Upgrade to remove ads
Only $35.99/year

Health Assessment Quizzes

Terms in this set (117)

Resonance
Medium/loud amplitude, moderate duration, over lungs
Hyperresonace
Louder amplitude, longer duration, normal in child lung
Tympany
Loud amplitude, drumlike, over stomach
Dull
Soft amplitude, muffled thud, over liver or spleen
Flat
Softest amplitude, stop of sound, bone
_____________ palpation is using both hands to envelop certain body parts.
A. Deep

B. Light

C. Fingertip

D. Bimanual
D. Bimanual
Which type of precautions apply to all patients, regardless of suspected or confirmed infection status?

A. Standard

B. Contact

C. Droplet

D. Neutropenic
A. Standard
Which factors can be assessed during palpation? (Select all that apply)

A. Temperature

B. Pulsation

C. Moisture

D. Lumps/masses

E. Crepitation
A. Temperature
B. Pulsation
C. Moisture
D. Lumps/masses
E. Crepitation
Providing resistance while the patient shrugs the shoulders and turns the head to each side is testing muscle strength and the status of which cranial nerve?
A. III

B. IV

C. IX

D. XI
D. XI
Confrontation Test
peripheral vision fields
Cover Test
Eye muscle weakness or paralysis
EOM (Diagnostic Position) Test
Nystagmus or CN III, IV and VI dysfunction
Accommodation
Pupillary dilation when changing focus from far to near object
Snellen Chart
Visual Acuity
Which description would be most indicative of a tension headache?
A. Tend to be occipital or frontal or with bandlike tightness

B. Tend to be supra-orbital, retro-orbital or fronto-temporal

C. Produce pain around the eye, temple, forehead, and cheek

D. Pain is usually described as throbbing and is unilateral
A. Tend to be occipital or frontal or with bandlike tightness
Which question is most appropriate to ask a female patient with a suspected thyroid problem?
A. "How much alcohol do you drink?"

B. "Have you noticed any changes in your sleep pattern and energy levels?"

C. Do you have any unusually frequent or severe headaches?"

D. "Have you noticed any neck stiffness?"
B. "Have you noticed any changes in your sleep pattern and energy levels?"
A patient has a lymph node that is hard, unilateral, nontender and fixed, the nurse would suspect:
A. Acute infection

B. Chronic Inflammation

C. Cancer

D. Normal node
C. Cancer
Preauricular
in front of the ear
Postauricular
behind the ear
Occipital
base of skull
Submental
midline, behind the tip of the mandible
Submandibular
halfway between the angle and the tip of the mandible
Jugulodigastric (Tonsillar)
under the angle of the mandible
Superficial Cervical
superficial to the sternomastoid
Deep Cervical
deep under the sternomastoid muscle
Posterior Cervical
in the posterior triangle along the edge of the trapezius muscle
Supraclavicular
just above and behind the clavicle, at the sternomastoid muscle
Infraclavicular
Directly under the clavicle
Dizziness
A lightheaded, swimming sensation, or a feeling of falling.
vertigo subjective
Perception that the person is spinning
Vertigo objective
Perception the room is spinning
Syncope
fainting
A patient's thyroid is enlarged and the nurse is preparing to auscultate the thyroid for the presence of a bruit. Which best describes a bruit?
A. Low, Gurgling sound best heard with the diaphragm of the stethoscope.

B. Loud, whooshing, whistling sound best heard with the bell of the stethoscope.

C. Soft, whooshing, pulsing sound best heard with the bell of the stethoscope.

D. High-pitched, tinkling sound best heard with the diaphragm of the stethoscope
C. Soft, whooshing, pulsing sound best heard with the bell of the stethoscope.
A patient reports a sever headache accompanied by nausea, vomiting, and intolerance to light. These symptoms are most consistent with which type of headache?
A. Migraine

B. Cluster

C. Tension

D. Traumatic
A. Migraine
Stabismus
cross-eyed
Presbyopia
Far-sighted
Myopia
near-sighted
Nystagmus
Involuntary, rapid rhythmic movement of the eyeball
Flexion
bending a limb at a joint
Extension
straightening a limb at a joint
Abduction
moving a limb away from the midline of the body
Adduction
moving a limb toward the midline of the body
Pronation
turning the forearm so that the palm is down
Supination
turning the forearm so that the palm is up
Circumduction
moving the arm in a circle around the shoulder
Inversion
moving the sole of the foot inward at the ankle
Eversion
moving the sole of the foot outward at the ankle
Rotation
moving the head around a central axis
Protraction
moving a body part forward and parallel to the ground
Retraction
moving a body part backward and parallel to the ground
Elevation
raising a body part
Depression
lowering a body part
When interviewing an older adult, how should the examiner proceed differently than a young adult?
A. Consider the patient may become fatigued and offer breaks as needed

B. Give the patient a shorter time to answer questions

C. Ask the family member to complete records while the interview is being conducted

D. Raise your voice while asking questions
A. Consider the patient may become fatigued and offer breaks as needed
Which finding is considered subjective?
A. Measured weight loss of 15 pounds since last office visit

B. Pulse rate of 94 beats per minute

C. Pain lasting 2 hours

D. Temperature of 101.2 degrees F
C. Pain lasting 2 hours
What is the purpose of an interview with a client/patient?

A. Gather health information while establishing a relationship with the patient

B. Assess the patient for pain

C. Formulate a care plan based on the reason for visit

D. Perform a head to toe assessment
A. Gather health information while establishing a relationship with the patient
When reading a chart, you see the following entry patient states "I have had a cold for a week now and am having difficulty breathing". This is an example of which part of the health history?
A. Reason for seeking care

B. Past health history

C. Functional assessment

D. Review of systems
A. Reason for seeking care
What is the most reliable indicator of pain?
A. The patient's report of pain

B. The results of diagnostic testing

C. Nonverbal behaviors of the patient

D. The ability to care for self
A. The patient's report of pain
What finding is considered to be objective?

A. I feel tired all the time

B. Blood pressure reading of 132/80 mmHg

C. My hair is thinning

D. I have pain in my right toe
B. Blood pressure reading of 132/80 mmHg
What does active listening include? Select all that apply
A. Fully focusing on the patient

B.Observing body language

C. Listening to tone of voice

D. Taking detailed notes

E. Interrupting to ask questions for clarification
A. Fully focusing on the patient

B. Observing body language

C. Listening to tone of voice
The mnemonic "PQRST" is used to assess pain. What question by the nurse reflects the "Q"?
A. "What caused the pain?"

B. "How would you describe the pain"

C. "When did the pain start?"

D. "Does the pain radiate?"
B. "How would you describe the pain"
Which statements reflect a potential trap of interviewing? Select all that apply
A. "When were you diagnosed with hypertension and hypercholesterolemia?"

B. "If I were you, I would not have the surgery"

C. "Can you tell me more about the illness you mentioned"

D. "Why did you wait so long to come to the hospital?"

E. "Don't worry, I am sure everything will be just fine"
A. "When were you diagnosed with hypertension and hypercholesterolemia?"

B. "If I were you, I would not have the surgery"

D. "Why did you wait so long to come to the hospital?"

E. "Don't worry, I am sure everything will be just fine"
Hematopoiesis takes place in which of the following?
A. Bone marrow

B. Liver

C.Spleen

D.Kidneys
A. Bone marrow
Examination of the shoulder includes 4 motions. These are:

A. Forward flexion, internal rotation, abduction, and external rotation

B. Abduction, adduction, pronation, and supination

C. Circumduction, inversion, eversion, and rotation

D. Elevation, retraction, protraction, and circumduction
A. Forward flexion, internal rotation, abduction, and external rotation
A 70-year-old woman has come for a health examination. Which is a common age-related change in the curvature of the spinal column?

A.Kyphosis

B.Lordosis

C.Scoliosis

D.Lateral scoliosis
A.Kyphosis
Irritability
annoyed, easily provoked, impatient
Lability
rapid shift of emotions
Flat affect
Lack of emotion response
Elation
joy and optimism, overconfidence
A positive Phalen test and Tinel sign are found in a patient with:
A.Carpal tunnel syndrome

B.A torn meniscus

C.Hallux valgus

D.Tennis elbow
A. Carpal tunnel syndrome
The bulge sign is a test for:

A. Swelling in the suprapatellar pouch

B. Carpal tunnel syndrome

C. Heberden's nodes

D. Olecranon bursa inflammation
A. Swelling in the suprapatellar pouch
CN I
olfactory nerve
CN II
optic nerve
CN III
oculomotor nerve
CN IV
trochlear nerve
CN V
trigeminal nerve
CN VI
abducens nerve
CN VII
facial nerve
CN VIII
acoustic nerve
CN IX
glossopharyngeal nerve
CN X
vagus nerve
CN XI
spinal accessory nerve
CN XII
hypoglossal nerve
During an examination, the nurse can assess mental status by which activity?

A. Observing the patient performing an IQ test.

B. Observing the patient and inferring health or dysfunction.

C. Examining the patients electroencephalogram.

D. Examining the patient's response to a specific set of questions.
B. Observing the patient and inferring health or dysfunction.
Which group of Cranial Nerve(s) are associated with the eyes?
A. CN IX and X

B. CN V and VII

C. CN III, IV, and VI

D. CN XII
C. CN III, IV, and VI
Paralysis
Loss of motor function due to a lesion in the neurologic or muscular system or loss of sensory
paresthesia
Abnormal sensation- (burning, numbness, tingling, prickling, etc)
Dysphonia
Difficulty or discomfort in talking, voice sounds hoarse or whispered
Dysarthria
Distorted speech sounds, may sound unintelligible.
A nurse has difficulty eliciting a bicep reflex from a patient. What exercises can the nurse have the patient perform to facilitate a response? Choose all that apply.
A. Lock fingers and pull

B. Clench teeth

C. Grasp thigh

D. Stomp feet

E. Stick out took
...
When assessing an older adult, the nurse knows that one of the first items to assess before making judgements concerning mental status is their:____________
A. Sensory-perceptive abilities

B. Presence of irrational thinking patterns

C. General intelligence

D. Presence of phobias
A. Sensory-perceptive abilities
Arteriosclerosis
Rigid blood vessels
Atherosclerosis
Fatty plaque build-up
Occlusion of artery
Blockage of artery
Aneurysm
Weakened sac formed by dilation in an artery
Which documentation identifies a "normal" inspection of the peripheral vascular system of the upper extremities?
A.Arms are pale, clubbing present, capillary refill >3 seconds, scar to right wrist

B.Color consistent with ethnicity, arms are symmetric and equal, profile sign <160, capillary refill <2 seconds, no lesions, scars or edema noted

C.Arms symmetrical and equal, hands blush with red palm, clubbing, capillary refill <2 seconds, scarring to antecubital fossa

D.Color consistent with ethnicity, right arm with edema, profile sign <160, capillary refill <5 seconds, no lesions or scars
B.Color consistent with ethnicity, arms are symmetric and equal, profile sign <160, capillary refill <2 seconds, no lesions, scars or edema noted
Which terms are used to describe the quality of murmurs?

A.Early, mid, late, holo
B.High, medium, low
C.Grade 1, 2, 3, 4, 5, 6
D.Musical, blowing, harsh, rumbling
D.Musical, blowing, harsh, rumbling
Which valve closures can best be heart at the base of the heart?
A.Aortic and pulmonic
B.Tricuspid and pulmonary
C.Mitral and tricuspid
D.Mitral and aortic
A.Aortic and pulmonic
Which risk factors for cardiovascular disease are non-modifiable? Select all that apply
A.Smoking

B.Hypertension

C.Sex

D.Race/ethnicity

E.Inadequate diet

F.Genetics
C. Sex
D. Race/Ethnicity
F. Genetics
Agina
chest pain
Dyspnea
shortness of breath
Orthopnea
Assuming more upright position to breath
Pallor
paleness
Nocturia
urination at night
Thrill
palpable vibration on the chest wall accompanying severe heart murmur
A pleural friction rub is best detected by?
Percussion
Auscultation
Palpation
Observation
Auscultation
After examining a patient, the nurse makes the following notation: increased respiratory rate, chest expansion decreased on left side, dull to percussion over left lower lobe, breath sounds louder with fine crackles over left lower lobe. These finds are consistent with?

Asthma

Bronchitis

Pleural effusion

Lobar pneumonia
Lobar pneumonia
A patient has a barrel-shaped chest, characterized by?

Anteroposterior transverse diameter of 3:7 and ribs sloping back

Anteroposterior transverse diameter of 1:2 and an elliptic shape

Anteroposterior transverse diameter of 2:1 and ribs being elevated

Equal anteroposterior transverse diameter and ribs being horizontal
Equal anteroposterior transverse diameter and ribs being horizontal
Pulse oximetry measures?

Combined saturation of arterial and venous blood

Arterial oxygen saturation of hemoglobin

Carboxyhemoglobin levels

Venous oxygen saturation of hemoglobin
Arterial oxygen saturation of hemoglobin
Select the best description of bronchovesicular breath sounds:?

Low-pitched, inspiration greater than expiration

Moderate-pitched, inspiration equal to expiration

Rustling sound, like the wind in the trees

High-pitched, of longer duration on inspiration than expiration
Moderate-pitched, inspiration equal to expiration
Which best describes how to proceed when auscultating breath sounds on a patient?

Hold the bell of the stethoscope against the chest wall; listen to the entire right field and then the entire left field.

Listen from the apices to the bases of each lung field using the bell of the stethoscope.

Select the bell or diaphragm depending on the quality of sounds heard; listen for one respiration in each location, moving from side to side.

Hold the diaphragm of the stethoscope against the chest wall; listen to one full respiration in each location, being sure to do side to side comparisons.
Hold the diaphragm of the stethoscope against the chest wall; listen to one full respiration in each location, being sure to do side to side comparisons.
When examining for tactile fremitus, it is important to?

Use the bell of the stethoscope

Ask the patient to breathe quickly

Palpate the chest symmetrically

Ask the patient to cough
Palpate the chest symmetrically
Which assessment best confirms symmetric chest expansion?

Placing hands on the posterolateral chest wall with thumbs at the level of T9 or T10 and then sliding the hands up to pinch a small fold of skin between the thumbs.


Percussion of the posterior chest


Inspection of the shape and configuration of the chest wall.


Placing the palmar surface of the fingers of one hand against the chest and having the person repeat the words "ninety-nine"
Placing hands on the posterolateral chest wall with thumbs at the level of T9 or T10 and then sliding the hands up to pinch a small fold of skin between the thumbs.
The nurse assesses a patient who reports a cough. The characteristic timing of the cough of chronic bronchitis is described as:


Occurring in the afternoon or evening because of exposure to irritants at work


Continuous throughout the day

Productive cough for at least 3 months of the year for 2 consecutive years


Occurring in the early morning
Productive cough for at least 3 months of the year for 2 consecutive years
The nurse is inspecting a female patient's breast for retraction. Which position is the best technique for performing this assessment?
A.Lying supine with arms at sides.

B.Leaning forward with hands outstretched.

C.One arm at the side, the other arm elevated.

D.Sitting with hands pushing onto hips.
D.Sitting with hands pushing onto hips.
Which description is most consistent with a cancerous breast mass?

A.
Round , firm, well demarcated

B.
Irregular, poorly defined, fixed

C.
Lobular, clear margins, negative skin retraction

D.
Rubbery, mobile, tender
B.
Irregular, poorly defined, fixed
On examining a patient's nails, the nurse notes that the angle of the nail base is >160 degrees and that the nail base feels spongy to palpation. These findings are consistent with:


Acute rrespiratory distress syndrome


Congential heart disease and COPD


Atelectasis


Normal findings for the nails
Congential heart disease and COPD
To use the technique of egophony, ask the patient to:


Take several deep breaths and then hold for 5 seconds.


Whisper a phrase as auscultation is performed.


Repeat the phrase "ninety-nine" each time the stethoscope is moved.


Say "eeeeee" each time the stethoscope is moved.
Say "eeeeee" each time the stethoscope is moved.
Students also viewed