”

 “On a scale of 1 to 10, how would you rate the severity of your headaches?”

 “At what time of the day are your headaches the most severe?”

Question 27 Periods of silence during the interview can serve important purposes, such as:

Providing time for the patient to reflect and gather their thoughts.

Promoting a calm environment.

allowing the provider time to think of more questions to ask

Letting the interviewer take a break

Question 28 Mr. F. is speaking with you, the health care provider, about his respiratory problem. Mr.

F. says, "I've had this cough for 3 days, and it's getting worse." You reply, "Tell me more about your cough." Mr. F. 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?

 “I’ll have to examine you to figure out what the problem is.”

 “I understand. After 3 days, you’re tired of coughing. Have you had a fever?”

 “ Your symptoms are so vague, it will take a while to figure it out.”

 “There's no need to get angry. Let me ask you some history questions. Where were you born?”

Question 29 A 50­year­old man comes to the primary care clinic. He tells you he is worried because he has had severe chest pains for the past 2 weeks. Which question below corresponds to the "C" in " OLDCARTS"?

“Can you describe the pain?”

 “When did the pain start?”

 “Does the pain radiate to your arm, back or neck?”

 “What makes the pain better or worse?”

Question 30 A postoperative patient who recently underwent an appendectomy reports pain and a nurse medicates him for presumed incisional pain. When she goes back in thirty minutes to evaluate the patient she finds he is in acute respiratory distress. A code is called and on EKG, he is found to be experiencing ACS, acute coronary syndrome and is transferred to ICU.          This patient's condition would have been detected sooner if the nurse had followed which principle of pain assessment?

Trauma usually is associated with pain.

The intensity of the pain should always be evaluated.

A patient who appears to be resting comfortably may still be experiencing pain.

There may be more than one cause of pain.

Question 31 A genogram is drafted for the purpose of obtaining:

ethnic and cultural backgrounds

genetic and familial health problems

growth and developmental status

the present medical history

Question 32 A fixed image of any group that rejects its potential for originality or individuality is known as a(n):

stereotype

acculturation

norm

ethos

Question 33 Your new patient is a 40­year­old Middle Eastern man 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:

do the exam as it is a necessary part of the physical examination

ask a colleague from the same geographic area if this examination is acceptable

forego the examination for fear of violating cultural norms

inform the patient of the reason for the examination and ask if it is acceptable to him

Question 34Knowledge of the culture or cultures represented by the patient should be used to:

form a sense of the patient based on prior knowledge

help make the interview questions more pertinent

form a standard practice procedure for that culture

draw conclusions regarding individual patient needs

Question 35 Which technique is used during both the history taking and the physical examination process?

auscultation

inspection

percussion

palpation

Question 36 A comprehensive health history is an essential guide for the rest of the examination, but not if the patient cannot communicate it. There is any number of reasons for this lack of communication: age, trauma, language difficulties, or simply that the patient is uncooperative. When documenting this type of data, the healthcare practitioner should:

Assess the symptoms and use her own judgment in interpreting the history

Write it down in the patient's own words

Not write it down

Write it down, but note that she feels that the patient is unreliable

Question 37 Choose the most correct statement regarding focused and comprehensive physical examinations:

A comprehensive (head to toe) exam should be performed on all nonemergent, new patients who will be receiving ongoing primary care form a particular provider or group of clinicians.

A focused physical exam is performed only in non­emergent situations and if the patient does not have usual provider follwing their care.

A comprehensive and focused exam should never be done in the same office visit.

A comprehensive exam should take no longer than 10 minutes.

 

 

 

Question 38 Choose the most correct statement regarding preparing to do a physical examination:

Develop a pattern that is systmeatic and comfortable for the patient and that will prompt you not to omit parts of the exam.

Learn to adapt to the situation and establish a routine that feels comfortable and natural to you.

A third party should be allowed in the room to make the patient more comfortable.

all of the above.

Question 39 Which of the following is true regarding the data taken in a health history?

Subjective data, being inherently less accurate, is of less value than objective data.

A successful individualized plan of care must incorporate subjective data.

Most health history data is objective and measurable.

Objective data is error­free, quantifiable data.

Question 40The Objective component of the exam begins with:

the diagnostic testing

the interview process

the physical exam, which includes inspection of the patient when the clinician first sees them, whether sitting on the exam table or walking into the room.

the hands­on physical exam

Question 41During an interview, tears appear in the patient's eyes and his voice becomes shaky. Initially, you should:

ask him if he would like some time alone.

offer a tissue and let him know it is all right to cry.

explain to the patient that you will be able to help him more if he can control his emotions.

ask the patient what he is upset about.

Question 42 After you ask a patient about her family history, she says, "Tell me about your family now." Which response is generally most appropriate?

Give a brief, undetailed answer.

Ask the patient why she needs to know.

Ignore the patient’s comment and continue with the interview.

Ask a direct question that re­focuses the patient on the chief complaint.

Question 43 Fluorescing lesions are best distinguished by using a(n):

Wood's light

magnifying glass

transilluminator

incandescent bulb

Question 44 In a sun­exposed area of the body, a shiny, elevated nodule that is pearly or translucent, with tiny blood vessels noted on the surface describes this most common cutaneous neoplasm. What is the name of this lesion?

Basal cell carcinoma.

Squamous cell carcinoma

Malignant melanoma.

Seborrheic keratosis.

Question 45 Which of the following occurs when firm pressure is used to apply the stethoscope's bell end­piece to the skin?

Most sounds are amplified.

It functionally converts to a diaphragm endpiece.

It transmits low­pitched sounds.

Assessment findings are more accurate.

Question 46 Mr. S presents with eye pain. He points to a specific location in his eye and says, “ It feels like I

have something in my eye.” Which is the most appropriate question for the healthcare practitioner to ask?

Is the foreign body sensation in one or both eyes?

When did you last have something to eat?

When was your last eye exam?

Have you always been near­sighted?

Question 47 When examining the eyes of a neonate, it is important to remember:

that the eyes of the fetus are not formed until late in gestation.

that the neonates visual acuity is about 20/200

that central vision is fully developed at birth.

ocular mobility is not measured in the infant since it develops later in the first year of life.

Question 48Which statement is most correct:

Near sightedness is known as diplopia

Testing vision with a Snellen Eye Chart tests peripheral vision

Ishihara plates are used to test visual fields.

Acuity is expressed as two numbers. The first number describes the patient's distance from the chart, and the second describes the distance at which the normal eye can read the line of letters or symbols.

Question 49 How is Impetigo best characterized at assessment?

serous exudation and crusting; contagious; caused by Staph aureu

 chronic excoriated dermatitis

Papules and pustules

flat, usually found on extensor surfaces exposed to repeated traumas

Question 50 Which of the following assessment pieces directly provides data best categorized by the

healthcare provider as part of a patient's social history?

Before seeing the healthcare provider, Ms. F fills out a form describing her illnesses, on which she includes having been diagnosed with hypertension and diabetes.

During the health assessment, Mr. K says that he never received any childhood immunizations because of his mother's mistrust of them.

Prior to a follow­up visit, Mr. D returns a document on which he has recorded his food and beverage intake for a typical week.

As part of the patient interview, Ms. G reports that all four of her grandparents are alive and well.