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NUR-631 ADVANCED HEALTH ASSESSMENT TEST 1 LATEST 2024/
QUESTIONS WITH CORRECT ANSWERS
“For which of the following patients would a comprehensive health history be appropriate? A) A new patient with the chief complaint of "I sprained my ankle" B) An established patient with the chief complaint of "I have an upper respiratory infection" C) A new patient with the chief complaint of "I am here to establish care"
D) A new patient with the chief complaint of "I cut my hand" - CORRECT ANSWER c) a new
patient with the CC of "I am here to establish care" the patient is new to the provider so a comprehensive health history is needed" " The following information is best placed in which category? "The patient had a stent placed in the left anterior descending artery (LAD) in 1999." A) Adult illnesses B) Surgeries C) Obstetrics/gynecology
D) Psychiatric - CORRECT ANSWER A) adult illnesses
a stent is a major procedure but does not involve a surgeon" "11. The following information is best placed in which category? "The patient was treated for an asthma exacerbation in the hospital last year; the patient has never been intubated." A) Adult illnesses B) Surgeries C) Obstetrics/gynecology
D) Psychiatric - CORRECT ANSWER A) adult illnesses"
"A patient presents for evaluation of a sharp, aching chest pain which increases with breathing. Which anatomic area would you localize the symptom to? A) Musculoskeletal B) Reproductive C) Urinary
D) Endocrine - CORRECT ANSWER A)musculoskeletal"
"A patient comes to the emergency room for evaluation of shortness of breath. To which anatomic region would you assign the symptom? A) Reproductive B) Urinary C) Cardiac
D) Hematologic - CORRECT ANSWER C)cardiac"
"A patient presents for evaluation of a cough. Which of the following anatomic regions can be responsible for a cough? A) Ophthalmologic B) Auditory C) Cardiac
D) Endocrine - CORRECT ANSWER C) cardiac"
"A 22-year-old advertising copywriter presents for evaluation of joint pain. The pain is new, located in the wrists and fingers bilaterally, with some subjective fever. The patient denies a rash; she also denies recent travel or camping activities. She has a family history significant for rheumatoid arthritis. Based on this information, which of the following pathologic processes would be the most correct? A) Infectious B) Inflammatory C) Hematologic
D) Traumatic - CORRECT ANSWER B) inflammatory"
"You are excited about a positive test finding you have just noticed on physical examination of your patient. You go on to do more examination, laboratory work, and diagnostic tests, only to find that there is no sign of the disease you thought would correlate with the finding. This same experience happens several times. What should you conclude? A) Consider not doing this test routinely. B) Use this test when you have a higher suspicion for a certain correlating condition. C) Continue using the test, perhaps doing less laboratory work and diagnostics.
D) Omit this test from future examinations. - CORRECT ANSWER C) continue using the test,
perhaps doing less laboratory work and diagnostics" "You are growing fatigued of performing a maneuver on examination because you have never found a positive and are usually pressed for time. How should you next approach this maneuver? A) Use this test when you have a higher suspicion for a certain correlating condition. B) Omit this test from future examinations. C) Continue doing the test, but rely more heavily on laboratory work and diagnostics.
D) Continue performing it on all future examinations. - CORRECT ANSWER A) use this test
when you have a higher suspicion for a certain correlating condition" "You have recently returned from a medical missions trip to sub-Saharan Africa, where you learned a great deal about malaria. You decide to use some of the same questions and maneuvers in your "routine" when examining patients in the midwestern United States. You are disappointed to find that despite getting some positive answers and findings, on further workup,
"On a very busy day in the office, Mrs. Donelan, who is 81 years old, comes for her usual visit for her blood pressure. She is on a low-dose diuretic chronically and denies any side effects. Her blood pressure is 118/78 today, which is well-controlled. As you are writing her script, she mentions that it is hard not having her husband Bill around anymore. What would you do next? A) Hand her the script and make sure she has a 3-month follow-up appointment. B) Make sure she understands the script. C) Ask why Bill is not there.
D) Explain that you will have more time at the next visit to discuss this. - CORRECT ANSWER
C) ask why bill is not there? patient is looking for support and empathy" "A patient is describing a very personal part of her history very quickly and in great detail. How should you react to this? A) Write down as much as you can, as quickly as possible. B) Ask her to repeat key phrases or to pause at regular intervals, so you can get almost every word. C) Tell her that she can go over the notes later to make sure they are accurate.
D) Push away from the keyboard or put down your pen and listen. - CORRECT ANSWER D)
push away from the keyboard and put down your pen and listen" "You arrive at the bedside of an elderly woman who has had a stroke, affecting her entire right side. She cannot speak (aphasia). You are supposed to examine her. You notice that the last examiner left her socks at the bottom of the bed, and although sensitive areas are covered by a sheet, the blanket is heaped by her feet at the bottom of the bed. What would you do next? A) Carry out your examination, focusing on the neurologic portion, and then cover her properly. B) Carry out your examination and let the nurse assigned to her "put her back together." C) Put her socks back on and cover her completely before beginning the evaluation.
D) Apologize for the last examiner but let the next examiner dress and cover her. - CORRECT
ANSWER C) put her socks back on and cover her completely before beginning the evaluation
make patient comfortable before examining" "When you enter your patient's examination room, his wife is waiting there with him. Which of the following is most appropriate? A) Ask if it's okay to carry out the visit with both people in the room. B) Carry on as you would ordinarily. The permission is implied because his wife is in the room with him. C) Ask his wife to leave the room for reasons of confidentiality.
D) First ask his wife what she thinks is going on. - CORRECT ANSWER A) ask if it's okay to
carry out the visit with both people in the room"
"A patient complains of knee pain on your arrival in the room. What should your first sentence be after greeting the patient? A) How much pain are you having? B) Have you injured this knee in the past? C) When did this first occur?
D) Could you please describe what happened? - CORRECT ANSWER D) could you please
describe what happened" "A 55-year-old bookkeeper comes to your office for a routine visit. You note that on a previous visit for treatment of contact dermatitis, her blood pressure was elevated. She does not have prior elevated readings and her family history is negative for hypertension. You measure her blood pressure in your office today. Which of the following factors can result in a false high reading? A) Blood pressure cuff is tightly fitted. B) Patient is seated quietly for 10 minutes prior to measurement. C) Blood pressure is measured on a bare arm. D) Patient's arm is resting, supported by your arm at her mid-chest level as you stand to measure
the blood pressure. - CORRECT ANSWER A) blood pressure cuff is tightly fitted"
"A 49-year-old truck driver comes to the emergency room for shortness of breath and swelling in his ankles. He is diagnosed with congestive heart failure and admitted to the hospital. You are the student assigned to do the patient's complete history and physical examination. When you palpate the pulse, what do you expect to feel? A) Large amplitude, forceful B) Small amplitude, weak C) Normal
D) Bigeminal - CORRECT ANSWER B) small amplitude, weak
CHF has decreased stroke volume" "An 18-year-old college freshman presents to the clinic for evaluation of gastroenteritis. You measure the patient's temperature and it is 104 degrees Fahrenheit. What type of pulse would you expect to feel during his initial examination? A) Large amplitude, forceful B) Small amplitude, weak C) Normal
D) Bigeminal - CORRECT ANSWER A) large amplitude, forceful
fever results in increased stroke volume"
examination, you note that the pattern of eruption is like a Christmas tree and that there are a variety of erythematous papules and macules on the cleavage lines of the back. Based on this description, what is the most likely diagnosis? A) Pityriasis rosea B) Tinea versicolor C) Psoriasis
D) Atopic eczema - CORRECT ANSWER a) pityriasis rosea
one large patch that erupted into many lesions "Christmas tree pattern"" "A 19-year-old construction worker presents for evaluation of a rash. He notes that it started on his back with a multitude of spots and is also on his arms, chest, and neck. It itches a lot. He does sweat more than before because being outdoors is part of his job. On physical examination, you note dark tan patches with a reddish cast that has sharp borders and fine scales, scattered more prominently around the upper back, chest, neck, and upper arms as well as under the arms. Based on this description, what is your most likely diagnosis? A) Pityriasis rosea B) Tinea versicolor C) Psoriasis
D) Atopic eczema - CORRECT ANSWER B) tinea versicolor
fungal infection so sweating and increased moisture led to this" "A 68-year-old retired farmer comes to your office for evaluation of a skin lesion. On the right temporal area of the forehead, you see a flattened papule the same color as his skin, covered by a dry scale that is round and feels hard. He has several more of these scattered on the forehead, arms, and legs. Based on this description, what is your most likely diagnosis? A) Actinic keratosis B) Seborrheic keratosis C) Basal cell carcinoma
D) Squamous cell carcinoma - CORRECT ANSWER A) actinic keratosis"
"A 58-year-old gardener comes to your office for evaluation of a new lesion on her upper chest. The lesion appears to be "stuck on" and is oval, brown, and slightly elevated with a flat surface. It has a rough, wartlike texture on palpation. Based on this description, what is your most likely diagnosis? A) Actinic keratosis B) Seborrheic keratosis C) Basal cell carcinoma
D) Squamous cell carcinoma - CORRECT ANSWER B) seborrheic keratosis
"stuck on"" "A 72-year-old teacher comes to a skilled nursing facility for rehabilitation after being in the hospital for 6 weeks. She was treated for sepsis and respiratory failure and had to be on the ventilator for 3 weeks. You are completing your initial assessment and are evaluating her skin condition. On her sacrum there is full-thickness skin loss that is 5 cm in diameter, with damage to the subcutaneous tissue. The underlying muscle is not affected. You diagnose this as a pressure ulcer. What is the stage of this ulcer? A) Stage 1 B) Stage 2 C) Stage 3
D) Stage 4 - CORRECT ANSWER C) stage 3
full thickness skin loss with damage to subcutaneous tissue" "An 8-year-old girl comes with her mother for evaluation of hair loss. She denies pulling or twisting her hair, and her mother has not noted this behavior at all. She does not put her hair in braids. On physical examination, you note a clearly demarcated, round patch of hair loss without visible scaling or inflammation. There are no hair shafts visible. Based on this description, what is your most likely diagnosis? A) Alopecia areata B) Trichotillomania C) Tinea capitis
D) Traction alopecia - CORRECT ANSWER A) alopecia areata"
"A mother brings her 11 month old to you because her mother-in-law and others have told her that her baby is jaundiced. She is eating and growing well and performing the developmental milestones she should for her age. On examination you indeed notice a yellow tone to her skin from head to toe. Her sclerae are white. To which area should your next questions be related? A) Diet B) Family history of liver diseases C) Family history of blood diseases
D) Ethnicity of the child - CORRECT ANSWER A) diet"
"A new mother is concerned that her child occasionally "turns blue." On further questioning, she mentions that this is at her hands and feet. She does not remember the child's lips turning blue. She is otherwise eating and growing well. What would you do now? A) Reassure her that this is normal B) Obtain an echocardiogram to check for structural heart disease and consult cardiology C) Admit the child to the hospital for further observation
D) Question the validity of her story - CORRECT ANSWER A) reassure her that this is normal
"a 49 year old man presents with a skin lesion suspicious for malignant melanoma. you describe the lesion as having: a. deep, black-brown coloring throughout b. sharp borders c. a diameter of 3 mm or less
d. variable pigmentation - CORRECT ANSWER d. variable pigmentation
remember ABCDE rule" "a 72 year old woman presents with a newly formed painless, pearly, ulcerated nodule with an overlying telangiectasis on the upper lip. this most likely represents: a. actinic keratosis b. basal cell carcinoma c. squamous cell carcinoma
d. molluscum contagiosa - CORRECT ANSWER basal cell carcinoma
remember PUT ON" "when examining a mole for malignant melanoma, all of the following characteristics can indicate a melanoma, except: a. asymmetry with non matching sides b. color that is not uniform c. a recently formed lesion
d. a lesion that has been present for at least 2 years - CORRECT ANSWER d. a lesion that has
been present for at least 2 years ABCDE E-evolving (new or changing lesion)" "the most common sites for squamous and basal cell carcinoma include: a. palms of hands and soles of feet b. pelvic and lumbar c. abdomen
d. the face and scalp - CORRECT ANSWER d. the face and scalp
(where we get the most sun exposure)"
"a 56 year old truck drive presents with a new nodular, opaque lesion with non distinct borders on his left forearm. This most likely represents: a. actinic keratosis b. squamous cell carcinoma c. basal cell carcinoma
d. malignant melanoma - CORRECT ANSWER b. squamous cell carcinoma
remember NO SUN" "An urticarial lesion is usually described as a: A. wheal B. plaque C. patch
D. papule - CORRECT ANSWER a. wheal"
"Blood pressure abnormalities found more commonly in Western elderly include which of the following? A) Isolated elevation of the diastolic BP B) Narrow pulse pressure C) Elevation of the systolic BP
D) Elevation of the BP with standing - CORRECT ANSWER C) elevation of the systolic BP"
"Mr. Chin is an 82-year-old man who comes to your office for a routine check. On examination, you notice a somewhat high-pitched murmur in the second right intercostal space during systole. It does not radiate and the rest of his examination is normal for his age. Which is true of the most likely cause of this murmur? A) It often decreases carotid upstroke. B) It carries with it increased risk for cardiovascular disease. C) It is usually accompanied by an S3 gallop.
D) It is found in 10% of otherwise normal elderly patients. - CORRECT ANSWER B) It carries
with it increased risk for cardiovascular disease. caused by calcification of the valve" "Mrs. Glynn is 90 years old and lives alone. She is able to bathe, dress, prepare her food, and transfer from bed to chair independently. She has children in the area who help her with her medications and transportation needs. Which of the following is considered an instrumental activity of daily living? A) Bathing B) Dressing
B teaching the patient new medical terms. C discouraging an emotional outburst.
D encouraging more detail. - CORRECT ANSWER d. encouraging more detail"
"While interviewing an angry patient, you start to become annoyed and inpatient and are beginning to dislike the patient. The best way to resolve this is to: A spend the least amount of time possible with the patient. B displace your annoyance toward the patient on an inanimate object. C ignore the feelings and remain neutral in your interactions.
D express concern and explore the problem with the patient - CORRECT ANSWER d. express
concern and explore the problem with the pt" "Which of the following behaviors is most important in establishing a connection with the patient? A Documenting data from the history using direct patient quotes. B Phrasing questions so that they are clear and explicit. C Avoiding the trap of giving advice during an interview.
D Listening intently while observing nonverbal cues. - CORRECT ANSWER d. listening
intently while observing nonverbal cues" "During an interview, the patient describes problems associated with an illness and begins to cry. The best action in this situation is to: A stop the interview and reschedule for another time. B allow the patient to cry, then resume when the patient is ready. C change the topic to something less upsetting.
D continue the interview while the patient cries in order to get through it quickly. - CORRECT
ANSWER b. allow the pt to cry then resume when pt is ready"
"Which statement best describes the chief complaint? A General health and illness B The reason the individual is seeking care C Information to make the diagnosis
D Concerns about confidentiality and trust - CORRECT ANSWER b. the reason why the
individual is seeking care" "A woman presents to a women's health clinic stating that she has had a positive home pregnancy test and desires prenatal care. You would conduct a/an:
A complete history. B focused history. C problem-oriented history.
D interim history. - CORRECT ANSWER a. complete history = makes you as throughouly
familiar with the pt as possible. Usually for the 1st time seeing pt" "You are responding to a patient who has behaved toward you in a seductive manner. Which of the following is most appropriate? A Respond in a manner that acknowledges that the patient is embarrassed. B Remain calm, firm, and direct regarding the professional nature of the relationship. C Be courteous.
D Ignore the patient's behavior. - CORRECT ANSWER b. remain calm, firm, and direct
regarding the professional nature of the relationship" "Various behaviors can create tension during the interview. For the following patient behavior, identify the response by the examiner that is least likely to decrease tension. Anxiety Which interviewer behavior would least contribute to decreasing tension in an anxious patient? A Avoid information overload. B Slow the conversation. C Maintain a calm demeanor.
D Finish the interview promptly. - CORRECT ANSWER Least!!! d. finish the interview
promptly" "On a follow-up appointment for management of asthma, a patient tells you that she has not started some of her medication because of financial issues. Which statement least applies to the provider role in this situation? A Financial issues are outside the provider's areas of concern. B Financial concerns may inhibit full disclosure of the patient's family and personal history. C Discussion of financial issues should be redirected to the importance of treatment for health.
D Providers should know local resources to which patients can be referred. - CORRECT
ANSWER d. providers should know local resources to which pts can be referred"
"Which of the following information is particular to a pediatric history? A Family history B Developmental history
"Long periods of silence during an interview may indicate: A a need for the health care provider to increase the pace of the interview. B an inability of the patient to communicate. C a reluctance of the patient to verbalize information.
D a need to terminate the interview because of the decreased attention of the patient. -
CORRECT ANSWER c. a reluctance of the pt to verbalize information"
"Interviewers should identify and assess their own feelings, such as hostility and prejudice, in order to: A avoid inappropriate behavior. B explain their biases to patients. C express personal idiosyncrasies.
D promote self-awareness. - CORRECT ANSWER a. avoid inappropriate behavior"
"J.F. shares with you that he has an uncle and a brother with sickle cell disease. Where would this information best be documented? A Chief complaint B Past medical history C Social history
D Family history - CORRECT ANSWER d. family hx"
"A mother runs into the emergency department with her 6-year-old son. She says that her son fell 15 feet from a tree. The child is screaming and has an open fracture of the left forearm. You would conduct a/an: A complete history. B focused history. C problem-oriented history.
D interim history. - CORRECT ANSWER b. focused hx= when problem is acute, possibly life-
threatening, and requires immed. attention Inventory hx= does not replace the complete hx but touches the major points , good when the hx will be completed in more than 1 session" "A patient with diabetes comes into the medical clinic, stating that he has noticed a sore on his foot for the last week. You note that his last visit was 2 months ago. You would conduct a/an: A complete history. B focused history. C problem-oriented history.
D interim history. - CORRECT ANSWER d. interim hx = designed to chronicle events that
have occured since the last time you saw a pt. Its substance is determined by the nature of the problem and the need at the moment" "Which behavior is least likely to facilitate an interview with a patient who is dissembling? A Allow the topic to be changed. B State "I noticed that you changed the topic." C Use gentle questioning to help the patient explore the topic.
D Return to the topic at later time in the interview. - CORRECT ANSWER a. allow the topic to
be changed" "Which interviewer action is least appropriate when a patient engages in excessive flattery? A Respond warmly and intimately. B Remain calm, firm, and direct. C Recognize that flattery can be manipulative.
D Ignore the patient's behavior. - CORRECT ANSWER a. respond warmly and intimately"
"Some older adults may have sensory losses that make communication more difficult. Some degree of hearing loss is common in older adults. One action that tends to worsen hearing or communication problems is: A positioning yourself so the patient is looking at your face. B speaking clearly and slowly. C using a high-pitched voice.
D avoiding noisy interviewing rooms. - CORRECT ANSWER c. using a high-pitched voice"
"Older adults with impaired visual perception and light-dark adaptation generally do better: A with written interviews. B in dimly lit interview rooms. C in a well-illuminated environment.
D with a light source that reflects in their eyes. - CORRECT ANSWER c. in a well-illuminated
environement" "A 26-year-old woman presenting for a pre-employment physical is found to have bruising on her back and buttocks? What would be your best immediate response? Ask "Would you care to tell me about these bruises on your back and buttocks?" Say "I see bruises. How did you get them?" Correct Ask "Do you feel safe in your current relationships?" Say "I am required by the law to document these bruises so I am asking your permission to take a picture of them."
"The following information is recorded in the health history: "The patient completed 8th grade. He currently lives with his wife and two children. He works on old cars on the weekend. He works in a glass factory during the week." Which category does it belong to? A) Chief complaint B) Present illness C) Personal and social history
D) Review of systems - CORRECT ANSWER C) personal and social history"
"The following information is recorded in the health history: "I feel really tired." Which category does it belong to? A) Chief complaint B) Present illness C) Personal and social history
D) Review of systems - CORRECT ANSWER A) chief complaint
pt's own words" "The following information is recorded in the health history: "Patient denies chest pain, palpitations, orthopnea, and paroxysmal nocturnal dyspnea." Which category does it belong to? A) Chief complaint B) Present illness C) Personal and social history
D) Review of systems - CORRECT ANSWER D) review of systems"
"The following information is best placed in which category? "The patient has had three cesarean sections." A) Adult illnesses B) Surgeries C) Obstetrics/gynecology
D) Psychiatric - CORRECT ANSWER B) surgeries"
"A 47-year-old contractor presents for evaluation of neck pain, which has been intermittent for several years. He normally takes over-the-counter medications to ease the pain, but this time they haven't worked as well and he still has discomfort. He recently wallpapered the entire second floor in his house, which caused him great discomfort. The pain resolved with rest. He denies fever, chills, rash, upper respiratory symptoms, trauma, or injury to the neck. Based on this description, what is the most likely pathologic process? A) Infectious
B) Neoplastic C) Degenerative
D) Traumatic - CORRECT ANSWER C) degenerative"
"A 15-year-old high school sophomore comes to the clinic for evaluation of a 3-week history of sneezing; itchy, watery eyes; clear nasal discharge; ear pain; and nonproductive cough. Which is the most likely pathologic process? A) Infection B) Inflammation C) Allergic
D) Vascular - CORRECT ANSWER C) allergic
consistent with allergic rhinitis" "A 19-year old-college student presents to the emergency room with fever, headache, and neck pain/stiffness. She is concerned about the possibility of meningococcal meningitis. Several of her dorm mates have been vaccinated, but she hasn't been. Which of the following physical examination descriptions is most consistent with meningitis? A) Head is normocephalic and atraumatic, fundi with sharp discs, neck supple with full range of motion B) Head is normocephalic and atraumatic, fundi with sharp discs, neck with paraspinous muscle spasm and limited range of motion to the right C) Head is normocephalic and atraumatic, fundi with blurred disc margins, neck tender to palpation, unable to perform range of motion D) Head is normocephalic and atraumatic, fundi with blurred disc margins, neck supple with full
range of motion - CORRECT ANSWER C)"
"A 37-year-old nurse comes for evaluation of colicky right upper quadrant abdominal pain. The pain is associated with nausea and vomiting and occurs 1 to 2 hours after eating greasy foods. Which one of the following physical examination descriptions would be most consistent with the diagnosis of cholecystitis? A) Abdomen is soft, nontender, and nondistended, without hepatosplenomegaly or masses. B) Abdomen is soft and tender to palpation in the right lower quadrant, without rebound or guarding. C) Abdomen is soft and tender to palpation in the right upper quadrant with inspiration, to the point of stopping inspiration, and there is no rebound or guarding. D) Abdomen is soft and tender to palpation in the mid-epigastric area, without rebound or
guarding. - CORRECT ANSWER C) tender to palpation in RUQ"
"A 55-year-old data entry operator comes to the clinic to establish care. She has the following symptoms: headache, neck pain, sinus congestion, sore throat, ringing in ears, sharp brief chest
