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HEALTH EXAM 4

Total questions: 50

Worksheet time: 2hrs 40mins

Name
Class
Date
1.

During a health history, the patient states "I have pain all the time in my stomach. Its worse 2 hours after I eat, but it gets better if I eat again" Based on these symptoms, the nurse suspects that the patient has which condition?

a)

appendicitis

b)

gastric ulcer

c)

duodenal ulcer

d)

cholecystitis

2.

The nurse is preparing to examine a patient who has been complaining of right lower quadrant pain. Which technique is correct during the assessment?

a)

examine the tender area first

b)

examine the tender area last

c)

avoid palpating the tender area

d)

palpate the tender area first, then auscultate for bowel sounds

3.

During an abdominal assessment, the nurse tests for a fluid wave. A positive fluid wave test occurs with:

a)

splenomegaly

b)

distended bladder

c)

constipation

d)

ascites

4.

During an assessment, the nurse notices that a patients umbilicus is enlarged and everted. It is positioned midline with no change in skin color. The nurse recognizes that the patient may have which condition?

a)

intra-abdominal bleeding

b)

constipation

c)

umbilical hernia

d)

abdominal tumor

5.

During reporting, the student nurse hears that a patient has hepatomegaly and recognizes that this term refers to:

a)

enlarged liver

b)

enlarged spleen

c)

distended bowel

d)

excessive diarrhea

6.

The nurse is assessing a patient for possible peptic ulcer disease. Which condition or history often causes this problem?

a)

hypertension

b)

streptococcal infections

c)

recurrent constipation with frequent laxative use

d)

frequent use of NSAIDs

7.

The nurse is reviewing statistics for lactose intolerance. In the US, the incidence of lactose intolerance is higher in adults of which ethnic group?

a)

blacks

b)

hispanics

c)

whites

d)

asians

8.

When palpating the abdomen of a 20 year old patient, the nurse notices the presence of tenderness in the left upper quadrant with deep palpation. Which of these structures is most likely to be involved?

a)

spleen

b)

sigmoid colon

c)

appendix

d)

gallbladder

9.

Which of these percussion findings would the nurse expect to find in a patient with a large amount of ascites?

a)

dullness across the abdomen

b)

flatness in the right upper quadrant

c)

hyperresonance in the left upper quadrant

d)

tympany in the right and left lower quadrants

10.

A patient is suspected of having inflammation of the gallbladder, or cholecystitis. The nurse should conduct which of these techniques to assess for this condition?

a)

obturator test

b)

test for murphy sign

c)

assess for rebound tenderness

d)

iliopsoas muscle test

11.

The nurse is assessing the abdomen of an older adult. Which statement regarding the older adult and abdominal assessment is true?

a)

abdominal tone is increased

b)

abdominal musculature is thinner

c)

abdominal rigidity with an acute abdominal condition is more common

d)

the older adult with an acute abdominal condition complains more about pain than younger people

12.

During an abdominal assessment, the nurse elicits tenderness on light palpation in the right lower quadrant. The nurse interprets that this finding could indicate a disorder of which of these structures?

a)

spleen

b)

sigmoid

c)

appendix

d)

gallbladder

13.

The nurse notices that a patient has had a black, tarry stool and recalls that a possible cause would be:

a)

gallbladder disease

b)

overuse of laxatives

c)

gastrointestinal bleeding

d)

localized bleeding around the anus

14.

An older patient has been diagnosed with pernicious anemia. The nurse knows that this condition could be related to:

a)

increased gastric acid secretion

b)

decreased gastric acid secretion

c)

delayed gastrointestinal emptying time

d)

increased gastrointestinal emptying time

15.

The external male genital structures include the:

a)

testis

b)

scrotum

c)

epididymis

d)

vas deferens

16.

A male patient with possible fertility problems asks the nurse where sperm is produced. The nurse knows that sperm production occurs in the:

a)

testes

b)

prostate

c)

epididymis

d)

vas deferens

17.

During an examination of an aging man, the nurse recognizes that normal changes to expect would be:

a)

enlarged scrotal sac

b)

increased pubic hair

c)

decreased penis size

d)

increased rugae over the scrotum

18.

A 59 year old patient has been diagnosed with prostatitis and is being seen at the clinic for complaints of burning and pain during urination. He is experiencing:

a)

dysuria

b)

nocturia

c)

polyuria

d)

hematuria

19.

The nurse is examining the glans and knows which finding is normal for this area?

a)

the meatus may have a slight discharge when the glans is compressed

b)

hair is without pest inhabitants

c)

the skin is wrinkled and without lesions

d)

smegma may be present under the foreskin of an uncircumcised male

20.

When performing a genitourinary assessment, the nurse notices that the urethral meatus is ventrally positioned. This finding is:

a)

hypospadias

b)

phimosis

c)

due to a stricture

d)

associated with aging

21.

When performing a scrotal assessment, the nurse notices that the scrotal contents show a red glow with transillumination. On the basis of this finding, the nurse would:

a)

assess the patient for the presence of a hernia

b)

suspect the presence of serous fluid in the scrotum

c)

consider this finding normal, and proceed with the exam

d)

refer the patient for evaluation of a mass in the scrotum

22.

The nurse is describing how to perform a testicular self-examination to a patient. Which statement is most appropriate?

a)

a good time to examine your testicles is just before you take shower

b)

if you notice an enlarged testicle or a painless lump, call your health care provider

c)

the testicle is egg shaped and movable. It feels firm and has a lumpy consistency

d)

perform a testicular exam atleast once a week to detect the early stages of testicular cancer

23.

When performing a genital assessment on a middle aged man, the nurse notices multiple soft, moist, painless papules in the shape of cauliflower-like patches scattered across the shaft of the penis. These lesions are characteristic of:

a)

carcinoma

b)

syphilitic chancres

c)

genital herpes

d)

genital warts

24.

The nurse is performing an examination of the anus and rectum. Which of these statements is correct and important to remember during this examination?

a)

the rectum is approximately 8 cm long

b)

the anorectal junction cannot be palpated

c)

above the anal canal, the rectum turns anteriorly

d)

no sensory nerves are in the anal canal or rectum

25.

A 60 year old patient has just been told that he has benign prostatic hypertrophy. He has a friend who just died from cancer of the prostate. He is concerned this will happen to him. How should the nurse respond?

a)

the swelling in your prostate is only temporary and will go away

b)

we will treat you with chemo so we can control the cancer

c)

it would be very unusual for a man your age to have cancer of the prostate

d)

enlargement of your prostate is caused by hormonal changes, not cancer

26.

The nurse is preparing to palpate the rectum and should use which of these techniques? The nurse should:

a)

flex the finger, and slowly insert it toward the umbilicus

b)

first instruct the patient that this procedure will be painful

c)

insert an extended index finger at a right angle to the anus

d)

place the finger directly into the anus to overcome the tight sphincter

27.

During an assessment of a 20 year old man, the nurse finds a small palpable lesion with a tuft of hair located directly over the coccyx. The nurse knows that this lesion would most likely be a:

a)

rectal polyp

b)

pruritus ani

c)

carcinoma

d)

pilonidal cyst

28.

During an examination, the nurse asks the patient to perform the valsalva maneuver and notices that the patient has a moist, red, donut shaped protrusion from the anus. The nurse knows that this finding is consistent with a:

a)

rectal polyp

b)

hemorrhoid

c)

rectal fissure

d)

rectal prolapse

29.

During a speculum inspection of the vagina, the nurse would expect to see what at the end of the vaginal canal?

a)

cervix

b)

uterus

c)

ovaries

d)

fallopian tubes

30.

Generally, the changes normally associated with menopause occur because the cells in the reproductive tract are:

a)

aging

b)

becoming fibrous

c)

estrogen dependent

d)

able to respond to estrogen

31.

The nurse is reviewing changes that occur with menopause. Which changes are associated with menopause?

a)

Uterine and ovarian atrophy, along with a thinning of the vaginal epithelium

b)

ovarian atrophy, increased vaginal secretions, and increasing clitoral size

c)

cervical hypertrophy, ovarian atrophy, and increased acidity of vaginal secretions

d)

vaginal mucosa fragility, increased acidity of vaginal secretions, and uterine hypertrophy

32.

A patient is being assessed for range of joint movement. The nurse asks him to move his arm in toward the center of his body. This movement is called:

a)

flexion

b)

abduction

c)

adduction

d)

extension

33.

A patient tells the nurse that she is having a hard time bringing her hand to her mouth when she eats or tries to brush her teeth. The nurse knows that for her to move her hand to her mouth, she must perform which movement?

a)

flexion

b)

abduction

c)

adduction

d)

extension

34.

The articulation of the mandible and the temporal bone is known as the:

a)

intervertebral foramen

b)

condyle of the mandible

c)

temporomandiublar joint

d)

zygomatic arch of the temporal bone

35.

The nurse is checking the range of motion in a patients knee and knows that the knee is capable of which movement(s)?

a)

flexion and extension

b)

supination and pronation

c)

circumduction

d)

inversion and eversion

36.

An 85 year old patient comments during his annual physical examination that he seems to be getting shorter as he ages. The nurse should explain that decreased height occurs with aging because:

a)

long bones tend to shorten with age

b)

the vertebral column shortens

c)

a significant loss of subcutaneous fat occurs

d)

a thickening of the intervertebral disks develops

37.

A patient has been diagnosed with osteoporosis and asks the nurse, "what is osteoporosis?" The nurse explains that osteoporosis is defined as:

a)

increased bone matrix

b)

loss of bone density

c)

new, weaker bone growth

d)

increased phagocytic activity

38.

The nurse is teaching a class on preventing osteoporosis to a group of perimenopausal women. Which of these actions is the best way to prevent or delay bone loss in this group?

a)

taking calcium and vitamin D supplements

b)

taking medications to prevent osteoporosis

c)

performing physical activity, such as fast walking

d)

assessing bone density annually

39.

A patient states, "I can hear crunching or grating sound when I kneel." She also states that it is very difficult to get out of bed in the morning because of stiffness and pain in my joints. The nurse should assess for signs of?

a)

crepitation

b)

bone spur

c)

loose tendon

d)

fluid in the knee joint

40.

The nurse is performing a vision exam. Which of these charts is most widely used for vision exams?

a)

snellen

b)

shetllen

c)

smoolen

d)

schwellon

41.

During an exam, the nurse notices that a patients legs turn white when they are raised above the patients head. The nurse should suspect:

a)

lymphedema

b)

raynaud disease

c)

chronic arterial insufficiency

d)

chronic venous insufficiency

42.

The nurse documents that a patient has coarse, thickened skin and brown discoloration over the lower legs. Pulses are present. This finding is probably the result of:

a)

lymphedema

b)

raynaud disease

c)

chronic arterial insufficiency

d)

chronic venous insufficiency

43.

The nurse notices that a patient has ulcerations on the tips of the toes and on the lateral aspect of the ankles. This finding indicates:

a)

lymphedema

b)

raynaud disease

c)

arterial insufficiency

d)

venous insufficiency

44.

A patient tells the nurse, "Sometimes I wake up at night and I have real trouble breathing. I have to sit up in bed to get a good breath. When documenting this information, the nurse would note:

a)

orthopnea

b)

acute emphysema

c)

paroxysmal nocturnal dyspnea

d)

acute shortness of breath episode

45.

The nurse suspects that a patient has carpal tunnel syndrome and wants to perform the phalen test. To perform this test, the nurse should instruct the patient to:

a)

dorsiflex the foot

b)

plantarflex the foot

c)

hold both hands back to back while flexing the wrists 90 degrees for 60 seconds

d)

hyperextend the wrists with the palmar surface of both hands touching, and wait for 60 seconds

46.

During an exam, the nurse notices that a patient is unable to stick out his tongue. Which cranial nerve is involved with the successful performance of this action?

a)

I

b)

V

c)

XI

d)

XII

47.

During an exam, a patient has completed the finger-to-nose and rapid-alternating movements tests and is able to run each heel down the opposite shin. The nurse will conclude that the patients ____ function is intact.

a)

occipital

b)

cerebral

c)

temporal

d)

cerebellar

48.

While recording in a patients medical record, the nurse notices that a patients Hematest results are positive. This finding means that there is:

a)

crystals in the urine

b)

parasites in the stool

c)

occult blood in the stool

d)

bacteria in the sputum

49.

The nurse notices that a woman in an exercise class is unable to jump rope. The nurse is aware that to jump rope, that ones shoulder has to be capable of:

a)

inversion

b)

supination

c)

protraction

d)

circumduction

50.

When the nurse performs the confrontation test, the nurse has assessed:

a)

extraocular eye muscles

b)

pupils (PERRLA)

c)

near vision

d)

visual fields