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PCHA Final Exam | Latest 2025 / 2026 Update |
Questions and Verified Answers | Personal Care Home
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A patient tells the nurse that he is very nervous, nauseated and that he "feels hot". This type of data would be considered: subjective Because the physical environment in which an interview takes place is an important consideration for the success of an interview, the interviewer should: reduce noise by turning off televisions and cell phones A nurse is taking complete health histories on all the patients attending a wellness workshop. While conducting an interview with a patient, the nurse asks, "Can you tell me a little about yourself?" This question is an example of: an open-ended question During an interview, a parent of a hospitalized child is sitting in an open position. As the interviewer begins to discuss the child's treatment, however, the parent suddenly crosses the arms against the chest and crosses the legs. Based on the understanding that nonverbal modes of communication provide clues to understanding feelings, the sudden change in body position would suggest that the parent is: uncomfortable talking about his child's treatment
A 59-year-old patient is returning to the outpatient clinic for a follow up visit. The patient has a history of ulcerative colitis. The patient states he has been having "black stools" for the last 24 hours. Which of the following would be the most complete way for the nurse to document the patient's reason for seeking care? J.M. is a 59-year-old patient here for having "black stools" for the past 24 hours. Which of the following statements best describes the purpose of a health history? to provide a database of subjective information about the patient's past and current health. The inspection phase of the physical assessment: begins the moment you first meet the person and develop a "general survey". A patient is at the clinic for a physical examination. He states that he is "very anxious" about the physical exam. What steps can the examiner take to make the patient more comfortable? Appear unhurried and confident when examining the patient. When performing a physical examination, safety must be considered to protect the examiner and the patient against the spread of infection. Which of the following statements describes the most appropriate actions the examiner should take when performing a physical examination? Wash hands at the beginning of the examination and any time that one leaves and re-enters the room. A 50-year-old patient who is taking anti-hypertensive medications returns to the clinic to have their blood pressure (BP) checked. The last BP was 146/88. The BP reported to the nurse is 168/96. Both blood pressures were taken at the brachial site. Which of the following is true regarding blood pressure assessment in this patient? Choose all that apply:
Inflate the blood pressure cuff 30 mm Hg above the point at which the palpated pulse disappeared. A patient is being seen in the clinic for "fainting episodes". The patient has a blood pressure of 150/90 in a lying position, 120/80 in a sitting position, and 90/60 in a standing position. How should the nurse interpret these findings? The change in blood pressure readings is called orthostatic hypotension. In the article by Rakotz, 'Medical students and measuring blood pressure: Results from the American Medical Association Blood Pressure Check Challenge', what are the consequences of poor technique when measuring blood pressure? all of the above
- A 5- to 10-mm Hg error can result in an incorrect diagnosis of hypertension.
- Poor technique can cause patients with hypertension that is controlled to appear uncontrolled.
- Without accurate blood pressure readings, improving blood pressure control in unlikely because physicians will not reliably know which patients need to be more aggressively treated and which do not. Which of the following is correct about arterial blood pressure? It is important to know the normal blood pressure of each individual. The nurse has just admitted the patient for evaluation of unexplained fever. The patient's temperature is 102o F, blood pressure 76/50 (baseline 130/74), pulse 110 bpm (baseline 72), respiration 16 bpm (baseline 12). Which of the following best explains the patient's hypotension? Vasodilation secondary to his illness.
Which of the following is NOT true regarding assessment of the respiratory system? Orthopnea refers to a subjective feeling of not being able to get enough oxygen while standing. The patient is a 85-years-old and has come to your clinic with complaints of fatigue, cough and decreased appetite for 3 days. When taking vital signs on this client, you note the oral temperature to be 99.3o F. You should: consider this a concerning finding which needs attention According to the article by Kiekkas, et al., 'Physical Antipyresis in Critically Ill Adults', what is the benefit of temperature elevation? inhibits bacterial growth In the article by Cretikos, et al., 'Respiratory rate: The neglected vital sign', a patient with a respiratory rate of over 24 breaths/minute should be monitored more closely, even if other vital signs are normal. true Which of the following is true with regard to using the temporal artery thermometer? Measure only the 'up' or exposed side for the most accurate reading. The patient is admitted to the hospital after a three day history of severe vomiting and diarrhea secondary to a bacterial infection of the colon. The patient is otherwise in good health with no chronic illnesses. The baseline blood pressure is 130/84, pulse 78. During the admission assessment, what might the nurse expect the patient's vital signs to be based on the illness? (All blood pressures taken in the supine (lying) position). Pulse: 130, Blood Pressure: 90/50, Resp: 24, Temp: 102°F
resonant percussion tones over lung tissue and symmetrical thoracic expansion. When auscultating the posterior lower lung lobes of the adult client, the practitioner notes low pitched, soft breath sounds with inspiration being longer than expiration. The practitioner knows that these are: vesicular breath sounds and are normal in that location Which of the following techniques is appropriate during auscultation of breath sounds? Listen to at least one full respiration (inspiration and expiration) in each location. The angle of Louis: is a landmark used to mark tracheal bifurcation anteriorly. When inspecting the anterior chest of an adult, the nurse should assess for: (choose all that apply)
- diaphragmatic excursion.
- symmetric chest expansion.
- the presence of breath sounds.
- the shape and configuration of the chest wall.
- retractions or bulging
- skin temperature
- use of accessory muscles 2, 4, 5, 7
The nurse has noted unequal chest expansion and recognizes that this occurs when: part of the lung is obstructed or collapsed When listening to heart sounds, the nurse knows that which of the following statements concerning S1 is true? S1 is caused by closure of the mitral and tricuspid valves. Ms. Key has a visible apical impulse in the seventh to eighth left intercostal space lateral to the midclavicular line. Upon palpation, the impulse, which feels like a short 'tap', is approximately 5 cm in diameter and feels more forceful than usual. These physical finding indicate: left ventricular enlargement Which of the following is true regarding an S3 heart sound? S3 occurs early in diastole. Normal physiologic splitting of S2 occurs due to: early aortic valve closure and late pulmonic valve closure. When listening to heart sounds, the nurse knows that the valve closures that can be heard best at the base of the heart are: aortic; pulmonic
Assessment findings which may indicate cardiac disease include: pitting edema In assessing a patient's major risk factors for heart disease, which would the nurse want to include when taking a history? all of the above
- cigarette smoking
- hypertension
- high blood cholesterol The patient has 20/100 vision. When the patient asks the nurse what this means, the correct response would be: "This is a variation from normal and means that you see at 20 feet what average eyes would see at 100 feet." The patient presents to the hospital Emergency Department with a dilated left pupil, left ptosis, and inability to look up, down, or medially with the left eye. These signs may indicate a problem with: Left oculomotor nerve (CN III) The patient visits the clinic complaining of excessive tearing in the left eye. The nurse should assess the patient's eye for: lacrimal sac obstruction.
The patient comes to the clinic for a routine well patient yearly physical exam. The patient has no complaints at this visit, and no history of any chronic illnesses. Upon examining the nasal cavity, the nasal septum is symmetrical with scant amount of clear drainage; no masses or lesions are noted. No other symptoms are noted. These findings are: normal findings The size of the normal pupil is determined by: all of the above
- amount of light entering the eye
- closeness of the object being visualized
- function of cranial nerves II (optic) and III (oculomotor) The patient comes to the clinic complaining of blurred vision when reading the newspaper. After testing the patient's near vision, the nurse explains to the patient that he has impaired near vision and discusses a possible reason for the condition. The nurse determines the patient has understood the teaching when the patient states presbyopia is usually due to: decreased ability of the lens to accommodate Which of the following best describes the test performed to assess the function of cranial nerve XII (hypoglossal)? Ask the patient to stick out his tongue and observe for midline position. Which of the following is true regarding assessment of the thyroid gland? The physical characteristics of the thyroid gland tell you little about thyroid function.
Which of the following is an expected normal finding when examining the function of the extraocular eye muscles? parallel movement of both eyes The patient is at the clinic for an eye examination. The nurse suspects that the patient has a ptosis of one eye. How would the nurse check for this? Observe the distance between the upper and lower eyelid (palpebral fissure). When performing the whisper test to assess hearing, which of the following would be appropriate? Whisper words or numbers 1 - 2 feet behind the client and ask the client to repeat them. The patient comes to the clinic with a suspected lesion of cranial nerve XI (spinal accessory). How would the nurse assess for this? Ask the client to shrug his shoulders against resistance and turn his head side-to-side against resistance. Which of the following best describes the test the nurse should use to assess the function of cranial nerve X? Ask the patient to say "ahhh" and watch for movement of the soft palate and uvula. The practitioner shines a light straight toward the bridge of the nose of the client. A bright dot of light appears at the 3 o'clock position in the left eye and 10 o'clock position in the right eye. This finding is known as a/an: abnormal corneal light reflex
Which of the following is needed by a primary care clinician (for example a physician or nurse practitioner) to conduct a thorough oral exam? all of the above
- exam light to illuminate key features in the mouth
- tongue depressors to lift the lip and retract the cheek
- gauze pads to grasp the tongue What can the primary care clinician (for example a physician or nurse practitioner) do to promote oral health? Collaborate with dental and other health professionals What is the suggested pathway linking chronic periodontitis and conditions such as diabetes, coronary artery disease and adverse pregnancy outcomes? Inflammation Oral cancer is most common in which area of the mouth? Posterolateral tongue During an abdominal assessment, the nurse would consider which of these findings as normal? Tympanic percussion note in the umbilical region
- Men with a history of undescended testes are at risk for development of testicular cancer. Which of the following statements made by the patient regarding testicular self-exam would indicate a need for further education? "I should examine the testicles when I take a cool or cold shower." Mrs. L., a 25 - year- old female, comes to your clinic for a routine physical exam. While performing her breast exam, she tells you she has never had anyone teach her how to properly examine her breasts and asks that you educate her on the breast self exam. Which of the following is true regarding assessment of the breasts? A & D
- To perform a breast self-exam, press the three middle fingers in a circular motion and follow an up and down method.
- The best time to perform the breast self exam is right after the menstrual period. During a discussion for a men's health group, the nurse relates that the group with the highest incidence of prostate cancer is: African-American The nurse is collecting subjective data prior to the female genitourinary exam. The patient describes pain and cramping before and during her menstrual period. How would the nurse document this finding? dysmenorrhea Normal inspection findings for the female genitourinary examination include: all of the above
- Vaginal discharge is small, clear, and nonirritating.
- Labia minora are dark pink and symmetric
- No lesions are present except for occasional sebaceous cysts
- Anus has coarse skin of increased pigmentation. Life style factors related to breast cancer risk include: A & B
- drinking alcohol
- obesity ROM should be performed with and without palpation to reveal findings such as crepitation of the joint. true Which of the following is true regarding assessment of the muscle? Muscle tone is assessed with muscles in their resting state or with slight resistance. Active range of motion should be performed before muscle strength testing because: if muscle strength were tested before ROM, more marked contraction of the muscle may cause pain in the client and therefore skew the ROM findings. When testing range of motion of the shoulders, the practitioner should: with arms at sides and elbows extended, ask the patient to move both arms forward and up to test forward flexion.
The patient comes to the neurology clinic complaining of inability to plantar flex the foot. Upon examination, the nurse notices the Achilles reflex is absent and sensory sensations over the dorsum of the big toe are absent. The lesion is in which spinal cord segments? L4 - L5, S1 - S The nurse has just stuck herself with a sharp needle. In order for the nurse to be able to interpret this sensation, which of the following areas must be intact? lateral spinothalamic tract, thalamus, and sensory cortex. While taking a health history on the patient, the nurse notes a history of polio as a child. During the physical exam, the nurse also notes flaccid paralysis of the patient's left leg only with atrophy of the leg muscles. The patient's paralysis would be due to damage of the: ventral horn cells The patient has uncoordinated rapid alternating movements, an intentional tremor when asked to perform finger-to-nose movements, and sways excessively with the eyes open and closed. The nurse would suspect a lesion in the: cerebellum The patient is admitted to the neurology unit following a motor vehicle accident with severe head injuries. The patient opens the eyes to pain, but the patient's words are incomprehensible. With painful stimuli, the patient has rigid flexion of the upper arms which are held tightly to the chest, and the feet are plantar flexed and internally rotated. The patient's Glasgow Come Scale score is
- What information would the nurse give to this patient's family when they ask about the patient's condition? "His condition is very, very serious. The next 48 hours will be critical."
Which of the following must be functioning in order to correctly interpret numbers written in the palm of the hand (graphesthesia)? contralateral parietal lobe The Glasgow Coma scale involves assessment of: eye opening, verbal response, and motor response Which of the following is true regarding assessment of the neurologic system? Babinski reflex in a 2-month-old is considered normal. The patient arrives to the Emergency Department following a motorcycle accident in which the patient was thrown from a motorcycle. Initial tests show the patient has completely severed the spinal cord only at the level of the third thoracic vertebrae. The anterior horn cells are intact. What would be the most likely findings upon examination of this client? Severe muscle weakness or paralysis (spinal shock) below the level of the lesion initially (24- 48 hours), followed by spastic paralysis within several days or weeks. While performing a neurologic exam on , the nurse notes rapid rhythmic contraction of muscle groups while testing the ankle (Achilles) reflex. This finding is referred to as: clonus The practitioner places a key in the hand of the patient; the patient identifies it as a penny. What term would the nurse use to describe the result of this sensory exam? Astereognosis
