NSG 6020 Final Exam – Question and Answers- South University, Quizzes of Nursing

Download NSG 6020 Final Exam – Question and Answers- South University and more Quizzes Nursing in PDF only on Docsity! NSG 6020 Final Exam – Question with Answers – South University  1. Question : You are beginning the examination of the skin on a 25-year-old teacher. You have previously elicited that she came to the office for evaluation of fatigue, weight gain, and hair loss. You strongly suspect that she has hypothyroidism. What is the expected moisture and texture of the skin of a patient with hypothyroidism?   Student Answer:  Moist and smooth    Moist and rough    Dry and smooth    Dry and rough   Points Received: 1 of 1   Comments: Question 2. Question : You are assessing a patient with joint pain and are trying to decide whether it is inflammatory or non-inflammatory in nature. Which one of the following symptoms is consistent with an inflammatory process?   Student Answer:  Tenderness    Cool temperature    Ecchymosis    Nodules   Points Received: 1 of 1   Comments: Question 3. Question : A 68-year-old retired farmer comes to your office for evaluation of a skin lesion. On the right temporal area of the forehead, you see a flattened papule the same color as his skin, covered by a dry scale that is round and feels hard. He has several more of these scattered on the forehead, arms, and legs. Based on this description, what is your most likely diagnosis?   Student Answer:  Actinic keratosis    Seborrheic keratosis    Basal cell carcinoma    Squamous cell carcinoma   Points Received: 0 of 1   Comments: Question 4. Question : A 28-year-old graduate student comes to your clinic for evaluation of pain “all over.” With further questioning, she is able to relate that the pain is worse in the neck, shoulders, hands, low back, and knees. She denies swelling in her joints. She states that the pain is worse in the morning. There is no limitation in her range of motion. On physical examination, she has several points on the muscles of the neck, shoulders, and back that are tender to palpation. Muscle strength and range of motion are normal. Which one of the following is likely the cause of her pain?   Student Answer:  Rheumatoid arthritis    Osteoarthritis    Fibromyalgia    Polymyalgia rheumatica   Points Received: 1 of 1   Comments: Question 5. Question : Heberden’s nodes are commonly found in which one of the following diseases?   Student Answer:  Rheumatoid arthritis    Degenerative joint disease    Psoriatic arthritis 1. Question : Which of the following would lead you to suspect a hydrocele versus other causes of scrotal swelling?   Student Answer:  The presence of bowel sounds in the scrotum    Being unable to palpate superior to the mass    A positive transillumination test    Normal thickness of the skin of the scrotum   Comments: Question 2. Question : You are examining a newborn and note that the right testicle is not in the scrotum. What should you do next?   Student Answer:  Refer to urology    Recheck in six months    Tell the parent the testicle is absent but that this should not affect fertility    Attempt to bring down the testis from the inguinal canal   Comments: Question 3. Question : A 50-year-old truck driver comes to your clinic for a work physical. He has had no upper respiratory, cardiac, pulmonary, gastrointestinal, urinary, or musculoskeletal system complaints. His past medical history is significant for mild arthritis and prior knee surgery in college. He is married and just changed jobs, working for a different trucking company. He smokes one pack of cigarettes a day, drinks less than six beers a week, and denies using any illegal drugs. His mother has high blood pressure and arthritis and his father died of lung cancer in his sixties. On examination, his blood pressure is 130/80 and his pulse is 80. His cardiac, lung, and abdominal examinations are normal. He has no inguinal hernia, but on his digital rectal examination you palpate a soft, smooth, and nontender pedunculated mass on the posterior wall of the rectum. What anal, rectal, or prostate disorder best fits his presentation?   Student Answer:  Internal hemorrhoid    Prostate cancer    Anorectal cancer    Rectal polyp   Comments: Question 4. Question : A 15-year-old high school football player is brought to your office by his mother. He is complaining of severe testicular pain since exactly 8:00 this morning. He denies any sexual activity and states that he hurts so bad he can't even urinate. He is nauseated and is throwing up. He denies any recent illness or fever. His past medical history is unremarkable. He denies any tobacco, alcohol, or drug use. His parents are both in good health. On examination, you see a young teenager lying on the bed with an emesis basin. He is very uncomfortable and keeps shifting his position. His blood pressure is 150/100, his pulse is 110, and his respirations are 24. On visualization of the penis, he is circumcised and there are no lesions and no discharge from the meatus. His scrotal skin is tense and red. Palpation of the left testicle causes severe pain and the patient begins to cry. His prostate examination is unremarkable. His cremasteric reflex is absent on the left but is normal on the right. By catheter you get a urine sample and the analysis is unremarkable. You send the boy with his mother to the emergency room for further workup.   Student Answer:  Acute orchitis    Acute epididymitis    Torsion of the spermatic cord    Prostatitis   Comments: Question 5. Question : Which is true of prostate cancer?   Student Answer:  It is commonly lethal.    It is one of the less common forms of cancer.    Family history does not appear to be a risk factor.    Ethnicity is a risk factor.   Comments: Question 6. Question : Which of the following conditions involves a tight prepuce which, once retracted, cannot be returned?   Student Answer:  Phimosis    Paraphimosis    Balanitis    Balanoposthitis   Comments: Question 7. Question : A 12-year-old is brought to your clinic by his father. He was taught in his health class at school to do monthly testicular self- examinations. Yesterday, when he felt his left testicle, it was enlarged and tender. He isn't sure if he has had burning with urination and he says he has never had sexual intercourse. He has had a sore throat, cough, and runny nose for the last three days. His past medical history is significant for a tonsillectomy as a small child. His father has high blood pressure and his mother is healthy. On examination, you see a child in no acute distress. His temperature is 100.8 and his blood pressure and pulse are unremarkable. On visualization of his penis, he is uncircumcised and has no lesions or discharge. His scrotum is red and tense on the left and normal appearing on the right. Palpating his left testicle reveals a mildly sore swollen testicle. The right testicle is unremarkable. An examining finger is put through both inguinal rings, and there are no bulges with bearing down. His prostate examination is unremarkable. Urine analysis is also unremarkable. What abnormality of the testes does this child most likely have? marijuana leads to breast enlargement in males. The young man adamantly denies using any tobacco, alcohol, or drugs. He has recently noticed changes in his penis, testicles, and pubic hair pattern. Otherwise, his past medical history is unremarkable. His parents are both in good health. He has two older brothers who never had this problem. On examination, you see a mildly overweight teenager with enlarged breast tissue that is slightly tender on both sides. Otherwise, his examination is normal. He is agreeable to taking a drug test. What is the most likely cause of his gynecomastia?   Student Answer:  Breast cancer    Imbalance of hormones of puberty    Drug use   Points Received: 1 of 1   Comments: Question 4. Question : Which of the following represents metrorrhagia?   Student Answer:  Fewer than 21 days between menses    Excessive flow    Infrequent bleeding    Bleeding between periods   Points Received: 1 of 1   Comments: Question 5. Question : What does a KOH (potassium hydroxide) prep help the nurse practitioner diagnose?   Student Answer:  Herpes zoster infections    Yeast infections    Herpes simplex infections    Viral infections   Points Received: 1 of 1   Comments: Question 6. Question : Abby is a newly married woman who is unable to have intercourse because of vaginismus. Which of the following is true?   Student Answer:  This is most likely due to lack of lubrication.    This is most likely due to atrophic vaginitis.    This is most likely due to pressure on an ovary.    Psychosocial reasons may cause this condition.   Points Received: 1 of 1   Comments: Question 7. Question : A 30-year-old man notices a firm, 2-cm mass under his areola. He has no other symptoms and no diagnosis of breast cancer in his first-degree relatives. What is the most likely diagnosis?   Student Answer:  Breast tissue    Fibrocystic disease    Breast cancer    Lymph node   Points Received: 0 of 1   Comments: Question 8. Question : Which of the following is true regarding breast self-examination?   Student Answer:  It has been shown to reduce mortality from breast cancer.    It is recommended unanimously by organizations making screening recommendations.    A high proportion of breast masses are detected by breast self-examination.    The undue fear caused by finding a mass justifies omitting instruction in breast self-examination.   Points Received: 0 of 1   Comments: Question 9. Question : A 23-year-old computer programmer comes to your office for an annual examination. She has recently become sexually active and wants to be placed on birth control. Her only complaint is that the skin in her armpits has become darker. She states it looks like dirt, and she scrubs her skin nightly with soap and water but the color stays. Her past medical symptoms consist of acne and mild obesity. Her periods have been irregular for 3 years. Her mother has type 2 diabetes, and her father has high blood pressure. The patient denies using tobacco but has four to five drinks on Friday and Saturday nights. She denies any illegal drug use. On examination, you see a mildly obese female who is breathing comfortably. Her vital signs are unremarkable. Looking under her axilla, you see dark, velvet-like skin. Her annual examination is otherwise unremarkable. What disorder of the breast or axilla is she most likely to have?   Student Answer:  Peau d'orange    Acanthosis nigricans    Hidradenitis suppurativa   Points Received: 1 of 1   Comments: Question 10. Question : Which of the following is true of women who have had a unilateral mastectomy?   Student Answer:  They no longer require breast examination.    They should be examined carefully along the surgical scar Question 4. Question : Josh is a 14-year-old boy who presents with a sore throat. On examination, you notice dullness in the last intercostal space in the anterior axillary line on his left side with a deep breath. What does this indicate?   Student Answer:  His spleen is definitely enlarged and further workup is warranted.    His spleen is possibly enlarged and close attention should be paid to further examination.    His spleen is possibly enlarged and further workup is warranted.    His spleen is definitely normal.   Points Received: 0 of 1   Comments: Question 5. Question : Diminished radial pulses may be seen in patients with which of the following?   Student Answer:  Aortic insufficiency    Hyperthyroidism    Arterial emboli    Early “warm” septic shock   Points Received: 0 of 1   Comments: Question 6. Question : A 42-year-old florist comes to your office, complaining of chronic constipation for the last six months. She has had no nausea, vomiting, or diarrhea, and no abdominal pain or cramping. She denies any recent illnesses or injuries. She denies any changes to her diet or exercise program. She is on no new medications. During the review of systems (ROS), you note that she has felt fatigued, had some weight gain, has irregular periods, and has cold intolerance. Her past medical history is significant for one vaginal delivery and two cesarean sections. She is married, has three children, and owns a flower shop. She denies tobacco, alcohol, or drug use. Her mother has type 2 diabetes and her father has coronary artery disease. There is no family history of cancers. On examination, she appears her stated age. Her vital signs are normal. Her head, eyes, ears, nose, throat, and neck examinations are normal. Her cardiac, lung, and abdominal examinations are also unremarkable. Her rectal occult blood test is negative. Her deep tendon reflexes are delayed in response to a blow with the hammer, especially the Achilles tendons. What is the best choice for the cause of her constipation?   Student Answer:  Large bowel obstruction    Irritable bowel syndrome    Rectal cancer    Hypothyroidism   Points Received: 1 of 1   Comments: Question 7. Question : A 57-year-old maintenance worker comes to your office for evaluation of pain in his legs. He has smoked two packs per day since the age of sixteen, but is otherwise healthy. You are concerned that he may have peripheral vascular disease. Which of the following is part of common or concerning symptoms for the peripheral vascular system?   Student Answer:  Intermittent claudication    Chest pressure with exertion    Shortness of breath    Knee pain   Points Received: 1 of 1   Comments: Question 8. Question : You are assessing a 59-year-old gas station owner for atherosclerosis in the lower extremities. In which of the following locations would the patient's pain make you concerned for this disease process?   Student Answer:  Thigh    Knee    Calf    Ankle   Points Received: 1 of 1   Comments: Question 9. Question : A 55-year-old secretary with a recent history of breast cancer, for which she underwent surgery and radiation therapy, and a history of hypertension comes to your office for a routine checkup. Which of the following aspects of the physical are important to note when assessing the patient for peripheral vascular disease in the arms?   Student Answer:  Femoral pulse, popliteal pulse    Dorsalis pedis pulse, posterior tibial pulse    Carotid pulse    Radial pulse, brachial pulse   Points Received: 1 of 1   Comments: Question 10. Question : Cody is a teenager with a history of leukemia and an enlarged spleen. Today he presents with fairly significant left upper quadrant (LUQ) pain. On examination of this area, a rough grating noise is heard. What is this sound?   Student Answer:  It is a splenic rub.    It is a variant of bowel noise.    It represents borborygmi.   Comments: Question 5. Question : The most important reason to share information and offer brief teaching while performing the physical examination is to help:   Student Answer:  the examiner feel more comfortable and gain control of the situation.    build rapport and increase the patient’s confidence in the examiner.    the patient understand his or her disease process and treatment modalities.    the patient identify questions about his or her disease and potential areas of patient education.   Instructor Explanation: Sharing of information builds rapport and increases the patient’s confidence in you as an examiner. It also gives the patient a little more control in a situation in which it’s easy to feel completely helpless.   Points Received: 4 of 4   Comments: Question 6. Question : A patient says that she has recently noticed a lump in the front of her neck below her “Adam’s apple” that seems to be getting bigger. During the assessment, the finding that reassures the nurse practitioner that this may not be a cancerous thyroid nodule is that the lump (nodule):   Student Answer:  is tender.    is mobile and not hard.    disappears when the patient smiles.    is hard and fixed to the surrounding structures.   Instructor Explanation: Suspect any painless, rapidly growing nodule, especially the appearance of a single nodule in a young person. Cancerous nodules tend to be hard and are fixed to surrounding structures.   Points Received: 4 of 4   Comments: Question 7. Question : A patient visits the clinic because he has recently noticed that the left side of his mouth is paralyzed. He states that he cannot raise his eyebrow or whistle. The nurse practitioner suspects that he has:   Student Answer:  Cushing’s syndrome.    Parkinson’s syndrome.    Bell’s palsy.    had a cerebrovascular accident (stroke).   Instructor Explanation: With an upper motor neuron lesion (as with CVA) the patient will have paralysis of lower facial muscles, but the upper half of the face is not affected owing to the intact nerve from the unaffected hemisphere. The person is still able to wrinkle the forehead and close the eyes.   Points Received: 4 of 4   Comments: Question 8. Question : The temporomandibular joint is just below the temporal artery and anterior to the:   Student Answer:  hyoid.    vagus.    tragus.    mandible.   Instructor Explanation: The temporomandibular joint is just below the temporal artery and anterior to the tragus.   Points Received: 4 of 4   Comments: Question 9. Question : During an examination of a patient’s abdomen, the nurse practitioner notes that the abdomen is rounded and firm to the touch. During percussion, the nurse practitioner notes a drum-like quality of the sound across the quadrants. This type of sound indicates:   Student Answer:  constipation.    air-filled areas.    the presence of a tumor.    the presence of dense organs.   Instructor Explanation: A musical or drum-like sound (tympany) is the sound heard when percussion occurs over air-filled viscus, such as the stomach or intestines.   Points Received: 4 of 4   Comments: Question 10. Question : A patient tells the nurse that he is allergic to penicillin. What would be the nurse practitioner’s best response to this information?   Student Answer:  “Are you allergic to any other drugs?”    “How often have you received penicillin?”    “I’ll write your allergy on your chart so you won’t receive any.”    “Please describe what happens to you when you take penicillin.”   Instructor Explanation: Note both the allergen (medication, food, or contact agent, such as fabric or environmental agent) and the reaction (rash, itching, runny nose, watery eyes, difficulty breathing). With a drug, this symptom should not be a side effect but a true allergic reaction.   Points Received: 4 of 4   Comments: Question 11. Question : A patient’s thyroid is enlarged, and the nurse practitioner is preparing to auscultate the thyroid for the presence of a bruit. A    takes time and reveals a surprising amount of information.    may be somewhat uncomfortable for the expert practitioner.    requires a quick glance at the patient’s body systems before proceeding on with palpation.   Instructor Explanation: A focused inspection takes time and yields a surprising amount of data. Initially, the examiner may feel uncomfortable “staring” at the person without also “doing something.”   Points Received: 4 of 4   Comments: Question 16. Question : The mother of a 2-year-old is concerned because her son has had three ear infections in the past year. What would be an appropriate response by the nurse practitioner?   Student Answer:  “It is unusual for a small child to have frequent ear infections unless there is something else wrong.”    “We need to check the immune system of your son to see why he is having so many ear infections.”    “Ear infections are not uncommon in infants and toddlers because they tend to have more cerumen in the external ear.”    “Your son’s eustachian tube is shorter and wider than yours because of his age, which allows for infections to develop more easily.”   Instructor Explanation: The infant’s eustachian tube is relatively shorter and wider, and its position is more horizontal than the adult’s, so it is easier for pathogens from the nasopharynx to migrate through to the middle ear.   Points Received: 4 of 4   Comments: Question 17. Question : The nurse practitioner would use bimanual palpation technique in which situation?   Student Answer:  Palpating the thorax of an infant    Palpating the kidneys and uterus    Assessing pulsations and vibrations    Assessing the presence of tenderness and pain   Instructor Explanation: Bimanual palpation requires the use of both hands to envelop or capture certain body parts or organs such as the kidneys, uterus, or adnexa.   Points Received: 4 of 4   Comments: Question 18. Question : The patient’s record, laboratory studies, objective data, and subjective data combine to form the:   Student Answer:  database.    admitting data.    financial statement.    discharge summary.   Instructor Explanation: Together with the patient’s record and laboratory studies, the objective and subjective data form the database.   Points Received: 4 of 4   Comments: Question 19. Question : When preparing to perform a physical examination on an infant, the examiner should:   Student Answer:  have the parent remove all clothing except the diaper on a boy.    instruct the parent to feed the infant immediately before the exam.    encourage the infant to suck on a pacifier during the abdominal exam.    ask the parent to briefly leave the room when assessing the infant’s vital signs.   Instructor Explanation: The parent should always be present for the child’s feeling of security and to understand normal growth and development. Timing of the examination should be 1 to 2 hours after feeding when the baby is not too drowsy nor too hungry. Infants do not object to being nude; clothing should be removed and a diaper left on a boy.   Points Received: 4 of 4   Comments: Question 20. Question : The nurse practitioner notices that an infant has a large, soft lump on the side of his head and that his mother is very concerned. She tells the nurse practitioner that she noticed the lump about 8 hours after her baby’s birth, and that it seems to be getting bigger. One possible explanation for this is:   Student Answer:  hydrocephalus.    craniosynostosis.    cephalhematoma.    caput succedaneum.   Instructor Explanation: A cephalhematoma is a subperiosteal hemorrhage that is the result of birth trauma. It is soft, fluctuant, and well defined over one cranial bone. It appears several hours after birth and gradually increases in size.   Points Received: 4 of 4   Comments: Question 21. Question : When examining an infant, the nurse practitioner should examine which area first?   Student Answer:  Ear    Nose    Throat    Abdomen   Instructor Perform the least distressing steps first. Save the invasive steps of screens. One person has a cholesterol level of 225. She is concerned about her risk for developing heart disease. Which of the following factors is used to estimate the 10-year risk of developing coronary heart disease?   Student Answer:  Ethnicity    Alcohol intake    Gender    Asthma   Comments: Question 2. Question : You are concerned that a patient has an aortic regurgitation murmur. Which is the best position to accentuate the murmur?   Student Answer:  Upright    Upright, but leaning forward    Supine    Left lateral decubitus   Comments: Question 3. Question : You are screening people at the mall as part of a health fair. The first person who comes for screening has a blood pressure of 132/85. How would you categorize this?   Student Answer:  Normal    Prehypertension    Stage 1 hypertension    Stage 2 hypertension   Comments: Question 4. Question : How should you determine whether a murmur is systolic or diastolic?   Student Answer:  Palpate the carotid pulse.    Palpate the radial pulse.    Judge the relative length of systole and diastole by auscultation.    Correlate the murmur with a bedside heart monitor.   Comments: Question 5. Question : A 78-year-old retired seamstress comes to the office for a routine check-up. You obtain an electrocardiogram (ECG) because of her history of hypertension. You diagnose a previous myocardial infarction and ask her if she had any symptoms related to this. Which of the following symptoms would be more common in this patient’s age group for an AMI?   Student Answer:  Chest pain    Syncope    Pain radiating into the left arm    Pain radiating into the jaw   Comments: Question 6. Question : On examination, you find a bounding carotid pulse on a 62-year- old patient. Which murmur should you suspect?   Student Answer:  Mitral valve prolapse    Pulmonic stenosis    Tricuspid insufficiency    Aortic insufficiency   Comments: Question 7. Question : Which of the following correlates with a sustained, high- amplitude point of maximal impulse (PMI)?   Student Answer:  Hyperthyroidism    Anemia    Fever    Hypertension   Comments: Question 8. Question : A 68-year-old woman with hypertension and diabetes is seen by the nurse practitioner for a dry cough that worsens at night when she lies in bed. She has shortness of breath, which worsens when she exerts herself. The patient’s pulse rate is 90/min and regular. The patient has gained 6 lbs over the past two months. She is on a nitroglycerine patch and furosemide daily. The explanation for her symptoms is:   Student Answer:  Kidney failure    Congestive heart failure    Angiotensin-converting enzyme (ACE) inhibitor induced coughing    Thyroid disease   Comments: Question 9. Question : When listening to a soft murmur or bruit, which of the following may be necessary?   Student Answer:  Asking the patient to hold their breath.    Asking the patient in the next bed to turn down the TV.    Checking your stethoscope for air leaks.    All of the above. with a closed fist over her sternum to describe it. Which of the following diagnoses should be considered because of her gesture?   Student Answer:  Bronchitis    Costochondritis    Pericarditis    Angina pectoris   Comments: Question 6. Question : When crackles, wheezes, or rhonchi clear with a cough, which of the following is a likely etiology?   Student Answer:  Bronchitis    Simple asthma    Cystic fibrosis    Heart failure   Comments: Question 7. Question : Is the following information subjective or objective? Mr. Mazz has shortness of breath that has persisted for the past ten days; it is worse with activity and relieved by rest.   Student Answer:  Subjective    Objective   Comments: Question 8. Question : All of the following are implicated in causing chronic cough except:   Student Answer:  Chronic bronchitis    Allergic rhinitis    Acute viral upper respiratory infection    Gastroesophageal reflux disease   Comments: Question 9. Question : A mother brings her infant to you because of a “rattle” in his chest with breathing. Which of the following would you hear if there is a problem in the upper airway?   Student Answer:  Different sounds from the nose and the chest    Asymmetric sounds    Inspiratory sounds    Sounds louder in the lower chest   Comments: Question 10. Question : Which of the following is consistent with good percussion technique?   Student Answer:  Allow all of the fingers to touch the chest while performing percussion.    Maintain a stiff wrist and hand.    Leave the plexor finger on the pleximeter after each strike.    Strike the pleximeter over the distal interphalangeal joint.