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REGIS. NU 650 REVISION QUESTIONS WITH ANSWERS REGIS. NU 650 REVISION QUESTIONS WITH ANSWERS
Typology: Exams
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Order of Assessment - CORRECT ANSWER Inspection, Palpation, Percussion and Auscultation. EXCEPT with abdomen Comprehensive Health History - CORRECT ANSWER chief complaint, reason for visit, ROS, past medical and surgical history, social history and family history Pediatric Body measurements - CORRECT ANSWER length, height, weight, head circumference fro birth to 36 months Normal/Hypertension cut off - CORRECT ANSWER <130 normal 140+ hypertension Fontanel Closure - CORRECT ANSWER posterior 1-2 months, anterior 9mo-2years otoscope - CORRECT ANSWER adult-up and back, peds- down and back, using largest speculum that will fit comforably tympanic membrane - CORRECT ANSWER Cone of light R-5 l- EOM testing - CORRECT ANSWER CN III, IV, VI AP diameter of chest - CORRECT ANSWER 1:2 (AP less than transverse) barrel chest - CORRECT ANSWER COPD Flat or Dull percussion - CORRECT ANSWER effusion or pneumonia normal resonant percussion - CORRECT ANSWER healthy lung
Hyperressonance (percussion) - CORRECT ANSWER trapped air crackles/rales - CORRECT ANSWER high pitched, discontinuous Wheezes - CORRECT ANSWER high-pitched whistling or squeaking sounds during inspiration or expiration Rhonchi - CORRECT ANSWER snoring, rumbling sounds heard upon auscultation of the chest during respiration-low pitched tactile fremitus - CORRECT ANSWER • INCREASED FREMITUS
PMI - CORRECT ANSWER point of maximal impulse mid-clavicular and 5th ICS S1 - CORRECT ANSWER normal, closure of AV, Start of systole, loudest at Apex, contraction of ventricles S2 - CORRECT ANSWER normal, closure of semilunar, end of systole, loudest at base, filling of ventricles S3 - CORRECT ANSWER third heart sound (normal in pregnant young adults, and children), gallop S4 - CORRECT ANSWER extra heart sound, end of diastole, indicative of disease-AFIB murmur grading scale - CORRECT ANSWER I-Barely Audible II-Quiet, Clearly Audible III-moderately Loud IV-loud, thrill V-Very loud, can palpate thrill VI-Very loud, thrill palpable and visible clubbing - CORRECT ANSWER bulbous enlargement of distal phalanges of fingers and toes that occurs with chronic cyanotic heart and lung conditions edema scale - CORRECT ANSWER 1+ = disappears rapidly. 2+ = last 10-15 seconds. 3+ = lasts more than one minute. 4+ = lasts 2-5 minutes. These are signs used in what scale?
normal/abnormal findings spleen - CORRECT ANSWER normal=tympanic, dullness could be enlargement not normally felt on exam Blumberg Sign: Rebound Test - CORRECT ANSWER peritoneal inflammation, hurts more when release from palpation
Impingement Sign - CORRECT ANSWER POSITIVE: pain in the shoulder INDICATES: overuse injury to the supraspinatus and possibly biceps tendon
Drop Arm Test - CORRECT ANSWER identifies tear and/or full rupture of rotator cuff Allen test - CORRECT ANSWER determining the patency of the radial and ulnar arteries by compressing one artery site and observing return of skin color as evidence of patency of the other artery Phalen's sign - CORRECT ANSWER Tingling, numbness, or pain in the fingers within 60 seconds of performing Phalen's maneuver, a diagnostic test for carpal tunnel syndrome Tinel's sign - CORRECT ANSWER A distal tingling sensation on percussion of median nerve of the inner wrist; characteristic of carpal tunnel syndrome Drawer Test - knee - CORRECT ANSWER Patient supine, examiner flexes the hip and the knee of the patient's affected leg until the foot is flat on the table. Examiner sits on the foot of thepatient's afectedleg. Examinergrasps behindthe patient'sflexed knee and exerts a pushing and pulling pressure into the affected knee. +(1) Gapping > 6mm (tibia moves posterior) when the leg is pushed. +(2) same when the leg is pulled. INDIC: (1) Torn posterior cruciate ligament. (2) Torn anterior cruciate ligament. Confirmation Test: Lachman'sTest Lachman's Test - CORRECT ANSWER pivot shift test (ACL tear) Ballottment sign - CORRECT ANSWER medical sign which indicates increased fluid over the patella at the knee joint
Cranial Nerves - CORRECT ANSWER I. Olfactory-smell II. Optic-VA III. Oculomotor-EOM, PERRLA IV. Trochlear-EOM V. Trigeminal-facial sensation, chewing VI. Abducens-EOM VII. Facial-face actions VIII. Vestibulocochlear-hearing IX. Glossopharyngeal-gag, tongue X. Vagus-ahh XI. Accessory-raise shoulders XII. Hypoglossal-ahh Weber test - CORRECT ANSWER Test done by placing the stem of a vibrating tuning fork on the midline of the head and having the patient indicate in which ear the tone can be heard. conductive in lateral side or sensory in opposite Rinne test - CORRECT ANSWER hearing test using a tuning fork; checks for differences in bone conduction and air conduction rinne usually conductive hearing loss Muscle strength scale - CORRECT ANSWER 0 - no movement 1 - flicker of muscle 2 - joint movement, not against gravity 3 - moves against gravity, not resistance 4 - moves against resistance, but weak 5 - strong against resistance.
Denominator is always 5. Strength is only tested with "normal" movement
Moro reflex (startle reflex) - CORRECT ANSWER Sudden loud noise will cause symmetric abduction and extension of the arms followed by adduction and fl exion of the arms over the body. Disappears by 3 to 4 months. ■ Absence on one side: Rule out brachial plexus injury, fracture, shoulder dystocia.
■ Absence on both sides: Rule out spinal cord or brain lesion. ■ Older infant: Persistence of Moro refl ex abnormal. Rule out brain pathology. rooting reflex - CORRECT ANSWER a baby's tendency, when touched on the cheek, to turn toward the touch, open the mouth, and search for the nipple, 3-4 months palmar grasp reflex - CORRECT ANSWER in response to stroking a baby's palm, the baby's hand will grasp. This reflex lasts a few months gone by 3-4 months Prostate screening - CORRECT ANSWER Yearly PSA blood test and digital rectal examination starting at age 50 or at age 45 if at high risk testicular self-examination - CORRECT ANSWER a self-help step in early detection of testicular cancer by detecting lumps, swelling, or changes in the skin of the scrotum, 1 x per month with warm water in shower breast self-examination - CORRECT ANSWER a self-care procedure for the early detection of breast cancer, raise arms for retraction or dimpling, best done 5-7 days after period Pap smear test - CORRECT ANSWER microscopic examination of stained cells removed from the vagina and cervix, in order form vag pool, cervical scrape, endocervical infant milestones - CORRECT ANSWER 2 months - holds up head 4 months - rolls from abdomen to back 7 months - sits alone 9 months - crawls 8 - 15 months - standing with support &
Aortic regurgitation murmur - CORRECT ANSWER early diastolic murmur-high pitched "blowing" Mitral stenosis murmur - CORRECT ANSWER "early to mid diastolic low pitch rumble murmur best heard at apex in left lateral decubitus position. May also have presystolic murmur." Mitral regurgitation murmur - CORRECT ANSWER pansystolic murmur, loudest at the apex with radiation to the axilla MR PASS MVP - CORRECT ANSWER mitral regurgitation, physiologic, aortic stenosis, systolic MS ARD - CORRECT ANSWER Mitral Stenosis Aortic Regurgitatio n Diastolic AS SAD - CORRECT ANSWER Aortic stenosis syncope, angina, dyspnea harsh sounds murmur - CORRECT ANSWER stenosis blowing sounds murmur - CORRECT ANSWER regurgitation Tanner stage girls - CORRECT ANSWER Stage 1-Prepuberty Stage 2-Brest bud(onset of thelarche or breast development) Stage 3-Breast tissue and areola are in one
mound Stage 4-Areola/nipples separate and form a secondary mound) Stage 5-Adult pattern Tanner stage Boys - CORRECT ANSWER 1. Prepuberty II. enlargement of scrotum & testes
position and vibration sense - CORRECT ANSWER posterior column Discrimination - CORRECT ANSWER cortex and tract/column
breast cancer risk factors - CORRECT ANSWER age, family history, early menses, null/late parity, hormone replacement testicular cancer risk factors - CORRECT ANSWER Cryptochordism, prior testicular cancer or family hx; race (Caucasian 5X greater risk than African American) Baker's cyst - CORRECT ANSWER accumulation of synovial fluid in the knee joint rheumatoid arthritis (RA) - CORRECT ANSWER chronic systemic disease characterized by autoimmune inflammatory changes in the connective tissue throughout the body herbeden's (DIP) and bouchard's nodes(PIP) - CORRECT ANSWER OA McMurray Test - CORRECT ANSWER compression of the meniscus of the knee combined with internal and external rotation while the patient is face-up to assess the integrity of the meniscus Osteoporosis T score - CORRECT ANSWER T score < -2. Osteopenia T score - CORRECT ANSWER between -1 and -2. Joint types - CORRECT ANSWER 1. Ball -and-Socket joint: Allows movement in all directions (hip & shoulder joints) 2. Hinge Joint: Allows movement in one direction (elbow) 3. Pivot Joint: Allows turning from side to side (a pivot joint connects the skull to the spine) Ortolani test - CORRECT ANSWER -hip abduction w/a resulting clunk as the head relocates into the joint Allis test - CORRECT ANSWER used to check for hip dislocation in infants by comparing