Deck :19 Health Assessment, History, and Physical Examination

Question 1

A family member serves as a translator for a patient who does not speak English. The answers to the provider's questions reflect the opinion of the family member, and not the patient. What is this phenomenon called?

A) Translator bias
B) Family member bias
C) Caregiver bias syndrome
D) Two patient syndrome

Answer 1

D

Question 2

Which component of the mnemonic device PQRST would involve asking the patient to assess their pain level on a scale from 0 to 10?

A) P
B) Q
C) R
D) S

Answer 2

D

Question 3

Which of the following sections of the health history involves collecting information about a patient's surgical procedures and hospitalizations?

A) Past medical history
B) Family history
C) Social history
D) Review of systems

Answer 3

A

Question 4

Which of the following is true of a comprehensive review of systems?

A) It is conducted when a patient presents with a specific chief complaint.
B) Questions are directed toward the system(s) most likely to be involved in producing the patient's symptoms.
C) The patient would not be questioned about symptoms in nonrelated body systems.
D) It is conducted when a patient presents for general health maintenance or disease prevention care.

Question 5

Which of the following is considered best practice when taking a health history?

A) Use closed-ended questions.
B) Help the patient choose the best words to describe his or her symptoms.
C) Put all of your focus on taking good notes during the interview.
D) If using a translator, address the questions to the patient, not the translator.

Question 6

Using the mnemonic device CLIENT OUTCOMES, which component involves asking the patient what precipitates, aggravates, or alleviates the symptoms?

A) Impact
B) Complementary
C) Modulating
D) Exposure

Question 7

Which of the following is best practice when taking a family history?

A) The family history should extend back for three generations.
B) Cases of intermarriage do not need to be reported.
C) Patients should only report the history of first-degree relatives.
D) The age of onset should be reported for each of the conditions.

Question 8

Which of the following pieces of equipment is used to gather specimens?

A) Nasal speculum
B) Sphygmomanometer
C) Occult blood testing materials
D) Taste-testing substances

Question 9

The patient examination begins:

A) when the patient enters the room.
B) after the patient has changed into the gown.
C) when the patient describes the chief complaint.
D) after vital signs have been recorded.

Question 10

Collecting data through sight and smell is known as:

A) inspection.
B) palpation.
C) percussion.
D) auscultation.

Question 11

Which of the following components of the physical exam would be assessed using the Hirschberg test?

A) Skin characteristics
B) Corneal light reflex for symmetry
C) Pinnae symmetry
D) Hearing acuity

Question 12

What is the preferred position for examining a pregnant patient?

A) Supine
B) Knee-chest
C) Lithotomy
D) Side-lying

Question 13

Which of the following should be done when examining a pediatric patient?

A) You should use the same sequence of assessments for every pediatric patient.
B) Do invasive procedures first.
C) Don't allow him or her to play with medical equipment.
D) Allow the child to be examined on his or her parent's lap.

Question 14

The Weber or Rinne tests are used to test:

A) corneal symmetry.
B) hearing acuity.
C) sense of smell.
D) thoracic expansion.

Question 15

Which of the following is considered best practice when documenting health history and the physical examination?

A) Include notes about your opinion
B) Use your own abbreviations
C) Do not include drawings
D) Record only facts

Question 16

Using the SOAP approach, which section would include the chief complaint and history of present illness?

A) S
B) O
C) A
D) P

Question 17

When documenting notes from a patient encounter, what information should be recorded first?

A) Chief complaint
B) Health history
C) Patient identifiers
D) Treatment plan

Question 18

Which of the following is best practice when documenting the history of present illness (HPI)?

A) Only record the symptoms related to the chief complaint.
B) Details related to previous diagnostic tests are not necessary to include.
C) If signs and symptoms appear to be related, spend time on the component that is related to the chief complaint.
D) Pertinent test results and test dates should be included.

Question 19

What is the purpose of a genogram?

A) To show the patient's health history
B) To identify genetic disorders
C) To explore family history
D) To understand social history

Question 20

The nutritional history falls under which of the following assessments?

A) Social history
B) Family history
C) Past medical history
D) History or present illness

Question 21

Which component of the final assessment plan is frequently reserved for hospitalized patients?

A) Nonpharmacological interventions
B) Pharmacological interventions
C) Education
D) Follow-up

Question 22

A patient discloses that they have received acupuncture treatments to provide relief from their symptoms. Which component of the mnemonic ETHNIC may have been used to elicit this information?

A) E
B) T
C) H
D) N

Question 23

__________ is a nonprofit initiative where professionals can explore and identify their implicit biases.

A) Implicit Association Test
B) Project Implicit
C) Georgetown University National Center for Cultural Competence
D) ETHNIC

Question 24

Which of the following spiritual assessment tools assesses the use of spiritual rituals?

A) FICA
B) HOPE
C) SPIRITual
D) Royal College of Psychiatry Instrument

Question 25

A non-English speaking patient is having trouble communicating with a health provider. What is the best way to overcome this barrier?

A) Have the patient bring an English-speaking family member to the next visit.
B) Hire a translator.
C) Hire an interpreter.
D) Use a translation device.

Question 26

Which of the following conditions should be considered when conducting a skin assessment for a Native American?

A) Traction alopecia
B) Hot comb folliculitis
C) Pseudofolliculitis barbate
D) Scleroderma

Question 27

Which of the following should be a consideration when performing a gastrointestinal assessment on a Native American patient?

A) This population has a higher incidence of colon cancer than the general population.
B) This population has a higher incidence of H. pylori than Caucasians.
C) Gastroesophageal reflux is more prevalent in this population.
D) This population tends to buy foods high in fat and sodium because they are less expensive.

Question 28

According to Betty Neuman's systems theory of nursing, which of the following subsystems transcends all others?

A) Physiologic
B) Psychologic
C) Spiritual
D) Developmental

Question 29

According to the World Health Organization, diet is a major causative factor of:

A) Parkinson's disease.
B) congestive heart failure.
C) lipid profile abnormalities.
D) rheumatoid arthritis.

Question 30

What is the prevalence of malnutrition in today's healthcare landscape?

A) 5 to 10%
B 10 to 15%
C) 20 to 30%
D) 30 to 50%

Question 31

Patients taking pharmacologic agents to decrease production of stomach acid may have:

A) increased metabolic rates.
B) protein deficits.
C) dysregulation of lipoproteins.
D) decreased appetite.

Question 32

Which of the following is the main storage organ involved with energy homeostasis?

A) Stomach
B) Small intestine
C) Adipose tissue
D) Protein

Question 33

The __________ performs better than anthropometry and laboratory data as an assessment method for nutritional status.

A) Malnutrition Screening Tool
B) Nutritional Risk Screening
C) Mini-Nutritional Assessment Short Form
D) Subjective Global Assessment

Question 34

Which of the following tests would be used to assess the use of fat for energy production?

A) Urine indicant
B) Urine ketones
C) Urine sediment analysis
D) Serum Ca:PO₄ ratio

Question 35

The Weiss urochrome test is used to indicate:

A) protein breakdown.
B) catabolism.
C) metabolism.
D) level of physical activity.

Question 36

The __________ is primarily responsible for processing sensory data.

A) frontal lobe
B) temporal lobe
C) parietal lobe
D) occipital lobe

Question 37

Which of the following mediates certain patterns of behavior that determine survival, such as fear, aggression, and mating?

A) Cranial nerves
B) Limbic system
C) Temporal lobe
D) Occipital lobe

Question 38

Which of the following sleep patterns may be indicative of anxiety?

A) Not experiencing deep levels of sleep
B) Falling asleep too easily
C) Feeling tired after a full night's sleep
D) Having difficulty falling asleep

Question 39

Which component of the mnemonic SIGECAPS would be used to determine if the patient is still taking time to enjoy their hobbies?

A) S
B) I
C) G
D) E

Question 40

The assessment of talkativeness would be used to diagnose which of the following mental health disorders?

A) Depression
B) Generalized anxiety disorder
C) Bipolar disorder
D) Dysthymia

Question 41

A patient presents with tachycardia and complains of heart palpitations. Which of the following may be the cause of these symptoms?

A) Generalized anxiety disorder
B) Bipolar disorder
C) Schizophrenia
D) Delirium

Question 42

A patient can be aroused for short periods of time to visual, verbal, or painful stimuli. Which level of consciousness would be used to characterize the patient?

A) Confused
B) Lethargy
C) Delirium
D) Stupor

Question 43

Secretions from which of the following are released under cholinergic and hormonal control?

A) Eccrine glands
B) Apocrine glands
C) Sweat glands
D) Sebaceous gland

Question 44

Keratinocytes can be found on the basal layer of the:

A) epidermis.
B) dermis.
C) subcutaneous layer.
D) apocrine glands.

Question 45

Which of the following is most often found on the face?

A) Herpes zoster
B) Impetigo
C) Varicella
D) Rubella

Question 46

A patient reports that he rarely burns when exposed to sun and that he tans easily. What type would he be characterized as using the Fitzpatrick Skin Type Classification?

A) I
B) III
C) IV
D) V

Question 47

A patient presents with fever and malaise. Which of the following may be associated with these symptoms?

A) Varicella
B) Atopic dermatitis
C) Psoriasis
D) Erythema infectious

Question 48

A patient complains of anorexia and abdominal pain. Which of the following diseases may be the cause of these symptoms?

A) Roseola
B) Stasis dermatitis
C) Psoriasis
D) Rubeola

Question 49

Which of the following should be used when identifying lesions of vascular origin?

A) Squeezing
B) Palpation
C) Diascopy
D) Paring

Question 50

The __________ innervate(s) the levator palpebrae muscle.

A) tarsal plates
B) palpebral fissure
C) oculomotor nerve
D) sympathetic nerve

Question 51

Which of the following translates light images into a series of impulses or visual stimuli to the brain?

A) Fundus
B) Inner retina
C) Iris
D) Anterior chamber

Question 52

Soft contact wearers are at higher risk for:

A) glaucoma.
B) Pseudomonas infection.
C) corneal trauma.
D) diplopia.

Question 53

A patient presents with acquired nystagmus. Which of the following may explain this symptom?

A) Papilledema
B) Glaucoma
C) Multiple sclerosis
D) Ocular hemorrhage

Question 54

During an eye exam, you notice that the patient has mydriasis. Which of the following recreational drugs may the patient be taking to cause this finding?

A) Heroin
B) Alcohol
C) Benzodiazepines
D) Cocaine

Question 55

When testing central vision, which of the following should be done?

A) Position the patient 5 feet away from the chart.
B) Allow the patient to keep both eyes open.
C) Face the patient, gazing eye to eye.
D) Ask the patient to cover one eye with a card.

Question 56

To diagnose a corneal abrasion, which of the following diagnostic tests should be used?

A) Fluorescein stain
B) Observation
C) Referral to ophthalmology
D) Visual fields test

Question 57

The __________ lies just in front of the opening to the external ear.

A) pinnae
B) tragus
C) tympanic membrane
D) vestibular nerve

Question 58

Which of the following lies between the tympanic membrane and the oval window of the cochlea?

A) Tympanic cavity
B) Pinna
C) Ear canal
D) Auditory tube

Question 59

Which of the following results from disorders of the inner ear or central vestibular pathways?

A) Vertigo
B) Tinnitus
C) Otorrhea
D) Hearing loss

Question 60

A patient complains of yellow discharge coming from the ear. What could this indicate?

A) Tympanic membrane perforation
B) Fungal infection
C) Liquefied cerumen
D) Infection in the external or middle ear

Question 61

A patient presents with sore throat and periodontal pain. Which of the following may be responsible for these symptoms?

A) Otomycosis
B) Serous otitis
C) Vertigo
D) Tinnitus

Question 62

Which of the following should be considered when performing an ear assessment on a pregnant patient?

A) Pregnancy is associated with a decreased incidence of otosclerosis.
B) Maternal diabetes is associated with hearing abnormalities in the offspring.
C) Pregnancy is associated with a decreased ability to hear high-pitched sounds.
D) Pregnancy is associated with slowing of preexisting otosclerosis.

Question 63

A tympanogram may be used to diagnose:

A) acute otitis media.
B) chronic otitis media.
C) serous otitis.
D) trauma.

Question 64

Both subjective and objective data are subject to error.

Question 65

Ethnocentrism supports effective patient-provider relationships.

Question 66

When you recognize a communication barrier with a patient, you should stop the usual routine of the visit and share these perceptions with the patient.

Question 67

Comprehensive physical examinations should be performed in emergency situations.

Question 68

When performing a physical examination on a geriatric patient, it is important to consider that their reaction time may be longer.

Question 69

Stethoscope tubing should be double lumen so sound is magnified.

Question 70

The SOAP format for documentation can only be used for focused examinations.

Question 71

Any physical findings that the provider identifies should be documented in the objective component.

Question 72

When collecting a nutritional history as part of a social history assessment, it is always recommended to perform a 24-hour recall.

Question 73

According to Campinha-Bacote, cultural competence is an ongoing process.

Question 74

It is best to have a family member translate for a non-English speaking patient because they know the patient most intimately.

Question 75

The key focus of the cultural assessment is to determine the level of mistrust a patient may have with the provider.

Question 76

When the sympathetic nervous system is activated, saliva production is inhibited.

Question 77

The Nutritional Risk Screening (NRS) is valid and reliable for ambulatory subacute and ambulatory patients.

Question 78

A low level of serum PO₄ is an indicator of malnutrition.

Question 79

Delirium has an acute onset.

Question 80

Some conditions, such as HIV or AIDS, may contribute to mental health disorders.