Medical Interview & Examination Techniques: HPI, CC, Objective & Subjective Data, Exams of Nursing

Download Medical Interview & Examination Techniques: HPI, CC, Objective & Subjective Data and more Exams Nursing in PDF only on Docsity! 1 / 15 1 1. A patient is seen in the office for amenorrhea, for which you obtain a urine pregnancy test in the office that returns negative. You would document this find- ing in which of the following sections of the ecounter? A. HPI B. CC C. Subjective Data D. Objective Data D. Objective Data 2. A patient you are seeing for the first time in your office, C. Subjective Data brings their previous medical records for the review. you would document a summer of the previous med- ical records in which of the following sections of the encounter note? A. HPI B. CC C. Subjective Data D. Objective Data 3. The most effective process to elicit the ROS is for the NP to: A. Limit the ROS to systems related to the CC B. Follow the patients lead regarding the order of symptoms C. incorporate the ROS during the physical exam, stopping to make notes as necessary D. Start with general questions on each of the different body systems 4. The NP can determine higher cognitive function by asking the patient to perform which of the following tasks? A. Explain the meaning of a proverb B. Identify the day of the week, month, season, date and year D. start with gen- eral question on each of the differ- ent body systems A. Explain the meaning of a proverb 2 / 15 2 C. Recall details of historical events D. Spell a five-letter word such as WORLD backword 5. The NP will ask the patient which of the following questions to assess for depression? A. have you ever been annoyed by other criticizing your alcohol use? B. Over the past two weeks have you felt little interest or pleasure in doing things? C. Over the past two weeks have you been unable to stop or control worrying? D. How often do you have contact with those that you care about or care about you? 6. The NP will document the reason for visit in which of the following sections of the encounter? A. HPI B. CC C. Subjective Data D. Objective Data 7. The primary care provider will anticipate that what percent of outpatients have mental health disorders? A. 10% B. 15 % C. 20% d. 25% 8. Which of the following actions by the NP demonstra- tions patient-centered interviewing techniques? A. Determine the personal context of the patients symptoms B. Focus on symptoms to identify a disease or condi- tion C. Offer his or her perspective to lead the patients response B. Over the past two weeks have you felt little inter- est or pleasure in doing things? B. CC c. 20% A. A. Determine the personal con- text of the patients symptoms 5 / 15 5 C. solid red raised lesion D. Diameter of 5 mm 17. Which of the following secondary lesions is usually the result of a self-inflicted abrasion? A. Excoriation B. Scale C. Lichenification D. Atrophy 18. You have just read in the patients chart that she has a lesion that is confluent in nature. On exam you would expect to find: A. lesions that run together B. Angular lesions that have grown togeher C. Lesions arranged in a line along a nerve route D. Lesions that are grouped or clustered togther 19. Which of the following represents the proper position for the NP to assess the patients abdomen? A. Stand at the patients left side and proceed in a systematic fashion. B. Stand at the patients left side and assess any prob- lem areas first C. Stand at the patients right side and process in a systemic fashion D. Stand at the patients right side and assess any problem areas first 20. The NP will demonstrate the correct order of exam- ination for the abdomen by using examination tech- niques that follows: 1. Auscultation 2. Inspection 3. Palpation 4. Percussion A. Excoriation A. Lesions that run together. C. Stand at the patients right side and process in a systemic fashion D. 2-1-3-4 6 / 15 6 A. 1-2-3-4 B. 2-3-4-1 C. 3-4-1-2 D. 2-1-3-4 21. A 36 year old female patient is seen in the clinic for a reported fever and back pain. She complained of pain when the NP percussed over the left CVA angle. This finding supports which of the following differential diagnosis? A. Pyelonephritis B. Left lower lobe pneumonia C. Splenomegaly D. Cholesystitis 22. The liver border can be palpated normally below the costal margin at the: A. Left mid-clavicular line B. Right mid-axillary line C. Right mid-calvicular line D. Left mid-axillary line 23. The NP will recognize which of the following subjec- tive or objective findings as worrisome for an abdom- inal aortic aneursym? A. aortic width of 2.8 cm B. 25 pack year smoking history C. age of 60 D. Female gender 24. The NP will use which of the following examination techniques to determine muscular resistance, super- ficial organs and masses in the abdomen A. inspection B. light palpation A. Pyelonephritis C. Right mid-calvicular line B. 25 pack year smoking history B. light palpation 7 / 15 7 C. deep palpation D. percussion 25. The NP will use which of the following methods to help C. palpate the ab- the patient relax during the abdominal exam? A. ask the patient to hold their breath B. Palpate the abdomen after inspiration C. palpate the abdomen after expiration D. Palpate the abdomen using quick short movements 26. The parents of a 4 month old infant share concern domen after expi- ration A. Most umbilical about their child's umbilical hernia at a well-child visit. hernias disappear The NP will correctly inform them that: A. Most umbilical hernias disappear by 12 months of age B. The hernia can be surgically repaired before the child reaches adolescence C. This finding indicates that their child is at high risk for other hernias D. There is a strong familial history for umbilical her- nias 27. When percussing the abdomen in a patient with con- stipation, which of the following sounds would you expect to find in the LLQ? A. Tympanic B. Dull C. Resonant D. Hyperresonant 28. When percussing the abdomen, you would document the normal finding of percussion over the intestines as: A. Tympanic B. Dull by 12 months of age B. Dull A. Tympanic 10 / 15 10 C. Accomodation test D. Confrontation test 37. The NP will recognize which of the following findings C. Enlarged supra- when assessing the lymph nodes in the head and neck clavicular nodes as worrisome, warranting further workup? A. Tender tonsillar and submandibular nodes in the presence of a streptococcal infection B. Any lymph node that the NP is able to roll in two directions: up and down, side to side C. Enlarged supraclavicular nodes D. Deep cervical chain nodes that are inaccessible to exam 38. When conducting an ophthalmoscopic exam, the NP will differentiate arteries from veins by noting: A. Larger size of arteries B. Bright light reflection of arteries C. Dark red color of arteries D. location of the vessel to the optic disc 39. When examining a 3 y.o presenting to your office with right ear pain, which would be the appropriate order for the assessment? A. Right ear, left ear, mouth, nose, neck, lungs, heart B. Neck, lungs, heart, mouth, nose, left ear, right ear C. Left ear, right ear, neck, lungs, heart and nose D. Lungs, heart, mouth, nose, and right ear. 40. Which of the following describes the proper technique for examination of the ear canal and drum for a 5 year old? A. Use the smallest ear speculum, position the pt. head so that you see comfortable, straighten the ear canal by grasping the auricle firmly and pulling it upward and backward, slightly away from the head. B. Bright light re- flection of arteries B. Neck, lungs, heart, mouth, nose, left ear, right ear B. use the largest ear speculum that inserts easily in the canal, posi- tion the patients head so that you see comfortable, straighten the ear 11 / 15 11 B. use the largest ear speculum that inserts easily in the canal, position the patients head so that you see comfortable, straighten the ear canal by grasping the auricle firmly and pulling it downward and backward, slightly away from the head 41. Which of the following findings on exam of the nasal mucosa and septum would most likely indicate aller- gic rhinitis? A. Reddened nasal mucosa with purulent drainage B. pale or bluish nasal mucosa with clear drainage C. fresh blood or crusting of the nasal mucosa D. Asymmetry in appearance between the right and left sides 42. Which of the following is/are normal in the examina- tion of the oral cavity? A. a midline lingual frenulum extending from the tongue to the floor of the mouth B. papillae covering the dorsum of the tongue C. Pink buccal mucosa lining the cheeks D. All of the above are normal 43. Which of the following techniques identifies the cor- rect way to use an ophthalmascope to inspect the optic disc and retina in the patients left eye? The NP will hold the ophthalmoscope: A. in their left hand and examine the patients left eye with his or hear left eye B. in the right hand and examine the patients left eye with her or her right eye. C. In their dominant hand and examine both of the patients eyes with his/her dominant eye D. According to personal preference and experience canal by grasp- ing the auricle firmly and pulling it downward and backward, slight- ly away from the head B. pale or bluish nasal mucosa with clear drainage D. All of the above are normal A. in their left hand and examine the patients left eye with his or hear left eye 12 / 15 12 44. Yoi are examining a 4 y.o boy who presents to the office with his mother who complains that he gets bloody noses frequently.You know that the most com- mon cause of epitaxis in the age group is: A. Chronic rhinitis B. Foreign body C. picking their nose D. Allergic rhinitis 45. You are examining a 9 month old in your office and do not see a red reflex on the fundoscopic exam. This finding would cause concern as it can be indicative of which of the following? A. Glaucoma B. Dacryostenosis C. Cararacts D. Retinoblastoma 46. A newborn is in the office with cold symptoms. you go into the room to see a distressed mom who is very concerned about her baby. She expresses to you that something is wrong. Your initial thought that comes to mind is that this could be RSV. You must look for signs of respiratory distress. Those signs include A. Vomiting and diarrhea B. coughing, pulling legs up C. retractions, nasal flaring, tachypnea, grunting D. fever of 100.4 or higher, tachypnea, vomiting 47. An 85 y.o. woman is brought to the urgent care cen- ter for possible aspiration pneumonia. The NP under- stands that, based on normal anatomy adventitious lung sounds will most likely be heard in which of the following areas? C. picking their nose D. Retinoblastoma C. retractions, nasal flaring, tachypnea, grunt- ing D. Right middle and lower lobes