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NSG 6020 MIDTERM/ FINAL EXAM
NEWEST 2 LATEST VERSIONS
(VERSION A AND B) ACTUAL EXAM
COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS
which of the following is the most important question to ask during cardiovascular health history
- ANSWER sudden death of a family member a key symptom of ischemic heart disease is chest pain. However, angina equivalents may include exertional dyspnea. Angina equivalenstare important because - ANSWER A and B (Women with ischemic heart disease/some patients may have no symptoms) A 55 year old post menopausal woman with a history of hypertension complains of jaw pain on heavy exertion. There were no complaints of chest pain. Her ECG indicates normal sinus rhythm without ST segment abnormalities. Your plan may include - ANSWER exercise test Jenny is a 24 year old graduate student that presents to the clinic today with complaints of fever, mid sternal chest pain and generalized fatigue for the past two days. She denies any cough or sputum production. She states that when she takes ibuprofen and rest that the chest pain does seem to ease off. Upon examination the patient presents looking very ill. She is leaning forward and states that this is the most comfortable position for her. Temp is 102, BP 100/70, heart rate is 120/min and regular. Upon auscultation a friction rub is audible. Her lungs sounds clear. With these presenting symptoms your initial diagnosis would be - ANSWER pericarditis which symptom is more characteristic of non-cardiac chest pain - ANSWER pain tends to occur with movement stretching or palpation
what is the most common valvular heart disease in the older adult - ANSWER aortic stenosis
- Jeff, 48 years old, presents to the clinic complaining of fleeting chest pain, fatigue, palpitations, lightheadedness, and shortness of breath. The pain comes and goes and is not associated with activity or exertion. Food does not exacerbate or relieve the pain. The pain is usually located under the left nipple. Jeff is concerned because his father has cardiac disease and underwent a CABG at age 65. The ANP examines Jeff and hears a mid-systolic click at the 4th ICS mid-clavicular area. The ANP knows that this is a hallmark sign of: - ANSWER mitral valve prolapse The aging process causes what normal physiological changes in the heart? - ANSWER the heart valve thickens and becomes rigid, secondary to fibrosis and sclerosis Dan G., a 65-year-old man, presents to your primary care office for the evaluation of chest pain and left-sided shoulder pain. Pain begins after strenuous activity, including walking. Pain is characterized as dull, aching; 8/10 during activity, otherwise 0/10. Began a few months ago, intermittent, aggravated by exercise, and relieved by rest. Has occasional nausea. Pain is retrosternal, radiating to left shoulder, definitely affects quality of life by limiting activity. Pain is worse today; did not go away after he stopped walking. BP 120/80. Pulse 72 and regular. Normal heart sounds, S1 and S2, no murmurs. Which of the following differential diagnoses would be most likely - ANSWER Coronary artery disease with angina pectoris a common auscultatory finding in advanced CHF is - ANSWER S3 gallop rhythm Your 35-year-old female patient complains of feeling palpitations on occasion. The clinician should recognize that palpitations are often a sign of - ANSWER all of the above The best way to diagnose structural heart disease/dysfunction non-invasively is - ANSWER echocardiogram
you should do all of the following except - ANSWER Determine he has 'white coat' hypertension because his home readings are also elevated Mr. A has many issues that seem to be interfering with his health outcomes. In order to negotiate and formulate a patient-centered management plan you take the time to gather more information. This can be started by asking the following question - ANSWER What do you think caused your hypertension and how has it affected your life? Which of the following is the most important question to ask during cardiovascular health history? - ANSWER Sudden death of a family member A key symptom of ischemic heart disease is chest pain. However, angina equivalents may include exertional dyspnea. Angina equivalents are important because - ANSWER A & B only A.Women with ischemic heart disease many times do not present with chest pain B. Some patients may have no symptoms or atypical symptoms. Diagnosis may only be made at the time of an actual myocardial infarction A 55-year-old post-menopausal woman with a history of hypertension complains of jaw pain on heavy exertion. There were no complaints of chest pain. Her ECG indicates normal sinus rhythm without ST segment abnormalities. Your plan may include - ANSWER Exercise stress test Which symptom is more characteristic of Non-Cardiac chest pain? - ANSWER Pain tends to occur with movement, stretching or palpation The aging process causes what normal physiological changes in the heart? - ANSWER The heart valve thickens and becomes rigid, secondary to fibrosis and sclerosis What is the most common valvular heart disease in the older adult? - ANSWER Aortic stenosis
Jenny is a 24 year old graduate student that presents to the clinic today with complaints of fever, midsternal chest pain and generalized fatigue for the past two days. She denies any cough or sputum production. She states that when she takes Ibuprofen and rest that the chest pain does seem to ease off. Upon examination the patient presents looking very ill. She is leaning forward and states that this is the most comfortable position for her. Temp is 102. BP= 100/70. Heart rate is 120/min and regular. Upon auscultation a friction rub is audible. Her lung sounds are clear. With these presenting symptoms your initial diagnosis would be - ANSWER Pericarditis A common auscultatory finding in advanced CHF is - ANSWER S3 gallop rhythm Mr. A returns to your clinic and a diagnosis of hypertension is made. He is started on a diuretic and counseled on lifestyle modifications including increasing activity and smoking cessation. On his next visit you note that his blood pressure remains elevated. Before referring to a specialist you should do all of the following except - ANSWER Determine he has 'white coat' hypertension because his home readings are also elevated Jeff, 48 years old, presents to the clinic complaining of fleeting chest pain, fatigue, palpitations, lightheadedness, and shortness of breath. The pain comes and goes and is not associated with activity or exertion. Food does not exacerbate or relieve the pain. The pain is usually located under the left nipple. Jeff is concerned because his father has cardiac disease and underwent a CABG at age 65. The ANP examines Jeff and hears a mid-systolic click at the 4th ICS mid- clavicular area. The ANP knows that this is a hallmark sign of: - ANSWER Mitral valve prolapse
SOUTH UNIVERSITY NSG 6020 FINAL
EXAM NEWEST 2 LATEST VERSIONS
(VERSION A AND B) ACTUAL EXAM
COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS
Which of the following may be noted in patient with a migraine headache? - ANSWER Aura An unsteady gait or difficulty balancing referred to as which of the following? - ANSWER Ataxia Which of the following is not considered a short-term stroke risk? - ANSWER Age >50 years Pinpoint pupils may be a result of which of the following? - ANSWER Heroin use Which of the following contraindicated when assessing the comatose patient? - ANSWER Dilate the patient's pupils to assess optic nerve Which of the following is not associated with a diagnosis of possible meningitis? - ANSWER Neck supple with full ROM.
Which of the following refers to the patient's ability to identify an object by feeling it with eyes closed? - ANSWER Stereognosis. Risk factors for stroke include all of the following except: - ANSWER Hypotension Which category should this information be placed in the SOAP note: "Abdominal pain 3 days, Intermittent with a pain score of 7/10 accompanied by nausea and vomiting". - ANSWER History of present illness Where is the differential diagnoses located? - ANSWER Assessment Which of the following statements regarding the differential diagnoses is true? - ANSWER A group of 3 evidence- based diagnoses that do not include the primary diagnosis as one of the differential diagnoses in which a clinician must be aware of if the client does not improve. Which of the following would not be identified as a portion of the History of Present. - ANSWER "My father died of a stroke 3 years ago".
Which of the following is a symptom of the eye? - ANSWER Scotoma What is the best procedure for evaluating a corneal abrasion? - ANSWER Fluorescein Stain The Weber test is considered normal in which of the following exams. - ANSWER Client verbalizes that sound is heard bilaterally. What is considered a common cause of acute epistaxis? - ANSWER Foreign Body When assessing the client pupil for constriction, the clinician notes that the other pupil contracts as well. Which medical terminology describes this reflex? - ANSWER Consensual Reaction Which of the following lymph nodes are not located in the head and neck regions? - ANSWER Axillary Hearing acuity can be assessed by using the following techniques. - ANSWER Whisper
Which of the following is the proper technique for utilizing a tuning fork? - ANSWER Tap the turning fork to elicit vibration and place on top of the client head. Which of the following is not part of the examination of the head? - ANSWER Auscultation Which of the following would be considered subjective data of the pulmonary system? - ANSWER Positive shortness of breath Which of the following would be considered a normal pulmonary finding? - ANSWER Absence of rhonchi Which of the following would not be documented in the objective data? - ANSWER Positive tobacco use Which of the following pulmonary documentation would be considered objective data? - ANSWER Pursed lip breathing
Which of the following would not be considered a healthy lifestyle modification to prevent hypertension? - ANSWER Intake of less than 6 g sodium per day. Which of the following would not be criteria for a diagnosis of Metabolic Syndrome? - ANSWER HDL > 50 mg/dL Which of the following patient meet the criteria for screening for Diabetes? - ANSWER Polycystic ovarian syndrome. Which of the following is considered Prehypertension? - ANSWER 128/ Which of the following are risk factors for Secondary Hypertension? - ANSWER Thyroid Disease. Which of the following are risk factors for Primary Hypertension? - ANSWER Obesity
The apical pulse is noted in which of the following locations? ICS intercostal space MCL - clavicular line) - ANSWER 5th Left ICS MCL Which position should the patient be placed to assess the PMI. - ANSWER Left lateral decubitus position. Which of the following is not proper technique when examining the carotid pulse? - ANSWER Palpate each side simultaneously. Which of the following factors is not included when calculating a patient's 10- year CVD risk? - ANSWER Asthma Which of the following would not warrant screening for RAD? - ANSWER One kidney noted to be 1 cm smaller as compared to the other kidney What estimated size of an abdominal aortic aneurysm significantly increases the risk for rupture? - ANSWER 5.5 cm What is the proper technique when performing the Homan's Sign? - ANSWER Dorsiflex the foot of the affected extremity to assess for tenderness.
Which of the following is not considered a symptom of perimenopause? - ANSWER Vaginal discharge. Patients who are diagnosed with gonorrhea should be treated for which of the following infections? - ANSWER Chlamydia. A 22-year-old female presents to the clinic with a 7-day history of thick white vaginal discharge with vaginal itching. LMP 3 weeks ago; currently not sexually active. On speculum examination, there is a copious amount of white thick discharge; Negative KOH whiff test; Wet Prep: positive budding hyphae. Which of the following is the most likely diagnosis? - ANSWER Candidiasis Which of the following is true regarding the HPV virus? - ANSWER Most HPV infections clear spontaneously within 2 years in females less than 21 years. Which of the following regarding breast examination is incorrect? - ANSWER Instruct patient to perform breast exam during the onset of monthly menses. During a pelvic exam the clinician noted small yellow nodules on the surface
of the cervix. What is the most likely cause? - ANSWER Nabothian Cysts. The squamocolumnar Junction is noted in which portion of the female genitalia? - ANSWER Cervical Os. Which of the following is true concerning the HPV Vaccination? - ANSWER It can protect against anal cancers in both females and males. Which of the following is the most common cause of acute pelvic pain? - ANSWER Pelvic Inflammatory Disease 34-year-old female presents with acute, sharp pelvic pain x 6 hours. States that nothing makes the pain better or worse. GYN History: G3P3. Prior Surgical History Appendectomy age 15. was 8 weeks ago. BP is 90/60 Pulse 110. Temp 98.6. Positive bowel sounds 4. Pelvic exam reveals negative vaginal discharge, negative cervical motion tenderness. Positive right adnexal tenderness noted upon palpation Urinalysis is negative, UCG test pending. Which of the following adnexal disorders could be causing this presentation? - ANSWER Ectopic Pregnancy. Which of the following is not associated with Acute Bacterial Prostatitis? - ANSWER Chlamydia and Gonorrhea may be the cause in males older than 35 years
Which is the following information regarding testicular cancer is false? - ANSWER Testicular cancer is five times more common in African American males compared to Caucasian males. Which of the following symptoms is not indicated for a prompt clinical examination? - ANSWER One testicle hanging lower than the other testicle While examining the penis, the clinician notes a tight prepuce that cannot be retracted over the glans. Which of the following is the correct diagnosis? - ANSWER Phimosis Which of the following is considered a non-inflammatory joint disorder? - ANSWER Rotator cuff tear Which is the following systemic involved joint disorder would a clinician note a positive malar rash on the cheeks? - ANSWER Systemic Lupus erythematous Which of the following symptoms is not considered a red flag in a patient with low back pain? - ANSWER Radicular Pain from hip to popliteal area
Which of the following is not considered a risk factor of osteoporosis? - ANSWER Premenopausal women Positive pain and tenderness along the lateral epicondyle as a result of overuse maybe which of the following diagnoses? - ANSWER Tennis Elbow Which of the following is not associated with Carpal Tunnel Syndrome? - ANSWER Positive "Snuffbox" Tenderness Which of the following is the most common skin cancer? - ANSWER Basal cell carcinoma C - ANSWER C A 40-year-old female reports a 2-day history of painful lesions on her left side. Upon examination, a cluster of erythematous vesicular lesions noted along the left trunk in a dermatomal distribution. What is the most likely diagnosis? - ANSWER Herpes zoster Which of the following would be most appropriate medical term to define a fluid filled lesion greater than 1 cm? - ANSWER Bulla
