NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100, Exams of Nursing

Download NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100 and more Exams Nursing in PDF only on Docsity! NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct 1. During pregnancy, dyspnea accompanied by increased respiratory rate, cough, rales, or respiratory distress raises concerns of: peripartum cardiomyopathy Explanation: Dyspnea accompanied by increased respiratory rate, cough, rales, or respiratory distress raises concerns of possible infection, asthma, pulmonary embolus, or peripartum cardiomyopathy. 2. The middle section of the thoracic cavity containing the esophagus, trachea, heart, and great vessels is the: mediastinum Explanation: The middle section of the thoracic cavity containing the esophagus, trachea, heart, and great vessels is the mediastinum. The right and left pleural cavities, are on either side of the mediastinum and those contain the lungs. The visceral pleura encloses the lung. The pericardium surrounds the heart. 3. A patient is unable to identify the smell of an orange. This inability could reflect an abnormality in cranial nerves: CN I Explanation: Cranial Nerve I is the olfactory nerve responsible for the sense of smell. To test the sense of smell, the examiner presents the patient with familiar and nonirritating odors. A person should normally perceive odor on each side and correctly identify the source. Cranial Nerves II and III assess vision and pupillary reaction. Cranial Nerve VIII tests the hearing and balance. 4. A transient ischemic attack is: a transient episode of neurologic dysfunction by focal brain, spinal cord, or retinal ischemia, without acute infarction Explanation: TIA is now defined as “a transient episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia, without acute infarction.” Ischemic stroke is “an infarction of central nervous system tissue” that may be symptomatic or silent. The other terms are not related to the new definitions. 5. The term asteatosis refers to: skin that is dry, flaky, rough, and often itchy NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct Explanation: Physiologic changes of aging include loss of elastic turgor, and wrinkling. Skin that appears dry, flaky, rough, and itchy is termed asteatosis. Sun exposure can cause damage to the skin resembling an appearance as weather beaten, thickened, yellowed, and deeply furrowed. Seborrheic keratosis appear as raised, yellowish lesions that feel greasy, velvety, or warty. Painful vesicular lesions in a dermatomal distribution may suggest herpes zoster. NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct anserine bursitis Explanation: Swelling 1-2 inches below the knee joint and on the medial surface would be suggestive of anserine bursitis. Swelling over the tibial tubercle suggests infrapatellar bursitis. Swelling over the patella suggests prepatellar bursitis. Semimembranous bursitis would be suggested by swelling on the posterior and medial surface of the knee. 11. A patient states that the only way he can sleep at night is to use several pillows or to sleep upright in a recliner. This sleep pattern is most consistent with: obstructive lung disease Explanation: With obstructive lung disease, the patient experiences orthopnea, dyspnea that occurs when the patient lies down but improves with sitting. Therefore, the patient would use several pillows or sleep upright in a recliner. Orthopnea is seen in obstructive lung disease, mitral stenosis, and heart failure. Paroxysmal nocturnal dyspnea describe episodes of sudden dyspnea that cause the patient to awaken from sleep where the patient must sit up, walk, or stand for it to resolve. Coughing and wheezing may also occur. Angina pectoris commonly creates chest pain or shortness of breath. Jugular venous pressure reflects right atrial pressure and volume status. In cases of cardiac or pulmonary dysfunction, jugular venous pressures usually raise. 12. A positive obturator sign would elicit pain in the: right hypogastric area Explanation: Assessment of the obturator sign is performed by flexing. By flexing the patient's right thigh at the hip with the knees bent, rotating the leg internally at the hip. If this causes increased pain in the right epigastric area, then the obturator sign is positive. Hypogastric pain occurs as the obturator muscle rubs an inflamed appendix. 13. The lateral bone that serves as a strut between the scapula and the sternum is known as the: clavicle Explanation: The lateral bone that serves as a strut between the scapula and the sternum is known as the clavicle. The humerus is the long bone of the upper arm. The acromion process is an extension of the spine of the scapula and located at the highest point of the shoulder. The thick curved extension of the superior border of the scapula is referred to as the coracoid process. 14. When examining the foot of a patient, the nurse practitioner notes focal heel tenderness on palpation of the plantar fascia. This could be suggestive of: NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct plantar fasciitis Explanation: Focal heel tenderness on palpation of the plantar fascia suggests plantar fasciitis. Bone spurs may NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct be present on the calcaneus as bony projections and may cause numbness, tenderness, or pain. Localized tenderness on examination of the ankle joint could be suggestive of arthritis, infection of the ankle, or ligamentous injury. Tenderness along the posterior medial malleolus suggests posterior tibial tendinitis. 15. When examining the conjunctiva and sclera, have the patient look upward and then: depress both lower lids with your thumbs, exposing the sclera and conjunctiva Explanation: When examining the conjunctiva and the sclera, the best way to expose these structures is to have the patient look upward and depress both lower lids with your thumbs. Covering one eye while visualizing the other eyes checks for visual acuity. Observing for excessive tearing or dryness assesses the lacrimal apparatus. Checking the position of the lids may identify variations and abnormalities in the eyelids. 16. The groove of the metacarpophalangeal joint can be palpated by having the patient: flex his hand Explanation: The groove of the metacarpophalangeal joints can be palpated by having the patient flex his hand. 17. A patient complains of shooting pains below the knee radiating into the lateral leg and calf. This type of low back pain is referred to as: radicular low back pain Explanation: Radicular low back pain, or sciatica, presents with shooting pains below the knee, into the lateral leg or posterior calf. It may be accompanied by paresthesias and/or weakness in the affected leg. Mechanical low back pain often arises from muscle and ligament injuries (~70%) or age-related intervertebral disc or facet disease. Common symptoms include aching pain in the lumbosacral area that radiates to the upper leg. Common risk factors include heavy lifting, poor conditioning, and obesity. Lumbar spinal stenosis or "pseudoclaudication" refers to pain in the back or legs with walking that improves with rest, lumbar flexion, or both. 18. When assessing a 3-month-old for developmental dysplasia of the hips (DDH), which one of the following symptoms would be suspicious of dysplasia? Limitation of abduction of the affected extremity, shortening of the femur and positive Ortolani's sign Explanation: Developmental dysplasia of the hips (DDH) presents with limitation of abduction, shortening of the extremity, as the head of the femur does not fit into the acetabulum, and a positive NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct 24. Tenderness in the costovertebral angles may signify: NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct pyelonephritis Explanation: Because the kidney lies directly under the costovertebral angle, tenderness over this area would be related to renal issues such as renal stones or pyelonephritis. 25. A patient presents with an altered level of consciousness. He/she is considered in a stuporous state if he/she: arouses from sleep after exposure to painful stimuli, exhibits slow verbal responses, and easily lapses into an unresponsive state Explanation: A stuporous patient arouses from sleep after exposure to painful stimuli, verbal responses are slow, and lapses into an unresponsive state. A lethargic patient appears drowsy but opens the eyes, looks at the examiners, answers the questions, and then falls asleep. An obtunded patient opens the eyes and looks at the examiner, but responds slowly and is somewhat confused. A comatose patient remains unarousable with eyes closed. There is no evident response to inner need or external stimuli. 26. A flat affect can be an identifiable finding in an older adult who has: depression Explanation: Flat affect occurs in depression, Parkinson’s disease, or Alzheimer’s disease. 27. Pain and crepitus over the patella suggests: roughening of the patellar undersurface Explanation: Pain and crepitus over the patella suggests roughening of the patellar undersurface that articulates with the femur. Tenderness over the patellar tendon or inability to extend the knee suggests a partial or complete tear of the patellar tendon. A degenerative patella produces pain with compression and patellar movement during quadriceps contraction. Swelling above and adjacent to the patella suggest synovial thickening or effusion of the knee joint. 28. A child with a heart murmur audible at the lower left sternal border would be suggestive of: ventricular septal defect Explanation: This type murmur is not considered a normal finding in children. The murmur associated with a ventricular septal defect is audible at the lower left sternal border. A child with a heart murmur located at the midsternum or upper right sternal border and associated with a click could be NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct suggestive of aortic valve stenosis. A murmur located at the upper left sternal border with a prominent ejection click in early systole could be suggestive of pulmonary valve stenosis. 29. In order to visualize the opening of Stensen's duct, examine the: NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct of pre-eclampsia. Both conditions usually occur during the later stages of pregnancy, or sometimes after childbirth. Its characteristics: H (hemolysis), EL (elevated liver enzymes) and LP (low platelet count). 34. Flexion contracture of the knee suggests hamstring tightness or: limb paralysis Explanation: Flexion contracture (inability to extend fully) is seen in hamstring tightness or limb paralysis. Swelling over the patella suggests prepatellar bursitis. Stumbling or "giving way" of the knee during the heel strike phase of gait suggests quadriceps weakness or abnormal patellar tracking. 35. A protrusion of the membranes that cover the spine and the spinal cord itself, through a defect in the bony encasement of the vertebral column is known as: a meningomyelocele Explanation: A meningomyelocele is defined as the protrusion of the membranes that cover the spine and the spinal cord itself, through a defect in the bony encasement of the vertebral column. A developmental congenital disorder caused by the incomplete closing of the embryonic neural tube is known as spina bifida. A protrusion of the spinal cord through a defect in the vertebral arch is referred to as a myelocele. An omphalocele is a type of abdominal wall defect in which the intestines, liver, and occasionally other organs remain outside of the abdomen in a sac. 36. Static stabilizers of the shoulder are referred to as those structures that are: bony structures of the shoulder girdle Explanation: Static stabilizers are incapable of movement and include the bony structures of the shoulder girdle, the labrum, the articular capsule, and the glenohumeral ligaments that add to joint stability. Dynamic stabilizers are capable of movement and include the SITS muscles of the rotator cuff (supraspinatus, infraspinatus, teres minor, and subscapularis). These muscles move the humerus and compress and stabilize the humeral head within the glenoid cavity. 37. With inspection of the male infant's penis, the urethral orifice appears on the dorsal surface of the glans. This finding is consistent with: epispadias Explanation: With inspection of the male infant's penis, the urethral orifice appears on the dorsal surface of the glans. This finding is consistent with epispadias. A chordee refers to the fixed downward bowing of the penis. With inspection of the male infant's penis, the urethral orifice appears on the ventral surface of the glans. This finding is consistent with hypospadias. Cryptorchidism is a NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct term used to describe undescended testicles in a male. 38. The nurse practitioner should base a response to a parent's question about the prognosis of acute lymphoblastic leukemia (ALL) on which of the following statement: NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct A majority of children go into remission and remain symptom free when treatment is completed Explanation: The majority of children diagnosed with the most common form of leukemia, acute lymphoblastic leukemia, go into remission and remain symptom free when treatment is complete and will have an 85% disease free survival rate. With the majority of children surviving 5 years or longer, it is inappropriate to refer to leukemia as a fatal disease. The research statement is true, but it does not address the parent's concern. About 95% of children achieve remission within the first month of chemotherapy. 39. To assess for strabismus in a child, use the: cover-uncover test Explanation: The cover-uncover test assesses coordination of eye muscle movement when one eye is covered. It is always assessed bilaterally. Strabismus is identified when the covered eye is found to deviate from its forward focus. Snellen eye chart assesses visual acuity; ophthalmoscope is used to visually assess the fundus of the eye. Pupillary reaction tests the ability of the eyes to react to light and accommodate. 40. While assessing the cranial nerves, the nurse practitioner touches the cornea lightly with a wisp of cotton. This maneuver assesses which cranial nerve? Cranial Nerve V (CN V) Explanation: Touching the cornea and assessing for a reflex assesses cranial nerve V. (sensory) 41. When examining the foot of a patient, the nurse practitioner notes tenderness of the posterior medial malleolus. This could be suggestive of: tibial tendinitis Explanation: Tenderness along the posterior medial malleolus suggests posterior tibial tendinitis. Bone spurs may be present on the calcaneus as bony projections and may cause numbness, tenderness, or pain. Localized tenderness on examination of the ankle joint could be suggestive of arthritis, infection of the ankle, or ligamentous injury. Focal heel tenderness on palpation of the plantar fascia suggests plantar fasciitis. NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct Explanation: Strabismus is misalignment of the eyes and can be assessed using the cover-uncover teats and the Hirschberg test (corneal light reflex). With the cover-uncover test, eye muscle weakness is seen as eye deviation when the eye is uncovered. With Hirschberg's test, an asymmetric light reflex indicates a deviation. Cataracts are visualized by a cloudiness or opacity in the lens. NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct Conjunctivitis is diagnosed by observation of a discharge from the eyes and erythema of the conjunctiva. Amblyopia is diagnosed by visual assessment and testing by an optometrist or ophthalmologist. 47. If fetal movement cannot be perceived after 24 weeks gestation, all of the following may be considered except: normal finding Explanation: If fetal movement cannot be perceived after 24 weeks, consider error in calculating gestational age, fetal death or severe morbidity, or false pregnancy. Confirm fetal health and gestational age with an ultrasound. 48. To palpate an indirect inguinal hernia in a woman, have her stand and palpate in the labia majora and: palpate upward to just lateral to the pubic tubercles Explanation: To palpate an indirect inguinal hernia in a woman, have her stand and palpate in the labia majora and upward to just lateral to the pubic tubercles. 49. Bilateral exophthalmos suggests: Grave's disease Explanation: Exophthalmos is an abnormal protrusion of the eye. When it presents bilaterally, it is suggestive of Grave's disease, a form of hyperthyroidism. Unilateral exophthalmos may be due to Grave's disease or to a tumor or inflammation of the orbit. Hashimoto's thyroiditis, hypothyroidism, and goiter do not present with exophthalmos. 50. If regular uterine contractions occur prior to 37 weeks gestation, this could be: preterm labor Explanation: Before 37 weeks, regular uterine contractions with or without pain and bleeding are abnormal, suggesting preterm labor. 51. A form of aphasia in which the person has difficulty speaking and understanding words and is unable to read or write is termed: global aphasia Explanation: With global aphasia, the person has difficulty speaking and understanding words and is unable to read or write. In Broca's aphasia, speech is confluent, slow, with few words and laborious NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct effort. Inflection and articulation are impaired but words are meaningful, with nouns, transitive verbs, and important adjectives. Small grammatical words are often dropped. With anomic aphasia, the person has word-finding difficulties and because of the difficulties, the person struggles to find the right words for speaking and writing. With Wernicke's aphasia, speech is fluent, often rapid, NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct Clubbing, frequent respiratory infections, and rectal prolapse Explanation: Cystic fibrosis is one of the most common genetic disorders in Caucasian children in the United States and is usually diagnosed at an early age. However, if it is not diagnosed in infancy, some of the symptoms seen in children include: not growing or gaining weight appropriately, frequent lung infections, persistent cough, and wheezing. Other symptoms may also develop in childhood such as: clubbing, rectal prolapse, and polyps in the nose or sinuses. The other choices are not seen in cystic fibrosis. 57. The most effective method to use when assessing visual acuity in young children, is the: E chart. Explanation: The E chart and Snellen charts assess visual acuity but for the young child, but the E chart is more appropriate. The child can tell the examiner which direction the E is pointing. The Snellen test requires that the child be able to identify letters of the alphabet. The most effective method to use when assessing conjugate gaze in young children, is the use of the cover-uncover test and the corneal light reflex test. The Ishihara chart assesses color blindness. 58. An adolescent visits the nurse practitioner for a sports participation physical. The nurse practitioner instructs the adolescent to hold his arms against his lateral upper legs against resistance. This maneuver assesses for: strength of the deltoid muscle Explanation: This maneuver assesses strength of the deltoid muscle. 59. Ptosis of the left eye would be suggestive of damage to which cranial nerve? Cranial Nerve III (CN III) Explanation: Ptosis of the left eye would be suggestive of 3rd nerve palsy (CN III)-Oculomotor nerve. 60. When performing the first Leopold maneuver on a pregnant woman, if the fetal buttocks and head are not easily palpated at the fundus, the fetus is said to be in: transverse lie Explanation: The top of the uterus (fundus) is palpated to establish which end of the fetus (fetal pole) is in the upper part of the uterus. If either the head or buttocks (Breech) of the fetus is in the fundus, then the fetus is in vertical lie. Otherwise the fetus is most likely in transverse lie. If the cephalic prominence is on the same side as the small parts, then the fetus is in vertex presentation. If the cephalic prominence is on the same side as the back , then the head is extended and the fetus is in NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct face presentation. 61. Which of the following substances is found in the urine of a child suspected of having post streptococcal glomerulonephritis? NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct Blood and protein Explanation: With post streptococcal (strep) glomerulonephritis, a child may have a history of a recent strep infection (pharyngitis or impetigo). Proteinuria is secondary to altered glomerular structure and functioning. Gross hematuria causes the urine to be tea-colored. Bacteria, white blood cells and mucus can be seen with urinary tract infections. Glucose and ketones present in the urine may be associated with diabetes. 62. When describing muscle strength, the term quadriplegia means: inability to move all four extremities Explanation: Quadriplegia means inability to move or paralysis of all four limbs. Hemiparesis refers to weakness of one half of the body. Impaired strength is called weakness, or paresis. Absence of strength is called paralysis, or plegia. 63. Which of the following screening tests for hearing loss can detect both sensorineural and conductive hearing loss? Weber Test Explanation: The Weber hearing screening test can detect unilateral conductive hearing loss (middle ear hearing loss) and unilateral sensorineural hearing loss (inner ear hearing loss). 64. A female patient presents with a gray, thin, malodorous (fishy) vaginal discharge. These symptoms are most consistent with: bacterial vaginosis Explanation: The discharge associated with bacterial vaginosis can be gray or white, thin, malodorous, and not usually profuse. The odor is usually fishy. Trichomonas vaginalis causes trichomonal vaginitis. Presenting symptoms include a profuse, yellowish, green vaginal discharge that is malodorous. Candidal vaginitis produces a white and curd-like thin discharge that is rarely malodorous. The discharge associated with gonorrhea is usually thick and bloody. 65. The classic signs of a basilar skull fracture include hemotympanum and: CSF leak from nose and ears Explanation: Signs of a basilar skull fracture are battle's sign, raccoon eyes, rhinorrhea, otorrhea and NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct Venous hum Explanation: A venous hum, or continuous mammary souffle that occurs during pregnancy is due to increased blood flow through normal vessels. The mammary souffle is commonly heard during late pregnancy or lactation. It is heard loudest in the second or third intercostal space at the sternal NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct border, and is typically both systolic and diastolic, though only the systolic component may be audible. 71. Part of the nutritional assessment includes anthropometric measurements. These measurements include all of the following except: height and weight: blood pressure, pulse, and respiration: mass index (BMI): basal metabolic rate (BMR). Explanation: Anthropometric measurements are a set of noninvasive, quantitative techniques for determining an individual's body fat composition by measuring, recording, and analyzing specific dimensions of the body: height, weight, BMI, BMR, distribution of body fat, and skin fold thickness. Vital signs are considered physiologic measurements. 72. Cognitive and language development between twelve years and adulthood, follows which one of Piaget's stages of development? Formal operational stage Explanation: Cognitive and language development between twelve years and adulthood, follows the formal operational stage of Piaget's stages of development. 73. If a newborn develops a cephalohematoma, the newborn is at an increased risk for: jaundice Explanation: Cephalohematomas are characterized by bleeding between the bone and the periosteum. Because of breakdown of the red blood cells within a hematoma, the infants are at greater risk for jaundice. They do not increase the risk for infections. Caput succedaneum is an edematous area on the head from pressure against the cervix. Erythema toxicum is a benign rash of unknown cause that consists of blotchy red areas. 74. A 40 year old male complains of right flank pain. His temperature is 102° F. These symptoms may be characteristic of: acute pyelonephritis Explanation: Kidney pain in the flank area and groin that is accompanied by fever and chills is consistent with acute pyelonephritis. Renal or ureteral colic usually presents with a sudden onset of pain in the flank area, abdomen, or groin. Chills and fever do not generally accompany urinary calculi. In men, painful urination without frequency or urgency suggests urethritis. Acute prostatitis presents with frequency, urgency, and dysuria. NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct 75. When examining a patient with atopic dermatitis, there is a thickening and roughening of the skin with increased visibility of the normal skin furrows. This condition is termed: lichenification Explanation: NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct angina pectoris Explanation: Assessing chest pain can be very difficult but a thorough patient history and physical exam can help the clinician determine a likely cause. Exertional pain can be angina pectoris. Symptoms most often seen with myocardial infarction include a retrosternal type pain that often radiates up to the neck, shoulder, and jaw and down to the ulnar aspect of the left arm. Pain and tenderness associated with costochondritis worsens with coughing or taking deep breaths. A sudden sharp pain that radiates to the back or into the neck is usually associated with aortic dissection. Any pain in the chest is cardiac until proven otherwise. 81. The Sexual Maturity Rating in girls includes 5 stages. Characteristics of Stage 5 include: coarse, curly hair as in adults covering the pubis and inner thighs Explanation: The Sexual Maturity Rating is also termed, Tanner staging; named after Dr. James Tanner. The stages are characterized by the following findings: Stage 1: (prepubertal): absence of breasts, pubic hair; Stage 2: Long, downy pubic hair near the labia, appearance of breast buds; Stage 3: Dark, coarse, curly hair sparsely over the symphysis pubis, enlargement of breast tissue and areola, with no separation of contours; Stage 4: Pubic hair as in an adult female but not in distribution; areola and nipple form secondary mound above breast tissue; Stage 5: Pubic hair as in adult female with distribution in inner thighs, linea alba; large breasts with single contour. 82. B/P readings greater than 140 mm HG systolic and greater than 90 mm HG diastolic prior to pregnancy, before 20 weeks gestation, or beyond 12 weeks postpartum is: chronic hypertension Explanation: Chronic hypertension occurs when systolic BP (SBP) >140 mm Hg or diastolic BP (DBP) >90 mm Hg documented prior to pregnancy, before 20 weeks, or beyond 12 weeks postpartum. Gestational hypertension refers to elevated blood pressure detected after 20 weeks gestation in the absence of proteinuria. Pre-eclampsia occurs in a woman who was previously normotensive but now has new onset hypertension with either proteinuria or end-organ damage. Primary hypertension, formerly known as essential hypertension, is a disorder which is associated with elevated blood pressure and an unidentifiable cause. 83. The lateral collateral ligament of the knee: connects the lateral femoral epicondyle and the head of the fibula Explanation: NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct The lateral collateral ligament (LCL) connects the lateral femoral epicondyle and the head of the fibula. The anterior cruciate ligament (ACL) crosses obliquely from the anterior medial tibia to the lateral femoral condyle, preventing the tibia from sliding forward on the femur. The posterior cruciate ligament (PCL) crosses from the posterior tibia and lateral meniscus to the medial NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct femoral condyle, preventing the tibia from slipping backward on the femur. The medial and lateral menisci are fibrocartilaginous discs that cushion the action of the femur on the tibia. 84. Which of the following procedures should NOT be performed in a comatose patient? Dilate the pupils Explanation: When assessing a comatose patient, the nurse practitioner should not dilate the eyes because pupillary reaction is the single most important clue to the underlying cause of the coma: structural or metabolic. The other procedures can be performed on a comatose patient. 85. Where the head of the humerus articulates with the shallow glenoid fossa of the scapula is known as the: glenohumeral joint Explanation: The glenohumeral joint is where the head of the humerus articulates with the shallow glenoid fossa of the scapula. This joint is deeply situated and not normally palpable. The acromioclavicular joint lies at the lateral end of the clavicle and articulates with the acromion process of the scapula. The convex medial end of the clavicle articulates with the concave hollow in the upper sternum to form the sternoclavicular joint. There is no manubrium joint; it is the broad upper part of the sternum. 86. The axioscapular group of muscles: pulls the shoulder backward Explanation: The axioscapular group pulls the shoulder backward and rotates the scapula. The scapulohumeral group of muscles rotates the shoulder laterally, including the rotator cuff, and depresses and rotates the head of the humerus. The axiohumeral group produces internal rotation of the shoulder. The serratus anterior draws the shoulder blade forward. 87. The ankle is a hinge formed by the tibia, fibula, and the: talus Explanation: The ankle is a hinge formed by the tibia, fibula, and the talus. The tibia and fibula act as a mortise, stabilizing the joint while bracing the talus like an inverted cup. 88. The maxillary sinuses: surround the nasal cavity Explanation: The paranasal sinuses include the maxillary, frontal, ethmoidal, and sphenoidal sinuses. The NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct routine screening for adults ages 76 to 85 years, due to moderate certainty that the net benefit is small. 94. The great saphenous vein enters the deep venous system by way of the: NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct femoral vein Explanation: The great saphenous vein, which originates on the dorsum of the foot, joins the femoral vein of the deep venous system below the inguinal ligament. 95. When discussing the musculoskeletal system, all of the following statements related to articular structure disease are true except which one? Articular disease is usually due to stiffness or pain Explanation: Articular disease typically involves swelling and tenderness of the entire joint and limits both active and passive range of motion due either to stiffness or to pain. Extra-articular disease typically involves selected regions of the joint and types of movement. 96. Signs and symptoms associated with diabetic gastroparesis may include all of the following except: vomiting of undigested food: weight loss: diarrhea: erratic glucose levels. Explanation: Diabetic gastroparesis occurs as a result of damage to the vagus nerve (controls the movement of food through the digestive system). Signs and symptoms associated with diabetic gastroparesis may include vomiting of undigested food, weight loss, erratic glucose levels, and gastroesophageal reflux. Diarrhea is not associated with diabetic gastroparesis or vagus nerve disorders since the vagus nerve innervates the stomach. 97. The portion of the umbilicus in a newborn that is covered with a firm gelatinous substance and dries up within two weeks of birth is known as: the umbilicus amniotic Explanation: The umbilicus amniotic refers to the amniotic portion of the umbilical cord which is covered with a firm gelatinous substance. This portion dries up and falls out within two weeks of birth. The portion of the umbilicus in a newborn that is covered with skin and retracts to become flush with the abdominal wall, is known as the umbilicus cutis. An umbilical hernia in infants is a defect in the abdominal wall which can measure up to six centimeters. An umbilical granuloma reflects granulation tissue at the base of the navel formed during the healing process. 98. A patient was recently diagnosed with gluten intolerance and needs instructions on what foods to eat. The patient should be told that a gluten restricted diet includes: corn NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct Explanation: A gluten-free diet is a diet that excludes the protein gluten. Gluten is found in grains such as wheat, barley, rye and triticale (a cross between wheat and rye). Corn and rice, and soybean products are allowed but processed foods are not. NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct 104. Uncontrolled electrical activity in the brain, which may produce minor physical signs, thought disturbances, or disturbed motor activity is: seizure Explanation: A seizure is an uncontrolled electrical activity in the brain which may produce minor physical signs, thought disturbances, or disturbed motor activity, or a combination of symptoms. Dystonia is a neurological disorder that causes involuntary muscle spasms and twisting of the limbs. Bradykinesia is the term used to describe the impaired ability to adjust to one's body position. This symptom is noted in patients who have Parkinson's disease. A rhythmic oscillatory movement of a body part resulting from the contraction of opposing muscle groups is a tremor. 105. A sudden, tearing, sharp pain that begins in the chest and radiates to the back or into the neck is usually associated with: an aortic dissection Explanation: Assessing chest pain can be very difficult but a thorough patient history and physical exam can help the clinician determine a likely cause. A sudden sharp pain that radiates to the back or into the neck is usually associated with aortic dissection. Exertional pain can be angina pectoris. Symptoms most often seen with myocardial infarction include a retrosternal type pain that often radiates up to the neck, shoulder, and jaw and down to the ulnar aspect of the left arm. Pain associated with pericarditis may radiate to the tip of the shoulder and to the neck and presents with a sharp knifelike pain. Any pain in the chest is cardiac until proven otherwise. 106. Involuntary movements of the body that involve larger portions of the body, including the trunk resulting in grotesque, twisted postures are suggestive of: dystonic movements Explanation: Dystonic movements are similar to athetoid movements, but often involve larger portions of the body, including the trunk. Grotesque, twisted postures may result. Facial tics are brief, repetitive, stereotyped, coordinated movements occurring at irregular intervals. Examples include repetitive winking, grimacing, and shoulder shrugging. Athetoid movements are slower and more twisting and writhing than choreiform movements, and have a larger amplitude. They most commonly involve the face and the distal extremities. Oral–facial dyskinesias are rhythmic, repetitive, bizarre movements that chiefly involve the face, mouth, jaw, and tongue: grimacing, pursing of the lips, protrusions of the tongue, opening and closing of the mouth, and deviations of the jaw. These are involuntary movements. NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct 107. To assess the oculomotor, trochlear, and abducens nerves (CN III, IV, & VI) for extraocular movements in an infant, the nurse practitioner would: observe how well the infant tracks the nurse practitioner's face Explanation: To assess the oculomotor, trochlear, and abducens nerves (CN III, IV, & VI) for extraocular NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct movements in an infant, the nurse practitioner would observe how well the infant tracks the nurse practitioner's face. 108. In infants, the palmar grasp reflex ceases after : 4 months Explanation: In infants, the palmar grasp reflex ceases after 4 months. Persistence beyond this time suggests pyramidal tract dysfunction. 109. A patient experienced a neck injury yesterday and presents to the nurse practitioner with aching paracervical pain and stiffness. Other complaints include dizziness, malaise, and fatigue. These findings may be associated with: neck pain with whiplash Explanation: In patients with mechanical neck pain with whiplash, the paracervical pain and stiffness begins the day after injury and may be accompanied by occipital headaches, dizziness, and malaise. Mechanical neck pain is described as aching pain in the cervical paraspinal muscles and ligaments with associated muscle spasm, stiffness, and tightness in the upper back and shoulder, lasting up to 6 weeks. With cervical radiculopathy, nerve root compression is the etiology. Symptoms may include sharp burning or tingling pain in the neck and one arm with associated paresthesias. In cervical myelopathy, cervical cord compression, the neck pain is associated with bilateral weakness and paresthesias in both upper and lower extremities. 110. Most peripheral nerves contain afferent and efferent fibers. The term efferent refers to: motor nerve fibers Explanation: The peripheral nervous system includes spinal and peripheral nerves that carry impulses to and from the cord. Spinal nerve fibers co-mingle with similar fibers from other levels in plexuses outside the cord, from which peripheral nerves emerge. Most peripheral nerves contain both sensory (afferent) and motor (efferent) fibers. 111.At what age should an infant begin to say consonant sounds? Six months Explanation: A six-month-old infant should be able achieve these tasks: look at self in the mirror, respond to his own name, begin to say consonant sounds, begin to pass things from one hand to another, roll over in both directions, know familiar faces, and begin to know if someone is a stranger. 112. Genu varum refers to: NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct venous system. 117. The central nervous system extends from the medulla into the: NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct spinal cord Explanation: Below the medulla, the central nervous system extends into the elongated spinal cord, encased within the bony vertebral column and terminating at the first or second lumbar vertebra. 118. The Weber test uses a tuning fork to test hearing. The frequency range closest to that of conversational speech would be one with a frequency of: 512 Hz Explanation: The Weber hearing test screens for unilateral conductive hearing loss with a tuning fork. The tuning fork is measured in frequencies of 256 Hz or 512 Hz. These frequencies fall within the range of conversational speech. The ideal frequency for the Weber test is 256 Hz. A frequency of 512 Hz is the ideal frequency for the Rinne hearing test. 119. The nurse practitioner holds the infant around the trunk. One sole touches the table. The hip and knee of the foot will flex and the other foot will step forward. Alternating stepping will occur. This maneuver assesses the: placing and stepping reflexes Explanation: The placing or stepping reflex (formerly known as the dancing reflex) is assessed by holding the infant around the trunk. One sole touches the table. The hip and knee of the foot will flex and the other foot will step forward. Alternating stepping will occur. To elicit the Landau reflex, the infant is suspended prone with one hand, and the infant's head will lift and the spine will straighten. Galant's reflex, or trunk incurvation reflex, is elicited when the infant is supported prone with one hand, and then one side of the back (one centimeter from the midline), is stroked from the shoulder to the buttocks. The spine curves toward the stimulus. To elicit the positive support reflex, hold the infant around the trunk, lower the infant until the feet touch a flat surface. Hips, knees, ankles extend and the infant stands up, partially bearing weight. 120. Which of the following findings in a preschooler would indicate the need for further evaluation? Responds to facial expressions and gestures rather than to verbal explanations Explanation: A child who responds to facial expressions and gestures rather than to verbal explanations is probably expressions rather than verbal clues. These children may have a hearing deficit that needs further evaluation. The other choices are normal behaviors for the preschooler. 121. Decreased spinal mobility in the lumbar region could be suggestive of: NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct osteoarthritis Explanation: Decreased spinal mobility in the lumbar region could be suggestive of osteoarthritis or ankylosing spondylitis. Dupuytren's contracture affects the hands. Torticollis would present a lateral deviation and rotation of the head. Kyphosis affects the thoracic spine. NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct 127. A patient presents with findings of pain, warmth, redness, and swelling below the inner canthus toward nose. Tearing is present and when pressure is applied to the lacrimal sac, purulent discharge from the puncta is noted. This is suggestive of: dacryocystitis Explanation: Dacryocystitis is an infection and blockage of lacrimal sac and duct. Symptoms include pain, warmth, redness, and swelling below the inner canthus toward the nose. Tearing is usually present and when pressure is applied to the lacrimal sac, a purulent discharge from the puncta can be noted. Red, scaly, greasy flakes and thickened, crusted lid margins are consistent with blepharitis. Symptoms include burning, itching, tearing, foreign body sensation, and some pain. Hordeolum is an infection usually secondary to localized Staphylococcal infection of the hair follicles at the lid margin. 128. A forty-year-old man presents with a slow growing lesion on the face. Further examination reveals a lesion with a depressed center, a firm elevated border, and visible telangiectatic vessels. This is most consistent with: basal cell carcinoma Explanation: Basal cell carcinoma typically presents with an initial translucent nodule that spreads, leaving a depressed center, a firm elevated border, and visible telangiectatic vessels. They usually appear in adults over forty and seldom metastasize. Squamous cell carcinoma appear on sun exposed skin of fair skinned adults over sixty and look like scaly red patches, open sores, elevated growths with a central depression, or warts; they may crust or bleed. Kaposi's sarcoma is seen in patients with AIDS and appears in many forms and on any part of the body. The abnormal cells form purple, red, or brown blotches or tumors on the skin and can become life threatening when the lesions are in the lungs, liver, or digestive tract. 129. Breath sounds consisting of a full inspiratory phase and a shortened and softer expiratory phase normally audible over the hilar region of the chest are termed: bronchovesicular Explanation: Bronchovesicular breath sounds consist of a full inspiratory phase with a shortened and softer expiratory phase. They are normally heard over the hilar region (center of the lungs near the heart). Vesicular breath sounds consist of a quiet, wispy inspiratory phase followed by a short, almost silent expiratory phase. They are heard over the periphery of the lung field. Bronchial breath sounds consist of a full inspiratory and expiratory phase with the inspiratory phase usually being louder. They are normally heard over the trachea and larynx. NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct 130. A child sustained a "full-thickness" burn injury. This type injury involves tissue destruction down to the: subcutaneous tissue Explanation: A full-thickness burn involves all skin layers, including the epidermis, dermis, and the NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct subcutaneous tissue and fat. Muscles and tendons may be involved. A superficial thickness burn involves the epidermis only. A superficial partial thickness burn involves the epidermis and the dermis. A deep thickness burn involves the entire layer of dermis, and is more severe than a superficial partial thickness burn. 131. When assessing the heart rate of a healthy 13-month-old child, which one of the following sites is the most appropriate for this child? Apical pulse between the 3rd and 4th intercostal space in the left midclavicular line Explanation: The apical pulse in a 13-month-old is auscultated for a full minute between the 3rd and 4th intercostal space to the left of the midclavicular line. The only time one would auscultate the right midclavicular line would be if the child had situs inversus or dextrocardia. 132. After attempting to elicit the Moro reflex in a newborn, the nurse practitioner identifies absence of movement of the left arm. The next assessment would be to: examine the clavicle Explanation: A positive Moro reflex occurs when both arms are extended. If this response is not elicited bilaterally, the nurse practitioner should assess the clavicle. If the clavicle is fractured, the Moro response will be demonstrated on the unaffected side only. Babinski reflex assesses for neurological abnormalities. Gallant reflex is checked while the infant is prone and assesses for trunk incurvation. Ortolani maneuver assesses for congenital hip dysplasia. 133. Raised or flat, deep purple colored lesions noted in the mouth may be suggestive of: Kaposi's sarcoma Explanation: Kaposi's sarcoma (a low-grade vascular tumor associated with human herpes virus 8), is associated with flat or raised deep purple colored lesions of the mouth. Approximately one third of patients with Kaposi’s sarcoma have lesions in the oral cavity. Other sites that could be affected include the gastrointestinal tract and the lungs. Koplik's spots are frequently seen in the early stage of measles (roseola) and appear as small white specks that resemble grains of salt on a red background on the buccal mucosa. Torus palatinus develops as a bony growth in the hard palate and is common in adults. Fordyce spots or granules appear as yellow spots in the buccal mucosa or on the lips. They are considered normal sebaceous glands. 134. A 60-year-old was concerned about a yellowish colored lesion above her right eyelid. Findings revealed a slightly raised yellowish, well circumscribed plaque along the nasal area of her right eyelid. This finding is most consistent with: xanthelasma NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct the helix. The antihelix is a curved prominence that is parallel and anterior to the helix. The auditory canal opens behind a nodular protuberance that points backward over the entrance to the canal, known as the tragus. 139. The cranial sutures are closed on the head of a 9 month old infant. This indicates: NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct craniosynostosis Explanation: Craniosynostosis is defined as the premature closing of the sutures in young children. When this occurs, a bony ridge can be felt along the suture line. This is not a normal finding since the sutures usually fuse between 12 and 18 months. Hydrocephalus refers to fluid on the brain and would appear as an enlarged head with sutures remaining open. Opisthotonos is a state of severe hyperextension and spasticity in which an individual's head, neck and spinal column enter into a complete "bridging" or "arching" position. This abnormal posturing is an extrapyramidal effect and is caused by spasm of the axial muscles along the spinal column. 140. A decrease in the degree of density in a bone that results in fragile bones is referred to as: osteoporosis Explanation: Osteoporosis is a condition characterized by a decrease in the density of bone, decreasing its strength and resulting in fragile bones. Osteoporosis leads to abnormally porous bone that is compressible, like a sponge. Osteopenia is a condition of bone that makes it slightly less dense than normal bone, but not as severe as in osteoporosis. Osteomyelitis refers to an infection in the bone. Osteoarthritis is a term used to describe degenerative joint disease. 141. Pain or cramping of the legs that occurs during exertion and is relieved by rest is termed: intermittent claudication Explanation: Pain or cramping in the legs that occurs with exertion and is relieved by rest is termed intermittent claudication. Atherosclerotic peripheral artery disease presents with symptomatic limb ischemia with exertion. Pain with walking or prolonged standing, radiating from the spinal area into the buttocks, thighs, lower legs, or feet, may be seen with neurogenic claudication. Raynaud's disease usually presents with numbness or tingling in the distal portions of one or more fingers aggravated by cold or emotional stress. 142. A patient presents with a fiery red, slightly raised 2 cm lesion on the upper truck that blanches when pressure is applied. The body of the lesion is surrounded by erythema and radiating legs. This is most likely: a spider angioma Explanation: A spider angioma is fiery red, slightly raised and surrounded by erythema and radiating legs that blanch with pressure. These are usually seen in patients with liver disease, pregnancy, vitamin B deficiency, and sometimes patients with no disease. The spider vein is blue. Cherry angiomas are bright or ruby red and increase in size and number as one ages. Petechiae are deep red or reddish purple and are seen when blood is outside the vessels. This suggests a bleeding disorder or injury NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct to the skin. 143. A cartilage-like articulation between the pubic bones is known as the: NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct cognitive impairment Explanation: Cognitive impairment is an intermediate stage between the expected cognitive decline of normal aging and the more serious decline of dementia. Delirium is a serious disturbance in a person's mental abilities that results in a decreased awareness of one's environment and confused thinking. In the older adult, it is defined as a geriatric syndrome or condition occurring as a temporary state of confusion and may be the first clue to infection or problems with medications. Functional impairment is a health condition in which the normal function of a part of the body is less than full capacity. One of the defining characteristics of functional impairment is that the reduction in physical or mental capacity is sufficient to interfere with managing day-to-day tasks. A multifactorial geriatric condition or syndrome characterized by an age-related lack of adaptive physiological capacity occurring in the absence of identifiable illness is known as frailty. 148. Symptoms of a child suspected of having a diagnosis of mixed failure to thrive (FTT) are usually seen in children: who have cleft palates or lips and the caretaker is insecure in his/her feeding abilities. Correct Explanation: Children with cleft lips and/or palates are at risk for aspiration when feeding. This can cause concern or fear for the parent/caregiver. This is considered a type of mixed FTT. Children with CHD fall in the category of an organic type of FTT. Children of mothers with postpartal depression may have a non-organic type of FTT. Cerebral palsy children with feeding tubes have a non-organic type of FTT. Feeding through feeding tubes actually increases the nutritional intake and calories and improves FTT. 149. Which of the following is the most age appropriate play for an 8-year-old girl? A board game Explanation: School-age children like the competitiveness of board games. Dress up is a preschool activity, experimenting with make-up is an adolescent activity and school age children like small puzzle pieces where as preschoolers like large puzzle pieces. 150. Breath sounds auscultated over the periphery of the lung fields are quiet and wispy during the inspiratory phase followed by a short, almost silent expiratory phase. These breath sounds are considered: vesicular Explanation: The three normal breath sounds are vesicular, bronchovesicular, and bronchial. Vesicular breath sounds consist of a quiet, wispy inspiratory phase followed by a short, almost silent expiratory NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct phase. They are heard over the periphery of the lung field. Bronchial breath sounds consist of a full inspiratory and expiratory phase with the inspiratory phase usually being louder. They are normally heard over the trachea and larynx. Bronchovesicular breath sounds consist of a full inspiratory phase with a shortened and softer expiratory phase. They are normally heard over the NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct hilar region. Crackles are adventitious sounds heard in the lungs and may be due to abnormalities in the lungs. 151. Fasciculations in atrophic muscles suggest: a lower motor neuron disease Explanation: Fasciculations are small muscle twitches and can be found in any muscle of the body. Fasciculations are not usually serious but can be annoying. If they occur in atrophic muscles, this may suggest a lower motor neuron disease. They are not seen in central or peripheral nervous system disease or rheumatoid arthritis. 152. To test the thumb for flexion, ask the patient to: move his thumb across his palm and touch the base of the fifth finger Explanation: To test the thumb for flexion, ask the patient to move his thumb to touch the base of the fifth finger. To test extension, ask the patient to move his thumb from the base of the fifth finger, across the palm, and then as far away from the palm as possible. Touching the thumb to each of the other fingers tests opposition. Placing the fingers and thumbs in the neutral position with the palm up and moving the thumb anteriorly away from the palm assesses abduction. Moving the thumb back to its neutral position assesses adduction. 153. When a patient complains of joint pain as progressing from one joint to another, the examiner should consider this pattern of involvement as migratory. This type of involvement would most likely be observed in a patient who has: rheumatic fever Explanation: A migratory pattern would involve migrating pain from joint to joint or steadily spreading from one joint to multiple joints. Examples of this type of joint pain migration is seen in patients who have rheumatic fever or gonococcal arthritis. Gout usually involves one joint and typically affects the first toe. Bursitis is consistent with extra-articular pain that occurs in inflammatory conditions. Osteomyelitis usually presents suddenly with a swollen joint and pain. This is more commonly seen in children. 154. During late adolescence, achievements are marked by: moral thinking Explanation: During the late adolescence, achievements are marked by moral thinking 155. By placing the patient in the supine position, the nurse practitioner raises the NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct 161. Symptoms of acrocyanosis in the newborn include: bluish color of the feet and the hands Explanation: NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct Shortly after birth, cyanosis of the hands, feet, and perioral area are common findings and typically resolve in 24 - 48 hours. A blue color around the lips and philtrum is a relatively common finding shortly after birth. The skin in the infant is usually well perfused, and the tongue and mucous membranes in the mouth are pink, a finding that assures that central cyanosis is not present. 162. The structure that creates a channel for the spinal nerve roots is known as the: intervertebral foramen Explanation: The intervertebral foramen creates a channel for the spinal nerve roots. The vertebral foramen encloses the spinal cord. The transverse foramen creates a channel for the vertebral artery. The articular processes are located on each side of the vertebra at the junction of the pedicles and the laminae, also referred to as the articular facets. 163. Retraction of the nipple and areola suggest: an underlying breast mass Explanation: Retraction of the nipple and areola suggest an underlying breast mass. This is not normal and never found in association with cystic breast disease or fibroadenoma. 164. If a patient presents with non-midline lumbar back pain, the nurse practitioner should assess for: muscle strain Explanation: For midline back pain, assess for musculoligamentous injury, disc herniation, vertebral collapse, spinal cord metastases, and, rarely, epidural abscess. Muscle strain, sacroiliitis, trochanteric bursitis, sciatica, and hip arthritis is suggestive of non-midline back pain. Pyelonephritis and renal stones may also be suggestive of non-midline back pain. 165. On examination of the foot, the nurse practitioner notes acute inflammation of the first metatarsophalangeal joint. This finding could be consistent with: gout Explanation: Acute inflammation of the first metatarsophalangeal joint suggests gout. 166. When assessing a normal 5-year-old, the last site to assess would be the: throat Explanation: The throat and mouth are considered invasive sites and should be performed last. NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct 167. The palpation technique used to assess respiratory expansion of the chest is placing the hands on the eight or tenth ribs posteriorly with the thumbs close to the vertebrae, sliding the hand medially and grasping a small fold of skin between the thumbs. Then: NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct disc herniation Explanation: For midline back pain, assess for musculoligamentous injury, disc herniation, vertebral collapse, spinal cord metastases, and, rarely, epidural abscess. Muscle strain, sacroiliitis, bursitis, and sciatica is suggestive of non-midline back pain. 173. Orthopnea is typically associated with all of the following conditions except: left ventricular hypertrophy: pulmonary embolus: mitral stenosis: obstructive lung disease. Explanation: Orthopnea is defined as dyspnea that occurs when the patient is lying down and improves when the patient sits or stands up. It is generally seen in patients with mitral stenosis, left ventricular hypertrophy, and in obstructive lung disease. With a pulmonary embolus, the dyspnea is sudden and uncomfortable in any position. 174. To assess the facial nerve (CN VII) for motor function in an infant, the nurse practitioner would: note facial symmetry while the infant cries or smiles Explanation: To access the facial nerve (CN VII) for motor function in an infant, the nurse practitioner would note facial symmetry while the infant cries or smiles. The other choices do not assess the facial nerve. 175. The nine to ten year old school aged child: is conscious of fairness Explanation: By nine to ten years of age, the school aged child is able to perform several of the following tasks: question the reason for things, demonstrate excessive concern with competition and performance, overestimates own abilities, consider clubs important, conscious of fairness, and usually likes reading and writing. The other choices are consistent with the development of a 11- 12 year-olds. 176. The forward slippage of one vertebrae resulting in spinal cord compression is referred to as: spondylolisthesis NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct Explanation: The forward slippage of one vertebrae resulting in spinal cord compression is referred to as spondylolisthesis. NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct 177. When auscultating breath sounds in a patient who has left sided heart failure, the breath sounds are: vesicular with late inspiratory crackles in the dependent portions of the lungs and resonant on percussion Explanation: A patient with left sided heart failure experiences increased pressure in the pulmonary veins causing congestion and interstitial edema. The breath sounds are vesicular with late inspiratory crackles in the dependent portions of the lungs and are resonant on percussion. Consolidation in the lungs produces bronchial breath sounds with late inspiratory crackles over the involved area and is dull on percussion. A normal lung has vesicular breath sounds without adventitious sounds and is resonant on percussion. Chronic obstructive lung disease produces decreased breath sounds with some audible wheezes and is hyperresonant on percussion. 178. Assessment findings in a newborn at birth include: irregular respirations without crying, heart rate of 105 beats/minute, grimaces with reflex stimulation, kicking of both feet, and moving of both arms. The body and face are pink and hands and feet are cyanotic. What is the APGAR score? 7 Explanation: APGAR stands for: Activity, Pulse, Grimace, Appearance, and Respiration. It is an objective score of the condition of a baby immediately after birth and is determined by scoring the heart rate, respiratory effort, muscle tone, skin color, and response to a catheter in the nostril. Each of these objective signs receives 0, 1, or 2 points. An Apgar score of 10 means an infant is in the best possible condition. The Apgar score is done routinely 60 seconds after the birth of the infant. A child with a score of 0 to 3 needs immediate resuscitation. The Apgar score is often repeated 5 minutes after birth, and in the event of a difficult resuscitation. The Apgar score may be done again at 10, 15, and 20 minutes. This infant's score is 7: He receives a 1 for respiration, 2 for heart rate, 1 for grimace, 1 for color, and 2 for activity. Scores 7 and greater are generally considered to be normal. 179. A patient complains of severe epigastric pain that radiates to the posterior trunk and entire abdomen. This type of pain can be suggestive of: acute pancreatitis Explanation: Acute pancreatitis is inflammation of the pancreas. The pain is poorly localized in the abdomen, therefore, can be epigastric and may radiate to the posterior trunk. Biliary colic, sudden obstruction of the cystic or common bile ducts by a gallstone is characterized by pain in the NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct areas supplied by the nerve. 184. To test the thumb for adduction, ask the patient to place the fingers and thumbs in the neutral position with the palm up and move the thumb anteriorly away from the palm and then: NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct back to its neutral position Explanation: Placing the fingers and thumbs in the neutral position with the palm up and moving the thumb anteriorly away from the palm and then back to its neutral position assesses adduction. To test the thumb for flexion, ask the patient to move his thumb to touch the base of the fifth finger. To test extension, ask the patient to move his thumb from the base of the fifth finger, across the palm, and then as far away from the palm as possible. Touching the thumb to each of the other fingers tests opposition. Placing the fingers and thumbs in the neutral position with the palm up and moving the thumb anteriorly away from the palm assesses abduction. 185. A patient complains of an unpleasant abdominal fullness after a light meal. This complaint may be consistent with: diabetic gastroparesis Explanation: Complaints of an unpleasant abdominal fullness after a light or moderate meal, or the inability to eat a full meal is often seen in patients with diabetic gastroparesis, gastric outlet obstruction, gastric cancer, early satiety in hepatitis, or those taking anticholinergic medications. 186. Which technique would be least effective in gaining the cooperation of a toddler during a physical exam? Tell the child that another child the same age was not afraid Explanation: Telling the child that another child the same age was not afraid would not be an effective technique as a toddler is unable to process that concept. The other choices are appropriate techniques. 187. While assessing the trigeminal nerve V (CN V) for sensory function, the patient reports a pain sensation on the right cheek. This finding could be consistent with a: cranial nerve disorder Explanation: While assessing the trigeminal nerve, cranial nerve V (CN V) for sensory function, the patient reports a pain sensation on the right cheek. This finding could be consistent with a cranial nerve disorder, such as trigeminal neuralgia. 188. Contracture of the sternocleidomastoid muscle could result in lateral deviation and rotation of the head. This condition is suggestive of: torticollis NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct Explanation: Contracture of the sternocleidomastoid muscle could result in lateral deviation and rotation of the head. This condition is suggestive of torticollis. 189. If a patient describes his stool as thin and "pencil-like", this could be associated with: NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct 194. The term used to describe low back pain with nerve pain that radiates down the leg is: sciatica Explanation: The term used to describe low back pain with nerve pain that radiates down the leg is sciatica. Asterixis refers to an abnormal tremor consisting of involuntary jerking movements, especially in the hands, frequently occurring with impending hepatic coma and other forms of metabolic encephalopathy. This is also called flapping tremor. A dermatome is a band of skin innervated by the sensory root of a single spinal nerve. Stereognosis refers to the ability to identify an object by feeling it. 195. When the term rubor is used in describing the skin, it means that the appearance is: dusky red Explanation: Rubor is a term used to describe the response of the skin to inflammation. Skin that appears dusky red is rubor. 196. Assessment findings in an infant with increased intracranial pressure would include: drowsiness Explanation: Symptoms of increased intracranial pressure in an infant include: drowsiness, separated sutures on the skull, bulging fontanel, and vomiting. Papilledema can be observed in people of any age, but is relatively uncommon in infants because the bones of the skull are not fully fused together at this age. 197. When suspecting pediculosis capitis, the chief complaint is: itching Explanation: With pediculosis capitis (lice), itching is the most common symptom and is caused by an allergic reaction. Lice will bite the skin in order to feed on the infected person's blood. Saliva from these bites causes the allergic reaction and itching. The lice lay eggs that eventually hatch which causes more irritation. Vesicles, fluid filled lesions, are not usually seen in this condition. Alopecia may be seen with tinea capitis. 198. What geriatric condition is characterized by reduction in physical or mental capacity sufficient to interfere with managing day to day tasks? Functional impairment Explanation: Functional impairment is a health condition in which the normal function of a part of the body is NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct less than full capacity. One of the defining characteristics of functional impairment is that the reduction in physical or mental capacity is sufficient to interfere with managing day-to-day tasks. Delirium is a serious disturbance in a person's mental abilities that results in a decreased awareness of one's environment and confused thinking. In the older adult, it is defined as a geriatric syndrome or condition occurring as a temporary state of confusion and may be the first NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct clue to infection or problems with medications. Cognitive impairment is an intermediate stage between the expected cognitive decline of normal aging and the more serious decline of dementia. A multifactorial geriatric condition or syndrome characterized by an age-related lack of adaptive physiological capacity occurring in the absence of identifiable illness is known as frailty. 199. If urethritis or inflammation of the paraurethral glands is suspected in a female patient, the index finger should be inserted into the vagina and: milk the urethra gently from the inside outward Explanation: If urethritis or inflammation of the paraurethral glands is suspected, the examiner should insert the index finger into the vagina and milk the urethra gently from inside outward. Note any discharge from or about the urethral meatus. If present, it should be cultured. 200. When palpating the carotid pulse, it is important to: position the patient in the lying or sitting positions Explanation: The carotid artery should be palpated gently and while the patient is sitting or lying down. The patient's chin should be elevated to allow easy palpation and yet not enough to tighten the neck muscles. Stimulating its baroreceptors with low palpation can provoke severe bradycardia or cause cardiac arrest in some sensitive persons. Also, carotid arteries should never be palpated at the same time. This may limit blood flow to the head, possibly leading to fainting or cerebral ischemia. A carotid pulse is palpable between the anterior border of the sternocleidomastoid muscle, above the hyoid bone and lateral to the thyroid cartilage 201. A 40 -year-old male states that he felt "something" above his left testis. On examination, a painless cyst is noted above the left testicle. Transillumination is positive. This is consistent with a: spermatocele of the epididymis Explanation: A painless, movable cystic mass just above the testicle suggests a spermatocele or an epididymal cyst. Both transilluminate and are difficult to distinguish clinically. An acutely inflamed epididymis is tender and swollen and may be difficult to distinguish from the testicle. Additionally, the scrotum may be reddened and the vas deferens inflamed. Coexisting urinary tract infection, or prostatitis, supports the diagnosis. Varicocele refers to varicose veins of the spermatic cord, usually found on the left. It feels like a soft “bag of worms" upon palpation of the scrotum. Torsion, or twisting, of the testicle on its spermatic cord produces an acutely painful, tender, and swollen organ that is retracted upward in the scrotum. The scrotum becomes red and edematous. There is no associated urinary infection. NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct Explanation: An obstructed nasolacrimal duct would present with a mucopurulent discharge from the puncta of the eye. Conjunctivitis is an inflammation of the conjunctiva and findings include red, burning, and itchy eyes. Dacryocystitis is an inflammation of the lacrimal sac, the area between the lower eyelid and the nose. Dacryocystitis presents as a painful, red, and tender area around NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct the eye especially near the nose. A pinguecula refers to a harmless yellowish triangular nodule noted in the bulbar conjunctiva on either side of the iris. This finding may be seen in aging or in patients who are exposed chronically to dust. 207. When trying to determine the level of consciousness in a patient whose level of consciousness is altered, a comatose patient: unarousable with eyes closed Explanation: A comatose patient remains unarousable with eyes closed. There is no evident response to inner need or external stimuli. A lethargic patient appears drowsy but opens the eyes, looks at the examiners, answers the questions, and then falls asleep. An obtunded patient opens the eyes and looks at the examiner, but responds slowly and is somewhat confused. A stuporous patient arouses from sleep after exposure to painful stimuli, verbal responses are slow, and lapses into an unresponsive state. 208. When performing an examination of the rectal area, a linear tear at the anal opening was observed. This could be indicative of: .an anal fissure Explanation: A linear crack or tear suggests an anal fissure from large, hard stools, inflammatory bowel disease, or sexually transmitted diseases. 209. When examining the prostate gland the examiner should inform the patient that this procedure may: prompt an urge to urinate Explanation: When examining the prostate gland on a male patient, the examiner should inform the patient that this procedure may prompt an urge to urinate but reassure him that he will not void on himself. 210. When administering ear drops to a 6-year-old, the pinna should be pulled: upward and back Explanation: To examine the ears of an infant it is usually necessary to pull the auricle backward and downward. In the older child, the external ear is pulled backward and upward. 211. A patient who is being evaluated for frequent headaches, mentions that the headache worsens with coughing, sneezing, or when changing positions. Increasing pain with these maneuvers may be suggestive of: NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct a brain tumor Explanation: If coughing, sneezing, or changing positions increases the pain associated with the headache, sinusitis or a brain tumor may be considered. Migraines may present with symptoms of nausea NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct 216. A 45-year-old patient complains of vertigo, tinnitus and pressure in the right ear. These symptoms are consistent with: Meniere's disease Explanation: Meniere's Disease begins with a episodic vertigo and a feeling of fullness or pressure in the affected ear along with fluctuating tinnitus. Dizziness associated with benign positional vertigo typically occurs when the patient rolls over onto the affected side or with tilting the head upward. Nausea and vomiting may be present. Cluster headaches are usually one sided and the patient often has a runny nose with reddening and tearing of the nose without mention of dizziness. In vestibular neuronitis, the dizziness is sudden followed by nausea and vomiting without tinnitus. 217. With the adult patient lying supine, the nurse practitioner flexes the patient's neck while observing the hips and knees. Flexion of both hips and knees was noted. This is a positive: Brudzinski's sign Explanation: To elicit Brudzinski's sign, flex the neck. Flexion of both the hips and knees is positive for Brudzinski's sign. To test for Kernig's sign, flex the patient's leg at both the hip and the knee and then straighten the knee. Pain and increased resistance to extending the knee are positive for Kernig's sign. With the patient lying supine, the nurse practitioner places her hands behind the patient's head while flexing his neck forward so that his chin touches his chest. Neck stiffness with resistance to flexion is noted. This is positive for nuchal rigidity and suggestive of meningeal inflammation from meningitis or subarachnoid hemorrhage. To elicit the Babinski response, stroke the lateral aspect of the sole from the heel to the ball of the foot with the end of an applicator stick; plantar flexion is normal. Dorsiflexion of the big toe is a positive Babinski's sign. 218. Immediate treatment for a sprain includes: rest and cold applications Explanation: Resting the extremity and applying ice is the most immediate actions to relieve swelling of the injured joint. Rest and elevation are appropriate, but giving pain medication immediately may mask more serious problems. Compression is appropriate for sports injuries, but heat application should not be an immediate action. While rest is important after a sprain, early mobility hastens recovery. NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct 219. The vertebral column angles sharply posteriorly and becomes immovable at the: lumbosacral junction Explanation: The vertebral column angles sharply posteriorly and becomes immovable at the lumbosacral junction. The intervertebral discs cushion movement between vertebrae and allow the vertebral NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct NSG 3370 STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct column to curve, flex, and bend. The coccyx is the final segment of the vertebral column and serves as an attachment for various tendons, muscles, and ligaments. It also supports weight while sitting. The sacroiliac joint overlays the posterior superior iliac spine. 220. When auscultating heart sounds in a newborn, if a louder than normal pulmonic component (P2) is audible, suspect: pulmonary hypertension Explanation: The aortic (A2), or first component of the second sound at the base, is normally louder than the pulmonic (P2), or second component. A louder than normal pulmonic component, particularly when louder than the aortic sound, suggests pulmonary hypertension. 221. The nurse practitioner places an infant lying supine on the exam table, and turns the head to one side, holding the jaw over the shoulder. The arms and legs on the side to which the head is turned extend, while the opposite arm and leg flex. This maneuver assesses: the asymmetric tonic neck reflex Explanation: The maneuver described assesses the asymmetric tonic neck reflex. Moro or startle reflex assesses arm abduction and extension, open hands, and flexed legs in response to a loud noise. To elicit the Landau reflex, the infant is suspended prone with one hand, and the infant's head will lift and the spine will straighten. Galant's reflex, or trunk incurvation reflex, is elicited when the infant is supported prone with one hand, and then one side of the back (one centimeter from the midline), is stroked from the shoulder to the buttocks. The spine should curve toward the stimulus. 222. When performing a rectal exam, a reddish, moist, protruding mass is noted at the anal opening. This finding is most likely a(n): a prolapsed internal hemorrhoid Explanation: Internal hemorrhoids are enlargements of the normal vascular cushions located above the pectinate line. They are not usually visible but may become visible if prolapse occurs after defecation. They would appear in the anal canal as reddish, moist, protruding masses. External hemorrhoids are dilated hemorrhoidal veins that originate below the pectinate line and are covered with skin. They present as tender, swollen, bluish, ovoid masses at the anal margin. A tender, purulent, reddened mass palpated in the rectum would be consistent with an anal abscess, especially in the presence of fever and chills. Rectal polyps are typically located in the rectum and ,if palpable, feel soft to touch. NSG 3370STUDY QUESTIONS & answers latest exam guide best exam solution upgraded/rated 100% correct