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Health Assessment Midterm Review Exam With Answers (107 Solved Questions)

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    Advanced Health Assessment Midterm Review of Quiz Questions 1. The following information belongs in which section of the Comprehensive Heath History (H&P)? "3 day history of rash and swelling" A. History of Present Illness B. Review of Systems C. Allergies D. Chief Complaint D. Chief Complaint 2. A patient with abdominal pain describes "what" the pain feels like and "how long" it lasts. In which part of the H&P would you place this information? A. History of Present Illness B. Past Medical History C. Sexual History D. Review of Systems A. History of pre- sent illness 3. Which of the following best describes the patient record? A. describes the approach to a problem B. serves a dual purpose as it reflects your anaylsis of the patient's health status and documents exami- nation findings C. shows your clinical thought process D. reflects you interpersonal skills with the patient B. serves a dual purpose as it re- flects your anayl- sis of the patient's health status and documents exami- nation findings 4. The consideration of culture and ethnicity during the interview process are important because: A. similar cultures always provide similar responses B. some cultures consider certain questions and ges- tures offensive C. it is politically correct D. none of the above B. some cul- tures consider certain questions and gestures of- fensive 1 / 45

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    5. During an interview, your patient admits to feeling worthless and having a sleep disturbance for the last 3 weeks. These are clues that warrant exploration of: A. risk for suicide B. split personality C. cognitive function D. functional assessment A. risk for suicide 6. Worries persisting for =>6 months most likely reflects one of the most prevalent psychiatric conditions in the United States known as: A. posttraumatic stress disorder B. generalized anxiety disorder C. fatigue D. social phobia B. generalized anxiety disorder 7. Risk factors for fatal overdose of pain medications include all of the following except: A. age 65 or older B. depression C. arthritis D. concurrent benzodiazepine use C. arthritis 8. A healthy BMI can best be described as: A. 18.5-24.9 B. 30.0-34.9 C. 25.0-29.9 D. 35.0-39.9 A. 18.5-24.9 9. The comprehensive health history: A. has a completely different format that varies with C. follows the same general for- mat regardless of the institution or 2 / 45

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    each institution B. varies from country to country C. follows the same general format regardless of the institution or geographical location D. follows the exact same format across the world, except Europe geographical loca- tion 10. Which of the following is not a common symptom of depression? A. Anhedonia B. Dry lips C. Appetite disturbance D. Worthlessness B. Dry lips 11. During a mental status exam, which question might you ask to assess abstraction ability? A. What does a rolling stone gathers no moss mean? B. Start with 100 and keep subtracting by 7 C How long have you been here? D. What's your mother's maiden name? A. What does a rolling stone gathers no moss mean? 12. Dave, age 76, is brought in by his wife, who states that within the last 2 days Dave has become agitated and restless, has had few lucid moments, slept very poor- ly last night and can remember only recent events. Of the following differential diagnoses, which best fits the symptoms from this brief history? A. Depression B. Dementia C. Delirium D. Schizophrenia C. Delirium 13. Which technique is applied throughout the entire ex- amination and interview process? A. Inspection 3 / 45

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    A. Inspection B. Palpation C. Percussion D. Auscultation 14. During a patient's pain assessment, the most impor- tant element is the patient's: A. Sleep hygiene B. Perception of his/her own pain C. Vital signs D. Fear of addiction B. Perception of his/her own pain 15. The general survey of the patient includes all of the following except: A. appearance B. tanner stage C. height D. weight B. tanner stage 16. One of the main differences between a comprehen- sive and focused assessment is: A. for the comprehensive assessment you will select the methods relevant to thorough assessment of the targeted problem B. for the focused assessment you will select the methods relevant to thorough assessment of the tar- geted problem C. for the focused assessment you perform a thor- ough head to toe examination D. for the comprehensive assessment you always refer the patient to a specialist at the end of the examination B. for the focused assessment you will select the methods relevant to thorough as- sessment of the targeted problem 4 / 45

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    17. Which of the following is an example of subjective data: A. Mr. D's vital signs are BP 138/66 P 107 T 99.9 SPO2 92% RR 20 B. Mr. D has inspiratory and expiratory wheezes noted during auscultation of the lungs C. Mr D's CXR shows an infiltrate in the left lower lobe consistent with pneumonia D. Mr D is a 53 year old male who presents to the clinic complaining of shortness of breath and says "it hurts to take deep breaths." He reports this started 2 days ago and says he's been having fever and chills. D. Mr D is a 53 year old male who presents to the clinic complaining of shortness of breath and says "it hurts to take deep breaths." He re- ports this started 2 days ago and says he's been having fever and chills. 18. All of the following are included in the Review of Systems except: A. general B. Cardiovascular C. Psychiatric D. All of the above D. All of the above 19. Which of the following is not a goal when developing a systematic sequence of examination: A. maximize the patients' comfort B. perform invasive imaging first C. avoid unnecessary changes in position D. enhance clinical efficiency B. perform inva- sive imaging first 20. All of the following are examples of health promotion except: A. using USPSTF guidelines for practice during the exam C. removing baby aspirin 81 mg from the medica- tion list of a patient with know coro- nary artery dis- 5 / 45

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    B. using American College of Chest Physicians grad- ing criteria during the exam C. removing baby aspirin 81 mg from the medication list of a patient with know coronary artery disease during the exam D. using CDC recommendations for exercise during the exam ease during the exam 21. The initial moments of your encounter with a pa- tient lay the foundation for your ongoing relationship. Which of the following best helps lay that foundation: A. ensure there is more than adequate lighting in the exam room B. explain your role, your status as a student provider and how you will be involved in the patient's care C. check the light source in the otoscope D. check the light source in the opthalmascope B. explain your role, your sta- tus as a student provider and how you will be in- volved in the pa- tient's care 22. Which of the following is not one of the seven attrib- utes of a symptom: A. location B. quality C. timing D. immunization status D. immunization status 23. All of the following are examples of empathic re- sponses except: A. "I cannot imagine how hard this must be for you" B. "I think you need a psych consult immediately" C. "You must be feeling sad" D. "That sounds upsetting" B. "I think you need a psych con- sult immediately" 24. Which of the following are components of the three dimensions of cultural humility: D. all of the above 6 / 45

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    A. self-awareness B. respectful communication C. collaborative partnership D. all of the above 25. When performing the general survey which of the following is not considered a sign of distress: A. pain B. labored breathing C. large mole on forehead D. anxiety C. large mole on forehead 26. You are speaking to an 8th grade class about health prevention and are preparing to discuss the ABCDEs of melanoma. Which of the following descriptions correctly defines the ABCDEs? A = asymmetry; B = irregular borders; C = color changes, especially blue; D = diameter >6 mm; E = evolution A = actinic; B = basal cell; C = color changes, espe- cially blue; D = diameter >6 mm; E = evolution A = actinic; B = irregular borders; C = keratoses; D = dystrophic nails; E = evolution A = asymmetry; B = regular borders; C = color changes, especially orange; D = diameter >6 mm; E = evolution A = asymmetry; B = irregular bor- ders; C = col- or changes, espe- cially blue; D = di- ameter >6 mm; E = evolution 7 / 45

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    27. A 28-year-old patient comes to the office for evalua- tion of a rash. At first there was only one large patch, but then more lesions erupted suddenly on the back and torso; the lesions itch. On physical examination, you note that the pattern of eruption is like a Christ- mas tree and that there are a variety of erythematous papules and macules on the cleavage lines of the back. Based on this description, what is the most likely diagnosis? Tinea versicolor Pityriasis rosea Psoriasis Atopic eczema Pityriasis rosea 28. A 19-year-old construction worker presents for eval- uation of a rash. He notes that it started on his back with a multitude of spots and is also on his arms, chest, and neck. It itches a lot. He does sweat more than before because being outdoors is part of his job. On physical examination, you note dark tan patches with a reddish cast that has sharp borders and fine scales, scattered more prominently around the upper back, chest, neck, and upper arms as well as under the arms. Based on this description, what is your most likely diagnosis? Tinea versicolor Pityriasis rosea Tinea versicolor 8 / 45

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    Psoriasis Atopic eczema 29. Which skin lesions are most commonly found on sun-exposed skin of older, fair-skinned people? Skin tags Seborrheic keratoses Actinic keratoses Angiomas Actinic keratoses 30. A 68-year-old retired farmer comes to your office for evaluation of a skin lesion. On the right temporal area of the forehead, you see a flattened papule the same color as his skin, covered by a dry scale that is round and feels hard. He has several more of these scattered on the forehead, arms, and legs. Based on this description, what is your most likely diagnosis? Seborrheic keratosis Actinic keratosis Basal cell carcinoma Actinic keratosis 9 / 45

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    Squamous cell carcinoma 31. Which type of lesion often grows out of already pre- sent nevi that are changing or atypical, especially if the patient is over 50 years old: malignant melanoma basal cell carcinoma squamous cell carcinoma karposi sarcoma malignant melanoma 32. Nail involvement characterized by painless separa- tion of the nail plate from the nail bed is termed: Hippocratic nails Onycholysis Koilonychia Anonychia Onycholysis 33. A 72-year-old teacher comes to a skilled nursing fa- cility for rehabilitation after being in the hospital for 6 weeks. She was treated for sepsis and respiratory failure and had to be on the ventilator for 3 weeks. You are completing your initial assessment and are Stage 3 10 / 45

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    evaluating her skin condition. On her sacrum there is full-thickness skin loss that is 5 cm in diameter, with damage to the subcutaneous tissue. The underlying muscle is not affected. You diagnose this as a pres- sure ulcer. What is the stage of this ulcer? Stage 1 Stage 2 Stage 3 Stage 4 34. Sammy, age 12, presents with claerly demarcated round or oval patches of hair loss without visible scaling or inflammation. What do you suspect? Psoriasis Erythema multiforme Alopecia Areata Syphilis Alopecia Areata 35. A basal cell carcinoma is: an epithelial tumor that originates from either the basal layer of the epidermis or cells in the sur- rounding dermal structures and are usually found in an epithelial tu- mor that origi- nates from either the basal layer of the epidermis 11 / 45

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    sun-exposed areas a malignant tumor of the squamous epithelium of the skin or mucous membranes an overgrowth and thickening of the cornified epithe- lium lined with epithelium and contains a fluid or semisol- id material or cells in the surrounding der- mal structures and are usually found in sun-exposed ar- eas 36. You ask a patient to follow your finger laterally when evaluating extraocular movements. Which cra- nial nerves are you testing? IV, VII III, VI III, X II, III III, VI 37. The mental status examination enables the nurse practitioner to identify: Intelligence quotient and reasoning Abstract thinking and memory functioning Reasoning and psychomotor skills Abstract thinking and memory func- tioning 12 / 45

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    Memory functioning and intelligence 38. An assessment of a client experiencing hallucina- tions would most likely reveal all of the following except: experiences that seem real but lack actual external stimulation may be auditory may be visual only occurs in the setting of schizophrenia only occurs in the setting of schizo- phrenia 39. The nurse practitioner is examining an adolescent who has been a long-term IV cocaine user. What other findings would alert the nurse practitioner to a fre- quent complication. Epistaxis and chronic rhinorrhea Cardiac arrhythmias and hypertension Chest congestion and wheezing Hepatitis and cellulitis Hepatitis and cel- lulitis 40. The nurse practitioner is completing a history and physical on a child who she suspects may be autistic. Findings associated with autism include: Delay in language development Delay in language development 13 / 45

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