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

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    NURS 6512, Week 6 Midterm Exam This exam is a test of your knowledge in preparation for your certification exam. No outside resources including books, notes, websites, or any other type of resource are to be used to complete this exam. You are expected to comply 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, you should 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 Information Submit Your Midterm Exam by Day 7 QUESTIONS 1. Before performing an abdominal examination, the examiner should: Have the patient empty their bladder 2. During an interview, tears appear in the patient’s eyes and his voice becomes shaky. Initially, you should: Keep the interview moving to distract the patient 3. Which of the following is the most accurate reflection of an individual’s food intake? Food Diary 4. Percussing at the right midclavicular line, below the umbilicus, and continuing upward is the correct technique for locating the: Lower liver border 5. A fixed image of any group that rejects its potential for originality or individuality is known as a: Stereotype 6. Peritonitis produces bowel sounds that are Decreased/Hypoactive 7. Brittle nails are typical findings in: Older adults 8. Which of the following is an expected change in the assessment of the thyroid during pregnancy? A Bruit is auscultated d/t increased vascularity 9. You are planning to palpate the abdomen of your patient. Which part of the examiner's hand is best for palpating 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 you should palpate over the: Maxillary sinuses only 11. 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 to Ask the patient if this characteristic runs in his family 12. Unusual white areas on the skin may be due to Vitiligo 13. You are using an ophthalmoscope to examine a patient’s inner eye. You rotate the lens selector clockwise, then counterclockwise to compensate for: Myopia 14. Mrs. Webb is a 38-year old patient who has been changing her lifestyle to eat in a healthy way and lose weight: during your health promotion education regarding her nutritional status, you explain the function of dietary protein as: Building and maintaining tissues 15. Mr. Akins is a 78-y/o patient who presents to the clinic with complaints of hearing loss. Which of the following are changes in hearing that occur in the elderly? Select all that apply. c. Loss of high frequency e. Sounds may be garbled, difficult to localize f. Unable to hear in a crowded room 16. The most superior part of the stomach is the Fundus 17. Mrs. Grace is a 58-year-old patient who has a diagnosis of pernicious anemia. Which B vitamin is deficient in patients with pernicious anemia? B12 18. A 51-y/o woman calls with complaints of weight loss and constipation. She reports enlarged hemorrhoids 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 Sound 20. 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. He describes a long-standing nasal dripping. He is seeking treatment for a mild hearing loss that has not gone away. Information concerning his chronic postnasal drip should be documented within which section of the history? Past medical data 22. 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, boggy consistency 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 about your cough.” Mr. Franklin states, “I wish I could tell you more, that’s why I am here! You tell me what’s wrong.” 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 the problem-oriented medical record (POMR)? Brief SOAP note 26. Mr. and Mrs. Johnson have presented to the office with their infant son with complaints of ear drainage. When examining an infant’s middle ear, the nurse should use one hand to stabilize the otoscope against the head while using the other hand to: Pull the auricle down and back in an effort to straighten the upward curvature of the canal 27. 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 is from his job involving computer data entry. As the examiner, you are checking the range of motion in his neck 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 adults 29. 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: CRAFFT 31. Under normal circumstances, how much water is lost daily by the body? Under normal circumstances , approximately 2 to 2.5 liters of water is lost daily 32. You have just completed a skin assessment on Mr. Baker. During your assessment, you have transilluminated a skin lesion. During the physical examination, you know that skin lesions are transilluminated to distinguish: Transillumination is used to determine the presence of fluid in cysts and masses. Fluid-filled lesions will transilluminate 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. A survey 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 concern 36. 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 and can be used 37. Which cranial nerves innervate the face? 5 and 7 38. 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 and development, it has been suggested that it can reduce body fat in overweight patient 39. When are open-ended questions generally most useful? During the initial part of the interview 40. Knowledge of the culture or cultures represented by the patient should be used to? Help make interview questions more pertinent 41. Mrs. Berger is a 39-year-old woman who presents with a complaint of epigastric abdominal pain. You have completed the inspection of the abdomen. What is your next step in the assessment process? Auscultation 42. A guideline for history taking is for caregivers to? Make notes sparingly so that patients can be observed during the history taking 43. Which type of speculum should be used to examine a patient’s tympanic membrane? The largest speculum that will fit comfortably in ear 44. You are palpating a patient’s thyroid and find that its broadest dimension measures 4cm. the right lobe is 25% larger than the left. These data would indicate? The description is most likely a normal finding 45. Mr. L. presents to the clinic with severe groin pain and a history of kidney stones. Mr. L.’s son tells you that, for religious reasons, his father wishes to keep any stone that is passed into the urine filter that he has been using. What is your most appropriate response? Healthcare provider should be willing to modify delivery and respectful of wishes/culture background 46. Before performing an abdominal examination, the examiner should? Have the patient empty his or her bladder 47. You are examining a pregnant patient and have noted a vascular lesion. When you Blanche over the vascular lesion, the site blanches and refills evenly from the center outward. The nurse documents this lesion as a? Telangiectasia 48. As you explain your patient’s condition to her husband, you notice that he is leaning toward you and pointedly blinking his eyes. Knowing that he is from England, your most appropriate response to this behavior is to?

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    The English worry about being overheard and tend to speak in a modulated voice, so when they lean toward you, they probably have a question 49. 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 abdomen 50. Expected normal percussion tones include? Normal lings produce renaissance percussion tones 51. Mr. Abdul is a 40-year-old Middle Eastern man who presents to the office for a first visit with the complaint of new abdominal pain. You ate concerned about violating a cultural prohibition when you prepare 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 him 52. Fluorescing lesions are best distinguished using a(n)? Wood’s lamp 53. Mrs. Hartzell is a 34-year-old patient who has presented for nutritional counseling because she is a vegetarian. Deficiency of which of the following is a concern in the vegetarian diet? Proteins, calcium, iron, B12, and vitamin D 54. 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 is more than one third of the upper arm 55. Mrs. Britton is a 34-year-old patient who presents to the office with complaints of skin rashes. You have noted a 4’3cm, rough, elevated area of psoriasis. This is an example of a? Plaque 56. Penicillin is considered a? Miracle drug for all the reasons except. It was not the first antibiotic. 57. Small, minute bruises are called? Petechiae 58. After thorough inspection of the abdomen, the next assessment step is? Auscultation 59. When you are questioning a patient regarding alcohol intake, she tells you that she is only a social drinker. 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 consistency 61. 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 abdomen 64. Mr. Kevin Marks is a new health care provider. What is the best method to develop cultural competence? Realize the cultural values are difficult to change and must be respected 65. Which of the following is an “ABCD” characteristic of malignant melanoma? Asymmetric borders 66. Tracheal tug suggests the presence of a(n)? Aortic aneurysm 67. Your patient presents with symptoms that lead you to suspect acute appendicitis. Which assessment finding is least likely to be associated with this condition early in its course? Consistent right lower quadrant pain 68. The review of systems is a component of the: Personal and social history 69. Cherry angiomas are a common finding in: Adults older than 30 years 70. Mr. Donalds is a 45-year-old roofer. Your inspection to determine color variations of the skin is best conducted: with illumination provided by daylight. 71. To correctly document absent bowel sounds, one must listen continuously for: 5 minutes 72. The adult recommended dietary fat intake should be ____g/day. 20 to 35 73. Mr. Jones is a 45-year-old patient who presents for a physical examination. On examination, you note costochondral beading, enlarged skull, and bowed legs and diagnose him with rickets. A deficiency of which fat-soluble micronutrient can result in rickets? Vitamin D 74. A flat, non-palpable lesion is described as a macule if the diameter is: Less than 1 cm 75. Mrs. Raymonds is a 24-year-old patient who has presented for a routine concern over her current weight. In your patient teaching with her, you explain the importance of macronutrients. Which of the following is a macronutrient? Fat 76. Which of the following organs is part of the alimentary tract? continuous tract from the mouth to the esophagus, stomach, small intestine, large intestine, and anus

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    77. Mr. Sanchez is a 45-year-old gentleman who has presented to the office for a physical examination to establish a new primary care health care provider. Which of the following describes a physical, not a cultural, differentiator? Race 78. To approximate vocal frequencies, which tuning fork should be used to assess hearing? 500 to 1000 Hz 79. During percussion, a dull tone is expected to be heard over: The liver 80. The attitudes of the health care professional: Culturally derived/are largely irrelevant to the success of relationships with the patient 81. When recording physical findings, which data are recorded first for all systems? Inspection 82. Spasmodic muscular contractions of the head, face, or neck are called: tics 83. Which of the following occurs when firm pressure is used to apply the stethoscope’s bell end-piece to the skin? It functionally converts to a diaphragm end-piece. 84. Differential diagnoses belong in the: Assessment 85. Pigmented, raised, warty lesions over the face and trunk should be assessed by an experienced practitioner 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 assessment of this complaint is achieved by using the: tympanometer 87. Mrs. Leonard brings her newborn infant into the pediatrician’s office for a first well-baby visit. As the health 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 abdominal structures is the: peritoneum 90. 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 left scapula with nausea and vomiting. Based on this history, your prioritized physical examination should be to: 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 board 94. Mr. Marks is a 66-year-old patient who presents for a physical examination to the clinic. Which question 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? water 96. What finding is unique to the documentation of a physical examination of an infant? Fontanel size 97. Mrs. G. reports an increase in her alcohol intake over the past 5 years. To screen her for problem drinking, you would use the: CAGE questionnaire 98. 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 history 99. You are completing a general physical examination on Mr. Rock, a 39-year-old man with complaints of constipation. When examining a patient with tense abdominal musculature, a helpful technique is to have the patient: flex his or her knees 100. When communicating with older children and teenagers, you should be sensitive to their: typical reluctance to talk 101 . Periods of silence during the interview can serve important purposes, such as: Providing time for reflection.  Question 1 1 out of 1 points 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 about your cough." Mr. Franklin states, "I wish I could tell you more. That's why I'm here. You tell me what's wrong!" Which caregiver response would be most appropriate for enhancing communication?  Question 2 1 out of 1 points Before performing an abdominal examination, the examiner should:

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     Question 3 1 out of 1 points Periods of silence during the interview can serve important purposes, such as:  Question 4 1 out of 1 points Your patient presents with symptoms that lead you to suspect acute appendicitis. Which assessment finding is least likely to be associated with this condition early in its course?  Question 5 1 out of 1 points To perform the Rinne test, place the tuning fork on the:  Question 6 1 out of 1 points As part of your health promotion education for a new patient, you explain that the risk factors for skin cancer include:  Question 7 1 out of 1 points A brief statement of the reason the patient is seeking health care is called the:  Question 8 1 out of 1 points When assessing abdominal pain in a college-age woman, one must include:  Question 9 1 out of 1 points Peritonitis produces bowel sounds that are:  Question 10 1 out of 1 points The most superior part of the stomach is the:  Question 11 1 out of 1 points To approximate vocal frequencies, which tuning fork should be used to assess hearing?

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     Question 12 1 out of 1 points Which of the following is the most vital nutrient?  Question 13 1 out of 1 points Which of the following is an expected change in the assessment of the thyroid during pregnancy?  Question 14 1 out of 1 points Mr. Donalds is a 45-year-old roofer. Your inspection to determine color variations of the skin is best conducted:  Question 15 1 out of 1 points Peritonitis produces bowel sounds that are:  Question 16 1 out of 1 points Macronutrients are so named because they:  Question 17 1 out of 1 points In examining the neck of a 34-year-old female patient, you note that the uppermost ridge of the tracheal cartilage is at the:  Question 18 1 out of 1 points Which of the following occurs when firm pressure is used to apply the stethoscope's bell end-piece to the skin?  Question 19 1 out of 1 points You have just completed a skin assessment on Mr. Baker. During your assessment, you have transilluminated a skin lesion. During the physical examination, you know that skin lesions are transilluminated to distinguish:

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     Question 20 1 out of 1 points The position on a clock, topographic notations, and anatomic landmarks:  Question 21 1 out of 1 points Mrs. Kinder is a 39-year-old patient who presents to the office with complaints of an earache. In explaining to the patient about the function of her ears, which ear structure would you tell her is responsible for equalizing atmospheric pressure when swallowing, sneezing, or yawning?  Question 22 1 out of 1 points Ms. Jones is a 31-year-old female patient who presents for a routine physical examination. Which examination technique will be used first?  Question 23 1 out of 1 points When recording physical findings, which data are recorded first for all systems?  Question 24 1 out of 1 points Percussing at the right midclavicular line, below the umbilicus, and continuing upward is the correct technique for locating the:  Question 25 1 out of 1 points Ms. G. is being seen for her routine physical examination. She is a college graduate and president of a research firm. Although her exact salary is unknown, she has adequate health insurance. Most of the above information is part of Ms. G.'s _____ history.  Question 26 1 out of 1 points You are planning to palpate the abdomen of your patient. Which part of the examiner's hand is best for palpating vibration?  Question 27 1 out of 1 points Which of the following is an "ABCD" characteristic of malignant melanoma?

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     Question 28 1 out of 1 points Mrs. Webb is a 38-year-old patient who has been changing her lifestyle to eat in a healthy way and lose weight. During your health promotion education regarding her nutritional status, you explain the function of dietary protein as:  Question 29 0 out of 1 points George Michaels, a 22-year-old patient, tells the nurse that he is here today to "check his allergies." He has been having "green nasal discharge" for the last 72 hours. How would the nurse document his reason for seeking care?  Question 30 1 out of 1 points Sweat glands, hair, and nails are all formed from:  Question 31 0 out of 1 points Your patient returns for a blood pressure check 2 weeks after a visit during which you performed a complete history and physical. This visit would be documented by creating a(n):  Question 32 1 out of 1 points Your patient is complaining of acute, intense sharp epigastric pain that radiates to the back and left scapula with nausea and vomiting. Based on this history, your prioritized physical examination should be to:  Question 33 1 out of 1 points Expected normal percussion tones include:  Question 34 0 out of 1 points Recommended carbohydrate content of total dietary intake (% total calories) is ____ %.  Question 35

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    1 out of 1 points Underestimation of blood pressure will occur if the blood pressure cuff's width covers:  Question 36 1 out of 1 points Which technique is most likely to result in the patient's understanding of questions?  Question 37 1 out of 1 points Which question would be considered a leading question?  Question 38 1 out of 1 points Spasmodic muscular contractions of the head, face, or neck are called:  Question 39 1 out of 1 points Tangential lighting is best used for inspecting skin:  Question 40 1 out of 1 points Small, minute bruises are called:  Question 41 1 out of 1 points When examining the skull of a 4-month-old baby, you should normally find:  Question 42 1 out of 1 points Mr. L. presents to the clinic with severe groin pain and a history of kidney stones. Mr. L.'s son tells you that, for religious reasons, his father wishes to keep any stone that is passed into the urine filter that he has been using. What is your most appropriate response?  Question 43 1 out of 1 points What finding is unique to the documentation of a physical examination of an infant?

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     Question 44 0 out of 1 points The recommended minimum daily protein requirement for the normal adult is ______.  Question 45 1 out of 1 points Ms. Davis is a 27-year-old patient with a BMI of 33. Based on her BMI, your diagnosis would be:  Question 46 1 out of 1 points As you explain your patient's condition to her husband, you notice that he is leaning toward you and pointedly blinking his eyes. Knowing that he is from England, your most appropriate response to this behavior is to:  Question 47 1 out of 1 points Which of the following organs is part of the alimentary tract?  Question 48 1 out of 1 points Mr. Abdul is a 40-year-old Middle Eastern man who presents to the office for a first visit with the complaint of new abdominal pain. You are concerned about violating a cultural prohibition when you prepare to do his rectal examination. The best tactic would be to:  Question 49 1 out of 1 points Tuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure:  Question 50 1 out of 1 points During an interview, tears appear in the patient's eyes and his voice becomes shaky. Initially, you should:  Question 51 1 out of 1 points Tympanic thermometers measure body temperature when a probe is placed:

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     Question 52 1 out of 1 points Under normal circumstances, how much water is lost daily by the body?  Question 53 1 out of 1 points After thorough inspection of the abdomen, the next assessment step is:  Question 54 1 out of 1 points Mrs. Britton is a 34-year-old patient who presents to the office with complaints of skin rashes. You have noted a 4' 3-cm, rough, elevated area of psoriasis. This is an example of a:  Question 55 1 out of 1 points Which cranial nerves innervate the face?  Question 56 1 out of 1 points Which technique is most likely to result in the patient's understanding of questions?  Question 57 1 out of 1 points Which of the following is the most accurate reflection of an individual's food intake?  Question 58 1 out of 1 points When assessing abdominal pain in a college-age woman, one must include:  Question 59 1 out of 1 points The infant should be placed in which position to have his or her height or length measured?  Question 60

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