Advanced Health Assessment Final Exam Questions & Answers with Correct Solutions., Exams of Nursing

Download Advanced Health Assessment Final Exam Questions & Answers with Correct Solutions. and more Exams Nursing in PDF only on Docsity! Advanced Health Assessment Final A circumscribed, elevated lesion, >1 cm I diameter and containing clear serous fluid is best described as - AnswerBulla The history and physical of a client indicates paste occurrences of lichenification. The NP identifies this as: - AnswerRough, thickened epidermis, accentuated skin markings On examination of a client's skin, the nurse practitioner finds a lesion that is about 0.75 cm in diameter, brown, and circumscribed. Correct term for this lesion is: - AnswerMacule In performing a skin assessment, the NP understands that the following characteristic of a mole would need intervention: - AnswerA new 2mm mole that is brown with a red, irregular border, and occasionally pruritic The NP describes an annular skin lesion as usually arranged in - AnswerA circle or ring shape An NP educating patients realizes that risk factors for skin cancer include all except: - AnswerDark eyes Which of the following in a client's history would place the patient most at risk for melanoma? - AnswerIntense, intermittent sun exposure An elderly retired farmer presents with a rolled border, pearly, firm nodule with telangiectasia on his nose. This is: - AnswerBasal cell carcinoma An adult female presents with an irregular, variegated nevus on her left lower back that has doubled in size the past ?. The NP should: - AnswerRefer immediately to a dermatologist The ABCDs of melanoma identification include all of the following EXCEPT: - AnswerB (bridging): connection across sides Your patient is 2 weeks old. During your assessment, you note that she has pinhead sized, smooth, white, raised areas. You document this as: - AnswerMilia Advanced Health Assessment Final Which skin lesions are directly related to chronic sun exposure and photo damage? - AnswerActinic keratosis In your assessment you note Ms. Angel has white nail syndrome, you order: - AnswerBUN & Creatinine Mary D. an 84 y.o F has multiple solar lentils <1 cm. These are not uncommon for her age. You would describe these as: - AnswerMacules Lou, a 50 yo homeless man is diagnosed with tinea capitis. You realize this is cause by a(n): - AnswerDermatophyte Ron R presents with dependent edema. You assess he has a >1 inch indentation up to mid-tibia bilaterally. You document this as: - Answer+4 edema The most common type of melanoma is the: - AnswerSuperficial You are assessing Arlene C's skin complaint. You get a +Auspitz sign. This aides you in the diagnosis of: - AnswerPsoriasis As you gather you history from a patient with atopic dermatitis what other items in the personal or family history would you expect with this patient? - AnswerAsthma Which of the following statements best describes squamous cell carcinoma? - AnswerOften has a keratinous horn You are assessing a newborn and note the baby is jaundiced. He is 3 days old. You realize that for this to be a normal finding it must be gone within: - Answer1 week What are the major components to be documented for a skin lesion? - Answer-Distribution -Configuration -Palpable features -Pattern Advanced Health Assessment Final Mrs Jones is a female patient with history of ETOH abuse. Your abdominal exam should include: - AnswerThe scratch test When examining the eyes, the NP realizes that the pupils change in size when the client focuses from a close object to a far object. This is: - AnswerNormal visual accommodation On ophthalmic examination, there appears to be narrowing or blocking of the vessels. Significance of this finding is: - AnswerThe client should be evaluated for chronic hypertension Mr Smith has a +bruit upon examination of the thyroid. This most likely indicates: - AnswerHyperthyroidism As you are getting your patients history you notice bilateral lid lag of the eye. You make a note to yourself to assess for problems with: - Answerthyroid 70 yo comes to clinic c/o blurred vision, problems w glare, no pain. NP should check first for ___ - Answercataract At what age do you approximate adult vision? - Answer4 years old The purpose of conducting the Rinne test is to determine the conduction of sound through bone and auditory canal to determine that: - AnswerAir conduction is twice as long as bone conduction Sally, age 19, presents with pain and pressure over her cheeks and discolored nasal discharge. You cannot transilluminate. Which sinus is affected? - AnswerMaxillary Zeke Gilbert, age 72, retired factory worker, has hearing loss in the right ear due to excessive cerumen. The NP would expect to find____ during the weber test - AnswerSound materializes to the Right ear What is the correct procedure for palpation of a client's thyroid gland? - AnswerHave a client lower chin and lean slightly toward the side being evaluated Advanced Health Assessment Final you are giving an 85 yo nursing home resident her annual physical exam. History of HTN. Margin of lower lid is turned outward and conjuctiva is exposed - AnswerEctropion 56 yo salesman evaluated area on the tongue that has been present for 3 ___, unable to scrape off. White painless plaques. What is the likely diagnosis? - AnswerLeukoplakia Client presents with conjunctivitis. Which lymph nodes would you expect to find enlarged? - AnswerPre- auricular and anterior cervical Conducting an ophthalmic exam on a patient with chronic hypertension. What would you expect to see? - Answercotton wool patches and flame hemorrhages When Judy, age 15, asks you to explain what 20/50 vision means you respond: - AnswerYou can see at 20 feet what normal people can see at 50 feet Ms Ins presents with eye pain. The external eye is red, tender, swollen, raised area, pointing outward on the lash border. This is: - AnswerHordeolum firm, painless, relatively fixed submandibular node would most likely be seen in the diagnosis of : - Answeroral caner As an APN, you believe strongly in anticipatory guidance and prevention education. You explain this to your patient that the development of screening and prevention guidelines is based on: - Answerincreased in average life expectancy ted who is 15 yo just moved into the community and is staying in a foster home temporality without any record of immunizations. Which immunizations does he need? - Answer-meningococcal -mmr -tdap -all of the above*** Advanced Health Assessment Final the client tells you that he takes aspirin daily. What question should you ask next? - AnswerWhy do you take aspirin daily? Mr. Bill presents to your office for a physical. You note that his BMI is 27. You inform him that this is considered - Answeroverweight You are evaluating an elderly man who was brought by his distraught daughter. You explain that many physical changes occur as we age that affect nutrition. Including all of the following except? - Answertotal caloric needs increase Mr P complains of a "pain in his stomach". In your note you document that he is c/o pain in the LLQ, radiating with worsening intensity towards the umbilicus. Pain is 6/10. Denies n/v/d. HPI should include- - AnswerWhen did it begin? During a routine physical exam of a 44 yo woman you note she has an inverted left nipple. You decide to investigate because: - AnswerThe inversion may be a recent change A 30 yo F is in the office c/o palpiations and some lightheadedness for the past ?, random episodes, no detectable pattern. NP notes a mid systolic click with a late systolic murmur heard best in the apical area. You suspect - AnswerMitral valve prolapse (MVP) All of the following tests require the patient's voice to perform correctly except: - Answer-egophany -tactile fremitus -whispered pectoriloquy *auscultation* 59 yo M with history of COPD presents with worsening dyspnea. Patient is afebrile, breath sounds are decreased bilaterally, noted to have JVD and pitting edema of lower extremities. What is the most likely cause of his dyspnea? - AnswerCHF James Jones 55 yo M smoker presents with thick sputum producing cough. Exam: +tactile fremitus, resonant percussion, and normal voice transmission. You suspect: - Answerbronchitis Advanced Health Assessment Final Keys to select for the right level of billing includes - AnswerHistory, exam, decision making Key element for all levels of CPT code is - AnswerChief complaint When obtaining health history from an older client must be taken into consideration? - AnswerAuditory acuity is the most common sensory loss in the aged population and may hinder the interview 70 yo Mr Willians is a new patient, has no complaints, requesting a physical. His physical is unremarkable but which of the following puts him at risk: - AnswerWaits of 42 inches Limiting public smoking is an example of secondary prevention. True or false - AnswerFALSE James is a 17yo patient who presents for school physical. Based on the leading cause of mortality for this age group, you should discuss: - AnswerSeat belt use Lisa is a 53 yo F who presents for a physical. According to ABCDE approach to preventing cardiology: the items to assess for the "A" include all EXCEPT - Answer-assessment of risk -antiplatelet use -*apple shape* -anticoagulation Larry 25 yo M presents to have TB test read. Should be billed at - Answer99211 Learning how to drive with a therapist after a stroke is called - AnswerTertiary prevention NP evaluating an 85 yo M NP instructs the patient to remember words and repeat them in 10 minutes. Which of the tests are being described? - AnswerMMSE A charitable foundation plans to build a community youth center in a large urban area with history of gang violence. What type of prevention is being done? - AnswerPrimary prevention Advanced Health Assessment Final All of the following are true about domestic abuse EXCEPT? - AnswerNo delay in seeking treatment The SCOFF screening tool is used to diagnose eating disorders - AnswerFalse A 58 yo dentist presents for routine check up. He has been healthy. Non smoker, does not drink alcohol. You hear a moderately loud murmur, no palpable thrill. What is the appropriate grade for this murmur? - AnswerGrade 3 57 yo college professor is hospitalized for SOB. As you examine her in ER, JVP of 45 degrees 8 cm above the clavicle. finding is most consistent with which of the following diagnoses? - AnswerRight sided heart failure What technique should be used to best auscultate the 2nd heart sounds? - AnswerDiaphragm of the stethoscope at 2nd intercostal space at the base of the heart You hear a split s2 on auscultation of a 25 yo client. What is your best action? - AnswerTell them to hold their breath and repeat The clinet has been told he has a heart murmur. He asks you what this means. You explain - AnswerIt is the rushing sound blood makes moving through narrow places. Some are harmless and others indicate problems Where would you expect to hear best an abnormal sound with mitral valve insufficiency? - Answer5th ICS at MCL when auscultating the heart sounds of a 72 yo client with history of HTN. NP notes an S4. This finding could indicate - AnswerAn increased resistance to ventricular filling As you assess Ms Jones you recall that the most prevalent cardiac symptom is - AnswerFatigue Joe Tiger presents with complaints of pain in his leg when walking that is relieved with rest. You perform ABI. Which result would be consistent with physical symptoms? - Answer0.6 Advanced Health Assessment Final As you assess your patient you document Osler's nodes. You realize that this could be a sign of? - AnswerEndocarditis During the physical exam of 72 yo Mary Rose you note a BP of 140/90. According to JNC 8, what would you do first? - AnswerCalculate cardiac risk When auscultating a clients heart you note short, high-frequency click (opening snap) after S2 during the beginning of diastole. What could this indicate? - AnswerMitral stenosis NP upon exam notes a bilateral gray ring around the irises of the 80 yo patient. Denies vision changes or pain. What is the possible diagnosis? - AnswerArcus senilis To rule out middle lobe pneumonia you would make sure to auscultate - AnswerUnder the right axillae In assessing a patient with a positive cardiac history, you utilize CHADS scoring. What are the elements of this scoring system? - AnswerHTN, DM, CHF The NP is aware that acute bronchitis is characterized by? - AnswerParoxyms of coughing that is dry or productive of mucoid sputum 21 year old college senior to clinic c/o SOB x 3 days. Hx asthma, controlled with medications. S/s URI with fever. Increased use of rescue inhaler. What would you expect her lung sounds to be? - AnswerWheezes during inspiration and expiration All of these are abnormal breathing in the infant EXCEPT - Answerlouder, harsher sounds A positive clinical sign on the physical exam indicating pneumonia is - AnswerDullness on percussion Lung sounds that have low pitch and soft in intensity and are heard better on inspiration - AnswerVesicular