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132 Cards in this Set
- Front
- Back
- 3rd side (hint)
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When reading a medical record you see the following notation: Patient states, "I have had a cold for about a week, and now i am having difficulty breathing." This is an example of?
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A) Past history
B) review of systems C) functional assessment D) a reason for seeking care |
D) a reason for seeking care
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you have reason to question the reliability of the information being provided by a patient. One way to verify the reliability within the context of the interview is to?
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rephrase the same question later in the interview
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the statement "Reason for seeking care" has replaced the "chief complaint." This change is significant because?
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the newer term incorporates wellness needs
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During an initial interview, the examiner says, "Mrs. J., tell me what you do when your headaches occur." With this question, the examiner is seeking information about?
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A) the pt's perception of the problem
B) aggravating or relieving factors C) the frequency of the problem D) the severity of the problem |
B) aggravating and relieving factors
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Which of the following is an appropriate recording of a patient's reason for seeking health care?`
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A) angina
B) substernal pain radiating to left axilla, 1hr duration C) "grabbing" chest pain for 2 hr D) pleurisy, 2 days duration |
C) "grabbing" chest pain
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A genogram is useful in showing information concisely. It is used specifically for?
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family history
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Select the best description of "review of systems" as part of the health history?
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A) evaluation of the past and present health state of each body system
B) documentation of the problem as described by the patient C) recording of the objective findings of the practitioner D) statement that describes the overall health state |
A) evaluation of the past and present health state of each body system
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which of the following is considered to be subjective?
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A) T: 101.2F
B) P: 96 C) wt loss of 20 pouinds since last visit D) pain lasting 2 hrs |
D) pain lasting 2hrs
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When taking a health history for a child, what information, in addition to that of an adult, is usually obtained?
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A) coping and stress management
B) a review of immunizations received C) environmental hazards D) hospitalization history |
B) immunization records
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Functional assessment measures how a person manages day-to-day activities. The impact of a disease on the daily activities of the older adult is referred to as?
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A) interpersonal relationship assessment
B) instrumental activites of daily living C) reason for seeking care D) disease burden |
D) disease burden
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although a full mental status exam may not be required, the examiner must be aware of the 4 main headings of the assessment while performing the interview and physical exam. These heading are?
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A) mood, affect, consciousness, orientation
B) memory, attention, thought content, perceptions C) language, orientation, attention, abstract reasoning D) appearance, behavior, cognition, thought processes |
D) appearance, behavior, cognition, thought processes
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select the finding that most accurately describes the appearance of a pt:
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A) tense posture and restless activity. clothing clean but not appropriate for season.
B) oriented x3. affect appropriate for circumstances C) alert and responds to verbal stimuli. tearful when diagnosis discussed. D) laughing inappropriately, oriented x3 |
A) tense posture and restless activity
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the ability to lay down new memories is part of the assessment of cognitive functions. One way to accomplish this is by:
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A) noting whether the pt completes a thought without wandering
B) test of general knowledge. C) description of past medical history D) use of the 4 unrelated words test |
D) 4 unrelated words test
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in order to accurately plan for discharge teaching, additional assessments may be required for the pt with aphasia. This may be accomplished by asking the pt to:
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A) calculate serial 7s
B) name his or her grandkids and birthdays C) demonstrate word comprehension by naming articles in teh room as you point to them D) interpret a proverb |
C) demonstrate word omprehension by naming articles around the room
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during an interview with a pt newly diagnosed with a seizure disorder, the pt states, "I plan to b an airline pilot." If the pt continues to have this as a career goal after teaching regarding seizure disorders has been proveded, the practitioner might question the pt's:
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A) thought processes
B) judgement C) attention span D) recent memory |
B)judgement
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On a pts second day in an acut care hospital, the pt complains about the "bugs" on the bed. The bed is clean. This would be an example of altered:
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A) thought processes
B) orientation C) perception D) higher intellectual function |
C) perception
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one way to assess cognitive function and to detect dementia is with:
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A) proverb intepretation test
B) mini-mental exam C) 4 unrelated words test D) older adult behavior checklist |
B) mini-mental
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the behavioral checklist, completed by a parent, is used to assess the mental status of:
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A) infants
B) kids 1-5 C) kids 7-11 D) adolescents |
D) kids 7-11
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a major characteristic of dementia is:
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A) impairment of short and longterm memory
B) hallucinations C) sudden onset of symptoms D) substance-induced |
A) impairment of short and lonterm memory
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lack of emotional response
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flat affect
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loss of identity
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depersonalization
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excessive well-being
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euphoria
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apprehensive from the anticipation of a danger whose source is unknown
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anxiety
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annoyed, easily provoked
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irritability
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loss of control
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rage
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sad, gloomy, dejected
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depression
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rapid shift of emotions
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lability
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worried about known external danger
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fear
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which of the following are examples of intimate partner violence?
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A) an ex-boyfriend stalks his ex-girlfriend
B) marital rape C) hitting a date D) all of the above |
D) all
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routine, universal screening for domestic violence means:
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A) asking women who come to the health care system if they are abused each time they come
B) asking women who have injuries if they are abused C) asking women who have symptoms of PTSD if they are abused D) asking women ages 18 to 30 if they are abused |
A) all women
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mental health problems associated with intimate partner violence include:
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A) hallucinations
B) suicidality C) schizophrenia D) ADHD |
B) suicidality
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gynecologic problems not associated with intimate partner violence include:
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A) pelvic pain
B) ovarian cysts C) STDs D) vaginal tearing |
B) ovarian cysts
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risk factors for intimate partner homicide include:
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A) abuse during pregnancy
B) victim substance abuse C) victim unemployment D) history of victim childhood sexual assault |
A) abuse during pregnancy
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elder abuse and neglect include:
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A) willful infliction of force
B) withholding prescription meds without medical orders C) not replacing broken eyeglasses D) threatening to place someone in a nursing home E) all of the above |
E) all
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when assessing an injury on a child, which of the following should be considered?
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A) the child's developmental level
B) the child's medical and medication history C) the history of ho the injury occurred D) all of the above |
D) all of the above
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known risk factors for a child maltreatment include which of the following?
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A) substance abuse
B) intimate partner violence C) physical disability/mental retardation in the child D) all above |
D) all above
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bruising in a non-cruising child:
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A) is a common finding from normal infant activity
B) needs to be further evaluated for either an abusive or medical explanation C) is commonly seen on the buttocks D) cannot be reported until after a full medical evaluation |
B) needs to be further evaluated for either an abusive or medical explanation
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various parts of the hand are used during palpation. The part of the hand used for the assessment of vibration is what?
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ulnar surface of the hand
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when performing indirect percussion, the stationary finger is struck:
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A) at the ulnar surface
B) at the middle joint C) distal interphalangeal joint D) wherever it is in contact with the skin |
C) distal interphalangeal joint
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the best description of the pitch of a sound wave obtained by percussion is:
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A) intensity of the sound
B) # of vibrations per second C) length of time the note lingers D) overtones of the note |
B) # vibrations
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the bell of the stethoscope is used for?
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soft, low-pitched sounds
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The opthalmoscope has 5 apertures. Which aperture would be used to assess the eyes of a pt with undilated pupils?
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A)grid
B)slit C)small D)large |
C) small
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at the conclusion of the exam, the examiner should?
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A) document findings before leaving the room
B) have findings confirmed by another HCP C) relate objective findings to the subjective findings D) summarize findings to the pt |
D) summarize findings to the pt
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When the practitioner enters the exam room the infant pt is asleep. The practitioner would best start the exam with?
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A) ht and wt
B) BP C)heart, lung, abdomen D) Temp |
C) heart lung and abdomen
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the sequence of an exam changes from the beginning with the thorax to that of head to toe with what age child?
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A) infant
B) preschool C) school-aged D) adolescent |
C) school-aged
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the 4 areas to consider during the general survey are:
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A) ethinicity, sex, age, socioeconomic
B) physical appearance, sex, ethnicity, affect C) dress, affect, nonverbal behavior, mobility D) physical appearance, body structure, mobility, behavior |
D) physical appearance, body structure, mobility, behavior
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during the general survey part of the examination, gait is assessed. When walking, the base is usually?
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shoulder width
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a child 18 months of age is brought in for a health screening visit. To assess the ht of the child:
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A) use a tape measure
B) use a horizontal measuring board C) have the child stand on the upright scale D) measure arm span to estimate ht |
B) horizontal measuring board
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B.D. was delivered by C-section at 38 weeks gestation because of fetal distress. She weighed 6lb4oz. This weight:
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A) normal
B) too small C) large D) cannot be determined by available data |
A) normal
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during the 8th and 9th decades of life, physical changes occur. Ht and wt:
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A) both increase
B) wt increases, ht decreases C) both decrease D) both remain the sameas during the 70s |
C) both decrease
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during an initial home visit, the pt's T=97.4F. This temperature
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A) cannot be evaluated without a knowledge of the pt's age
B) is below normal C) should be taken rectally for core temp D) should be reevaluated at the next visit before a decision is made |
A) cannot be evaluated withou the age
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Select the best description of an accurate assessment of a pt's pulse:
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A) count for 15 seconds if reg.
B) begin countin with 0, count for 30 seconds C) count for 30 secs and multiply by 2 for all cases D) count for 1 full minute beginning with 0 |
B) begin with 0, count for 30 sec
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after assessing the pt's pulse the practitioner determines it to be normal. This should be recorded as?
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2+
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Select the best description of an accurate assessment of a pt's respirations:
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A) count for a full minute before taking the pulse
B) ount for 15 secs and multiply by 4 C) count after informing the py where you are in teh assessment process D) count for 30 seconds following pulse assessment |
D) count for 30 seconds following pulse assessment
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Pulse pressure is:
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A) difference between systolic and diastolic pressures
B) reflection of the viscosity of the blood C) another way to express the sytolic pressure D) measure of vasoconstriction |
A) differece between systolic and diastolic pressures
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Examiner is going to assess for coarctation of the aorta. In an individual with a coarctation the thigh pressure would be:
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A) higher than in the arm
B) equal to that in the arm C) there is no constant relationship. findings are individual D) lower than in the arm |
D) lower than in the arm
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mean arterial pressure:
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A) arithmetic average of systolic and diastolic pressures
B) driving force of blood during systole C) diastolic pressure plus 1/3 pulse ressure D) corresponding to Phase III Korotkoff's |
C) diastolic + 1/3 pulse pressure
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at what phase during nociception does the individual become aware of a painful sensation>
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A) modulation
B) transduction C) peception D) transmision |
C) percepion
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While taking a history the pt describes a burning, painful sensation that moves around his toes and bottoms of his feet. These symptoms suggest:
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A) nociceptive pain
B) neuropathic pain |
B) neuropathic
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during the PE, your pt. is diaphoretic, pale and complains of pain directly over the LUQ. This would be categorized by:
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A) cutaneous pan
B) somatic pain C) visceral pain D) psychogenic pain |
C)visceral
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while caring for a preterm infant, you are aware that:
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A) inhibitory neurotransmitters are in sufficient supple by15 weeks gestation
B) the fetus has less capacity to feel pain C) repetitive blood draws have minimal long-term consequences D) the preterm infant is more sensitive to painful stimuli |
D) preterm is more sensitive to painfu stimuli
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the most reliable indicator of pain in the adult is:
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A) degree of physical funcitoning
B) nonverbal behaviors C) MRI findings D) pt's self report |
D) self-report
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while examining a broken arm of a 4yr old boy, select the appropriate assessment tool to evaluate his pain status:
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A) 1-10 numeric
B) wong-baker scale, faces C) simple descriptor D) 0-5 numeric |
B) wong-baker faces
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normal age-related findings in teh lower extremeties of an 80yr old woman would be:
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A) crepitus
B) joint swelling C)diminished strength D) unilateral muscle atrophy |
C) diminished strength
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when a person presents with aute pain of the abdomen, following initial examination, t is best to withhold analgesia until diagnostic testing is complete and diagnosis is made: T/F
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false
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for older adults post-op pts, poorly controlled acute pain places them at higher risk for:
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A) atelectasis
B) increased myocardial O2 demand C) impaired wound healing D) all of the above |
D) all
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30yr old female reports having persistent intense pain in her right arm r/t trauma sustained from a MVA 5 months ago. She states that the slightest touch or clothing can exacerbate the pain. This report is suggestive of:
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A) referred pain
B) psychogenic pain C) complex regional pain I D) cutaneous pain |
C) complex regional pain I
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the CRIES is an appropriate pain assessment tool for:
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A) cognitively impaired older adults
B) kids 2-8 C) infants D) preterm and term neonates |
D) neonates
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pain problem should be anticipated in a cognitively impaired older adult with a history of:
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A) diabetes
B) PVD C) COPD D) Parkinsons |
B) peripheral vascular disease
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the balance between nutrient intake and nutrient reqs is dscribed as:
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A) undernutrition
B) malnutrition C) nutritional status D) overnutrition |
C) nutritional status
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to support the synthesis of maternal and fetal tissue during pregnancy, a wt gain of ___lbs is recommended.
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A) 25-35
B) 28-40 C) 15-25 D) depends on BMI of mother before pregnancy |
D) depends on BMI
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which of the following are normal, expected changes in the older adult?
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A) increase in energy needs
B)increase in body water C) decrease i ht D) increase in AP diameter of the chest |
C) decrease in ht
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which of the following data would be obtained as part of a nutritional screening?
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A) Temp, P, Resp
B) BP, genogram C) wt and nutrition intake history D) serum creatinine levels |
C) wt and nutrition intake history
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current dietart guidelines recommend that complex carbs comprise ___% of total caloric intake?
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60
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24-hr recall of dietary intake:
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A) anthropometricmeasure of calories consumed
B) questionaire of everything eaten in the last 24 hrs C) same as a food frequency questionaire D) a form of food diary |
B) questionaire of everything eaten within the last 24 hrs
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the nutritional needs of a pt with trauma or major surgery:
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A) are met by fat reserves in obese individuals
B) may be 2 or 3 times greater than normal C) can be met with IV fluids, supplements with vitamins and electrolytes D) are met by glycogen reserves |
B) may be 2-3 times greater than normal
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Mary, a 15 yr old, has come for a school physcal. During the interview the examiner is told that menarche has not occured. An explanation to be explored is:
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A) nutritional deficiency
B) alcohol intake C) smoking history D) possible elevated blood sugar |
A) nutritional deficiency
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Older adults are at risk for alteration in nutrtional status. From the idividuals described below, select the individuals who appear least at risk:
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A) 80yr old widower who lives alone
B) 65 yr old widower who visits a senior center 5 times a week for meals C) 70 yr old with poor dentition who lives with a son D) 73 yr old couple with low income and no transportation |
B) 65yr with meal plan at senior center
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body wt as a % of ideal body wt is calculated to assess for malnutrition. Severe malnutrition is diagnosed when current body wt is:
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A) 80-90% ideal
B) 70-80% ideal C) less than 70% ideal D) 120% ideal |
C) <70%
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the examiner is completing an initial assesment for a pt being admitted to a long term care facility. The pt is unable to stand for a measurement of ht. in order to obtain this important anthropometric information the examiner may:
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A) measure the waist-to-hip circumference
B) estimate BMI C) measure arm span D) obtain mid-upper arm muscle circumference |
C) arm span
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a skin testing or anergy panel has been ordered for a patient. This test is done to:
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A) determine serum protein levels
B) determine the need for adult immunizations C) assess for excessive exposure to ultraviolet light D) assess for immunocompetence |
D) assess for immunocompetence
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which assessment finding indicates nutrition risk?
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A) BMI 24
B)serum albumin 2.5 C)wt 200lbs D)BMI 19 |
B) serum albumin
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marasmus is often characterized by:
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A) severely depleted visceral proteins
B) elevated triglycerides C) hyperglycemia D) low wt for ht |
D) low wt for ht
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What BMI = obesity
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>30
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select the best description of the secretion of the eccrine glands
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A) thick, milky
B) dilute saline solution C) protective lipid substance D) keratin |
B) dilute saine solution
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nevus is the medical term for:
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mole
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to assess for early jaundice you will assess
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sclera and hard palate
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checking for kin temp is best accomplished by using which part of the hand?
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dorsal (back)
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skin turgor is assessed by picking up a large fold of skin on the anterior chest under the clavicle. This is done to determine if the pt is?
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dehydrated
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what is teh nomal angle for the base of a nail?
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160 degrees
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capillary refill should be in what range?
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1-2 seconds
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during routine visit a 78 yr old asks about a small, round, flat, brown macule on the hands. You respond with,
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A) thse are the result of sun exposure and do not require attention
B) these are related to sun exposure and may become cancerous C) these are skin tags that occur with aging D) i will arrange a biopsy |
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an area of thin, shiny skin with decrased visibility of normal skin markings is called?
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A) lichenification
B) plaque C) atrophy D) keloid |
C) atrophy
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flattening of the angle between the nail and its base is?
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clubbing
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the configuration for individual lesions arranged in circles or arcs, as occurs with ringworm, is called:
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A) linear
B) clustered C) annular D) attenuated |
C) annular
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the A in ABCDE rule stands for
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asymmetry
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a risk factor of melanoma is:
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A) brown eyes
B) darkly pigmented skin C) skin that freckles or burns before tanning D) use of sunscreen |
C) skin that freckles or burns
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lyme disease is more prevalent:
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A) from May-September
B) along the west coast C) kids under 3 D) those participating in water sports |
A) May-September
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cutaneous anthrax:
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A) incubation is 10-15 days
B) completely curable with antibiotic treatment C) has absence of pain or edema D) forms pustular, umbilicated lesions |
B) curable with antibiotics
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What facial bone articulates at a joint not a suture?
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A) zygomatic
B)maxilla C) nasal D) mandible |
D) mandible
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what blood vessel runs diagonally across the sternomastoid muscle?
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A) temporal
B) carotid C) external jugular vein D) internaljugular vein |
C) ext jugular V
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the isthmus of the thyroid gland lies just below the ?
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A) mandible
B) cricoid cartilage C) hyoid cartilage D) thyroid cartilage |
B) cricoid cartilage
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select the statement that is true of cluster headaches...
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A) may be precipitated by alcohol and daytime napping
B) usually 2 per month lasting 1-3 days C) characterized as throbbing D) supraorbitol, retro-orbital, or frontotemporal |
A) alcohol and daytime napping
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select the symptom that is least likely to indicate a possible malignancy...
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A) history of radiation therapy to head and neck
B) history of using chewing tobacco C) large alcohol consumption D) tenderness |
D) tenderness
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providing resistance while the pt shrugs shoulders is a test of what CN?
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11th
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if the thyroid gland is enlarged bilaterally which of the following maneuvers is appropriate?
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A) check for deviation of the trachea
B) listen for a bruit over carotids C) listen for a murmur over the aortic area D) listen for a bruit over the thyroid lobes |
D) bruit over the thyroid lobes
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it is normal to palpate a few lymph moddes in the neck of a healthy person. What are the characteristics of these nodes?
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mobile, soft, nontender
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normal cervical lymph nodes are
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A) smaller than 1cm
B) warm to palpation C) fixed D) firm |
A) smaller than 1cm
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a throbbing unilateral pain associated with nausea, vomitting, and photophobia is characteristic of:
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A) cluster headache
B) subarachnoid hemorrhage C) migraine headache D) tension headache |
C) migraine
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the palpebral fissure is?
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open space between eyelids
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the corneal reflex is mediated by cranial nerves?
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A) 2 and 3
B) 2 and 6 C) 5 and 7 D) 6 and 4 |
C) 5 and 7
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What retinal structures are viewed through the opthalmoscope?
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optic disc, retinal vessels, macula
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what is a positive consensual light reflex?
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constricture of the left eye when a bright light is shown in the right eye
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what is the thickening and yellowing of the lens?
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senile cataract
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what would constitute an eye emergency?
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A) floaters
B) epiphoria C) sudden vision change D) photophobia |
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visual acuity is assessed with what?
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snellen chart
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the cover test assesses for?
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muscle weakness
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what CNs control eye movement?
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3.4.6
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In a person who is blind in one eye a nurse tests for consensual reflexes. what should happen
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both eyes constrict
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what color is the tympanic membrane?
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pearly gray
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which direction is the pinna pulled in a child before attempting to use the opthalmoscope?
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down
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to differentiate between air conduction and bone conduction what test should be performed?
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Rinne test
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where are the hearing receptors located?
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A) vestibule
B) semicircular canals C) middle ear D) cochlea |
D) cochlea
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a common cause of a conductive hearing loss is:
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A) impacted cerumen
B) acute rheumatic fever C) a CVA D) otitis externa |
A) cerumen
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the most common site of nosebleeds is
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A) turbinates
B) columellae C) Kiesselbach's plexus D) meatus |
D) Kiesselbach's plexus
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What sinuses are accessible for examination?
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frontal and maxillary
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what is the frenulum?
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connector of the tongue to the floor of the mouth
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oral malignancies are most likely to develop where?
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A) soft palate
B) tongue C) buccal cavity D) under the tongue |
D) under the tongue
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tonsils that touch the uvula are graded as?
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3+
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where is the most common area to develop breast cancer?
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upper outer quadrant
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when is the best time to perform a breast self exam
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same day each month
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what does an abnormal mass of the breast feel like?
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A) round, firm, wel demarcated
B) irregular, poorly defined, fixed C) rubbery, mobile, tender D) lobular, clear magins, no retraction |
B) irregular, poorly defined, fixed
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