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NUR314 - Health Assessment - Exam 3 - Quiz questions

Multple Choice Review Questions exclusive to Health Assessment Online Self Study Course, 5th Edition, Quiz 4, and Exam 3 Practice Quiz ADDED 05/08: Quiz 5
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Functions of the skin include:

A. protection, prevention, perception, and production of vitamin D.
B. temperature regulation, communication, and identification.
C. All of the above.
D. None of the above.
C. All of the above.
You are conducting an in-service on aging skin for nurses and students assigned to a medical floor at the local hospital. Which of the following pieces of information is essential for your in-service to include?

A. The loss of collagen increases the risk of shearing, tearing injuries.
B. Thinning and flattening of the stratum corneum increases absorption of chemicals.
C. Diminished vascularity and increased vascular fragility lead to senile purpura.
D. All of the above
D. All of the above
Casey Galen, a student nurse, conducts a dermatology in-service for nurses and students assigned to a medical surgical floor at the local hospital. Ms. Galen stresses the impact of accumulated risk factors in skin disease and breakdown. Such factors include:

A. loss of protective cushioning of the epidermal and dermal skin layers.
B. decreased vascular fragility.
C. lifetime of environmental trauma.
D. All of the above.
C. lifetime of environmental trauma.
Mrs. Jones is a 65-year-old patient who presents with complaints of skin spots during a dermatology follow-up. As the health care provider, you note some hyperpigmentation in this aging adult. On examination, you would expect to see:

A. café au lait spots and hemangioma.
B. keratosis and lentigines.
C. linea nigra and chloasma.
D. None of the above.
B. keratosis and lentigines.
Casey Galen, a student nurse, conducts a dermatology in-service for nurses and students assigned to a medical surgical floor at the local hospital. Casey covers skin changes indicative of prolonged sun exposure and shows slides of precancerous lesions. Which of the following is descriptive of a precancerous keratotic lesion?

A. Raised, thickened areas of pigmentation, which look crusted, scaly, and warty
B. A raised, thickened, crusted area of dark pigmentation that looks "stuck on" and greasy
C. A raised, rough plaque of red-tan pigmentation with a silver-white scale
D. A raised, thickened, dry area of decreased pigmentation with a tightly packed set of papules
C. A raised, rough plaque of red-tan pigmentation with a silver-white scale
John, a baby boy, is admitted to the transition nursery for a comprehensive physical, medications, and a bath prior to being transferred to the postpartum floor. Before you conduct the physical assessment, you review common skin variations of the newborn. Which of the following conditions requires further evaluation by the in-house neonatal nurse practitioner?

A. Cutis marmorata, which is a mottling of the trunk and extremities
B. Harlequin pattern, a condition that causes one side of the body to appear deep red and the other side pale, with a distinct demarcation down the midline
C. A grouping of café au lait spots
D. Erythema toxicum, a condition that causes punctuate macular-papular rash on cheeks, truck, back, and buttocks
C. A grouping of café au lait spots
Today is your last day of an emergency room (ER) rotation. A mother brings her 3-year-old child to the ER to be examined after a fall. The child is dressed in clothing that, although clean, is worn and wrinkled. The child sits quietly without fidgeting, arms in her lap, staring at the floor; she remains silent when you try to engage her. As her mother explains the circumstances of the fall and the resulting injuries, you wonder about the possibility of physical abuse. An x-ray is ordered to rule out fracture of the left arm. Which of the following physical findings might suggest abuse?

A. An x-ray depicting a simple fracture of the left arm
B. A skinned knee with torn pants midway down same leg
C. Three bite marks on the right upper arm/shoulder area
D. None of the above
C. Three bite marks on the right upper arm/shoulder area
An example of a primary lesion is a(n):

A. erosion.
B. ulcer.
C. urticaria.
D. port-wine stain.
C. urticaria.
Jesse Carter, a student nurse, has been assigned to teach fourth-graders about hygiene. Part of her lesson will focus on the apocrine glands. Which of the following statements is true?

A. The apocrine glands, a type of sweat gland, are mainly located in the axillae, anogenital area, nipples, and navel.
B. These glands produce a thick, milky secretion and open into the hair follicles.
C. The apocrine glands become active during puberty and decrease functioning in aging adults.
D. All of the above.
D. All of the above.
Mr. Cook is a 53-year-old patient who comes to the clinic for routine follow-up for his chronic obstructive pulmonary disease (COPD). Which of the following is indicative of COPD?

A. Acrocyanosis
B. Circumoral cyanosis
C. Pitting of nails
D. Clubbing of nails
D. Clubbing of nails
You are preparing the equipment that will be used to examine patients in the dermatology clinic. The equipment needed to assess the skin, its appendages and, if necessary, lesions include:

A. strong direct lighting (artificial light preferred), ruler, pen light, goniometer, gloves, filtered ultraviolet light, glass slide, and KOH.
B. strong direct lighting (natural daylight preferred), ruler, pen light, monometer, gloves, filtered ultraviolet light, glass slide, and KOH.
C. strong direct lighting (artificial light preferred), ruler, pen light, microscope, gloves, filtered ultraviolet light, glass slide, and KOH.
D. strong direct lighting (natural daylight preferred), ruler, pen light, magnifier, gloves, filtered ultraviolet light, glass slide, and KOH.
D. strong direct lighting (natural daylight preferred), ruler, pen light, magnifier, gloves, filtered ultraviolet light, glass slide, and KOH.
Essential components of a patient history for dermatology disorders include:

A. a previous history of skin disorders plus symptom analysis (or HPI) of current problems and allergies.
B. self-care behaviors, occupation, and hobbies.
C. prescribed medications, over-the-counter medications, herbs, and substance use.
D. All of the above.
D. All of the above.
Mrs. Davids is a 55-year-old patient who presents with complaints of spots in her nails. As the health care provider, you know that the components of a nail examination include:

A. contour, consistency, and color.
B. shape, surface, and circulation.
C. clubbing, pitting, and grooving.
D. texture, toughness, and translucency.
A. contour, consistency, and color.
Mr. Holmes is a 54-year-old patient who comes to the clinic for an initial dermatology assessment. On examination, you note a suppurative, inflammatory skin lesion due to an infected hair follicle. Which of the following terms best describes this lesion?

A. Furuncle
B. Pustule
C. Fissure
D. Acne
A. Furuncle
The term used to describe the shape of a lesion as being circular is:

A. scaphoid.
B. annular.
C. confluent.
D. zosteriform.
B. annular.
The sloughing of necrotic inflammatory tissue that causes a deep depression in the skin that extends into the dermis is called:

A. gangrene.
B. dermanecrosis.
C. ulceration.
D. maceration.
C. ulceration.
Mrs. Wilder, a 42-year-old patient, presents to the dermatology clinic with a confluent and extensive patch of petechiae and ecchymoses; flat macular hemorrhage is called a:

A. purpura.
B. hemangioma.
C. hematoma.
D. telengiectasia.
A. purpura.
Mr. Verdana is a 41-year-old gentleman who presents with a complaint of skin problems. On examination you note single-chambered, superficial lesions containing free fluid > 1 cm in diameter, which are called:

A. furuncles.
B. vesicles.
C. wheals.
D. bullae.
D. bullae.
Which of the following terms describes "compact, desiccated flakes of skin from shedding of dead skin cells"?

A. Crust
B. Scale
C. Dandruff
D. Plaque
B. Scale
Elevated skin lesions that are greater than 1 cm in diameter are called:

A. bullae.
B. papules.
C. nodules.
D. furuncles.
C. nodules.
A scooped-out, shallow depression in the skin is called a/an:

A. ulcer.
B. excoriation.
C. fissure.
D. erosion.
D. erosion.
An elevated cavity containing thick, turbid fluid is a:
A. cyst.
B. vesicle.
C. bulla.
D. pustule.
D. pustule.
A solid, circumscribed palpable skin lesion, which is less than 1 cm in diameter, is a:

A. nodule.
B. bulla.
C. papule.
D. vesicle.
C. papule.
An elevated cavity containing free fluid that is less than 1 cm in diameter is a(n):

A. wheal.
B. vesicle.
C. bulla.
D. edema.
B. vesicle.
Mr. Shea is a 51-year-old patient who presents with complaints of a skin lesion. On examination, you note a linear skin lesion that runs along a nerve route. Which of the following terms best describes this lesion?

A. Zosteriform
B. Annular
C. Dermatome
D. Shingles
A. Zosteriform
Lichenification is/are:

A. tightly packed sets of papules.
B. thickening of the skin.
C. due to prolonged, intense scratching.
D. All of the above.
D. All of the above.
Which of the following statements about hair is correct?

A. In humans, hair is vestigial.
B. In humans, hair is necessary to protect from cold or trauma.
C. Humans have one type of hair.
D. None of the above.
A. In humans, hair is vestigial.
Which of the following statements about sweat glands is correct?

A. Sweat glands are located everywhere on the skin except the palms and soles.
B. Sweat glands are eccrine glands that produce a thick, milky secretion and open into the hair follicles.
C. Eccrine glands mature by the time an infant is 2 months old.
D. All of the above
C. Eccrine glands mature by the time an infant is 2 months old.
Mrs. Black, a 29-year-old patient who is pregnant, comes to the office with concerns about skin changes. As the health care provider, you know that some skin changes occur during pregnancy as a result of increased pigmentation, including:

A. café au lait spots.
B. keratosis.
C. linea nigra.
D. lentigines.
C. linea nigra.
A flat macular hemorrhage is called a(n):

A. purpura.
B. ecchymosis.
C. petechiae.
D. hemangioma.
A. purpura.
Jesse Carter, a student nurse, has been assigned to teach fourth-graders about hygiene. She decides to begin the teaching module with a short lecture on the skin. Which of the following facts will Jesse include while discussing the skin's protective and adaptive properties?

A. The skin regulates body temperature. Heat is stored in fat pads or released through sweating.
B. The skin protects against infection. Normal skin flora fights off the invasion of microorganisms that can enter the body and cause infection.
C. The skin is an organ of excretion. It removes a significant amount of metabolic wastes, which are the byproducts of cellular decomposition such as minerals and urea.
D. All of the above.
D. All of the above.
Jesse Carter, a student nurse, has been assigned to teach fourth-graders about hygiene. She decides that her teaching module will cover the oil-producing glands. Which of the following will Jesse include while discussing the skin's sebaceous glands?

A. The sebaceous glands produce sebum, a protective oily substance that prevents water loss from the skin.
B. Dry skin results from the loss of oil and is treated by moisturizers.
C. Sebaceous glands are located everywhere on the skin; they are most abundant in the scalp, forehead, face, and chin.
D. All of the above.
A. The sebaceous glands produce sebum, a protective oily substance that prevents water loss from the skin.
Jesse Carter, a student nurse, has been assigned to teach fourth-graders about hygiene. While preparing, Jesse adds information about the sweat glands. Which of the following will Jesse include while discussing this topic?

A. There are two types of sweat glands: the eccrine and the sebaceous.
B. The evaporation of sweat, which is a dilute saline solution, increases body temperature.
C. Eccrine glands produce sweat and are mainly located in the axillae, anogenital area, and navel.
D. Newborn infants do not sweat; they use compensatory mechanisms to control body temperature.
D. Newborn infants do not sweat; they use compensatory mechanisms to control body temperature.
Mr. Kinder is a 59-year-old patient who comes to the clinic for follow-up after an emergency room visit. On examination of the abdomen, you note ascites. Ascites is:
A. a bowel obstruction.
B. a proximal part of the large intestine.
C. an abnormal enlargement of the spleen.
D. an abnormal accumulation of serous fluid within the peritoneal cavity.
D. an abnormal accumulation of serous fluid within the peritoneal cavity.
Borborygmi is/are:

A. a midline longitudinal ridge in the abdomen.
B. normal hyperperistaltic bowel sounds.
C. an inflammation of the peritoneum.
D. obesity.
B. normal hyperperistaltic bowel sounds.
Mr. Walker is a 56-year-old man who comes to the ambulatory health center for a routine health assessment. On examination, you note hepatomegaly, which is:

A. enlargement of the liver.
B. bowel protrusion through abdominal musculature.
C. inflammation of the peritoneum.
D. a burning sensation in the upper abdomen.
A. enlargement of the liver.
Linea alba is/are the:

A. midline abdominal muscles extending from the rib cage to the pubic bone.
B. ligament extending from the pubic bone to the anterosuperior iliac spine.
C. midline tendinous seam joining the abdominal muscles.
D. angle formed by the twelfth rib and the vertebral column.
C. midline tendinous seam joining the abdominal muscles.
Pyrosis is:

A. an inflammation of the peritoneum.
B. a burning sensation in the upper abdomen.
C. a congenital narrowing of the pyloric sphincter.
D. an abnormally sunken abdominal wall.
B. a burning sensation in the upper abdomen.
Splenomegaly is defined as a(n):

A. outflow obstruction of the stomach.
B. abnormal enlargement of the spleen.
C. enlargement of the liver.
D. sunken abdominal wall.
B. abnormal enlargement of the spleen.
Viscera is the term given to:

A. bowel obstruction.
B. the midline longitudinal ridge in the abdomen.
C. a proximal part of the large intestine.
D. internal organs.
D. internal organs.
Pyloric stenosis is defined as a(n):

A. abnormal enlargement of the pyloric sphincter.
B. inflammation of the pyloric sphincter.
C. congenital narrowing of the pyloric sphincter.
D. None of the above.
C. congenital narrowing of the pyloric sphincter.
The spleen is:

A. a soft, lobulated gland behind the stomach.
B. a soft mass of lymphatic tissue on the posterolateral wall.
C. a bean-shaped, retroperitoneal gland.
D. None of the above.
B. a soft mass of lymphatic tissue on the posterolateral wall.
The pancreas is:

A. a soft, lobulated gland behind the stomach.
B. a soft mass of lymphatic tissue on the postlateral wall.
C. a bean-shaped, retroperitoneal gland.
D. None of the above
A. a soft, lobulated gland behind the stomach.
The liver is:

A. a soft, lobulated gland behind the stomach.
B. a soft mass of lymphatic tissue on the postlateral wall.
C. a bean-shaped, retroperitoneal gland.
D. None of the above.
D. None of the above.
Mrs. Walker is a 68-year-old patient who is in very good health and comes to the clinic for a routine health assessment. Even though she is in good health, she shows signs of aging. Which is true for older adults?

A. Decreased salivation leads to dry mouth.
B. Gastric acid secretion increases.
C. Liver size increases.
D. None of the above.
A. Decreased salivation leads to dry mouth.
Which is true about a newborn's umbilical cord?

A. It contains two veins.
B. It contains one artery.
C. It contains two arteries.
D. None of the above.
C. It contains two arteries.
Which of the following refers to the four layers of large, flat abdominal muscles?

A. Linea alba
B. Rectus abdominus
C. Ventral abdominal wall
D. None of the above
C. Ventral abdominal wall
Mr. Jeffries is a 48-year-old patient who comes to the clinic for a follow-up after an emergency room visit. On examination, you note a soft mass of lymphatic tissue immediately under the diaphragm, which is the:

A. gallbladder.
B. liver.
C. cecum.
D. spleen.
D. spleen.
A soft, lobulated gland located behind the stomach is the:

A. pancreas.
B. liver.
C. gallbladder.
D. spleen.
A. pancreas.
Mr. Bowers is a 39-year-old patient who presents to the clinic, and you examine the abdomen. The right upper quadrant of the abdomen contains which of the following organs?

A. Spleen
B. Liver
C. Cecum
D. Left ureter
B. Liver
The left upper quadrant of the abdomen contains which of the following organs?

A. Stomach
B. Gallbladder
C. Ureter
D. Ovary
A. Stomach
The right lower quadrant of the abdomen contains which of the following organs?

A. Duodenum
B. Liver
C. Sigmoid colon
D. Appendix
D. Appendix
Mr. Sanchez is a 48-year-old patient who presents for a routine health assessment, and you examine his abdomen. The left lower quadrant contains which of the following organs?

A. Pancreas
B. Sigmoid colon
C. Kidney
D. Gallbladder
B. Sigmoid colon
Mrs. Griffin is a 31-year-old patient who is pregnant. She comes to the clinic complaining of "morning sickness." The cause of this ailment is:

A. hormone changes.
B. esophageal reflux.
C. an increase in water being reabsorbed from the colon.
D. unknown.
D. unknown.
Mr. Kimbel is a 71-year-old patient who comes to the clinic with his daughter, who is concerned about a mole on her father's abdomen. You know that moles:

A. are common on the abdomen.
B. are uncommon on the abdomen.
C. always require a biopsy.
D. are no cause for concern.
A. are common on the abdomen.
Bowel sounds are:

A. high pitched.
B. air and fluid moving through the small intestine.
C. irregular.
D. All of the above.
D. All of the above.
Finding mild tenderness is normal when:

A. palpating the kidneys.
B. palpating the sigmoid colon.
C. palpating the uterus.
D. None of the above.
B. palpating the sigmoid colon.
For the spleen to be palpable, it must be:

A. enlarged three times its normal size.
B. enlarged twice its normal size.
C. located superficially under the 11th rib.
D. rotated to the left side.
A. enlarged three times its normal size.
The left kidney usually:

A. can be felt easily.
B. can only be felt when the person breathes deeply.
C. is 1 cm lower than the right kidney.
D. cannot be felt.
D. cannot be felt.
Umbilical hernias in infants:

A. appear at 2 to 3 weeks of age.
B. are more prominent when the baby cries.
C. disappear by the time the baby is 1 year old.
D. All of the above
D. All of the above
The abdomen normally moves when a person breathes until the age of ____ years.

A. 4
B. 7
C. 14
D. 75
B. 7
Increased deposits of subcutaneous fat on the abdomen occur in:

A. toddlers.
B. teenagers.
C. aging adults.
D. pregnant women.
C. aging adults.
Which of the following physiologic processes takes place within the musculoskeletal system?

A. Hematopoiesis
B. Hemolysis
C. Hemoptysis
D. Hemianopsia
A. Hematopoiesis
Cartilage is which of the following?

A. Acellular
B. Avascular
C. Asynchronous
D. Atherosclerotic
B. Avascular
The functional unit of the skeletal system is the:

A. bursa.
B. articulation.
C. joint.
D. epiphysis.
C. joint.
Skeletal muscle is differentiated from other types of muscle by which of the following characteristics?

A. It is involuntary in its activity.
B. It is semivoluntary in nature.
C. It is under contractual regulation.
D. It is under voluntary control.
D. It is under voluntary control.
Bundles of muscle fibers that compose skeletal muscle are identified as:

A. fasciculi.
B. fasciculations.
C. ligaments.
D. tendons.
A. fasciculi.
The spinous processes that are prominent at the base of the neck are:

A. T7 and T8.
B. C7 and T1.
C. T12 and L1.
D. L3 and L4.
B. C7 and T1.
The shape of the spinal column and the resilient intervertebral disks facilitate:

A. greater mobility of the spinal column.
B. the ability to coordinate movement between the upper extremities and lower extremities.
C. ease and coordination of head and neck movement.
D. the ability to absorb a great deal of shock.
D. the ability to absorb a great deal of shock.
The shock absorber of the vertebral disks in the spine is which of the following?

A. Nucleus pulposus
B. Costal facet
C. Vertebral bursae
D. Nucleus fasciculi
A. Nucleus pulposus
The knee joint is the articulation of three bones, which are:

A. the femur, fibula, and patella.
B. the femur, radius, and olecranon process.
C. the fibula, tibia, and patella.
D. the femur, tibia, and patella.
D. the femur, tibia, and patella.
A pregnant woman is most likely to demonstrate which of the following alterations in her posture, which is directly related to her pregnancy?

A. Kyphosis
B. Lordosis
C. Scoliosis
D. List
B. Lordosis
Mrs. Bicker brings her infant son to the health clinic for a routine examination. When performing Ortolani's maneuver on the newborn infant, you feel a clunk as you abduct the infant's legs and flexed knees. The presence of a "clunk" is indicative of:

A. tibial torsion.
B. genu valgum.
C. hip dislocation.
D. talipes equinovarus.
C. hip dislocation.
Osteoporosis in older adults is due to which of the following factors?

A. Resorption of bone at a greater rate than deposition
B. Loss of water content and thinning of the intervertebral disks of the spinal column
C. A redistribution of fat and subcutaneous tissue
D. Loss of intervertebral cushioning resulting in an increased amount of weight-bearing on the long bones
A. Resorption of bone at a greater rate than deposition
Which of the following muscles may be congenitally absent in certain individuals?

A. Palmaris shortus
B. Palmaris longus
C. Peroneus secondus
D. Synovin membranous
B. Palmaris longus
Mrs. Moyer comes to the ambulatory health center for a routine assessment. After her examination, you suspect rheumatoid arthritis. Which of the following characteristics differentiates rheumatoid arthritis from other MS conditions?

A. Stiffness associated with RA occurs mostly at night.
B. Pain associated with RA is worse at night.
C. RA involves symmetric joints.
D. Activity increases pain in the RA-affected joint.
C. RA involves symmetric joints.
Assessing an older adult patient's ability to engage in activities of daily living is a part of which assessment?

A. Developmental
B. Functional
C. Cultural
D. Screening
B. Functional
Mr. Lee comes to the office for a routine health assessment. As part of it, you perform a screening MS exam. This consists of all the following except:

A. inspection and palpation of joints integrated with each body region.
B. observation of ROM as the individual proceeds through motions required for preparation for the exam and during the exam.
C. testing muscle strength of the major muscle groups.
D. age-specific measures.
C. testing muscle strength of the major muscle groups.
A thickened synovial membrane is described as feeling:

A. rigid.
B. pliable.
C. constricted.
D. boggy.
D. boggy.
Crepitation is an audible sound that is produced by:

A. roughened articular surfaces moving over each other.
B. tendons or ligaments that slip over bones during motion.
C. joints that are stretched when placed in hyperflexion or hyperextension.
D. an inflamed bursa.
A. roughened articular surfaces moving over each other.
An increase in fluid within a bursa is manifested by which of the following characteristics?

A. A decrease in the expected ROM of the joint
B. Crepitus heard when putting the joint through ROM
C. A bulge that appears on the opposite side of the joint after pushing on the other side
D. Subluxation of the joint after flexing and extending the joint
C. A bulge that appears on the opposite side of the joint after pushing on the other side
Fluid within the bursa that results in synovial thickening is also described by which of the following terms?

A. Subluxation
B. Ankylosis
C. Effusion
D. Effleurage
C. Effusion
Heberden's and Bouchard's nodes are hard and nontender and are associated with:

A. osteoarthritis.
B. rheumatoid arthritis.
C. Dupuytren's contracture.
D. metacarpophalangeal bursitis.
A. osteoarthritis.
Having the individual place the backs of the hands together while flexing the wrist 90 degrees assesses for the presence of:

A. Dupuytren's contracture.
B. wrist ganglion.
C. carpal tunnel syndrome.
D. Tinel's sign.
C. carpal tunnel syndrome.
Which of the following would you expect to see in an individual who demonstrates genu valgum?

A. Bowleg
B. Knock-knee
C. Pigeon-toed
D. Clubfoot
B. Knock-knee
Ballottement of the patella is used to assess which of the following?

A. Fluid in the knee
B. Pain with knee flexion
C. Crepitus with palpation of the knee joint
D. Presence of an audible pop or click
A. Fluid in the knee
During the performance of the McMurray test, the examiner hears and feels a click, which is an indication of:

A. a torn cruciate ligament.
B. subluxation of the knee.
C. dislocation of the femoral head.
D. a torn meniscus
D. a torn meniscus
When you assess an individual for the presence of a herniated nucleus pulposus, which of the following maneuvers should you ask the individual to perform?

A. Raise the legs straight while keeping the knee extended.
B. Bend over and attempt to touch the ground while keeping the legs straight.
C. Do a knee bend.
D. Abduct and adduct the legs while keeping the knee extended.
A. Raise the legs straight while keeping the knee extended.
Mrs. Harris brings her newborn infant to the office for a routine health assessment. On examination, you measure the equality of the infant's leg lengths, called the allis test. This assesses the presence of:

A. talipes equinovarus.
B. tibial torsion.
C. hip dislocation.
D. Colles fracture.
C. hip dislocation.
An individual with functional scoliosis will demonstrate which of the following?

A. A lateral spinal curvature that remains visible in the standing and bending position
B. A lateral spinal curvature that remains at less than 20 degrees
C. A lateral spinal curvature that is visible in the standing position but disappears when the individual bends over
D. A lateral spinal curvature that affects either the thoracic area or the lumbar area but not both
C. A lateral spinal curvature that is visible in the standing position but disappears when the individual bends over
Mrs. Kinder brings her infant son in for a health assessment. On examination, you note polydactyly. An infant with polydactyly would be expected to manifest which of the following?

A. Digits that are webbed together
B. Digits that are nonfunctional
C. Extra digits
D. Digits with extra joints
C. Extra digits
The musculoskeletal system provides which of the following functions for the human body?

A. Protection and storage
B. Movement and elimination
C. Storage and control
D. Propulsion and preservation
A. Protection and storage
The joint is the functional unit of the musculoskeletal system and is the point at which:

A. the tendon is attached to the bone.
B. cartilage meets bone.
C. two or more bones are joined.
D. the bursa is interconnected with bone.
C. two or more bones are joined.
Synovial joints are freely movable because:

A. the ligaments holding the joint together are more elastic.
B. the bones that form the joint are separated from each other and enclosed in a fluid-filled cavity.
C. the muscles attached to the joint are shorter, thus giving them the ability to move in more directions.
D. they are composed of cartilage, which is very soft and cushiony.
B. the bones that form the joint are separated from each other and enclosed in a fluid-filled cavity.
The divisions of the spinal vertebrae include which of the following?

A. Cervical, thoracic, and scaphoid
B. Scapular, clavicular, and lumbar
C. Thoracic, lumbar, and coccygeal
D. Cervical, lumbar, and iliac
C. Thoracic, lumbar, and coccygeal
The lateral view of the spine demonstrates two types of curvature associated with specific divisions of the spinal columns. The two types are:

A. convex and concave.
B. convex and ellipsoid.
C. parabolic and concave.
D. parabolic and ellipsoid.
A. convex and concave.
The rotator cuff of the body is associated with which of the following joints?

A. Radiocarpal joint
B. Temporomandibular joint
C. Acetabular joint
D. Glenohumeral joint
D. Glenohumeral joint
Mrs. Jones is a 32-year-old patient who is pregnant and comes to the clinic for a routine health assessment. As part of your patient education, you tell Mrs. Jones that she may feel some discomfort during the third trimester of her pregnancy. What kind of discomfort do you tell her to expect?

A. Stiffer joints
B. Back pain
C. Osteoporosis
D. Kyphosis
B. Back pain
In which of the following ethnic groups would you expect to see the lowest incidence of osteoporosis?

A. Blacks
B. Whites
C. Asians/Pacific Islanders
D. Native Americans
A. Blacks
Which of the following complaints are the most common musculoskeletal concerns that prompt an individual to seek health care?

A. Joint pain and myalgia
B. Loss of function and joint pain
C. Neuralgia and loss of function
D. Neuralgia and myalgia
B. Loss of function and joint pain
A functional assessment is primarily concerned with gathering information related to:

A. range of motion.
B. activities of daily living.
C. transcultural variations.
D. developmental capabilities.
B. activities of daily living.
Mrs. Landers is a 53-year-old patient with rheumatoid arthritis. On examination, which of the following would you expect to find due to this type of arthritis?

A. Dislocation
B. Painful motion
C. Increased ROM
D. Muscle spasms
B. Painful motion
Mr. Jenkins is a 43-year-old patient who goes to the ambulatory health center with complaints of muscle pain. When testing for muscle strength, the examiner:

A. applies an opposing force against the individual's actions during ROM of a joint.
B. asks the individual to try to break the examiner's joint movements during ROM.
C. measures the degree of muscle tension developed during active extension and flexion of a joint.
D. can assume that if an individual has adequate active ROM that muscle strength is fully developed.
A. applies an opposing force against the individual's actions during ROM of a joint.
Mrs. Painter is a 62-year-old patient who comes to the clinic for a follow-up health assessment for complaints of joint tenderness. On examination you note a joint that has a boggy, soft feel to palpation. This is generally indicative of:

A. rheumatoid arthritis.
B. synovial thickening.
C. synovial subluxation.
D. crepitation.
B. synovial thickening.
Mr. Yoder is a 49-year-old patient who comes to the clinic for a physical examination for his job. On examination, you perform a Phalen's test. This is used to assess for the presence of:

A. elbow joint subluxation.
B. wrist ROM.
C. osteoporosis.
D. carpal tunnel syndrome.
D. carpal tunnel syndrome.
Fluid in the knee may be confirmed by performing:

A. Tinel's sign.
B. bulge sign.
C. ROM.
D. McMurray's test.
B. bulge sign.
A herniated nucleus pulposus will produce which of the following results when an individual performs a straight leg-raising test?

A. Numbness and tingling in the foot and ankle
B. Limited ROM of the hip
C. Back and leg pain
D. Clicking sound when the knee is extended and externally rotated
C. Back and leg pain
The rugae:

A. is a corpus spongiosum cone of erectile tissue.
B. is folds of thin skin of the scrotal wall.
C. controls the size of the scrotum.
D. is an acute inflammation of the testes.
B. is folds of thin skin of the scrotal wall.
A 24-year-old man has scrotal pain and marked erythema. The examiner considers epididymitis. What finding is consistent with this problem?

A. An uneven scrotal size and shape is observed.
B. The patient has anorexia and nausea.
C. The patient reports an acute onset of severe pain.
D. Urinalysis shows elevated WBCs and bacteria.
D. Urinalysis shows elevated WBCs and bacteria.
The cremaster is:

A. a sperm storage site.
B. the muscle that controls the size of the scrotum.
C. a muscular duct continuous with the epididymis.
D. a shoulder where the glans joins the shaft.
B. the muscle that controls the size of the scrotum.
The epididymis is:

A. a sperm storage site.
B. folds of thin skin on the scrotal wall.
C. the joining of the vas deferens with the seminal vesicle.
D. the muscle that controls the size of the scrotum.
A. a sperm storage site.
The vas deferens is:
A. a narrow tunnel inferior to the inguinal ligament.
B. a narrow tunnel superior to the inguinal ligament.
C. the joining of the vas deferens with the seminal vesicle.
D. a muscular duct continuous with the epididymis.
D. a muscular duct continuous with the epididymis.
The spermatic cord is most commonly described as:

A. combining the vas deferens and seminal vesicle.
B. the vas deferens approximated with other vessels.
C. a muscular duct continuous with the epididymis.
D. a narrow tunnel superior to the inguinal ligament.
B. the vas deferens approximated with other vessels.
The ejaculatory duct is:

A. the joining of the vas deferens and the seminal vesicle.
B. a muscular duct continuous with the epididymis.
C. a narrow tunnel inferior to the inguinal ligament.
D. a narrow tunnel superior to the inguinal ligament.
A. the joining of the vas deferens and the seminal vesicle.
The inguinal canal is:

A. a narrow tunnel inferior to the inguinal ligament.
B. a muscular duct continuous with the epididymis.
C. a narrow tunnel superior to the inguinal ligament.
D. the joining of the vas deferens and the seminal vesicle.
A. a narrow tunnel inferior to the inguinal ligament.
Nocturia is:

A. an advanced and fixed foreskin too tight to retract over the glans.
B. awakening in the night with a need to urinate.
C. a circumscribed collection of serous fluid in the tunica vaginalis surrounding the testes.
D. a prolonged, painful erection of the penis without sexual desire.
B. awakening in the night with a need to urinate.
Cryptorchidism is:

A. an advanced and fixed foreskin too tight to retract over the glans.
B. a circumscribed collection of serous fluid in the tunica vaginalis surrounding the testes.
C. undescended testes.
D. hard, subcutaneous plaques associated with painful bending of the erect penis.
C. undescended testes.
The corona is:

A. a shoulder where the glans joins the shaft.
B. a hood or flap of skin over the glans.
C. a corpus spongiosum cone of erectile tissue.
D. folds of thin skin on the scrotal wall.
A. a shoulder where the glans joins the shaft
Phimosis is:

A. undescended testes.
B. an advanced and fixed foreskin too tight to retract over the glans.
C. hard, subcutaneous plaques associated with painful bending of the erect penis.
D. a prolonged, painful erection of the penis without sexual desire.
B. an advanced and fixed foreskin too tight to retract over the glans.
Which of the following conditions would best utilize the assessment technique of transilluminatation?

A. Palpating for inguinal hernia
B. Observing for hydrocele
C. Observing for phimosis
D. Palpating for tender testes
B. Observing for hydrocele
Epispadias is:

A. a meatus opening on the dorsal side of the glans or shaft.
B. a circumscribed collection of serous fluid in the tunica vaginalis surrounding the testes.
C. undescended testes.
D. an acute inflammation of the testes.
A. a meatus opening on the dorsal side of the glans or shaft.
Priapism is:

A. a meatus opening on the dorsal side of the glans or shaft.
B. an advanced and fixed foreskin too tight to retract over the glans.
C. a prolonged, painful erection of the penis without sexual desire.
D. a circumscribed collection of serous fluid in the tunica vaginalis surrounding the testes.
C. a prolonged, painful erection of the penis without sexual desire.
Orchitis is:

A. a meatus opening on the dorsal side of the glans or shaft.
B. hard, subcutaneous plaques associated with painful bending of the erect penis.
C. a circumscribed collection of serous fluid in the tunica vaginalis surrounding the testes.
D. an acute inflammation of the testes.
D. an acute inflammation of the testes.
A hydrocele is:

A. a circumscribed collection of serous fluid in the tunica vaginalis surrounding the testes.
B. a meatus opening on the dorsal side of the glans or shaft.
C. an acute inflammation of the testes.
D. awakening in the night with a need to urinate.
A. a circumscribed collection of serous fluid in the tunica vaginalis surrounding the testes.
A red, round, superficial ulcer with serous discharge, which is a possible sign of syphilis, is called:

A. cystitis.
B. a chancre.
C. hypospadias.
D. phimosis.
B. a chancre.
Undescended testes are called:

A. cryptorchidism.
B. phimosis.
C. orchitis.
D. a varicocele.
A. cryptorchidism.
Inflammation of the urinary bladder is called:

A. hypospadias.
B. orchitis.
C. urethritis.
D. cystitis.
D. cystitis.
Mr. Quigley is a 56-year-old man who presents with a complaint of testicular swelling. On examination you note swelling that occurs in the epididymis as a result of a cyst. Which of the following conditions best describes these clinical findings?

A. A spermatocele
B. Epispadias
C. Balanitis
D. A hydrocele
A. A spermatocele
Mrs. Baker comes to your office with her 2-year-old son. On examination you note that the urinary meatus appears on the upper surface of the penis. Which of the following conditions best describes these clinical findings?

A. Varicocele
B. Epispadias
C. Hydrocele
D. Balanitis
B. Epispadias
An STD characterized by clusters of small, painful vesicles caused by a virus is:

A. chancre.
B. herpes genitalis.
C. orchitis.
D. cystitis.
B. herpes genitalis.
Cystic fluid in the tunica vaginalis surrounding the testes is called:

A. hydrocele.
B. varicocele.
C. orchitis.
D. cryptorchidism.
A. hydrocele.
A congenital defect in which the urethra opens on the ventral side of the penis is known as:

A. phimosis.
B. urethritis.
C. priapism.
D. hypospadias.
D. hypospadias.
Acute inflammation of the testes is:

A. herpes progenitalis.
B. priapism.
C. orchitis.
D. paraphimosis.
C. orchitis.
A medical emergency due to a retracted and fixed foreskin behind the glans is called:

A. Peyronie disease.
B. paraphimosis.
C. phimosis.
D. cryptorchidism.
B. paraphimosis.
Mr. Tucker is a 28-year-old patient who presents to your office with a concern that during an erection his penis is bent and painful. This clinical finding is caused by nontender, hard plaques on the surface of the penis known as:

A. paraphimosis.
B. phimosis.
C. Peyronie disease.
D. spermatocele.
C. Peyronie disease.
Mr. Peyser is a 38-year-old patient who presents to your office for a yearly physical examination. On exam you note that the foreskin of the penis is very tight, preventing it from retracting over the glans. Which of the following conditions best describes this clinical finding?

A. Phimosis
B. Paraphimosis
C. Spermatocele
D. Epispadias
A. Phimosis
Mr. Harrison is a 28-year-old patient who presents to your office urgently with a concern of a penile erection that has not subsided. Which of the following is a prolonged penile erection that is often painful (most cases are idiopathic)?

A. Paraphimosis
B. Phimosis
C. Spermatocele
D. Priapism
D. Priapism
A retention cyst in the epididymis filled with milky fluid containing sperm is called a:

A. varicocele.
B. spermatocele.
C. Peyronie's disease.
D. prepuce.
B. spermatocele.
The sudden twisting of the spermatic cord causes a surgical emergency called:

A. prepuce.
B. spermatocele.
C. torsion.
D. progenitalis.
C. torsion.
Mr. Liggett is a 42-year-old patient who presents with a painful left testicle. On examination you note abnormal dilation and tortuosity of the veins along the spermatic cord. Which of the following conditions best describes this clinical finding?

A. Varicocele
B. Priapism
C. Hypospadias
D. Epididymitis
D. Epididymitis
The name for the hood or flap of skin over the glans is:

A. varicocele.
B. prepuce.
C. genitalis.
D. progenitalis.
B. prepuce.
A pinpoint, constricted opening at the meatus or inside along the urethra is:

A. urethral stricture.
B. urethritis.
C. acuminate.
D. progenitalis.
A. urethral stricture.
Mr. Hutchins is a 32-year-old patient who presents for follow-up examination. On examination you note painful clusters of small vesicles with surrounding erythema that erupt on the glans or foreskin. These are signs of:

A. cystitis
B. urethritis.
C. herpes progenitalis.
D. Peyronie disease.
C. herpes progenitalis.
Mr. Thompson is a 44-year-old patient who presents to the office with complaints of urinary burning. On examination you note an infection of the urethra. This is also known as:

A. progenitalis.
B. orchitis.
C. prepuce.
D. urethritis.
D. urethritis.
The penis:

A. is composed of two corpora cavernosa and one corpus spongiosum.
B. is composed of glans, shaft, and scrotum
C. contains the urethra, ejaculatory duct, and testes.
D. All of the above
A. is composed of two corpora cavernosa and one corpus spongiosum.
Mr. Turner is a 43-year-old patient who presents for a yearly physical examination. On exam you note balanitis associated with phimosis. Which individual is this most likely to occur in?

A. Newborn male infants
B. Diabetic men
C. Uncircumcised men
D. Men exposed to radiation
C. Uncircumcised men
Mr. Frank, a 32-year-old patient, presents to your office with a complaint of urinary frequency. On examination you note a painless lesion with a clear base and indurated borders that is located on the glans penis. Which of the following best describes this clinical finding?

A. Syphilitic chancre
B. Lymphogranuloma
C. Genital warts
D. Herpes simplex
A. Syphilitic chancre
Mrs. Bauer comes to your office with her 12-year-old daughter with a complaint of a lump in her groin. On examination you detect a hernia. Which of the following types of hernias is more common in females?

A. Direct hernia
B. Indirect hernia
C. Femoral hernia
D. Sliding hernia
C. Femoral hernia
Adnexa is/are:

A. an absence of menstruation.
B. uterine accessory organs.
C. a membranous fold of tissue partly closing the vaginal orifice.
D. painful intercourse.
B. uterine accessory organs.
Amenorrhea is the term used for:

A. painful intercourse.
B. the dislodging of the cervical mucous plug.
C. the bluish discoloration of the cervix.
D. the absence of menstruation.
D. the absence of menstruation.
Bloody show is the term used for:

A. red-tinged or bloody urine.
B. aberrant growths of endometrial tissue.
C. dislodging the cervical mucous plug in labor.
D. whitish or yellowish discharge from the vaginal orifice.
C. dislodging the cervical mucous plug in labor.
A caruncle is a(n):

A. vestibular gland located on either side of the vaginal orifice.
B. small, red mass protruding from the urethral meatus.
C. aberrant growth of endometrial tissue.
D. hard, painless nodule in the uterine wall.
B. small, red mass protruding from the urethral meatus.
Mrs. Gilder is a 32-year-old patient who presents to the office for a health assessment. On examination, you note a positive Chadwick's sign. This is:

A. an aberrant growth of endometrial tissue.
B. a cervical mucous plug.
C. the absence of menstruation.
D. a bluish discoloration of the cervix.
D. a bluish discoloration of the cervix.
Chancre is a(n):

A. superficial, painless ulcer.
B. aberrant growth of endometrial tissue.
C. hard, painless nodule in the uterine wall.
D. discoloration of the cervix.
A. superficial, painless ulcer.
Mrs. Harris is a 45-year-old patient who comes to the ambulatory health center for a yearly examination. On examination you note a cystocele. This is a:

A. prolapse of the rectum into the urinary bladder.
B. prolapse of the bladder into the vagina.
C. membranous fold of tissue protruding from the cervical os.
D. prolapse of the vagina into the bladder
B. prolapse of the bladder into the vagina.
Dysmenorrhea is a synonym for:

A. painful intercourse.
B. bowel spasms with defecation.
C. cramping with urination.
D. abdominal cramping and pain associated with menstruation.
D. abdominal cramping and pain associated with menstruation.
Which of the following occurs with endometriosis?

A. Aberrant endometrial tissue growth
B. Cervical polyps
C. Ovarian cysts
D. Red-tinged or bloody urine
A. Aberrant endometrial tissue growth
Dysuria is a term indicating:

A. painful urination.
B. clear mucous vaginal discharge.
C. malodorous vaginal discharge.
D. frequent urination.
A. painful urination.
Myoma is a(n):

A. hard, painless nodule in the uterine wall.
B. extrauterine endometrial nodule.
C. cervical nodule.
D. enlarged Skene's gland.
A. hard, painless nodule in the uterine wall.
A thin, grey-white, fishy smelling vaginal drainage is:

A. gonorrhea.
B. chlamydia.
C. candida.
D. bacterial vaginosis.
D. bacterial vaginosis.
Hematuria is a term used for:

A. bloody discharge.
B. blood in the urine.
C. bleeding after intercourse.
D. bloody vaginal discharge.
B. blood in the urine.
Hymen is the term used for the:

A. vestibular glands on either side of the vaginal orifice.
B. uterine accessory organs.
C. membranous fold of tissue partially closing the vaginal orifice.
D. hard, painless nodules in the uterine wall.
C. membranous fold of tissue partially closing the vaginal orifice.
Leukorrhea is the term for:

A. white to light yellow vaginal discharge.
B. bloody vaginal discharge.
C. purulent vaginal discharge.
D. clear, mucoid vaginal discharge.
D. clear, mucoid vaginal discharge.
Mrs. Gomeller is a 39-year-old patient who presents to the health clinic. After her examination, you have diagnosed Mrs. Gomeller with menorrhagia. Menorrhagia is a term that describes:

A. heavy menses.
B. the absence of menstruation.
C. scant menstruation.
D. None of the above
A. heavy menses.
Cessation of menses is known as:

A. menarche.
B. menopause.
C. salpingitis.
D. adnexa.
B. menopause.
Mrs. Peterson is a 43-year-old patient who presents to the women's health clinic from her primary care provider. During the taking of her history, Mrs. Peterson complains of a heavy menstrual flow. An excessively heavy menstrual flow is called:

A. menorrhagia.
B. multipara.
C. salpingitis.
D. bloody show.
A. menorrhagia.
Which of the following terms is used to describe the number of pregnancies?

A. PAL
B. Parosity
C. Para
D. Gravida
D. Gravida
The term associated with the number of births is:

A. menorrhagia.
B. leukorrhea.
C. para.
D. Hegar's sign.
C. para.
Ms. McMahon is a 33-year-old patient who presents for a routine yearly health assessment. On examination you note a bright red pedunculated growth emerging from the os. This is a:

A. caruncle.
B. polyp.
C. rectouterine pouch.
D. salpingitis.
B. polyp.
A deep recess formed by the peritoneum between the rectum and the cervix is called:

A. Chadwick's sign.
B. a cystocele.
C. a rectocele.
D. a rectouterine pouch.
D. a rectouterine pouch.
Mrs. Buckman is a 49-year-old patient who comes to the women's health clinic. On examination, you note a prolapse of the rectum and its vaginal mucosa into the vagina. This is the definition of:

A. rectocele.
B. menorrhagia.
C. hematuria.
D. nullipara.
A. rectocele.
Inflammation of the fallopian tubes is known as:

A. vaginitis.
B. salpingitis.
C. cystocele.
D. dyspareunia.
B. salpingitis.
Paraurethral glands are also called:

A. Bartholin's glands.
B. Hegar's sign.
C. Chadwick's sign.
D. Skene's glands.
D. Skene's glands.
Inflammation of the vagina is known as:

A. salpingitis.
B. vaginitis.
C. cystocele.
D. dyspareunia.
B. vaginitis.
A term for the female external genitalia is:

A. vagina.
B. vulva.
C. clitoris.
D. hymen.
B. vulva.
The most commonly reported sexually transmitted infection in the United States is:

A. gonorrhea.
B. syphilis.
C. chlamydia.
D. HIV.
C. chlamydia.
A term for dislodging the thick cervical mucous plug at the end of pregnancy is:

A. placenta.
B. menstruation.
C. bloody show.
D. All of the above
C. bloody show.
Mrs. Stevens is a 43-year-old patient who presents with multiple complaints and a concern that her husband was diagnosed with syphilis. Which of the following is a sign of syphilis?

A. Caruncle
B. Cystocele
C. Polyp
D. Chancre
D. Chancre
Mrs. Hoist is a 26-year-old patient who reports to the health clinic with complaints of painful intercourse. A synonym for painful intercourse is:

A. dysmenorrhea.
B. dyspareunia.
C. dysuria.
D. None of the above
B. dyspareunia.
Vaginal lubrication during intercourse is produced by:

A. Skene's glands.
B. Bartholin's glands.
C. sebaceous glands.
D. None of the above
B. Bartholin's glands.
Mrs. Black is a 59-year-old patient who presents to the health center with a complaint of being postmenopausal. When providing patient education to Mrs. Black, you would explain that the postmenopausal woman:

A. is more prone to vaginitis.
B. is less prone to vaginitis.
C. has no change in vaginitis risk.
D. None of the above
A. is more prone to vaginitis.
The nurse is bathing an 80-year-old man and notices that his skin is wrinkled, thin, lax, and dry. This finding would be related to which factor?

A) Increased vascularity of the skin in the elderly
B) Increased numbers of sweat and sebaceous glands in the elderly
C) An increase in elastin and a decrease in subcutaneous fat in the elderly
D) An increased loss of elastin and a decrease in subcutaneous fat in the elderly
D) An increased loss of elastin and a decrease in subcutaneous fat in the elderly

An accumulation of factors place the aging person at risk for skin disease and breakdown: the thinning of the skin, the decrease in vascularity and nutrients, the loss of protective cushioning of the subcutaneous layer, a lifetime of environmental trauma to skin, the social changes of aging, the increasingly sedentary lifestyle, and the chance of immobility. Page: 206
A 22-year-old woman comes to the clinic because of a severe sunburn and states, "I was just out in the sun for a couple of minutes." The nurse begins a medication review with her, paying special attention to which medication class?

A) Nonsteroidal anti-inflammatory drugs for pain
B) Tetracyclines for acne
C) Proton pump inhibitors for heartburn
D) Thyroid replacement hormone for hypothyroidism
B) Tetracyclines for acne

Drugs that may increase sunlight sensitivity and give a burn response include sulfonamides, thiazide diuretics, oral hypoglycemic agents, and tetracycline.
Pages: 208-209
The nurse is assessing a patient who has liver disease for jaundice. Which of these assessment findings is indicative of true jaundice?


A) Yellow patches in the outer sclera
B) Yellow color of the sclera that extends up to the iris
C) Skin that appears yellow when examined under low light
D) Yellow deposits on the palms and soles of the feet where jaundice first appears
B) Yellow color of the sclera that extends up to the iris

The yellow sclera of jaundice extends up to the edge of the iris. Calluses on the palms and soles of the feet often look yellow but are not classified as jaundice. Do not confuse scleral jaundice with the normal yellow subconjunctival fatty deposits that are common in the outer sclera of dark-skinned persons. Pages: 213-214
The nurse is assessing for clubbing of the fingernails and would expect to find:

A) a nail base that is firm and slightly tender.
B) curved nails with a convex profile and ridges across the nail.
C) a nail base that feels spongy with an angle of the nail base of 150 degrees.
D) an angle of the nail base of 180 degrees or greater with a nail base that feels spongy.
D) an angle of the nail base of 180 degrees or greater with a nail base that feels spongy.

The normal nail is firm at its base and has an angle of 160 degrees. In clubbing, the angle straightens to 180 degrees or greater and the nail base feels spongy. Pages: 217-218
A 40-year-old woman reports a change in mole size, accompanied by color changes, itching, burning, and bleeding over the past month. She has a dark complexion and has no family history of skin cancer, but she has had many blistering sunburns in the past. The nurse would:

A) tell the patient to watch the lesion and report back in 2 months.
B) refer the patient because of the suspicion of melanoma on the basis of her symptoms.
C) ask additional questions regarding environmental irritants that may have caused this condition.
D) suspect that this is a compound nevus, which is very common in young to middle-aged adults.
B) refer the patient because of the suspicion of melanoma on the basis of her symptoms.

The ABCD danger signs of melanoma are asymmetry, border irregularity, color variation, and diameter. In addition, individuals may report a change in size, development of itching, burning, bleeding, or a new-pigmented lesion. Any of these signs raise suspicion of malignant melanoma and warrant immediate referral. Pages: 212-213
While performing an assessment of a 65-year-old man with a history of hypertension and coronary artery disease, the nurse notices the presence of pitting edema in the lower legs bilaterally. The skin is puffy and tight but of normal color. There is no increased redness or tenderness over his lower legs, and the peripheral pulses are equal and strong. In this situation, the nurse suspects that the likely cause of the edema would be:

A) heart failure.
B) venous thrombosis.
C) a local inflammation.
D) blockage of lymphatic drainage.
A) heart failure.

Bilateral edema or edema that is generalized over the entire body is caused by a central problem such as heart failure or kidney failure. Unilateral edema usually has a local or peripheral cause. Page 215
The nurse has discovered decreased skin turgor in a patient and knows that this is an expected finding in which of these conditions?

A) Severe obesity
B) Childhood growth spurts
C) Severe dehydration
D) Connective tissue disorders such as scleroderma
C) Severe dehydration

Decreased skin turgor is associated with severe dehydration or extreme weight loss. Page 215
A physician has diagnosed a patient with purpura. After leaving the room, a nursing student asks the nurse what the physician saw that led to that diagnosis. The nurse should say, "The physician is referring to:

A) that blue dilation of blood vessels in a star-shaped linear pattern on the legs."
B) that fiery red, star-shaped marking on the cheek that has a solid circular center."
C) that confluent and extensive patch of petechiae and ecchymoses on the feet."
D) those tiny little areas of hemorrhage that are less than 2 mm, round, discrete, and dark red in color."
C) that confluent and extensive patch of petechiae and ecchymoses on the feet."

Purpura is a confluent and extensive patch of petechiae and ecchymoses and a flat macular hemorrhage seen in generalized disorders such as thrombocytopenia and scurvy. The blue dilation of blood vessels in a star-shaped linear pattern on the legs describes a venous lake. The fiery red, star-shaped marking on the cheek that has a solid circular center describes a spider or star angioma. The tiny little areas of hemorrhage that are less than 2 mm, round, discrete, and dark red in color describes petechiae. Pages: 239-240
A 65-year-old man with emphysema and bronchitis has come to the clinic for a follow-up appointment. On assessment, the nurse might expect to see which assessment finding?

A) Anasarca
B) Scleroderma
C) Pedal erythema
D) Clubbing of the nails
D) Clubbing of the nails

Clubbing of the nails occurs with congenital cyanotic heart disease, neoplastic, and pulmonary diseases. The other responses are assessment findings not associated with pulmonary diseases. Pages 217-218
A 75-year-old woman who has a history of diabetes and peripheral vascular disease has been trying to remove a corn on the bottom of her foot with a pair of scissors. The nurse will encourage her to stop trying to remove the corn with scissors because:

A) the woman could be at increased risk for infection and lesions because of her chronic disease.
B) with her diabetes, she has increased circulation to her foot and it could cause severe bleeding.
C) she is 75 years old and is unable to see, so she puts herself at greater risk for self-injury with the scissors.
D) with her peripheral vascular disease, her range of motion is limited and she may not be able to reach the corn safely.
A) the woman could be at increased risk for infection and lesions because of her chronic disease

A personal history of diabetes and peripheral vascular disease increases a person's risk for skin lesions in the feet or ankles. The patient needs to see a professional for assistance with corn removal. Pages: 210-211
11. 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.
C) adduction.

Moving a limb toward the midline of the body is called adduction; abduction is moving a limb away from the midline of the body. Flexion is bending a limb at a joint; extension is straightening a limb at a joint. Pages: 566-567
12. 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.
A) flexion.

Flexion, or bending a limb at a joint, would be required to move the hand to the mouth. Extension is straightening a limb at a joint. Moving a limb toward the midline of the body is called adduction; abduction is moving a limb away from the midline of the body. Pages: 566-567
13. The nurse is checking the range of motion in a patient's 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
A) Flexion and extension

The knee is a hinge joint, permitting flexion and extension of the lower leg on a single plane. The knee is not capable of the other movements listed. Page 572
14. The nurse is explaining the mechanism of the growth of long bones to a mother of a toddler. Where does lengthening of the bones occur?

A) Bursa
B) Calcaneus
C) Epiphyses
D) Tuberosities
C) Epiphyses

Lengthening occurs at the epiphyses, or growth plates. The other options are not correct. Page: 573
15. A woman who is 8 months pregnant comments that she has noticed a change in posture and is having lower back pain. The nurse tells her that during pregnancy women have a posture shift to compensate for the enlarging fetus. This shift in posture is known as:

A) lordosis.
B) scoliosis.
C) ankylosis.
D) kyphosis.
A) lordosis.

Lordosis compensates for the enlarging fetus, which would shift the center of balance forward. This shift in balance in turn creates strain on the low back muscles, felt as low back pain during late pregnancy by some women. Scoliosis is lateral curvature of portions of the spine; ankylosis is extreme flexion of the wrist, as seen with severe rheumatoid arthritis; and kyphosis is an enhanced thoracic curvature of the spine. Page 573
16. A patient is complaining of pain in his joints that is worse in the morning, is better after he has moved around for awhile, and then gets worse again if he sits for long periods of time. The nurse should assess for other signs of what problem?

A) Tendinitis
B) Osteoarthritis
C) Rheumatoid arthritis
D) Intermittent claudication
C) Rheumatoid arthritis

Rheumatoid arthritis is worse in the morning when arising. Movement increases most joint pain, except in rheumatoid arthritis, in which movement decreases pain. The other options are not correct. Page 574-575
17. The nurse suspects that a patient has carpal tunnel syndrome and wants to perform the Phalen's 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.
C) hold both hands back to back while flexing the wrists 90 degrees for 60 seconds.

For the Phalen's test, the nurse should ask the person to hold both hands back to back while flexing the wrists 90 degrees. Acute flexion of the wrist for 60 seconds produces no symptoms in the normal hand. The Phalen's test reproduces numbness and burning in a person with carpal tunnel syndrome. The other actions are not correct for testing for carpal tunnel syndrome.
Page: 587
18. The nurse is assessing a 1-week-old infant and is testing his muscle strength. The nurse lifts the infant with hands under the axillae and notices that the infant starts to "slip" between the hands. The nurse should:

A) suspect a fractured clavicle.
B) suspect that the infant may have a deformity of the spine.
C) suspect that the infant may have weakness of the shoulder muscles.
D) consider this a normal finding because the musculature of an infant this age is undeveloped.
C) suspect that the infant may have weakness of the shoulder muscles.

An infant who starts to "slip" between the nurse's hands shows weakness of the shoulder muscles. An infant with normal muscle strength wedges securely between the nurse's hands. The other responses are not correct. Pages: 600-601
19. The nurse should use which test to check for large amounts of fluid around the patella?

A) Ballottement
B) Tinel sign
C) Phalen's test
D) McMurray's test
A) Ballottement

Ballottement of the patella is reliable when larger amounts of fluid are present. The Tinel's sign and the Phalen's test are used to check for carpal tunnel syndrome. The McMurray's test is used to test the knee for a torn meniscus. Pages: 590-591
20. When assessing muscle strength, the nurse observes that a patient has complete range of motion against gravity with full resistance. What Grade should the nurse record using a 0 to 5 point scale?

A) 2
B) 3
C) 4
D) 5
D) 5

Complete range of motion against gravity is normal muscle strength and is recorded as Grade 5 muscle strength. Pages: 578-579
The nurse is percussing the seventh right intercostal space at the midclavicular line over the liver. Which sound should the nurse expect to hear?

A) Dullness
B) Tympany
C) Resonance
D) Hyperresonance
A) Dullness

The liver is located in the right upper quadrant and would elicit a dull percussion note.
REF: Page: 541
Which structure is located in the left lower quadrant of the abdomen?

A) Liver
B) Duodenum
C) Gallbladder
D) Sigmoid colon
D) Sigmoid colon

The sigmoid colon is located in the left lower quadrant of the abdomen.
REF: Page: 530
A patient is having difficulty in swallowing medications and food. The nurse would document that this patient has:

A) aphasia.
B) dysphasia.
C) dysphagia.
D) anorexia.
C) dysphagia.

Dysphagia is a condition that occurs with disorders of the throat or esophagus and results in difficulty swallowing. Aphasia and dysphasia are speech disorders. Anorexia is a loss of appetite.
REF: Pages: 532-533
The nurse suspects that a patient has a distended bladder. How should the nurse assess for this condition?

A) Percuss and palpate in the lumbar region.
B) Inspect and palpate in the epigastric region.
C) Auscultate and percuss in the inguinal region.
D) Percuss and palpate the midline area above the suprapubic bone.
D) Percuss and palpate the midline area above the suprapubic bone.

Dull percussion sounds would be elicited over a distended bladder, and the hypogastric area would seem firm to palpation.
REF: Pages: 539-540
The nurse is aware that one change that may occur in the gastrointestinal system of an aging adult is:

A) increased salivation.
B) increased liver size.
C) increased esophageal emptying.
D) decreased gastric acid secretion.
D) decreased gastric acid secretion.

Gastric acid secretion decreases with aging. As one ages, salivation decreases, esophageal emptying is delayed, and liver size decreases.
REF: Page: 531
A 22-year-old man comes to the clinic for an examination after falling off his motorcycle and landing on his left side on the handlebars. The nurse suspects that he may have injured his spleen. Which of these statements is true regarding assessment of the spleen in this situation?

A) The spleen can be enlarged as a result of trauma.
B) The spleen is normally felt upon routine palpation.
C) If an enlarged spleen is noticed, then the nurse should palpate thoroughly to determine size.
D) An enlarged spleen should not be palpated because it can rupture easily.
D) An enlarged spleen should not be palpated because it can rupture easily.

If an enlarged spleen is felt, then the nurse should refer the person but should not continue to palpate it. An enlarged spleen is friable and can rupture easily with overpalpation.
REF: Page: 549
A patient's abdomen is bulging and stretched in appearance. The nurse should describe this finding as:

A) obese.
B) herniated.
C) scaphoid.
D) protuberant.
D) protuberant.

A protuberant abdomen is rounded, bulging, and stretched. See Figure 21-7. A scaphoid abdomen caves inward.
REF: Page: 536
The nurse is describing a scaphoid abdomen. To the horizontal plane, a scaphoid contour of the abdomen depicts a _____ profile.
A) flat
B) convex
C) bulging
D) concave
D) concave

Contour describes the profile of the abdomen from the rib margin to the pubic bone; a scaphoid contour is one that is concave from a horizontal plane. See Figure 21-7.
REF: Page: 536
While examining a patient, the nurse observes abdominal pulsations between the xiphoid and umbilicus. The nurse would suspect that these are:

A) pulsations of the renal arteries.
B) pulsations of the inferior vena cava.
C) normal abdominal aortic pulsations.
D) increased peristalsis from a bowel obstruction.
C) normal abdominal aortic pulsations.

Normally, one may see the pulsations from the aorta beneath the skin in the epigastric area, particularly in thin persons with good muscle wall relaxation.
REF: Pages: 538-539
A patient has hypoactive bowel sounds. The nurse knows that a potential cause of hypoactive bowel sounds is:

A) diarrhea.
B) peritonitis.
C) laxative use.
D) gastroenteritis.
B) peritonitis.

Diminished or absent bowel sounds signal decreased motility from inflammation as seen with peritonitis, with paralytic ileus after abdominal surgery, or with late bowel obstruction.
REF: Page: 561
The nurse is watching a new graduate nurse perform auscultation of a patient's abdomen. Which statement by the new graduate shows a correct understanding of the reason auscultation precedes percussion and palpation of the abdomen?

A) "We need to determine areas of tenderness before using percussion and palpation."
B) "It prevents distortion of bowel sounds that might occur after percussion and palpation."
C) "It allows the patient more time to relax and therefore be more comfortable with the physical examination."
D) "This prevents distortion of vascular sounds such as bruits and hums that might occur after percussion and palpation."
B) "It prevents distortion of bowel sounds that might occur after percussion and palpation."

Auscultation is performed first (after inspection) because percussion and palpation can increase peristalsis, which would give a false interpretation of bowel sounds.
REF: Pages: 538-539
The nurse is listening to bowel sounds. Which of these statements is true of bowel sounds?

A) They are usually loud, high-pitched, rushing, tinkling sounds.
B) They are usually high-pitched, gurgling, irregular sounds.
C) They sound like two pieces of leather being rubbed together.
D) They originate from the movement of air and fluid through the large intestine.
B) They are usually high-pitched, gurgling, irregular sounds.

Bowel sounds are high-pitched, gurgling, cascading sounds that occur irregularly from 5 to 30 times per minute. They originate from the movement of air and fluid through the small intestine.
REF: Pages: 539-540
The physician comments that a patient has abdominal borborygmi. The nurse knows that this term refers to:

A) a loud continuous hum.
B) a peritoneal friction rub.
C) hypoactive bowel sounds.
D) hyperactive bowel sounds.
D) hyperactive bowel sounds.

Borborygmi is the term used for hyperperistalsis when the person actually feels his or her stomach growling.
REF: Pages: 539-540
During an abdominal assessment, the nurse would consider which of these findings as normal?

A) The presence of a bruit in the femoral area
B) A tympanic percussion note in the umbilical region
C) A palpable spleen between the ninth and eleventh ribs in the left midaxillary line
D) A dull percussion note in the left upper quadrant at the midclavicular line
B) A tympanic percussion note in the umbilical region

Tympany should predominate in all four quadrants of the abdomen because air in the intestines rises to the surface when the person is supine. Vascular bruits are not usually present. Normally the spleen is not palpable. Dullness would not be found in the area of lung resonance (left upper quadrant at the midclavicular line).
REF: Pages: 539-540
The nurse is assessing the abdomen of a pregnant woman who is complaining of having "acid indigestion" all the time. The nurse knows that esophageal reflux during pregnancy can cause:

A) diarrhea.
B) pyrosis.
C) dysphagia.
D) constipation.
B) pyrosis.
The nurse is performing percussion during an abdominal assessment. Percussion notes heard during the abdominal assessment may include:

A) flatness, resonance, and dullness.
B) resonance, dullness, and tympany.
C) tympany, hyperresonance, and dullness.
D) resonance, hyperresonance, and flatness.
C) tympany, hyperresonance, and dullness.

Percussion notes normally heard during the abdominal assessment may include tympany, which should predominate because air in the intestines rises to the surface when the person is supine; hyperresonance, which may be present with gaseous distention; and dullness, which may be found over a distended bladder, adipose tissue, fluid, or a mass.
REF: Pages: 539-540
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.
B) decreased gastric acid secretion.

Gastric acid secretion decreases with aging, and this may cause pernicious anemia (because it interferes with vitamin B12 absorption), iron deficiency anemia, and malabsorption of calcium.
REF: Page: 531
A patient is complaining of a sharp pain along the costovertebral angles. The nurse knows that this symptom is most often indicative of:

A) ovary infection.
B) liver enlargement.
C) kidney inflammation.
D) spleen enlargement.
C) kidney inflammation.

Sharp pain along the costovertebral angles occurs with inflammation of the kidney or paranephric area. The other options are not correct.
REF: Pages: 542-543
A nurse notices that a patient has ascites, which indicates the presence of:

A) fluid.
B) feces.
C) flatus.
D) fibroid tumors.
A) fluid.

Ascites is free fluid in the peritoneal cavity, and occurs with heart failure, portal hypertension, cirrhosis, hepatitis, pancreatitis, and cancer.
REF: Pages: 543-544
The nurse knows that during an abdominal assessment, deep palpation is used to determine:

A) bowel motility.
B) enlarged organs.
C) superficial tenderness.
D) overall impression of skin surface and superficial musculature.
B) enlarged organs.

With deep palpation, the nurse should notice the location, size, consistency, and mobility of any palpable organs and the presence of any abnormal enlargement, tenderness, or masses.
REF: Pages: 546-547
The nurse notices that a patient has had a pale, yellow, greasy stool, or steatorrhea, and recalls that this is caused by:

A) occult bleeding.
B) absent bile pigment.
C) increased fat content.
D) ingestion of bismuth preparations.
C) increased fat content.

Steatorrhea (pale, yellow, greasy stool) is caused by increased fat content in the stools, as in malabsorption syndrome. Occult bleeding and ingestion of bismuth products cause black stool, and absent bile pigment causes gray, tan stool.
After completing an assessment of a 60-year-old man with a family history of colon cancer, the nurse discusses with him early detection measures for colon cancer. The nurse should mention the need for a(n):

A) annual proctoscopy.
B) colonoscopy every 10 years.
C) fecal test for blood every 6 months.
D) digital rectal examinations every 2 years.
B) colonoscopy every 10 years.

Early detection measures for colon cancer include a digital rectal examination performed annually after age 50 years, a fecal occult blood test annually after age 50 years, sigmoidoscopy every 5 years or colonoscopy every 10 years after age 50 years; and a PSA blood test annually for men over 50 years old, except black men beginning at age 45 years (American Cancer Society, 2006).
The structure that secretes a thin, milky alkaline fluid to enhance the viability of sperm is the:

A) Cowper's gland.
B) prostate gland.
C) median sulcus.
D) bulbourethral gland.
B) prostate gland.

In men, the prostate gland secretes a thin milky alkaline fluid that enhances sperm viability. The Cowper's glands (also known as bulbourethral glands) secrete a clear, viscid mucus. The median sulcus is a groove dividing the lobes of the prostate gland and does not secrete fluid.
A patient calls the clinic for instructions before having a Papanicolaou (Pap) smear. The most appropriate instructions from the nurse are:

A) "If you are menstruating, please use pads to avoid placing anything into the vagina."
B) "Avoid intercourse, inserting anything into the vagina, or douching within 24 hours of your appointment."
C) "If you suspect that you have a vaginal infection, please gather a sample of the discharge to bring with you."
D) "We would like you to use a mild saline douche before your examination. You may pick this up in our office."
B) "Avoid intercourse, inserting anything into the vagina, or douching within 24 hours of your appointment."

When instructing a patient before a Papanicolaou (Pap) smear is obtained, the nurse should follow these guidelines: Do not obtain during the woman's menses or if a heavy infectious discharge is present. Instruct the woman not to douche, have intercourse, or put anything into the vagina within 24 hours before collecting the specimens. Any specimens will be obtained during the visit, not beforehand.
Which statement would be most appropriate when the nurse is introducing the topic of sexual relationships during an interview?

A) "Now it is time to talk about your sexual history. When did you first have intercourse?"
B) "Women often feel dissatisfied with their sexual relationships. Would it be okay to discuss this now?"
C) "Often women have questions about their sexual relationship and how it affects their health. Do you have any questions?"
D) "Most women your age have had more than one sexual partner. How many would you say you have had?"
C) "Often women have questions about their sexual relationship and how it affects their health. Do you have any questions?"

The nurse should begin with an open-ended question to assess individual needs. The nurse should include appropriate questions as a routine part of the history, because doing so communicates that the nurse accepts the individual's sexual activity and believes it is important. The nurse's comfort with discussion prompts the patient's interest and possibly relief that the topic has been introduced. This establishes a database for comparison with any future sexual activities and provides an opportunity to screen sexual problems.
During the interview a patient reveals that she has some vaginal discharge. She is worried that it may be a sexually transmitted infection. The nurse's most appropriate response to this would be:

A) "Oh, don't worry. Some cyclic vaginal discharge is normal."
B) "Have you been engaging in unprotected sexual intercourse?"
C) "I'd like some information about the discharge. What color is it?"
D) "Have you had any urinary incontinence associated with the discharge?"
C) "I'd like some information about the discharge. What color is it?"

Ask questions that help the patient reveal more information about her symptoms in a nonthreatening manner. Assess vaginal discharge further by asking about the amount, color, and odor. Normal vaginal discharge is small, clear or cloudy, and always nonirritating.
A patient has had three pregnancies and two live births. The nurse would record this information as gravida _____, para _____, AB _____.

A) 2; 2; 1
B) 3; 2; 0
C) 3; 2; 1
D) 3; 3; 1
C) 3; 2; 1

Gravida is number of pregnancies. Para is number of births. Abortions are interrupted pregnancies, including elective abortions and spontaneous miscarriages.
A woman is in the clinic for an annual gynecologic examination. The nurse should plan to begin the interview with the:

A) menstrual history because it is generally nonthreatening.
B) obstetric history because it is the most important information.
C) urinary system history because there may be problems in this area as well.
D) sexual history because it will build rapport to discuss this first.
A) menstrual history because it is generally nonthreatening.

Menstrual history is usually nonthreatening; thus it is a good place to start. Obstetric, urinary, and sexual histories are also part of the interview but not necessarily the best topics with which to start.
The nurse is reviewing the changes that occur with menopause. Which of these are changes associated with menopause?

A) Uterine and ovarian atrophy along with thinning 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
A) Uterine and ovarian atrophy along with thinning vaginal epithelium

The uterus shrinks because of its decreased myometrium. The ovaries atrophy to 1 to 2 cm and are not palpable after menopause. The sacral ligaments relax, and the pelvic musculature weakens, so the uterus droops. The cervix shrinks and looks paler with a thick glistening epithelium. The vaginal epithelium atrophies, becoming thinner, drier, and itchy. The vaginal pH becomes more alkaline, and secretions are decreased. This results in a fragile mucosal surface that is at risk for bleeding and vaginitis.
A 55-year-old man is in the clinic for a yearly check-up. He is worried because his father died of prostate cancer. The nurse knows that which tests should be done at this time? Select all that apply.

A) Blood test for prostate-specific antigen
B) Urinalysis
C) Transrectal ultrasound
D) Digital rectal examination
E) Prostate biopsy
A) Blood test for prostate-specific antigen
D) Digital rectal examination

Prostate cancer is typically detected by testing the blood for prostate-specific antigen (PSA) or by a digital rectal exam (DRE). It is recommended that both PSA and DRE be offered to men yearly, beginning at age 50 years. If the PSA is elevated, then further lab work or a transrectal ultrasound (TRUS) and biopsy may be recommended.
An older man is concerned about his sexual performance. The nurse knows that in the absence of disease, a withdrawal from sexual activity later in life may be due to:

A) side effects of medications.
B) decreased libido with aging.
C) decreased sperm production.
D) decreased pleasure from sexual intercourse.
A) side effects of medications.

In the absence of disease, a withdrawal from sexual activity may be due to side effects of medications such as antihypertensives, antidepressants, or sedatives. The other options are not correct.
A 62-year-old man states that his doctor told him that he has an "inguinal hernia." He asks the nurse to explain what a hernia is. The nurse should:

A) tell him not to worry and that most men his age develop hernias.
B) explain that a hernia is often the result of prenatal growth abnormalities.
C) refer him to his physician for additional consultation because the physician made the initial diagnosis.
D) explain that a hernia is a loop of bowel protruding through a weak spot in the abdominal muscles.
D) explain that a hernia is a loop of bowel protruding through a weak spot in the abdominal muscles.

A hernia is a loop of bowel protruding through a weak spot in the musculature. The other options are not correct responses to the patient's question.
The nurse is preparing for a certification course in skin care and needs to be familiar with the various lesions that may be identified on assessment of the skin. Which of the following definitions are correct? Select all that apply.

A) Petechiae: Tiny punctate hemorrhages, 1 to 3 mm, round and discrete, dark red, purple, or brown in color
B) Bulla: An elevated, circumscribed lesion filled with turbid fluid (pus)
C) Papule: A hypertrophic scar
D) Vesicle: Also known as a friction blister
E) Nodule: Solid, elevated, hard or soft, larger than 1 cm
A) Petechiae: Tiny punctate hemorrhages, 1 to 3 mm, round and discrete, dark red, purple, or brown in color
D) Vesicle: Also known as a friction blister
E) Nodule: Solid, elevated, hard or soft, larger than 1 cm

An elevated, circumscribed lesion filled with turbid fluid (pus) is a pustule. A hypertrophic scar is a keloid. A bulla is larger than 1 cm and contains clear fluid; a papule is solid, elevated, but less than 1 cm.
A semiconscious woman is brought to the emergency department after she was found on the floor in her kitchen. Her face, nail beds, lips, and oral mucosa are a bright cherry-red color. The nurse suspects that this coloring is due to:

A) polycythemia.
B) carbon monoxide poisoning.
C) carotenemia.
D) uremia.
B) carbon monoxide poisoning.

A bright cherry-red coloring in the face, upper torso, nail beds, lips, and oral mucosa appears in cases of carbon monoxide poisoning.
black patient is in the intensive care unit because of impending shock after an accident. The nurse would expect to find what characteristics in this patient's skin?

A) Ruddy blue
B) Generalized pallor
C) Ashen, gray, or dull
D) Patchy areas of pallor
C) Ashen, gray, or dull

Pallor due to shock (decreased perfusion and vasoconstriction) in black-skinned people will cause the skin to appear ashen, gray, or dull. See Table 12-2.
The nurse keeps in mind that a thorough skin assessment is very important because the skin holds information about a person's:

A) support systems.
B) circulatory status.
C) socioeconomic status.
D) psychological wellness.
B) circulatory status.

The skin holds information about the body's circulation, nutritional status, and signs of systemic diseases as well as topical data on the integument itself.
During an examination, the nurse finds that a patient has excessive dryness of the skin. The best term to describe this condition is:

A) xerosis.
B) pruritus.
C) alopecia.
D) seborrhea.
A) xerosis.
The nurse is caring for a black child who has been diagnosed with marasmus. The nurse would expect to find the:

A) hair to be less kinky and to be a copper-red color.
B) head to be larger than normal, with wide-set eyes.
C) skin on the hands and feet to be scaly and tender.
D) lymph nodes in the groin to be enlarged and tender.
A) hair to be less kinky and to be a copper-red color.

The hair of black children with severe malnutrition (e.g., marasmus) frequently changes not only in texture but in color—the child's hair becomes less kinky and assumes a copper-red color. The other findings are not present with marasmus.
A newborn infant is in the clinic for a well-baby check. The nurse observes the infant for the possibility of fluid loss because of which of these factors?

A) Subcutaneous fat deposits are high in the newborn.
B) Sebaceous glands are overproductive in the newborn.
C) The newborn's skin is more permeable than that of the adult.
D) The amount of vernix caseosa rises dramatically in the newborn.
C) The newborn's skin is more permeable than that of the adult.

The newborn's skin is thin, smooth, and elastic and is relatively more permeable than that of the adult, so the infant is at greater risk for fluid loss. The subcutaneous layer in the infant is inefficient, not thick, and the sebaceous glands are present but decrease in size and production. Vernix caseosa is not produced after birth.
Quiz 5: A patient states during the interview that she noticed a new lump in the shower a few days ago. It was on her left breast near her axilla. The nurse should plan to:
palpate the unaffected breast first.

ANS:B Page: 398
If the woman mentions a breast lump she has discovered herself, the nurse should examine the unaffected breast first to learn a baseline of normal consistency for this individual.
During an annual physical exam, a 43-year-old patient states that she doesn't perform monthly breast self-examinations (BSE). She tells the nurse that she believes that mammograms "do a much better job than I ever could to find a lump." The nurse should explain to her that:
BSEs may detect lumps that appear between mammograms.

ANS:A Pages: 389-391. The monthly practice of breast self-examination, along with clinical breast examination and mammograms are complementary screening measures. Mammography can reveal cancers too small to be detected by the woman or by the most experienced examiner. However, interval lumps may become palpable between mammograms.
The nurse is conducting a class about breast self-examination (BSE). Which of these statements indicates proper BSE technique?
The best time to perform BSE is 4 to 7 days after the first day of the menstrual period.

ANS: C Page: 398 The nurse should help each woman establish a regular schedule of self-care. The best time to conduct breast self-examination is right after the menstrual period, or the fourth through seventh day of the menstrual cycle, when the breasts are the smallest and least congested. Advise the pregnant or menopausal woman who is not having menstrual periods to select a familiar date to examine her breasts each month, for example, her birth date or the day the rent is due.
While examining a 75-year-old woman, the nurse notices that the skin over her right breast is thickened and the hair follicles are exaggerated. This condition is known as:
peau d'orange.

ANS:C Page: 404. This condition is known as peau d'orange. Lymphatic obstruction produces edema, which thickens the skin and exaggerates the hair follicles. The skin has a pig-skin or orange-peel look, and this condition suggests cancer.
During an examination, the nurse notices that a patient's legs turn white when they are raised above the patient's head. The nurse should suspect:
chronic arterial insufficiency.

ANS: C Pages: 499-525. Elevational pallor (marked) indicates arterial insufficiency. See Chapter 20.
The nurse has just recorded a positive obturator test on a patient who has abdominal pain. This test is used to confirm a(n):
perforated appendix.

ANS: C Pages: 527-564. A perforated appendix irritates the obturator muscle, producing pain. See Chapter 21.
A patient tells the nurse that "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:
paroxysmal nocturnal dyspnea.
During an examination, a patient has just successfully completed the finger-to-nose and the rapid-alternating-movements tests and is able to run each heel down the opposite shin. The nurse will conclude that the patient's ____ function is intact.
cerebellar

ANS: D Pages: 769-770. The nurse should test cerebellar function of the upper extremities by using the finger-to-nose test or rapid-alternating-movements test. The nurse should test cerebellar function of the lower extremities by asking the person to run each heel down the opposite shin.
When testing stool for occult blood, the nurse is aware that a false-positive result may occur with:
a large amount of red meat within the last 3 days.

ANS:D Pages: 716-717. When testing for occult blood, a false-positive finding may occur if the person has ingested significant amounts of red meat within 3 days of the test. Absent bile pigment causes the stools to be gray or tan in color. Increased fat content causes the stool to be pale, yellow, and greasy. Increased ingestion of iron medication causes the stool to be black in color.
A patient who is visiting the clinic complains of having "stomach pains for 2 weeks" and describes his stools as being "soft and black" for about the last 10 days. He denies taking any medications. The nurse is aware that these symptoms are most indicative of:
occult blood resulting from gastrointestinal bleeding.

ANS:C Page: 712. Black stools may be tarry due to occult blood (melena) from gastrointestinal bleeding or nontarry from ingestion of iron medications (not diet). Excessive fat causes the stool to become frothy; absence of bile pigment causes clay-colored stools.
An 85-year-old man has come in for a physical examination, and the nurse notices that he uses a cane. When documenting general appearance, the nurse should document this information under the section that covers:
mobility.

ANS: B Page: 764. Use of assistive devices would be documented under the mobility section. The other responses are all other categories of the general appearance section of the health history.
The nurse is assisting with a self-breast examination clinic. Which of these women reflect abnormal findings during the inspection phase of breast examination?
Woman whose nipples are in different planes (deviated)

ANS:A Pages: 392-393 | Page: 404. The nipples should be symmetrically placed on the same plane on the two breasts. With deviation in pointing, an underlying cancer causes fibrosis in the mammary ducts, which pulls the nipple angle toward it. The other examples are normal findings. See Table 17-3.
Which of these is included in assessment of general appearance?
Skin color

ANS:C Page: 764. General appearance includes items such as level of consciousness, skin color, nutritional status, posture, mobility, facial expression, mood and affect, speech, hearing, and personal hygiene. Height, weight, and vital signs are considered measurements.
During a health history of a patient who complains of chronic constipation, the patient asks the nurse about high-fiber foods. The nurse relates that an example of a high-fiber food would be:
broccoli.

ANS:A Pages: 712-713. High-fiber foods are either soluble type (i.e., beans, prunes, barley, broccoli) and insoluble type (i.e., cereals, wheat germ). The other examples are not considered high-fiber foods.
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:
chronic venous insufficiency.

ANS: D Pages: 499-525. Chronic venous insufficiency would present as firm brawny edema, coarse thickened skin, normal pulses, and brown discoloration. See Chapter 20.
The nurse is discussing breast self-examination with a postmenopausal woman. The best time for postmenopausal women to perform breast self-examination is:
the same day every month.

ANS: A Page: 398. Postmenopausal women are no longer experiencing regular menstrual cycles but need to continue to perform breast self-examination on a monthly basis. Choosing the same day of the month is a helpful reminder to perform breast self-examination.
A 70-year-old man is visiting the clinic for difficulty in passing urine. In the history he indicates he has to urinate frequently, especially at night. He has burning when he urinates and has noticed pain in his back. Given this history, what might the nurse expect to find during the physical assessment?
Asymmetric, hard, fixed prostate gland

ANS: a Subjective symptoms of carcinoma of the prostate include frequency, nocturia, hematuria, weak stream, hesitancy, pain or burning on urination, and continuous pain in lower back, pelvis, and thighs. Objective symptoms of carcinoma of the prostate include a malignant neoplasm often starts as a single hard nodule on the posterior surface, producing asymmetry and a change in consistency. As it invades normal tissue, multiple hard nodules appear, or the entire gland feels stone hard and fixed.
In performing a breast examination, the nurse knows that it is especially important to examine the
upper outer quadrant of the breast. The reason for this is that the upper outer quadrant is:
The location of most breast tumors.

ANS:B Pages: 384-385. The upper outer quadrant is the site of most breast tumors. In the upper outer quadrant, the nurse should notice the auxiliary tail of Spence, the cone-shaped breast tissue that projects up into the axilla, close to the pectoral group of auxiliary lymph nodes.
The nurse should wear gloves for which of these examinations?
Palpation of the mouth and tongue

ANS: C Page: 766. Gloves should be worn when the examiner is exposed to the patient's body fluids.
A 9-year-old girl is in the clinic for a sports physical. After some initial shyness she finally asks, "Am I normal? I don't seem to need a bra yet, but I have some friends who do. What if I never get breasts?" The nurse's best response would be:
"I understand that it is hard to feel different from your friends. Breasts usually develop between 8 and 10 years of age."

ANS: D Page: 386 | Page: 400. Adolescent breast development usually begins between 8 and 10 years of age. The nurse should not belittle the girl's feelings by using statements like "don't worry" or by sharing personal experiences. The beginning of breast development precedes menarche by about 2 years.