FNU Physical Assessment in Health Care Quiz 

Question 1

Which of the following is a relatively benign condition that may occur during pregnancy or labor?

a. Macular degeneration

b. Papilledema

c. Subconjunctival hemorrhage

d. Cupping of the optic disc

Question 2

Which maneuver can be done to reduce the systemic absorption of cycloplegic and mydriatic agents when examining a pregnant woman if the examination is mandatory?

a. Have the woman keep her eyes closed for several minutes.

b. Instill half the usual dosage.

c. Keep the patient supine, with her head turned and flexed.

d. Use nasolacrimal occlusion after instillation

Question 3

When there is an imbalance found with the corneal light test, you should then perform the ___________ test.

a. confrontation

b. accommodation

c. cover–uncover

d. visual acuity

Question 4

White specks scattered in a linear pattern around the entire circumference of the iris are called:

a. drusen bodies.
b. cotton wool spots.
c. rust spots.
d. Brushfield spots.

Question 5

Which of the following may be suggestive of Down syndrome?

a. Drusen bodies
b. Papilledema
c. Narrow palpebral fissures
d. Prominent epicanthal folds

Question 6

You are attempting to examine the eyes of a newborn. To facilitate eye opening, you would first:

a. dim the room lights.
b. elicit pain.
c. place him in the supine position.
d. shine the penlight in his or her eyes.

Question 7

When testing corneal sensitivity controlled by cranial nerve V, you should expect the patient to respond by:

a. brisk blinking.
b. copious tearing.
c. pupil dilation.
d. reflex smiling.

Question 8

Xanthelasma may suggest that the patient has an abnormality of:

a. lipid metabolism.
b. cognitive function.
c. renal metabolism.
d. bone marrow function.

Question 9

You observe pupillary response as the patient looks at a distant object and then at an object held 10 cm from the bridge of the nose.You are assessing for:

a. confrontation reaction.
b. accommodation.
c. pupillary light reflex.
d. nystagmus.

Question 10

Which of the following findings, when seen in the infant, is ominous?

a. Difficulty tracking objects with the eyes
b. Appearing to have better peripheral than central vision
c. Blinking when bright light is directed at the face
d. White pupils on photographs

Question 11

When you ask the patient to identify smells, you are assessing cranial nerve __.

Ans: 1

Question 12

Which risk factor is associated with the highest rate of oral cancers?

a. Women

b. Being younger than 55 years

c. excessive caffeine use

d. Fanconi anemia

Question 13

You are interviewing a parent whose child has a fever, is pulling at her right ear, and is irritable. You ask the parent about the child’s appetite and find that the child has a decreased appetite. This additional finding is more suggestive of:

a. acute otitis media.

b. otitis externa.

c. serous otitis media.

d. middle ear effusion.

Question 14

Which of the following signs and symptoms occur with a sensorineural hearing loss? (Select all that apply.)

a. Air conduction shorter than bone conduction

b. Lateralization to the affected ear

c. Loss of high-frequency sounds

d. Speaks more loudly

e. Disorder of the inner ear

f. Air conduction longer than bone conduction

Question 15

Which variation may be an expected finding in the ear examination of a newborn?

a. Diffuse light reflex

b. Purulent material in the ear canal

c. Redness and swelling of the mastoid process

d. Small perforations of the tympanic membrane

Question 16

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

a. Fordyce spots.

b. aphthous ulcers.

c. Stensen ducts.

d. leukoedema.

Question 17

You are performing Weber and Rinne hearing tests. For the Weber test, the sound lateralized to the unaffected ear; for the Rinne test, air conduction–to–bone conduction ratio is less than 2:1. You interpret these findings as suggestive of:

a. a defect in the inner ear.

b. a defect in the middle ear.

c. otitis externa.

d. impacted cerumen.

Question 18

You are performing hearing screening tests. Who would be expected to find difficulty in hearing the highest frequencies?

a. 7

b. 12

c. 20

d. 40

e. 65

Question 19

Which abnormality is common during pregnancy?

a. Eruption of additional molars

b. Hypertrophy of the gums

c. Otitis externa

d. Otitis media

Question 20

You are using a pneumatic attachment on the otoscope while assessing tympanic membrane movement. You gently squeeze the bulb but see no movement of the membrane. Your next action should be to:

a. remove all cerumen from the canal.

b. make sure the speculum is sealed form outside air.

c. squeeze the bulb with more force.

d. insert the speculum to depth of 2 cm.

Question 21

Which of the following is an expected change in the assessment of the thyroid during pregnancy?

a. Palpation of the gland becomes difficult.

b. A bruit is auscultated.

c. Inspection reveals a goiter.

d. The gland is tender on palpation

Question 22

Which type of headache usually occurs at night, is precipitated by alcohol consumption, and occurs more often in men than in women?

a. Classic migraine
b. Temporal arteritis
c. Cluster
d. Hypertensive

Question 23

Which of the following is true regarding caput succedaneum?

a. It is a subperiosteal collection of blood.

b. It is firm and its edges are well defined.

c. It develops several days after delivery.

d. It is seen over the presenting part of thehead

Question 24

You are palpating a patient’s thyroid and find that its broadest dimension measures 4 cm. The right lobe is 25% larger than the left.These data would indicate:

a. a congenital anomaly.

b. a normal thyroid gland.

c. a multinodular goiter.

d. thyroiditis.

Question 25

Which of the following findings would be consistent with fetal alcohol syndrome (FAS)?

a. Corneal clouding

b. Eye slanting

c. Mild ptosis

d. Symmetric, bulging fontanels

Question 26

Which of the following is a chronic autoimmune disorder?

a. tenosynovitis

b. fibromyalgia

c. rhabdomyolysis

d. myasthenia gravis

Question 27

Which cranial nerves innervate the face?

a. II and V

b. III and VI

c. V and VII

d. VIII and IX

Question 28

You are examining Ms. L, age 78 years. You find a sunken appearance of her eyes, cheeks, and temporal areas. Her skin is dry, and her nose appears sharp. This description of Ms. L’s facies is associated with:

a. cutis laxa syndrome.

b. Hurler syndrome.

c. old age.

d. terminal illness.

Question 29

Which of the following is true regarding a cephalohematoma?

a. It is bound by suture lines.

b. The affected part feels soft.

c. It is obvious at birth.

d. The margins are poorly defined

Question 30

Which is the best way to position a patient’s neck for palpation of the thyroid?

a. Flexed away from the side being examined
b. Flexed directly forward
c. Flexed toward the side being examined
d. Hyperextended directly backward 

Health care organizations continually face challenges from various regulatory and government agencies, and are also bound by Managed Care Organization (MCO) standards. View the video “College of Nursing and Health Care Professions: Do we know what our future is?” for insight into the challenges of health care reform. http://lc.gcumedia.com/zwebassets/courseMaterialPages/nur508_healthcare-reform-video-series-v1.1.php. Based on the video, describe, with rationale, two key factors that you feel will need to be addressed by future health care workers and health care leaders. (Note: you can download slides from this video within the media piece itself for ease of review in developing your forum response).

Additionally, what role does adherence to MCO standards play in your future health care vision?

Interview a patient with a chronic pulmonary health condition who is on at least two medications.

In a 1,350-1,600-word paper, discuss the following:

1. Obtain a complete health history.
2. Obtain a complete medication history, including prescription and over-the-counter drugs or supplements.
3. Analyze the client’s current knowledge level of medications and compliance with the prescribed dosing and administration.
4. For each medication, identify the pharmacokinetics, pharmacodynamics, dose, route of administration, side effects, adverse reactions, any drug interactions, potential safety issues, and the impact on the client’s health status.
5. Formulate possible interventions related to lack of drug efficacy, lack of client knowledge, or client compliance issues as identified during the interview.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.  # references

 Rate yourself using the results from the “Nurse Manager Skills Inventory”: http://www.aone.org/resources/nurse-manager-skills-inventory.pdf

Write a reflection of 750-1,000 words in which you identify your strengths and weaknesses related to the four content areas below:

1. Personal and professional accountability
2. Career planning
3. Personal journey disciplines
4. Reflective practice reference behaviors/tenets

Discuss how you will use your current leadership skill set to advocate for change in your workplace. Identify one personal goal for your leadership growth and discuss your implementation plan to achieve that goal.
 

Question 1:  Which of the following is a crucial element of developing a guideline?

a. Creating a physician expert panel
b. Reviewing the literature with ratings of available evidence
c. Conducting an external review of a guideline
d. Developing evidence-based tables

Question 2:  African American patients seem to have a negative reaction to which of the following asthma medications?

a. Inhaled corticosteroids 

b. Long-term beta-agonist bronchodilators 

c. Leukotriene receptor agonist
d. Oral corticosteroid

Question 3:  Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean?

a. The tumor size cannot be evaluated, the cancer has not spread to the lymph nodes, and the distant spread cannot be evaluated.
b. The cancer is in situ, it is spreading into the lymph nodes, but the spread otherwise cannot be evaluated.
c. The cancer is less than 2 cm in size and has not spread to the lymph nodes or other parts of the body.
d. The cancer is about 5 cm in size, nearby lymph nodes cannot be evaluated, and there is no evidence of distant spreading.

Question 4:  Sondra’s peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear?

a. Meclizine
b. Diphenhydramine
c. Diamox
d. Promethazine

Question 5:  Mandy presents with a cauliflower-like wart that is in her anogenital region. You suspect it was sexually transmitted and document this as a:
a. Filiform/digitate wart. 

b. Dysplastic cervical lesion. 

c. Condyloma accuminata.
d. Koilocytosis.

Question 6:  Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of?

a. Dementia

b. Alzheimer’s disease

c. Parkinson’s disease

d. Delirium

Question 7:  You have taught Jennifer, age 15, about using a flow meter to assess how to manage her asthma exacerbations. She calls you today because her peak expiratory flow rate is 65%. What would you tell her?

a. “Take your short-acting beta-2 agonist, remain quiet, and call back tomorrow.”
b. “Use your rescue inhaler, begin the prescription of oral glucocorticoids you have, and call back tomorrow.”
c. “Drive to the emergency room (ER) now.”
d. “Call 911.”

Question 8:  A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria?
a. NSAIDs 

b. Beets 

c. Vitamin A
d. Red meat 

Question 9:  Which of the following is an example of tertiary prevention in a patient with chronic renal failure?

a. Fluid restriction
b. Hemodialysis 4 days a week
c. High-protein diet
d. Maintain blood pressure at 120/80

Question 10:  Which of the following conditions is associated with cigarette smoking?

a. Glaucoma

b. Increased sperm quality

c. Bladder cancer

d. Eczema

Question 11: A chronic cough lasts longer than:

a. 3 weeks

b. 1 month

c. 6 months
d. 1 year

Question 12: The ‘freezing phenomenon’ is a cardinal feature of?

a.Parkinson’s disease

b. Alzheimer’s disease

c. A CVA

d. Bell’s palsy

Question 13: When administered at the beginning of an attack, oxygen therapy may help this kind of headache?

a. Tension

b. Migraine

c. Cluster

d. Stress

Question 14: Which ethnic group has the highest lung cancer incidence and mortality rates?

a. African American men

b. Scandinavian men and women

c. Caucasian women

d. Asian men

Question 15: The most significant precipitating event leading to otitis media with effusion is:

a. Pharyngitis

b. Allergies

c. Viral upper respiratory infection (URI)

d. Perforation of the eardrum

Question 16:  Samuel is going to the dentist for some work and must take endocarditis prophylaxis because of his history of:

a. Severe asthma.
b. A common valvular lesion.
c. Severe hypertension.
d. A previous coronary artery bypass graft (CABG).

Question 17: A 34-year-old patient was treated for a urinary tract infection (UTI) and has not responded to antibiotic therapy. Which of the following actions should be taken next?
a. Send a urine specimen for microscopy looking for fungal colonies.
b. Increase the dose of antibiotic.
c. Order a cytoscopy.
d. Order a different antibiotic.

Question 18: Which statement best describes a carotid bruit?

a. It is felt with the middle three fingers over the carotid artery.
b. A bruit becomes audible when the lumen is narrowed to 1 mm or less.
c. A low-pitched bruit is a medical emergency.
d. The higher the pitch of the bruit, the higher the degree of stenosis.

Question 19: Which statement is true regarding chloasma, the ‘mask of pregnancy’?

a. It is caused by a decrease in the melanocyte-stimulating hormone duringpregnancy.

b. This condition only occurs on the face.

c. Exposure to sunlight will even out the discoloration.

d. It is caused by increased levels of estrogen and progesterone.

Question 20: Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause?

a. “You must be under a lot of stress lately.”
b. “It is hereditary. Did your father experience this also?”
c. “The cause is unknown, but we suspect it is due to an immunologic mechanism.”
d. “We’ll have to do some tests.”

Question 21: A blood pressure (BP) of 150/90 is considered:

a. Stage 2 hypertension

b. Hypertensive

c. Normal in healthy older adults

d. Acceptable if the patient has DM

Question 22: When teaching post MI patients about their NTG tablets, theclinician should stress that the tablets should remain in thelight-resistant bottle in which they are packaged and shouldnot be put in another pill box or remain in areas that are orcould become warm and humid. Once opened, the bottlemust be dated and discarded after how many months?

a. 1 month

b. 3 months

c. 6 months

d. As long as the tablets are kept in this special bottle, they will last forever

Question 23: Your patient has decided to try to quit smoking with Chantix. You are discussing his quit date, and he will begin taking the medicine tomorrow. When should he plan to quit smoking?

a. He should stop smoking today.

b. He should stop smoking tomorrow.

c. His quit date should be in 1 week.

d. He will be ready to quit after the Frst 30 days

Question 24: When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are?

a. Spores 

c. Pseudohyphae
b. Leukocytes 

d. Epithelial cells

Question 25: The hallmark of an absence seizure is:

a. No activity at all.
b. A blank stare.
c. Urine is usually voided involuntarily.
d. The attack usually lasts several minutes.

Question 26: Which medication used for scabies is safe for children 2 months and older?

a. Permethrin cream

b. Lindane

c. Crotamiton lotion and cream

d. Ivermectin

Question 27: The clinician is seeing a patient complaining of red eye. The clinician suspects conjunctivitis. The presence of mucopurulent discharge suggests which type of conjunctivitis?

a. Viral conjunctivitis 

b. Keratoconjunctivitis 

c. Bacterial conjunctivitis
d. Allergic conjunctivitis

Question 28: Gabby, aged 22, has Bell’s palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her?

a. “Most patients have complete recovery in a few weeks to a few months.”
b. “Unfortunately, you’ll probably have a small amount of residual damage.”
c. “Don’t worry, I’ll take care of everything.”
d. “You may have a few more episodes over the course of your lifetime but no permanent damage.”

Question 29: How often should drug levels be monitored when a seizure medication has controlled the seizures and the drug level is adequate

a. Every 3 months
b. Every 6 months
c. Annually
d. Whenever there is a problem

Question 30:  Immunizations are an example of which type of prevention?

a. Primary
b. Secondary
c. Tertiary

Question 31: The result of the patient’s 24-hour urine for protein was 4.2 g/day. The clinician should take which of the following actions?

a. Repeat the test.
b. Refer to a nephrologist.
c. Measure the serum protein.
d. Obtain a blood urea nitrogen (BUN) and creatinine.

Question 32:  Which cranial nerve is afected in a patient with acerebrovascular accident who has difficulty chewing?

a. CN V

b. CN VII

c. CN IX

d. CN X

Question 33: Which of the following diagnostic tests should be ordered for a patient suspected of having bladder cancer?
a. KUB (kidneys, ureter, bladder) x-ray 

b. Cystoscopy with biopsy 

c. Magnetic resonance imaging (MRI)
d. Urine tumor marker (NMP22)

b

Question 34: The “B” in the ABCDEs of assessing skin cancer represents:

a. Biopsy. c. Boundary.
b. Best practice. d. Border irregularity.

Question 35: Which statement is true regarding driving and patients with a seizure disorder?

a. Once diagnosed with a seizure disorder, patients mustnever drive again.

b. After being seizure free for 6 months, patients may drive.

c. Each state has diferent laws governing driving forindividuals with a seizure disorder.

d. These persons may drive but never alone.

Question 36: Which high-density lipoprotein (HDL) level is considered cardioprotective?

a. Greater than 30 

b. Greater than 40 

c. Greater than 50
d. Greater than 60

Question 37: The most common cause of CAP is?

a. Incorrect octane gasoline 

b. A loose gas cap

c. A clogged muffler 

d. A bad spark plug

Question 38: Sandra has palpitations that occur with muscle twitching, paresthesia, and fatigue. What specific diagnostic test might help determine the cause?

a. Serum calcium

b. Electrocardiogram (ECG)

c. Thyroid-stimulating hormone test

d. Complete blood cell count

Question 39: A patient presents to the clinician with a sore throat, fever of 100.7?F, and tender anterior cervical lymphadenopathy. The clinician suspects strep throat and performs a rapid strep test that is negative. What would the next step be?

a. The patient should be instructed to rest and increase fluid intake as the infection is most likely viral and will resolve without antibiotic treatment.
b. Because the patient does not have strep throat, the clinician should start broad spectrum antibiotics in order to cover the offending pathogen.
c. A throat culture should be performed to confirm the results of the rapid strep test.
d. The patient should be treated with antibiotics for strep throat as the rapid strep test is not very sensitive.

Question 40: Patients with acute otitis media should be referred to a specialist in which of the following situations?
a. Concurrent vertigo or ataxia
b. Failed closure of a ruptured tympanic membrane
c. If symptoms worsen after 3 or 4 days of treatment
d. All of the above

Question 41: Which of the following tests is most useful in determining renal function in a patient suspected of chronic renal failure (CRF)?
a. Blood urea nitrogen (BUN) and creatinine
b. Electrolytes
c. Creatinine clearance
d. Urinalysis

Question 42: Marci has a wart on her hand. She says she  heard something about “silver duct tape therapy.” What do you tell her about his?

a. It is an old wives’ tale.
b. It is used as a last resort.
c. Salicylic acid is more effective.
d. It is a simple treatment that should be tried first.

Question 43: What is the first-line recommended treatment against Group A b-hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis?
a. Penicillin 

b. Quinolone 

c. Cephalosporin
d. Macrolide

Question 44: Which of the following is an example of sensorineural hearing loss?

a. Perforation of the tympanic membrane 

b. Otosclerosis 

c. Cholesteatoma
d. Presbycusis

Question 45: Which of the following is “a linear crack extending from the epidermis to the dermis?”

a. An ulcer 

b. A fissure 

c. Lichenification
d. An excoriation

Question 46: A 65-year-old man presents to the clinician with complaints of increasing bilateral peripheral vision loss, poor night visio0n, and frequent prescription changes that started 6 months previously. Recently, he has also been seeing halos around lights. The clinician suspects chronic open-angle glaucoma. Which of the following statements is true concerning the diagnosis of chronic open-angle glaucoma?

a. The presence of increased intraocular pressure measured by tonometry is definitive for the diagnosis of open-angle glaucoma.
b. The clinician can definitively diagnosis open-angle glaucoma based on the subjective complaints of the patient.
c. Physical diagnosis relies on goniscopic evaluation of the angle by an ophthalmologist.
d. Early diagnosis is essential in order to reverse any damage that has occurred to the optic nerve.

Question 47: The majority of HSV-1 and HSV-2 infections are asymptomatic so that only which elevated antibody titer shows evidence of previous infection?

a. IgA 

b. IgE 

c. IgG
d. IgM

Question 48: A patient is seen with a sudden onset of ±ank painaccompanied by nausea, vomiting, and diaphoresis. Inaddition to nephrolithiasis, which of the following should beadded to the list of diferential diagnoses? 

a. Pancreatitis

b. Peptic ulcer disease

c. Diverticulitis

d. All of the above

Question 49: Which of the following is abundant in the heart and rapidly rises in the bloodstream in the presence of heart failure, making it a good diagnostic test?

a. B-type natriuretic peptide

b. C-reactive protein

c. Serum albumin

d. Erythrocyte sedimentation rate

Question 50: You are doing a cerumen extraction and touch the external meatus of your patient’s ear. He winces and starts coughing. What is the name of this reflex?

a. Baker phenomenon

b. Arnold reflex

c. cough reflex

d. Tragus reflex