Deck 32: Health Assessment and Physical Examination

Question 1

During a genitourinary examination of a 30-year-old man,the nurse identifies a small amount of a white,thick substance on the patient's uncircumcised glans penis.What is the nurse's next step?

A)Notify his provider about a suspected sexually transmitted infection (STI).
B)Recognize this as a normal finding.
C)Tell the patient to avoid doing self-examinations until symptoms clear.
D)Avoid embarrassing questions about sexual activity.

Answer 1

Recognize this as a normal finding.

Question 2

A febrile preschool-aged child presents to the after-hours clinic.Varicella is diagnosed on the basis of the illness history and the presence of small,circumscribed skin lesions filled with serous fluid.The nurse documents the varicella lesions as which type of skin lesion?

A)Vesicle.
B)Wheal.
C)Papule.
D)Pustule.

Answer 2

Vesicle.

Question 3

An older patient is being seen for a chronic entropion.The nurse realizes that entropion places the patient at risk for which of the following?

A)Ectropion.
B)Infection.
C)Exophthalmos.
D)Strabismus.

Answer 3

Infection.

Question 4

During a routine pediatric history documentation and physical examination,the parents report that their child was a premature infant and was so small that he had to stay in the neonatal intensive care unit longer than usual.They state that the infant was yellow when born and that he developed an infection that required "every antibiotic under the sun" to cure him.Considering the neonatal history,the nurse determines that it is especially important to perform which focused examination?

A)Cardiac.
B)Respiratory.
C)Ophthalmic.
D)Hearing acuity.

Question 5

During a school physical examination,the nurse reviews the patient's current medical history,which is positive for asthma,eczema,and allergic rhinitis.Which physical finding should the nurse expect on nasal examination?

A)Polyp.
B)Yellow discharge.
C)Pale nasal mucosa.
D)Puffiness of nasal mucosa.

Question 6

For a weak patient with bilateral basilar pneumonia,which is the best position for a complete geriatric physical examination?

A)Prone position.
B)Sims's position.
C)Supine position.
D)Lateral recumbent.

Question 7

During an annual gynecological examination,a college student discusses her upcoming college break at a tropical location.After the student receives an oral contraceptive prescription,the nurse identifies the importance of skin cancer prevention by discussing which evidence-informed prevention technique?

A)Applying water-based sunscreen only before swimming.
B)Using tanning bed daily for 7 days before college break trip.
C)Applying broad-spectrum sunscreen of SPF 5.
D)Taking extra precautions in the sun secondary to the prescription.

Question 8

The patient is a 50-year-old African Canadian man who has come in for his routine annual physical examination.Which of the following preventive screenings does the nurse recommend?

A)Digital rectal examination of the prostate (DRE)annually.
B)Blood test for cancer antigen 125 once a year.
C)Complete eye examination every year.
D)Colonoscopy every 3 years.

Question 9

The nurse is urgently called to the gymnasium regarding an injured student.The student is crying in severe pain with a malformed fractured lower leg.What is the proper sequence for the nurse's initial assessment?

A)Deep palpation,light palpation,inspection.
B)Light palpation,deep palpation,inspection.
C)Inspection,light palpation.
D)Auscultation,deep palpation,light palpation.

Question 10

A parent calls the school nurse with questions regarding the recent school vision screening.Snellen chart examination revealed 20/60 for both eyes in the child.Considering the visual acuity results,what does the nurse inform the parent?

A)That the child should have an optometric examination.
B)That the child is suffering from strabismus.
C)That the child may have presbyopia.
D)That the child has vision issues most likely due to cataracts.

Question 11

A school nurse recognizes a belt buckle-shaped ecchymosis on a 7-year-old student.When privately asked about how the injury occurred,the student described falling on the playground.Upon suspecting abuse,the school nurse's best next action is which of the following?

A)Interviewing the patient in the presence of his or her teacher.
B)Ignoring the findings because child abuse is a declining problem.
C)Realizing that abuse victims usually report abusive situations.
D)Contacting Social Services and reporting suspected abuse.

Question 12

A teenaged female patient reports intermittent abdominal pain that has lasted 12 hours.No dysuria is present.During an abdominal assessment,what should the nurse do?

A)Recommend that the patient take more laxatives.
B)Ask the patient about the colour of her stools.
C)Avoid sexual references such as possible pregnancy.
D)Palpate first the spots that are most tender.

Question 13

On admission,a patient weighs 113.4 kg (250 pounds).The weight is recorded as 116.1 kg (256 pounds)on the second inpatient day.The nurse should evaluate the patient for

A)Fluid retention.
B)Fluid loss.
C)Decreased nutritional reserves.
D)Anorexia.

Question 14

Objective physical data describe air moving through small airways,auscultated over the lung's periphery.The expected inspiratory-to-expiratory phase of this normal vesicular breath sound is which of the following?

A)The inspiratory phase lasts exactly as long as the expiratory phase.
B)The expiration phase is longer than the inspiration phase.
C)The expiration phase is two times longer than the inspiration phase.
D)The inspiratory phase is three times longer than the expiratory phase.

Question 15

During a presentation about sexually transmitted infections to high school students,the nurse recommends the human papillomavirus (HPV)vaccine series to prevent which of the following?

A)Cervical cancer.
B)Genital lesions.
C)Vaginal discharge.
D)Swollen perianal tissues.

Question 16

A nurse identifies Pediculosis humanus capitis.Considering the possible complications of treatment,the nurse knows to not use which of the following treatment products?

A)Fine-toothed comb.
B)Pediculicide.
C)Lindane-based shampoo.
D)Vinegar hair rinse.

Question 17

A male student comes to the college health clinic.He hesitantly describes that his testis has a pea-sized hard lump.The nurse recognizes this as a potential sign of which of the following?

A)Inguinal hernia.
B)Sexually transmitted infection.
C)Testicular cancer.
D)Diuretic use.

Question 18

A nurse is a preceptor for a nurse who just graduated from nursing school.When caring for a patient,the new graduate nurse begins to explain to the patient the purpose of completing a physical assessment.Which of the following statements made by the new graduate nurse necessitates intervention by the preceptor?

A)"I will use the information from my assessment to figure out if your antihypertensive medication is working effectively."
B)"Nursing assessment data are used only to provide information about the effectiveness of your medical care."
C)"Nurses use data from their patient's physical assessment to determine a patient's educational needs."
D)"Information gained from physical assessment helps nurses better understand their patients' emotional needs."

Question 19

The nurse is caring for a female victim of rape.To perform the proper evaluation,the nurse should place the patient in which of the following positions?

A)Sitting.
B)Dorsal recumbent.
C)Lithotomy.
D)Knee-chest.

Question 20

A head and neck physical examination is completed on a 50-year-old woman.All physical findings are normal except that she has fine,brittle hair.On the basis of the physical findings,which of the following laboratory tests would the nurse expect to be ordered?

A)Liver function test.
B)Lead level.
C)Thyroid-stimulating hormone test.
D)Complete blood cell count (CBC).

Question 21

While assessing the skin of an 82-year-old male patient,a nurse discovers nonpainful ruby red papules on the patient's trunk.What is the nurse's next action?

A)Explain that the patient has basal cell carcinoma and should watch for spread.
B)Document cherry angiomas as a normal geriatric skin finding.
C)Tell the patient that he has a benign squamous cell carcinoma.
D)Document the presence of edema.

Question 22

A nurse suspects an abnormal thyroid shape during the physical examination.Why does the nurse offer the patient a glass of water and watch her as she drinks?

A)To visualize an enlarged thyroid gland.
B)To evaluate for exostosis.
C)To test the patient's gag reflex.
D)To visualize the uvula and soft palate.

Question 23

In preparation for a rectal examination,a nonambulatory male patient is informed of the need to be placed in which position?

A)Sims's position.
B)Forward bending with flexed hips.
C)Knee-chest.
D)Dorsal recumbent.

Question 24

The paramedics transport an adult involved in a motor vehicle accident to the emergency department.On physical examination,the patient's level of consciousness is reported as opening eyes to pain and responding to painful stimuli with inappropriate words and flexion withdrawal.The nurse correctly identifies the patient's Glasgow Coma Scale score as

A)5.
B)7.
C)9.
D)11.

Question 25

A patient in the emergency department is complaining of left lower abdominal pain.The comprehensive abdominal examination would include,in proper order,which of the following?

A)Inspection,palpation,auscultation.
B)Percussion,inspection,auscultation.
C)Inspection,palpation,percussion.
D)Inspection,auscultation,palpation.

Question 26

The nurse believes that several new female patients should receive additional health education about the need for more frequent Papanicolaou (Pap)smears and gynecological examinations.Which of the following assessment findings reveals the patient at highest risk for cervical cancer and thus having the greatest need for patient education?

A)13 years old,nonsmoker,not sexually active
B)15 years old,social smoker,celibate
C)22 years old,smokes 1 pack of cigarettes per day,has multiple sexual partners
D)50 years old,stopped smoking 30 years ago,history of hysterectomy

Question 27

The school nurse is assessing the tympanic membranes of a 3-year-old.Which of the following is a normal assessment finding?

A)Presence of a yellow waxy substance.
B)Swollen meatus.
C)Discomfort with palpation of the auricle.
D)Tenderness in the mastoid area.

Question 28

Asking a person what the statement "A stitch in time saves nine" means to him is a mental status examination technique;what is it used to assess?

A)Knowledge.
B)Long-term memory.
C)Abstract thinking.
D)Recent memory.

Question 29

The patient presents to the clinic with dysuria and hematuria.How does the nurse proceed to assess for kidney inflammation?

A)Lightly palpating each abdominal quadrant.
B)Inspecting abdomen for abnormal movement or shadows,with indirect lighting.
C)Using deep palpation posteriorly.
D)Percussing posteriorly the costovertebral angle at the scapular line.

Question 30

During a routine physical examination of a 70-year-old patient,a blowing sound is auscultated over the carotid artery.The nurse notifies the medical provider of the unexpected physical finding,which is known as which of the following?

A)Clubbing.
B)Bruit.
C)Right-sided heart failure.
D)Phlebitis.

Question 31

During a preschool readiness examination,the nurse prepares to perform visual acuity screenings.Given the children's age,the best equipment to test central vision is which of the following?

A)Snellen test.
B)E chart.
C)Reading test.
D)Penlight.

Question 32

An elderly patient has been taking high doses of antibiotics and is experiencing a sudden loss of hearing.The nurse should contact the health care provider and do what else?

A)Stop antibiotic use until the physician responds.
B)Tell the patient that older patients often lose low-frequency hearing.
C)Explain that hearing loss usually occurs with thinning of the eardrum.
D)Assure the patient that rapid hearing loss is normal in the elderly.

Question 33

What is the best term for breath sounds created by air moving through large lung airways?

A)Bronchovesicular.
B)Rhonchi.
C)Bronchial.
D)Vesicular.

Question 34

The advanced practice nurse is conducting a comprehensive eye examination on an 80-year-old African Canadian woman.Which of the following findings is an indication that the nurse should contact the patient's physician for further examination?

A)A thin white ring along the margin of the iris.
B)A black pupil.
C)Dilated pupils.
D)A black fundus of the eye.

Question 35

The patient is a 54-year-old man with a medium frame.He weighs 67.1 kg (148 pounds)and is 173 cm (5 feet 8 inches)tall,with a body mass index (BMI)of 22 kg/m².The nurse realizes that this patient is which of the following?

A)Overweight.
B)Underweight.
C)At his desired weight.
D)Obese.

Question 36

A teenaged patient is tearful and reports locating lumps in her breasts.Other history obtained is that she is currently menstruating.Physical examination reveals soft and movable cysts in both breasts that are painful to palpation.The nurse also notes that the patient's nipples are erect,but the areolae are wrinkled.The next nursing step is which of the following?

A)Reassure patient that her symptoms are normal.
B)Consult a breast surgeon because of the abnormal nipples and areolae.
C)Discuss fibrocystic disease as the likely cause.
D)Tell the patient that the symptoms may get worse when her period ends.

Question 37

The patient has had a stroke that has affected her ability to speak,and she becomes extremely frustrated when she tries to speak.She responds correctly to questions and instructions but cannot form words coherently.This patient is showing signs of which type of aphasia?

A)Expressive.
B)Receptive.
C)Sensory.
D)Combination.