NURS 6512 Midterm Exam 2022

Question 1

Small, minute bruises are called:

		telangiectasias.
		ecchymoses.
		petechiae.
		spider veins.

Question 2

White, rounded, or oval ulcerations surrounded by a red halo and found on the oral mucosa are:

		leukoedema.
		Stensen ducts.
		Fordyce spots.
		aphthous ulcers.

NURS 6512 Midterm Exam 2022 Question 11

When taking a history, you should:

		use a chronologic and sequential framework.
		start the interview with the patient’s family history.
		use a holistic and eclectic structure.
		ask the patient to give you any information they can recall about their health.

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Question 15

A patient comes into the clinic with a chief complaint of “I have found a lump in my neck.” This statement is indicative of:

		Past medical history
		Symptom perceived by the patient
		Physical assessment findings
		Family history

NURS 6512 Midterm Exam 2022Question 16

A Japanese American patient comes into the clinic to discuss new medications prescribed a month ago. During the discussion, the patient continually smiles and nods her head. This nonverbal behavior suggests what to the APRN?

		An acceptance of the treatment discussed
		Reflecting her cultural values and needs validation
		Agrees to keep taking her medication as planned
		Understands why the medication is needed

Question 19

Under normal circumstances, how much water is lost daily by the body?

		5 to 6 L
		2 to 2.5 L
		1 to 1.5 L
		3 to 4 L

Question 25

You are collecting a history from an 11-year-old girl. Her mother is sitting next to her in the examination room. When collecting history from older children or adolescents, they should be:

		allowed to direct the flow of the interview.
		mailed a questionnaire in advance to avoid the need for her to talk.
		given the opportunity to be interviewed without the parent at some point during the interview.
		ignored while you address all questions to the parent.

Question 26

Mr. Walters, a 32-year-old patient, tells you that his ears are “stopped up.” An objective assessment of this complaint is achieved by using the:

		tympanometer.
		tuning fork.
		reflex hammer.
		otoscope with pneumatic attachment.

Question 28

A patient comes to the clinic with the desire to have a surgical change from female to male. The patient expresses that he should have been born a man instead of a woman. What sexual orientation would you chart in the health history that this patient is demonstrating?

		Sexual confusion
		Homosexual
		Transsexual
		Bisexual

Question 29

Which question would be considered a leading question?

		“At what time of the day are your headaches the most severe?”
		“What do you think is causing your headaches?”
		“On a scale of 1 to 10, how would you rate the severity of your headaches?”
		“You don’t get headaches often, do you?”

Question 31

Your patient returns for a blood pressure check 2 weeks after a visit during which you performed a complete history and physical. This visit would be documented by creating a(n):

		triage note.
		problem-oriented medical record.
		accident report.
		progress note.

Question 32

Developing a knowledge base about cultural groups allows the APRN to:

		Predict the behavior and attitude of the patient based on their cultural group.
		Anticipate the patient’s compliance with care
		Change the behaviors and practices of the patient to conform to health care practice.
		Understand the behaviors, practices, and problems observed.

Question 36

What is the most important reason for taking a patient’s detailed family history?

		To identify disease-producing environmental factors
		To provide the patient with a family pedigree
		To identify the potential for genetically linked illnesses and risk factors
		To prove the patient with knowledge about his health

Question 37

Ms. Jones is a 31-year-old female patient who presents for a routine physical examination. Which examination technique will be used first?

		Inspection
		Light palpation
		Deep palpation
		Percussion

Question 39

Which of the following is the most vital nutrient?

		Carbohydrate
		Protein
		Water
		Fat

Question 41

The APRN should always take time to ask patients about their lifestyle and values to:

		Make small talk until the patient feels comfortable.
		Identify cultural factors pertinent to their health care.
		Document their sexuality and any deviations from normal.
		Assess their economic status and ability to pay.

Question 42

Which of the following behaviors displayed by the APRN is essential in establishing and maintaining an effective rapport with the patient?

		Neat and clean appearance
		Conducting all interviews with the door open
		Listening to the patient in a caring, unbiased, and unhurried manner
		Utilizing the same format for every initial health history situation

Question 44

Mr. Franklin is speaking with you, the health care provider, about his respiratory problem. Mr. Franklin says, “I’ve had this cough for 3 days, and it’s getting worse.” You reply, “Tell me more about your cough.” Mr. Franklin states, “I wish I could tell you more. That’s why I’m here. You tell me what’s wrong!” Which caregiver response would be most appropriate for enhancing communication?

		After 3 days, you’re tired of coughing. Have you had a fever?
		I’ll examine you and figure out later what the problem is.
		I’d like to hear more about your experiences. Where were you born?
		I don’t know what’s wrong. You could have almost any disease.

Question 49

A patient comes into the clinic alone who only speaks Swahili. When communicating with a patient who speaks a different language than the APRN, which evidence-based practice should the APRN implement?

		Speak louder to the patient
		Speak to both patient and family at the same time
		Speak with a translator present or on the phone
		Speak slower to allow the patient time to understand

Question 50

When examining the skull of a 4-month-old baby, you should normally find:

		B. closure of the posterior fontanel.
		A. closure of the anterior fontanel.
		D. overlap of cranial bones.
		C. ossification of all sutures.

Question 53

Mrs. Britton brings her 16-year-old son in with a complaint that he is not developing correctly into adolescence. Which structures disproportionately enlarge in the male during adolescence?

		B. Hyoid and cricoid cartilages
		C. Mandible and maxilla bones
		D. Nose and thyroid cartilages
		A. Coronal sutures

Question 55

What finding is unique to the documentation of a physical examination of an infant?

		Liver span
		Fontanel sizes
		Prostate size
		Thyroid position

Question 56

When assessing abdominal pain in a college-age woman, one must include:

		age at completion of toilet training.
		food likes and dislikes.
		the first day of the last menstrual period.
		history of interstate travel.

Question 57

When taking a patient’s history, the importance of the review of symptoms is to:

		Elicit information about current health practices.
		Determine the causes of the present illness.
		Prevent omission of essential data that may have been overlooked by the patient or health care professional.
		Establish trust and increase comfort during the physical exam.

Question 60

During the interview, the patient begins to ask you questions concerning your personal life. You:

		Answer in detail so they can relate.
		Answer as briefly as possible, then refocus on the patient.
		Ask the patient to refrain from asking any personal questions.
		Ignore the question and continue with the patient’s history.

Question 61

You are examining a pregnant patient and have noted a vascular lesion. When you blanche over the vascular lesion, the site blanches and refills evenly from the center outward. The nurse documents this lesion as a:

		C. petechiae.
		D. purpura.
		B. spider angioma.
		A. telangiectasia.

Question 64

When recording physical findings, which data are recorded first for all systems?

		Inspection
		Palpation
		Auscultation
		Percussion NURS 6512 Midterm Exam 2022

Question 65

Mr. Black is a 44-year-old patient who presents to the clinic with complaints of neck pain that he thinks is from his job involving computer data entry. As the examiner, you are checking the range of motion in his neck and note the greatest degree of cervical mobility is at:

		D. C4 to C5.
		A. C1 to C2.
		C. C3 to C4.
		B. C2 to C3.

Question 72

A 60-year-old patient comes in with a chief complaint of a “lump in his throat.” What is the purpose of providing a proper diagnosis for this patient using the history and physical?

		Normal finding patient can return in 3 months
		Failure to provide a proper diagnosis for this patient may allow the disease to progress from curable to incurable
		A good prognosis if monitored monthly
		Wait and watch the plan

Question 73

Sweat glands, hair, and nails are all formed from:

		C. invaginations of epidermis into dermis.
		D. papillae that penetrate the epidermis.
		A. basement membranes under cellular strata.
		B. closely packed squamous cells.

Question 75

In obtaining a social/personal profile, which of the following questions or statements would be appropriate?

		Tell me about your typical day.
		Let me know the date of your last dental examination.
		What prescription medications are you currently taking?
		Do you have any itching, sniffling, or sneezing associated with allergies?

Question 79

A 22-year-old female nurse is interviewing an 86-year-old male patient. The patient avoids eye contact and answers questions only by saying, “Yeah,” “No,” or “I guess so.” Which of the following is appropriate for the interviewer to say or ask?

		We will be able to communicate better if you will look at me.
		Are you uncomfortable talking with me?
		It s hard for me to gather useful information because your answers are so short.
		Does your religion make it hard for you to answer my questions?

Question 80

The APRN is obtaining the chief complaint from the patient. The patient has provided a long detailed list of symptoms. The patient may be exhibiting what issue?

		Inappropriate level of concern over their symptoms
		Thorough list of symptoms to put in their chart
		Exhibiting detail-oriented behaviors
		Avoidance of the questions needed for the history

Question 82

Mr. Mills is a 55-year-old patient who presents to the office for an initial visit for health promotion. A survey of mobility and activities of daily living (ADLs) is part of a(an):

		ethnic assessment.
		genetic examination.
		social history.
		functional assessment.

Question 84

To correctly document absent bowel sounds, one must listen continuously for:

		5 minutes.
		3 minutes.
		1 minute.
		30 seconds.

Question 85

Underestimation of blood pressure will occur if the blood pressure cuff’s width covers:

		less than 5 inches of the lower arm.
		more than two-thirds of the upper arm.
		more than 4 inches of the lower arm.
		less than one-half of the upper arm.

Question 87

During an interview with a patient, she describes abdominal pain that often awakens her at night. Which of the following responses facilitates the interviewing process?

		“Pain is always worse at night.”
		“I’d like to hear more about your experiences. Where were you born?”
		“I don’t know what’s wrong. You could have almost any disease.”
		“Tell me what you mean by often.”

Question 90

Tracheal tug suggests the presence of a(n):

		thoracic carcinoma.
		enlarged thyroid.
		aortic aneurysm.
		swallowing disorder.

Question 92

Mr. Marks is a 66-year-old patient who presents for a physical examination to the clinic. Which question has the most potential for exploring a patient’s cultural beliefs related to a health problem?

		“What are your age, race, and educational level?”
		“Why do you think you are having these symptoms?”
		“What types of symptoms have you been having?”
		“How often do you have medical examinations?”

Question 93

A guideline for history taking is for caregivers to:

		write detailed information as stated by patients so that their priorities are reflected.
		ask direct questions before open-ended questions so that data move from simple to complex.
		make notes sparingly so that patients can be observed during the history taking.
		ask for a complete history at once so that data are not forgotten between meetings.

Question 94

When are open-ended questions generally most useful?

		During the review of systems
		After several close-ended questions have been asked
		While designing the genogram
		During the initial part of the interview

Question 97

A patient becomes restless during the history and says, “I don’t have time for all of this conversation. I’ve got to get back to work.” The APRN’s most appropriate response would be to:

		Acknowledge his anger and proceed with the history and examination.
		Ask another open-ended question and insist upon an answer.
		Ask questions about his anger and move closer to him.
		Ignore his displeasure and become more assertive about getting answers.

Question 98

Which chief complaint is written correctly?

		The patient complains of trouble urinating,
		The patient came to the clinic with malaise, coughing & sneezing.
		R/O urinary tract infection.
		The patient complains of “Squeezing, stabbing pain in the middle of my chest.”