Advanced Health Assessment and Diagnostic Reasoning Final Exam

Question 1

Breath odors may clue the examiner to certain underlying metabolic conditions. The odor of ammonia on the breath may signify:

diabetic ketoacidosis.
hepatic dysfunction.
tuberculosis.
uremia.

Question 2

A parent is advised to restrict contact or collision sports participation for their child. An example of a sport in which this child could participate is: NURS 6512: Advanced Health Assessment and Diagnostic Reasoning Final Exam

hockey.
roller skating.
skateboarding.
riflery.
D

Question 3

To assess a cremasteric reflex, the examiner strokes the:

abdomen and observes whether the umbilicus moves away from the stimulus.
skin around the anus and observes for the anal wink.
inner thigh and observes whether the testicle and scrotum rise on the stroked side.
palm and observes whether the fingers attempt to grasp.

Question 4

Inspection of the scrotum should reveal:

two testes per sac.
smooth scrotal sacs.
left scrotal sac lower than the right.
lightly pigmented skin.
C

Question 5

One of the most important aspects to consider in the orthopedic screening examination is:

symmetry.
muscle contraction.
balance.
flexibility.

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Question 6

Tarry black stool should make you suspect:

upper intestinal bleeding.
rectal fistula.
prostatic cancer.
internal hemorrhoids.

Question 7
Which one of the following is a proper technique for use of a speculum during a vaginal examination?

Insert one finger; insert opened speculum.
Press introitus downward; insert closed speculum obliquely.
Allow labia to spread; insert speculum slightly open.
Spread labia; insert closed speculum horizontally.
D

Question 8

The Mini-Mental State Examination should be administered for the patient who:

has repetitive ritualistic behaviors.
uses illegal hallucinogenic drugs.
sleeps an excessive amount of time.
gets lost in her neighborhood.

Question 9

If pitting edema is unilateral, you would suspect occlusion of a:

superficial artery.
major vein.
surface capillary.
lymphatic duct.
B

Question 10

You are inspecting the genitalia of an uncircumcised adult male. The foreskin is tight and cannot be easily retracted. You should:

chart the finding as paraphimosis.
transilluminate the glans.
inquire about previous penile infections.
retract the foreskin firmly.

Question 11

Postural hypotension is defined as a _____ when the patient stands, compared with sitting or supine readings.

systolic pressure drop of more than 15 mm Hg with a pulse rate increase
pulse rate decrease with a systolic pressure increase of at least 15 mm Hg
pulse rate decrease and diastolic pressure decrease of more than 5 mm Hg
diastolic pressure increase of more than 5 mm Hg and no pulse rate changes

Question 12

Your older clinic patient is being seen today as a follow-up for a 2-day history of pneumonia. The patient continues to have a productive cough, shortness of breath, and lethargy and has been spending most of the day lying in bed. You should begin the chest examination by:

determining tactile fremitus.
percussing all lung fields.
estimating diaphragmatic excursion.
auscultating the lung bases.

Question 13

A red, hot swollen joint in a 40-year-old man should lead you to suspect:

cellulitis.
bursitis.
trauma.
gout.
D

Question 81

You are examining a patient in the emergency department who has recently sustained head trauma. In order to initially assess this patient’s neurologic status, you would:

test the six cardinal points of gaze.
observe for swallowing and test the gag reflex.
palpate the jaw muscles as the patient clenches teeth.
ask him to discriminate between the smell of orange and peppermint.
A

Question 14

While examining a 30-year-old woman, you note that one breast is slightly larger than the other. In response to this finding, you should:

tell the patient to get a mammary sonogram as soon as possible.
ask the patient if she has ever had breast cancer.
tell the patient to get a mammogram as soon as possible.
note the finding in the patient’s record.

Question 15

The Mini-Mental State Examination:

will determine the cause of memory loss.
scores do not vary with regard to age or education.
may be used to quantitatively estimate cognitive changes.
may be used to qualitatively estimate personality disorders.
C

Question 16

Breath sounds normally heard over the trachea are called:

bronchovesicular.
bronchial.
vesicular.
amphoric.
B

Question 17

Electrical activity recorded by the electrocardiogram (ECG) tracing that denotes the spread of the stimulus through the atria is the:

QRS complex.
ST segment.
P wave.
PR interval.
c

Question 18

The best way to ease the apprehension of a 3-year-old child before a physical examination is to:

hand the child a picture book.
explain that you will be gentle.
let the child hold the stethoscope while you listen.
tell the child he or she will get a lollipop for good behavior.
C

Question 19

A patient you are seeing in the emergency department for chest pain is suspected of having a myocardial infarction. During the health history interview of his family history, he relates that his father had died of “heart trouble.” The most important follow-up question you should pose is which of the following?

“What age was your father at the time of his death?”
“Did your father’s father have heart trouble also?”
“Did your father have coronary bypass surgery?”
“What were your father’s usual dietary habits?”
A

Question 20

An examiner has rotated a brush several times into the cervical os. The brush was withdrawn and stroked lightly on a glass slide. The slide was sprayed with fixative. Which type of specimen requires this technique for collection?

Trichomonas smear
Cytology smear
Haemophilus smear
Gonococcal culture
B

NURS 6512: Advanced Health Assessment and Diagnostic Reasoning Final Exam

Question 21

The goals of preparticipation sports evaluation include:

determining the best fit for positions in each sport.
identifying risk of injury or death during sports participation.
securing a legal contract before recommending limiting participation.
screening for steroid use or abuse.

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