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Created by donjulio 

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Guidelines for Standard Precautions indicate that mask and eye protection or a face mask should be worn while performing:

trachea care and suctioning.

Standard Precautions apply:

to all patients receiving care in hospitals.

According to the guidelines for Standard Precautions, the caregiver's hands should be washed:

after touching any body fluids and contaminated items, regardless of whether gloves are worn.

Which patient is at the highest risk for development of latex allergy?

The patient who has had multiple procedures or surgeries

One recommendation to prevent latex allergy is to:

wash hands with mild soap after removing gloves and then dry thoroughly.

Which lying position is useful for auscultating heart tones?

Left lateral recumbent

Which technique is used during both the history taking and the physical examination process?

Palpation

Which examination technique should be used first?

Inspection

The use of secondary, tangential lighting is most helpful in the detection of:

variations in contour of the body surface.

A nonambulatory 80-year-old male patient tells the female nurse that he feels like he is having drainage from his rectum. Which initial nursing action is appropriate?

Drape the patient and observe the rectal area.

You are conducting a head-to-toe examination as part of a patient's preventive health assessment. The room has adequate lighting, and you have access to both sides of the examining table. What position should you assume while conducting this examination?

Either side of the patient

What is the maximum depth of pressure on a body part that would be considered light palpation

1cm

Some cultural groups, such as Asians, might interpret direct eye contact during an examination as a

disrespectful act.

Which part of the examiner's hand is best for palpating vibration?

ulnar surface

The dorsal surface of the hand is most often used for the assessment of:

temp

When conducting the abdominal examination, after you inspect you proceed next to

auscultation.

The degree of percussion tone is determined by the density of the medium through which the sound waves travel. Which statement is true regarding the relationship between density of the medium and percussion tone?

The less dense the medium, the louder the percussion tone.

Expected normal percussion tones include:

tympany over an empty stomach.

When percussing, a dull tone is expected to be heard over:

liver

When using mediate or indirect percussion, which technique is appropriate

Place the palmar surface of the nondominant hand on the body surface with the fingers slightly spread apart.

During percussion, the downward snap of the striking fingers should originate from the

wrist

Which technique is commonly used to elicit tenderness arising from the liver, gallbladder, or kidneys?

fist percussion

During auscultation, you can limit your perceptual field best by:

closing your eyes

You are auscultating a patient's chest. The sounds are not clear, and you are having difficulty distinguishing between respirations and heartbeats. What technique can you use to facilitate your assessment?

Isolate each cycle segment.

When examining the abdomen, which technique should be used first?

Inspection

Auscultation should be carried out last, except when examining the:

abdomen.

Observing the rise and fall of the abdomen usually facilitates calculation of respiratory rate in the:

infant

Blood pressure is a peripheral measurement of:

cardiovascular function.

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

more than two-thirds of the upper arm.

A blood pressure cuff bladder should be long enough to:

cover 75% to 80% of the arm circumference.

If a sufficiently large cuff is unavailable to fit an obese arm, which technique may be used to assess blood pressure?

Wrap a standard cuff around the forearm and place the stethoscope over the radial artery

Axillary measurement of temperature correlates best with core temperatures of:

infants

The fifth vital sign is:

pain

A scale used to assess patients' weight should be calibrated:

each time it is used.

The height-measuring attachment of the standing platform scale should be pulled out:

before the patient steps on the scale.

The stethoscope's diaphragm is most useful in the assessment of _____ sounds.

high-pitched

Which of the following occurs when firm pressure is used to apply the stethoscope's bell end-piece to the skin?

It functionally converts to a diaphragm end-piece.

A rubber or plastic ring should be around the bell end-piece of a stethoscope to:

ensure secure contact with the body surface

Which technique should be used to stabilize the stethoscope during auscultation?

The end-piece should be held between the second and third fingers.

You are using an ophthalmoscope to examine a patient's inner eye. You rotate the lens selector clockwise, then counterclockwise in order to compensate for:

myopia

A patient in the emergency department has a concussion to the head. You suspect the patient may also have a retinal hemorrhage. You are using the ophthalmoscope to examine the retina of this patient. Which aperture of the ophthalmoscope is most appropriate for this patient?

Red-free filter

The Snellen "E" vision acuity chart would most likely be used for _____ patients

preschool

Which type of speculum should be used to examine a patient's tympanic membrane

The largest speculum that will fit comfortably in the ear

The pneumatic attachment for the otoscope is used to evaluate:

tympanic membrane movement.

The patient tells you that his ears are "stopped up." An objective assessment of this complaint is achieved by using the

tympanometer.

Tuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure

hearing range of normal speech.

To perform a deep tendon reflex measurement, you should

briskly tap the tendon with the rubber end of the hammer.

A variant of the percussion hammer is the neurologic hammer, which is equipped with which of the following?

brush and needle

When monitoring serial measures, such as head circumference or abdominal girth, which procedure is best to ensure that the tape measure is placed in the same position each time?

Mark the borders of the tape at several intervals on the skin with a pen.

Transillumination functions on the principle that:

air, fluid, and tissue transmit light differentially.

When performing transillumination of a body cavity, the use of which of the following could be harmful to the patient?

Halogen bulb

For a woman with a small vaginal opening, the examiner should use a _____ speculum

pederson

You are performing a vaginal examination for a patient with a history of spina bifida. As you insert the metal speculum, the patient suddenly feels nauseated, is sweating, and her skin turns blotchy. What is your most immediate reaction to this situation?

Remove the speculum

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