Deck 25: Putting it All Together

Question 1

Which patient characteristic is most likely to limit patient reliability during history taking?

A) The patient's measured IQ is above average.
B) The patient is alert and oriented to time and place.
C) The patient is depressed.
D) The patient speaks the same language as examiner.

Answer 1

The patient is depressed.

Question 2

Which are examined with the patient in a reclining 45-degree position?

A) Bilateral hips and popliteal angles
B) Facial bones and cranial nerves V and VII
C) Jugular venous pulsation and pressure
D) Oropharynx and thyroid gland placement

Answer 2

Jugular venous pulsation and pressure

Question 3

Which statement accurately reflects the sensitivity and specificity of laboratory tests?

A) The gold standard test has 100% sensitivity and specificity.
B) Sensitivity and specificity are inversely correlated.
C) Sensitivity and specificity are directly correlated.
D) No test has 100% sensitivity and specificity.

Answer 3

No test has 100% sensitivity and specificity.

Question 4

Which data is not part of your general inspection?

A) Dress and habitus
B) Sinus tenderness
C) Gait
D) Facial expression

Question 5

Which patient position facilitates inspection of the chest and shoulders?

A) Sitting
B) Supine
C) Trendelenburg
D) Prone

Question 6

As you greet the patient, which examination technique is first implemented?

A) Auscultation
B) Inspection
C) Measurement
D) Palpation

Question 7

The examiner should develop a demeanor that is exemplified by which one of the following behaviors?

A) Exhibits visible distaste about the condition.
B) Gives immediate reassurances to the patient.
C) Gives patient unsolicited advice.
D) Validates the patient's justified concerns.

Question 8

The sequence of the physical examination should be individualized to:

A) minimize the number of times that the patient must change positions.
B) maximize the convenience of the examiner.
C) improve patient flow.
D) minimize the time that the patient is in the room.

Question 9

Palpation of the epitrochlear nodes is part of the:

A) examination of the upper extremities.
B) assessment of the chest and thorax.
C) palpation of the abdomen.
D) examination of the head and neck.

Question 10

Which examiner behavior would help minimize your patient's dissatisfaction?

A) Assume a busy and rushed attitude.
B) Convey your own feelings of discomfort.
C) Keep the patient waiting for more than 30 minutes.
D) Seek information about the patient's problem.

Question 11

The reliability of health-related findings and observations is the responsibility of the:

A) patient.
B) professional and medical assistants.
C) attending clinician.
D) professional and the patient.

Question 12

When assessing the abdomen, the examiner needs to expose the patient:

A) from the waist down.
B) from the pubis to the epigastrium.
C) in entirety.
D) at no point during the examination.

Question 13

Which is true regarding the relationship between the examiner and patient?

A) It is the examiner's responsibility to help the patient understand that he or she is qualified to make decisions regarding health care.
B) The patient must trust the examiner completely.
C) The examiner-patient relationship is enhanced by ignoring cultural issues.
D) The patient is a full partner with the examiner.

Question 14

To inspect the abdominal muscles, ask the:

A) supine patient to raise their head.
B) standing patient to bend forward.
C) prone patient to raise their lower legs.
D) standing patient to stand on tiptoes.

Question 15

An ophthalmoscopic eye examination involves:

A) lens inspection.
B) near vision evaluation.
C) sclera observation.
D) visual field assessment.

Question 16

An examiner might be able to help a patient who seems uncomfortable with close contact during an examination by:

A) acknowledging the discomfort.
B) backing away from the patient.
C) joking about the patient's discomfort.
D) moving briskly to completion.

Question 17

At your first meeting with a patient, it is usually best to say:

A) "Let's get to the point."
B) "I hope you will learn to trust me."
C) "Let me tell you what I can do for you."
D) "Tell me about yourself."

Question 18

Which is most likely to enhance examiner reliability?

A) The examiner who seeks input from others.
B) The examiner is uncomfortable with his or her own skills.
C) The examiner believes that he or she must always be correct.
D) The examiner prejudges the patient and family.

Question 19

When performing a history and physical assessment, the examiner should:

A) change the sequence of observation with each interview.
B) develop a sequence of standard observations.
C) develop a preliminary diagnosis at the onset.
D) direct patient responses to fit the history sequence.

Question 20

According to the usual examination procedure, you would first assist your patient to assume which position?

A) Lithotomy
B) Prone
C) Sitting
D) Supine

Question 21

The cranial nerves are usually assessed while the patient is in which position?

A) Standing
B) Supine
C) Sitting
D) Prone

Question 22

Which cannot be assessed in the crying infant?

A) Tactile fremitus
B) Respiratory rate
C) Lung excursion
D) Facial symmetry

Question 23

Functional assessment is most important during the examination of a(n):

A) adolescent.
B) infant.
C) older adult.
D) young adult.

Question 24

Examination of the patient in the lithotomy, or knee-chest, position includes:

A) inspection for inguinal hernias.
B) palpation of anal sphincter tone.
C) percussion of pelvic structures.
D) stereognosis testing.

Question 25

Which portion of the physical examination is best done with the patient standing?

A) Spinal
B) Rectal
C) Neurologic
D) Musculoskeletal

Question 26

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

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

Question 27

To promote a child's cooperation during your examination, your approach to the examination should be to:

A) ask the parent to give the child a bottle during the examination.
B) sing songs with the child during the examination.
C) conduct the physical examination on the child while the parent is holding the child.
D) let the child play with examination room equipment to feel more comfortable.

Question 28

Mrs. Kia has brought her newborn infant in for a 2-week examination. The examination of the newborn should begin with:

A) inspection.
B) palpation.
C) vital signs.
D) auscultation.

Question 29

When you attempt to move a 10-month-old child from his mother's lap to the examination table, he screams loudly. Your best action is to:

A) move the child to the examination table and proceed matter of factly with the examination.
B) ask the mother to try to get the child to stop crying.
C) perform the examination while the child is in the mother's lap.
D) defer the examination until another day.

Question 30

When conducting a geriatric assessment, keep in mind that basic activities of daily living (ADL) include:

A) bathing.
B) housekeeping.
C) medication compliance.
D) communication skills.

Question 31

A common method for estimating gestational age of a newborn is to assess:

A) middle finger length.
B) creases on the sole of the foot.
C) umbilical placement.
D) visual acuity.

Question 32

Proprioception should be assessed while the patient is:

A) prone.
B) supine.
C) seated.
D) standing.

Question 33

Throughout the history and physical examination, the clinician should:

A) concentrate on emotional issues.
B) follow an inflexible sequence.
C) evaluate the whole patient.
D) deal only with previously identified problems.

Question 34

Observation of the child playing in the playroom provides information about which two systems?

A) Dermatologic and cardiovascular
B) Neurologic and musculoskeletal
C) Respiratory and ear, nose, and throat
D) Gastrointestinal and genitourinary

Question 35

For a routine physical examination, which equipment is not necessary?

A) A penlight
B) A measuring tape
C) Examination gloves
D) A monofilament

Question 36

The Ballard Gestational Age Test is completed within 36 hours of birth to:

A) determine if the menstrual estimated age is correct.
B) determine if the newborn is premature.
C) determine an actual quantitative measure.
D) determine combined objective and subjective observations.

Question 37

Which action should the nurse take before auscultating bowel sounds in an 18-month-old child?

A) Stand to the left of the child
B) Palpate the abdomen
C) Loosen the diaper
D) Position the child prone

Question 38

The greatest risk for potential health problems occurs in which age group?

A) Newborn
B) Toddler
C) School-age
D) Adolescence

Question 39

When examining a "difficult" patient, it is best to allow which person in the examination room?

A) The clinician
B) Patient's small children
C) An interpreter
D) A chaperone

Question 40

In crying infants, it is often difficult to:

A) perform tactile fremitus assessments.
B) determine lung expansion.
C) auscultate heart sounds.
D) visualize the pharynx.

Question 41

Ms. Stein visits the nurse practitioner for an annual examination. The nurse practitioner tests Ms. Stein's tongue for movement and strength. The nurse practitioner is assessing CN _______.

Question 42

Which position is most likely the most comfortable for a patient who is 6 months pregnant?

A) Side-lying
B) Lithotomy
C) Prone
D) Flexed-knee

Question 43

Mrs. Jones is a 44-year-old patient who presents for a routine physical examination. The patient is unable to shrug her shoulders against the examiner's hands during the examination. The cranial nerve involved with successful shoulder shrugging is CN ____.

Question 44

What is the "brown-bag approach" in regard to examining an older adult?

A) The patient's stool sample is brought to the examination in a brown bag.
B) The patient's medications are brought to the examination in a brown bag.
C) The patient's change of clothes is brought to the examination in a brown bag.
D) The patient's assistive device is brought to the examination in a brown bag.