History of Mitral Valve Problems
Question 1.A 30-year-old woman with a history of mitral valve problems states that she has been “very tired.” She has started waking up at night and feels like her “heart is pounding.” During the assessment, the nurse practitioner palpates a thrill and lift at the fifth left intercostal space midclavicular line. In the same area the nurse practitioner also auscultates a blowing, swishing sound right after S1. These findings would be most consistent with:
heart failure.
aortic stenosis.
pulmonary edema.
mitral regurgitation.
Question 2. Question : A patient presents with excruciating headache pain on one side of his head, especially around his eye, forehead, and cheek that lasts about 1/2 to 2 hours, occurring once or twice each day. The nurse practitioner suspects:
hypertension.
cluster headaches.
tension headaches.
migraine headaches.
Question 3. Question : A patient complains that while studying for an examination he began to notice a severe headache in the frontotemporal area of his head that is throbbing and is somewhat relieved when he lies down. He tells the nurse practitioner that his mother also had these headaches. The nurse practitioner suspects that he may be suffering from:
hypertension.
cluster headaches.
tension headaches.
migraine headaches.
Question 4. Question : A patient tells the nurse practitioner that he is very nervous, that he is nauseated, and that he “feels hot.” This type of data would be:
objective.
reflective.
subjective.
introspective
Question 5. Question : The most important reason to share information and offer brief teaching while performing the physical examination is to help:
the examiner feel more comfortable and gain control of the situation.
build rapport and increase the patient’s confidence in the examiner.
the patient understand his or her disease process and treatment modalities.
the patient identify questions about his or her disease and potential areas of patient education.
Question 6. Question : A patient says that she has recently noticed a lump in the front of her neck below her “Adam’s apple” that seems to be getting bigger. During the assessment, the finding that reassures the nurse practitioner that this may not be a cancerous thyroid nodule is that the lump (nodule):
is tender.
is mobile and not hard.
disappears when the patient smiles.
is hard and fixed to the surrounding structures.
Question 7. Question : A patient visits the clinic because he has recently noticed that the left side of his mouth is paralyzed. He states that he cannot raise his eyebrow or whistle. The nurse practitioner suspects that he has:
Cushing’s syndrome.
Parkinson’s syndrome.
Bell’s palsy.
had a cerebrovascular accident (stroke).
Question 8. Question : The temporomandibular joint is just below the temporal artery and anterior to the:
hyoid.
vagus.
tragus.
mandible.
Question 9. Question : During an examination of a patient’s abdomen, the nurse practitioner notes that the abdomen is rounded and firm to the touch. During percussion, the nurse practitioner notes a drum-like quality of the sound across the quadrants. This type of sound indicates:
constipation.
air-filled areas.
the presence of a tumor.
the presence of dense organs.
Question 10. Question : A patient tells the nurse that he is allergic to penicillin. What would be the nurse practitioner’s best response to this information?
“Are you allergic to any other drugs?”
“How often have you received penicillin?”
“I’ll write your allergy on your chart so you won’t receive any.”
“Please describe what happens to you when you take penicillin.”
Question 11. Question : A patient’s thyroid is enlarged, and the nurse practitioner is preparing to auscultate the thyroid for the presence of a bruit. A bruit is a:
low gurgling sound best heard with the diaphragm of the stethoscope.
loud, whooshing, blowing sound best heard with the bell of the stethoscope.
soft, whooshing, pulsatile sound best heard with the bell of the stethoscope.
high-pitched tinkling sound best heard with the diaphragm of the stethoscope.
Question 12. Question : After completing an initial assessment on a patient, the nurse practitioner has documented that his respirations are eupneic and his pulse is 58. This type of data would be:
objective.
reflective.
subjective.
introspective.
Question 13. Question : A patient tells the nurse that she has had abdominal pain for the past week. What would be the best response by the nurse?
“Can you point to where it hurts?”
“We’ll talk more about that later in the interview.”
“What have you had to eat in the last 24 hours?”
“Have you ever had any surgeries on your abdomen?”
Question 14. Question : A teenage patient comes to the emergency department with complaints of an inability to “breathe and a sharp pain in my left chest.” The assessment findings include the following: cyanosis, tachypnea, tracheal deviation to the right, decreased tactile fremitus on the left, hyperresonance on the left, and decreased breath sounds on the left. This description is consistent with:
bronchitis.
a pneumothorax.
acute pneumonia.
an asthmatic attack.
Question 15. Question : The inspection phase of the physical assessment:
yields little information.
takes time and reveals a surprising amount of information.
may be somewhat uncomfortable for the expert practitioner.
requires a quick glance at the patient’s body systems before proceeding on with palpation.
Question 16. Question : The mother of a 2-year-old is concerned because her son has had three ear infections in the past year. What would be an appropriate response by the nurse practitioner?
“It is unusual for a small child to have frequent ear infections unless there is something else wrong.”
“We need to check the immune system of your son to see why he is having so many ear infections.”
“Ear infections are not uncommon in infants and toddlers because they tend to have more cerumen in the external ear.”
“Your son’s eustachian tube is shorter and wider than yours because of his age, which allows for infections to develop more easily.”
Question 17. Question : The nurse practitioner would use bimanual palpation technique in which situation?
Palpating the thorax of an infant
Palpating the kidneys and uterus
Assessing pulsations and vibrations
Assessing the presence of tenderness and pain
Question 18. Question : The patient’s record, laboratory studies, objective data, and subjective data combine to form the:
database.
admitting data.
financial statement.
discharge summary.
Question 19. Question : When preparing to perform a physical examination on an infant, the examiner should:
have the parent remove all clothing except the diaper on a boy.
instruct the parent to feed the infant immediately before the exam.
encourage the infant to suck on a pacifier during the abdominal exam.
ask the parent to briefly leave the room when assessing the infant’s vital signs.
Question 20. Question : The nurse practitioner notices that an infant has a large, soft lump on the side of his head and that his mother is very concerned. She tells the nurse practitioner that she noticed the lump about 8 hours after her baby’s birth, and that it seems to be getting bigger. One possible explanation for this is:
hydrocephalus.
craniosynostosis.
cephalhematoma.
caput succedaneum.
Question 21. Question : When examining an infant, the nurse practitioner should examine which area first?
Ear
Nose
Throat
Abdomen
Question 22. Question : When preparing to examine a 6-year-old child, which action is most appropriate?
Start with the thorax, abdomen, and genitalia before examining the head.
Avoid talking about the equipment being used because it may increase the child’s anxiety.
Keep in mind that a child this age will have a sense of modesty.
Have the child undress from the waist up.
Question 23. Question : The nurse practitioner is assessing a patient’s skin during an office visit. What is the best technique to use to best assess the patient’s skin temperature?
Use the fingertips because they’re more sensitive to small changes in temperature.
Use the dorsal surface of the hand because the skin is thinner than on the palms.
Use the ulnar portion of the hand because there is increased blood supply that enhances temperature sensitivity.
Use the palmar surface of the hand because it is most sensitive to temperature variations because of increased nerve supply in this area.
Question 24. Question : Percussion notes heard during the abdominal assessment may include:
flatness, resonance, and dullness.
resonance, dullness, and tympany.
tympany, hyperresonance, and dullness.
resonance, hyperresonance, and flatness.
Question 25. Question : The nurse practitioner is assessing a patient for possible peptic ulcer disease and knows that which condition often causes this problem?
Hypertension
Streptococcus infections
History of constipation and frequent laxative use
Frequent use of nonsteroidal anti-inflammatory drugs
