NURS6512 Walden University Clinical Analysis Midterm Exam Week 6 With Answers (200 Solved Questions)

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NURS 6512, Week 6 Midterm ExamThis exam is a test of your knowledge in preparation for your certification exam.No outsideresourcesincluding books, notes, websites, or any other type of resource are to be used tocomplete this exam. You are expected tocomply with Walden University’s Code of Conduct.This exam will be on topics covered in weeks 1, 2, 3, 4, 5, and 6. Prior to starting the exam, youshould review all of your materials. This exam is timed with a limit of two hours for completion.When time is up, your exam will automatically submit.Submission and Grading InformationSubmit Your Midterm Exam by Day 7QUESTIONS1. Before performing an abdominal examination, the examiner should:Have the patient empty their bladder2. During an interview, tears appear in the patient’s eyes and his voice becomes shaky. Initially, youshould:Keep the interview moving to distract the patient3. Which of the following is the most accurate reflection of an individual’s food intake?Food Diary4. Percussing at the right midclavicular line, below the umbilicus, and continuing upward is the correcttechnique for locating the:Lower liver border5. A fixed image of any group that rejects its potential for originality or individuality is known as a:Stereotype6. Peritonitis produces bowel sounds that areDecreased/Hypoactive7. Brittle nails are typical findings in:Older adults8. Which of the following is an expected change in the assessment of the thyroid during pregnancy?A Bruit is auscultated d/t increased vascularity9. You are planning to palpate the abdomen of your patient. Which part of the examiner's hand is best forpalpating vibration?Ulnar Surface

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10. A 5-year-old child presents with nasal congestion and a headache to assess for sinus tenderness youshould palpate over the:Maxillary sinuses only11. During physical examination of a 30-year-old Chinese man you notice a slight asymmetry of his face.the cranial nerve examination is normal. Your best action is toAsk the patient if this characteristic runs in his family12. Unusual white areas on the skin may be due toVitiligo13. You are using an ophthalmoscope to examine a patient’s inner eye. You rotate the lens selectorclockwise, then counterclockwise to compensate for:Myopia14. Mrs. Webb is a 38-year old patient who has been changing her lifestyle to eat in a healthy way andlose weight: during your health promotion education regarding her nutritional status, you explain thefunction of dietary protein as:Building and maintaining tissues15. Mr. Akins is a 78-y/o patient who presents to the clinic with complaints of hearing loss. Which of thefollowing are changes in hearing that occur in the elderly? Select all that apply.c. Loss of high frequencye. Sounds may be garbled, difficult to localizef. Unable to hear in a crowded room16. The most superior part of the stomach is theFundus17. Mrs. Grace is a 58-year-old patient who has a diagnosis of pernicious anemia. Which B vitamin isdeficient in patients with pernicious anemia?B1218. A 51-y/o woman calls with complaints of weight loss and constipation. She reports enlargedhemorrhoids and rectal bleeding. You advise her to:Come to the laboratory for a stool guaiac test.19. Placing the base of a vibrating tuning fork on the midline vertex of the patient’s head is a test for:Lateralization of Sound20. Which technique is most likely to result in the patients understanding of questions?Use the patient's own terms if possible.21. Mr. Williams, age 25, has recovered recently from an upper and lower respiratory infection. Hedescribes a long-standing nasal dripping. He is seeking treatment for a mild hearing loss that has not goneaway. Information concerning his chronic postnasal drip should be documented within which section ofthe history?Past medical data22. Nasal symptoms that imply an allergic response include:

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Bluish gray turbinates. ("Turbinates that appear bluish gray or pale pink with a swollen, boggyconsistency may indicate allergies"-Seidel p.243)23. Mr. Franklin is speaking with you the health care provider, about his respiratory problem. Mr.Franklin says, “I’ve had this cough for 3 days and it’s getting worse.” You reply, “Tell me more aboutyour cough.” Mr. Franklin states, “I wish I could tell you more, that’s why I am here! You tell me what’swrong.” Which caregiver response would be the most appropriate for enhancing communication?After 3 days, you're tired of coughing. Have you had a fever?"24. When taking a history, you should:Use a chronologic and sequential framework.25. Which of the following formats would be used for visits that address problems not yet identified in theproblem-oriented medical record (POMR)?Brief SOAP note26. Mr. and Mrs. Johnson have presented to the office with their infant son with complaints of eardrainage. When examining an infant’s middle ear, the nurse should use one hand to stabilize the otoscopeagainst the head while using the other hand to:Pull the auricle down and back in an effort to straighten the upward curvature of the canal27. Which question would be considered a leading question?You don't get headaches often, do you?"28. Mr. Black is a 44y/o patient who presents to the clinic with complaints of neck pain that he thinks isfrom his job involving computer data entry. As the examiner, you are checking the range of motion in hisneck and note the greatest degree of cervical mobility is at?C 4 to C 5: C4 and C5 or C5 and C 6 provide the greatest horizontal mobility in adults29. The term denoting the caregiver’s need to do no harm to the patient is:Deontologic imperatives.30. A tool used to screen adolescents for alcoholism is the:CRAFFT31. Under normal circumstances, how much water is lost daily by the body?Under normal circumstances, approximately 2 to 2.5 liters ofwater is lost daily32. You have just completed a skin assessment on Mr. Baker. During your assessment, you havetransilluminated a skin lesion. During the physical examination, you know that skin lesions aretransilluminated to distinguish:Transillumination is used to determine the presence of fluid in cysts and masses. Fluid-filled lesions willtransilluminate with a red glow, and solid masses will not transilluminate.33. Mr. Mills is a 55/y/o patient who presents to the office for an initial visit for health promotion. Asurvey of mobility and activities of activities of daily living is part of a(n):Functional assessment.34. Sweat glands, hair, and nails are all formed from?Invagination of epidermis into dermis

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35. A brief statement of the reason the patient is seeking health care is called the?Chief concern36. Which part of the information contained in the patient’s record may be used in court?Anything that is entered into a patient’s record in paper or electronic form, is a legal document andcan be used37. Which cranial nerves innervate the face?5 and 738. In counseling a client regarding nutrition education, you explain that linoleic acid, a major fatty acid,is thought to be essential for?Linoleic acid, found abundantly in milk and dairy fat, is required for normal growth anddevelopment, it has been suggested that it can reduce body fat in overweight patient39. When are open-ended questions generally most useful?During the initial part of the interview40. Knowledge of the culture or cultures represented by the patient should be used to?Help make interview questions more pertinent41. Mrs. Berger is a 39-year-old woman who presents with a complaint of epigastric abdominal pain. Youhave completed the inspection of the abdomen. What is your next step in the assessment process?Auscultation42. A guideline for history taking is for caregivers to?Make notes sparingly so that patients can be observed during the history taking43. Which type of speculum should be used to examine a patient’s tympanic membrane?The largest speculum that will fit comfortably in ear44. You are palpating a patient’s thyroid and find that its broadest dimension measures 4cm. the right lobeis 25% larger than the left. These data would indicate?The description is most likely a normal finding45. Mr. L. presents to the clinic with severe groin pain and a history of kidney stones. Mr. L.’s son tellsyou that, for religious reasons, his father wishes to keep any stone that is passed into the urine filter thathe has been using. What is your most appropriate response?Healthcare provider should be willing to modify delivery and respectful of wishes/culturebackground46. Before performing an abdominal examination, the examiner should?Have the patient empty his or her bladder47. You are examining a pregnant patient and have noted a vascular lesion. When you Blanche over thevascular lesion, the site blanches and refills evenly from the center outward. The nurse documents thislesion as a?Telangiectasia48. As you explain your patient’s condition to her husband, you notice that he is leaning toward you andpointedly blinking his eyes. Knowing that he is from England, your most appropriate response to thisbehavior is to?

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The English worry about being overheard and tend to speak in a modulated voice, so when theylean toward you, they probably have a question49. When palpating the abdomen, you should note whether the liver is enlarged in the?The liver is located in the right upper quadrant of the abdomen50. Expected normal percussion tones include?Normal lings produce renaissance percussion tones51. Mr. Abdul is a 40-year-old Middle Eastern man who presents to the office for a first visit with thecomplaint of new abdominal pain. You ate concerned about violating a cultural prohibition when youprepare to do his rectal examination. The best tactic would be to?Inform the patient of the reason for the exam and ask if it is acceptable to him52. Fluorescing lesions are best distinguished using a(n)?Wood’s lamp53. Mrs. Hartzell is a 34-year-old patient who has presented for nutritional counseling because she is avegetarian. Deficiency of which of the following is a concern in the vegetarian diet?Proteins, calcium, iron, B12, and vitamin D54. Underestimation of blood pressure will occur if the blood pressure cuff’s width covers?Cuff that are too wide will underestimate blood pressure, which would happen with a cuff that ismore than one third of the upper arm55. Mrs. Britton is a 34-year-old patient who presents to the office with complaints of skin rashes. Youhave noted a 4’3cm, rough, elevated area of psoriasis. This is an example of a?Plaque56. Penicillin is considered a?Miracle drug for all the reasons except. It was not the first antibiotic.57. Small, minute bruises are called?Petechiae58. After thorough inspection of the abdomen, the next assessment step is?Auscultation59. When you are questioning a patient regarding alcohol intake, she tells you that she is only a socialdrinker. Which initial response is appropriate?What amount and what kind of alcohol do you drink in a week?60. Regardless of the origin, discharge is described by noting?Color and consistency61. Recommended carbohydrate content of total dietary intake (% total calories) is?50%62. Tuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure?Hearing range of normal speech

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63. Auscultation should be carried out last, except when examining the?The abdomen64. Mr. Kevin Marks is a new health care provider. What is the best method to develop culturalcompetence?Realize the cultural values are difficult to change and must be respected65. Which of the following is an “ABCD” characteristic of malignant melanoma?Asymmetric borders66. Tracheal tug suggests the presence of a(n)?Aortic aneurysm67. Your patient presents with symptoms that lead you to suspect acute appendicitis. Which assessmentfinding is least likely to be associated with this condition early in its course?Consistent right lower quadrant pain68. The review of systems is a component of the:Personal and social history69. Cherry angiomas are a common finding in:Adults older than 30 years70. Mr. Donalds is a 45-year-old roofer. Your inspection to determine color variations of the skin is bestconducted:with illumination provided by daylight.71. To correctly document absent bowel sounds, one must listen continuously for:5 minutes72. The adult recommended dietary fat intake should be ____g/day.20 to 3573. Mr. Jones is a 45-year-old patient who presents for a physical examination. On examination, you notecostochondral beading, enlarged skull, and bowed legs and diagnose him with rickets. A deficiency ofwhich fat-soluble micronutrient can result in rickets?Vitamin D74. A flat, non-palpable lesion is described as a macule if the diameter is:Less than 1 cm75. Mrs. Raymonds is a 24-year-old patient who has presented for a routine concern over her currentweight. In your patient teaching with her, you explain the importance of macronutrients. Which of thefollowing is a macronutrient?Fat76. Which of the following organs is part of the alimentary tract?continuous tract from the mouth to the esophagus, stomach, small intestine, large intestine, andanus

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77. Mr. Sanchez is a 45-year-old gentleman who has presented to the office for a physical examination toestablish a new primary care health care provider. Which of the following describes a physical, not acultural, differentiator?Race78. To approximate vocal frequencies, which tuning fork should be used to assess hearing?500 to 1000 Hz79. During percussion, a dull tone is expected to be heard over:The liver80. The attitudes of the health care professional:Culturally derived/are largely irrelevant to the success of relationships with the patient81. When recording physical findings, which data are recorded first for all systems?Inspection82. Spasmodic muscular contractions of the head, face, or neck are called:tics83. Which of the following occurs when firm pressure is used to apply the stethoscope’s bell end-piece tothe skin?It functionally converts to a diaphragm end-piece.84. Differential diagnoses belong in the:Assessment85. Pigmented, raised, warty lesions over the face and trunk should be assessed by an experiencedpractitioner who can distinguish:seborrheic keratoses from actinic keratoses.86. Mr. Walter’s, a 32-year-old patient, tells you that his ears are “stopped up.” An objective assessmentof this complaint is achieved by using the:tympanometer87. Mrs. Leonard brings her newborn infant into the pediatrician’s office for a first well-baby visit. As thehealth care provider, you teach her that newborns are more vulnerable to hypothermia due to:a poorly developed subcutaneous fat layer.88. Tympanic thermometers measure body temperature when a probe is placed:Eardrum (in the ear)89. A serous membrane that lines the abdominal cavity and forms a protective cover for many abdominalstructures is the:peritoneum90. White, rounded, or oval ulcerations surrounded by a red halo and found on the oral mucosa are:aphthous ulcers (canker sores)91. When assessing abdominal pain in a college-age woman, one must include:the first day of the last menstrual period.

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92. Your patient is complaining of acute, intense sharp epigastric pain that radiates to the back and leftscapula with nausea and vomiting. Based on this history, your prioritized physical examination should beto:inspect for ecchymosis of the flank.93. The infant should be placed in which position to have his or her height or length measured?Supine on a measuring board94. Mr. Marks is a 66-year-old patient who presents for a physical examination to the clinic. Whichquestion has the most potential for exploring a patient’s cultural beliefs related to a health problem?"Why do you think you are having these symptoms?"95. Which of the following is the most vital nutrient?water96. What finding is unique to the documentation of a physical examination of an infant?Fontanel size97. Mrs. G. reports an increase in her alcohol intake over the past 5 years. To screen her for problemdrinking, you would use the:CAGE questionnaire98. Mr. D. complains of a headache. During the history he mentions his use of alcohol and illicit drugs.This information would most likely belong in the:personal and social history99. You are completing a general physical examination on Mr. Rock, a 39-year-old man with complaintsof constipation. When examining a patient with tense abdominal musculature, a helpful technique is tohave the patient:flex his or her knees100. When communicating with older children and teenagers, you should be sensitive to their:typical reluctance to talk101.Periods of silence during the interview can serve important purposes, such as: Providing time forreflection.Question 11 out of 1 pointsMr. Franklin is speaking with you, the health care provider, about his respiratory problem.Mr. Franklin says, "I've had this cough for 3 days, and it's getting worse." You reply, "Tellme more about your cough." Mr. Franklin states, "I wish I could tell you more. That's whyI'm here. You tell me what's wrong!" Which caregiver response would be most appropriatefor enhancing communication?Question 21 out of 1 pointsBefore performing an abdominal examination, the examiner should:

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Question 31 out of 1 pointsPeriods of silence during the interview can serve important purposes, such as:Question 41 out of 1 pointsYour patient presents with symptoms that lead you to suspect acute appendicitis. Whichassessment finding is least likely to be associated with this condition early in its course?Question 51 out of 1 pointsTo perform the Rinne test, place the tuning fork on the:Question 61 out of 1 pointsAs part of your health promotion education for a new patient, you explain that the riskfactors for skin cancer include:Question 71 out of 1 pointsA brief statement of the reason the patient is seeking health care is called the:Question 81 out of 1 pointsWhen assessing abdominal pain in a college-age woman, one mustinclude:Question 91 out of 1 pointsPeritonitis produces bowel sounds that are:Question 101 out of 1 pointsThe most superior part of the stomach is the:Question 111 out of 1 pointsTo approximate vocal frequencies, which tuning fork should be used to assess hearing?

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Question 121 out of 1 pointsWhich of the following is the most vital nutrient?Question 131 out of 1 pointsWhich of the following is an expected change in the assessment of the thyroid duringpregnancy?Question 141 out of 1 pointsMr. Donalds is a 45-year-old roofer. Your inspection to determine color variations of theskin is best conducted:Question 151 out of 1 pointsPeritonitis produces bowel sounds that are:Question 161 out of 1 pointsMacronutrients are so named because they:Question 171 out of 1 pointsIn examining the neck of a 34-year-old female patient, you note that the uppermost ridgeof the tracheal cartilage is at the:Question 181 out of 1 pointsWhich of the following occurs when firm pressure is used to apply the stethoscope's bellend-piece to the skin?Question 191 out of 1 pointsYou have just completed a skin assessment on Mr. Baker. During your assessment, youhave transilluminated a skin lesion. During the physical examination, you know that skinlesions are transilluminated to distinguish:

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Question 201 out of 1 pointsThe position on a clock, topographic notations, and anatomic landmarks:Question 211 out of 1 pointsMrs. Kinder is a 39-year-old patient who presents to the office withcomplaints of an earache. In explaining to the patient about the functionof her ears, which ear structure would you tell her is responsible forequalizing atmospheric pressure when swallowing, sneezing, or yawning?Question 221 out of 1 pointsMs. Jones is a 31-year-old female patient who presents for a routinephysical examination. Which examination technique will be used first?Question 231 out of 1 pointsWhen recording physical findings, which data are recorded first for all systems?Question 241 out of 1 pointsPercussing at the right midclavicular line, below the umbilicus, andcontinuing upward is the correct technique for locating the:Question 251 out of 1 pointsMs. G. is being seen for her routine physical examination. She is a college graduate andpresident of a research firm. Although her exact salary is unknown, she has adequatehealth insurance. Most of the above information is part of Ms. G.'s _____ history.Question 261 out of 1 pointsYou are planning to palpate the abdomen of your patient. Which part ofthe examiner's hand is best for palpating vibration?Question 271 out of 1 pointsWhich of the following is an "ABCD" characteristic of malignant melanoma?

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Question 281 out of 1 pointsMrs. Webb is a 38-year-old patient who has been changing her lifestyle toeat in a healthy way and lose weight. During your health promotioneducation regarding her nutritional status, you explain the function ofdietary protein as:Question 290 out of 1 pointsGeorge Michaels, a 22-year-old patient, tells the nurse that he is heretoday to "check his allergies." He has been having "green nasal discharge"for the last 72 hours. How would the nurse document his reason forseeking care?Question 301 out of 1 pointsSweat glands, hair, and nails are all formed from:Question 310 out of 1 pointsYour patient returns for a blood pressure check 2 weeks after a visit during which youperformed a complete history and physical. This visit would be documented by creatinga(n):Question 321 out of 1 pointsYour patient is complaining of acute, intense sharp epigastric pain thatradiates to the back and left scapula with nausea and vomiting. Based onthis history, your prioritized physical examination should be to:Question 331 out of 1 pointsExpected normal percussion tones include:Question 340 out of 1 pointsRecommended carbohydrate content of total dietary intake (% total calories) is ____%.Question 35

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1 out of 1 pointsUnderestimation of blood pressure will occur if the blood pressure cuff's width covers:Question 361 out of 1 pointsWhich technique is most likely to result in the patient's understanding of questions?Question 371 out of 1 pointsWhich question would be considered a leading question?Question 381 out of 1 pointsSpasmodic muscular contractions of the head, face, or neck are called:Question 391 out of 1 pointsTangential lighting is best used for inspecting skin:Question 401 out of 1 pointsSmall, minute bruises are called:Question 411 out of 1 pointsWhen examining the skull of a 4-month-old baby, you should normally find:Question 421 out of 1 pointsMr. L. presents to the clinic with severe groin pain and a history of kidney stones. Mr. L.'sson tells you that, for religious reasons, his father wishes to keep any stone that is passedinto the urine filter that he has been using. What is your most appropriate response?Question 431 out of 1 pointsWhat finding is unique to the documentation of a physical examination of an infant?

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Question 440 out of 1 pointsThe recommended minimum daily protein requirement for the normal adult is______.Question 451 out of 1 pointsMs. Davis is a 27-year-old patient with a BMI of 33. Based on her BMI, yourdiagnosis would be:Question 461 out of 1 pointsAs you explain your patient's condition to her husband, you notice that he is leaningtoward you and pointedly blinking his eyes. Knowing that he is from England, your mostappropriate response to this behavior is to:Question 471 out of 1 pointsWhich of the following organs is part of the alimentary tract?Question 481 out of 1 pointsMr. Abdul is a 40-year-old Middle Eastern man who presents to the officefor a first visit with the complaint of new abdominal pain. You areconcerned about violating a cultural prohibition when you prepare to dohis rectal examination. The best tactic would be to:Question 491 out of 1 pointsTuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure:Question 501 out of 1 pointsDuring an interview, tears appear in the patient's eyes and his voice becomes shaky.Initially, you should:Question 511 out of 1 pointsTympanic thermometers measure body temperature when a probe isplaced:

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Question 521 out of 1 pointsUnder normal circumstances, how much water is lost daily by the body?Question 531 out of 1 pointsAfter thorough inspection of the abdomen, the next assessment step is:Question 541 out of 1 pointsMrs. Britton is a 34-year-old patient who presents to the office with complaints of skinrashes. You have noted a 4' 3-cm, rough, elevated area of psoriasis. This is an example ofa:Question 551 out of 1 pointsWhich cranial nerves innervate the face?Question 561 out of 1 pointsWhich technique is most likely to result in the patient's understanding of questions?Question 571 out of 1 pointsWhich of the following is the most accurate reflection of an individual's food intake?Question 581 out of 1 pointsWhen assessing abdominal pain in a college-age woman, one mustinclude:Question 591 out of 1 pointsThe infant should be placed in which position to have his or her height or lengthmeasured?Question 60

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