Tina jones respiratory shadow health transcript

May 30, | nursing, med, NURS, Paper

Tina jones respiratory shadow health transcript
Transcript

Started: Jul 22, 2022 | Total Time: 168 min

All Lines (154)Interview Questions (72)Statements (2)Exam Actions (80)

Hi Ms Jones, I’m xx and I’m going to examine you today.

Greet

07/22/22 1:55 PM MDT

Hey.

Can you verify your name and date of birth?

Question

07/22/22 1:55 PM MDT

My name’s Tina Jones, and my birthday’s February 17th.

What brings you in today?

Question

07/22/22 1:56 PM MDT

I came in because I’ve been having breathing problems, and my inhaler just isn’t working the way it normally does.

I’m sorry to hear you’re going through that.

Empathize

07/22/22 1:56 PM MDT

Thanks for understanding.

Can you please describe what’s going on with your inhaler? (No matching questions found.)

Question

07/22/22 1:57 PM MDT

Can you please describe what breathing problems you’re having? (Clarified to Can you describe your breathing problems?.)

Question

07/22/22 1:57 PM MDT

It feels like it’s been hard to take in air. My chest feels all tight and I’ve been wheezing… I’ve had to use my inhaler a lot, and it doesn’t feel like it’s totally working. (Clarified to to describe my breathing problems.)

Do you know what are causing your asthma to flare up? (Clarified to What started your recent asthma problems?.)

Question

07/22/22 1:58 PM MDT

This all started at my cousin’s house. She has cats, and I’m allergic, so my asthma always goes crazy when I’m there. (Clarified to what triggered my recent asthma problems.)

When was your most recent asthma exacerbation?

Question

07/22/22 1:59 PM MDT

The last time I had real trouble breathing was early this morning. But it’s been going on for the past two days.

How many puffs of your inhaler do you use when your asthma symptoms flare up?

Question

07/22/22 2:01 PM MDT

Sometimes I have to take three puffs of the 90 mcg albuterol inhaler instead of two, and the past couple days, always three. [AUDIO COMING SOON]

How often are you around cats?

Question

07/22/22 2:01 PM MDT

Not often. Just at my cousin’s house. . . and I’m only there a few times a year.

What else triggers your asthma besides cats?

Question

07/22/22 2:01 PM MDT

For the last two days, it seems worse at night when I’m lying down, or when I’m moving around too much. Typically it’s stuff like cats or dust that gets to me.

Do you have any other respiratory illnesses?

Question

07/22/22 2:02 PM MDT

No, just the asthma.

How long have you had asthma?

Question

07/22/22 2:02 PM MDT

I’ve had asthma a long time. . . since I was really little.

How do you manage your asthma?

Question

07/22/22 2:03 PM MDT

I try to avoid things that give me breathing problems, but when my asthma starts to act up, I just use my inhaler.

How is your breathing currently?

Question

07/22/22 2:03 PM MDT

My breathing feels okay right this second, but I’ve definitely been having problems recently with it.

How severe is your asthma?

Question

07/22/22 2:03 PM MDT

My asthma used to be really scary. I haven’t had a full attack in years, and if you had asked me before this I would have said my asthma wasn’t that bad anymore, but the last couple days I’ve had a lot of trouble breathing.

What other symptoms have you had besides trouble breathing?

Question

07/22/22 2:04 PM MDT

Other than what I’ve told you? I don’t think so. It’s just needing my inhaler so much and the cough that’s been bothering me.

Tell me more about your cough

Question

07/22/22 2:05 PM MDT

Um. . . I guess I’d describe it as a small, dry cough.

When did this cough start?

Question

07/22/22 2:05 PM MDT

Two days ago, a little while after I first started having these asthma problems.

Do you have any sputum with this cough?

Question

07/22/22 2:05 PM MDT

No, nothing’s coming up.

How often do you cough?

Question

07/22/22 2:06 PM MDT

I’ve been coughing pretty much all the time.

What are your allergies?

Question

07/22/22 2:06 PM MDT

I’m allergic to cats.

Any other allergy besides cats? (Clarified to Are you allergic to anything besides cats?.)

Question

07/22/22 2:06 PM MDT

Yeah, I’m allergic to penicillin. (Clarified to if I am allergic to anything besides cats.)

When did you have an allergic reaction to penicillin? (Clarified to Have you had an allergic reaction to penicillin?.)

Question

07/22/22 2:07 PM MDT

Yeah, but it was a long time ago, when I was little. . . the doctor told me not to take it again after that. (Clarified to if I have had a reaction to penicillin.)

What happens when you take penicillin?

Question

07/22/22 2:08 PM MDT

I don’t remember that well because the last time I had penicillin I was pretty little. . . I think I got a rash, like, hives. The doctor told me not to take it again after that.

How severe was your reaction to penicillin?

Question

07/22/22 2:08 PM MDT

It was a long time ago, so I don’t remember that well, but I don’t think it was that serious. I just got a rash–like, hives–I think. . . then the doctor said not to take penicillin again, so I didn’t.

Do you have any environmental allergies?

Question

07/22/22 2:09 PM MDT

No, unless cats count.

Can you describe what happens when you’re around cats?

Question

07/22/22 2:09 PM MDT

Whenever I’m around cats, I start sneezing, my eyes get itchy, my nose runs. . . and my asthma starts to act up.

How do your treat your allergy to cats?

Question

07/22/22 2:10 PM MDT

I try not to be around cats at all, but when I have to be around them and my breathing gets bad, I use my inhaler. . . but I don’t totally feel better until I go home and take a shower.

You mentioned your asthma flares up when you’re around dust. What happens when you’re around dust?

Question

07/22/22 2:10 PM MDT

If I’m around a lot of dust, I can get sneezy, or I can start wheezing.

Do you smoke?

Question

07/22/22 2:11 PM MDT

No. I think it’s gross.

Do you use any recreational drugs?

Question

07/22/22 2:11 PM MDT

No.

Do you use marijuana?

Question

07/22/22 2:11 PM MDT

Um, yeah, I’ve done that before. In high school, and after high school… I definitely don’t anymore, though.

When was the last time you used marijuana?

Question

07/22/22 2:12 PM MDT

I haven’t smoked pot since I was twenty or twenty-one.

Are you around secondhand smoke?

Question

07/22/22 2:12 PM MDT

Some of my friends smoke when we go out drinking. But I don’t smoke, and nobody at home smokes.

How often are you around your friends that smoke? (Clarified to How often are you around people who smoke?.)

Question

07/22/22 2:12 PM MDT

Some of my friends smoke when we go out drinking. But I don’t smoke, and nobody at home smokes. (Clarified to how often I am around secondhand smoke.)

Does anyone in your family have asthma?

Question

07/22/22 2:13 PM MDT

It’s just me and my baby sister that have asthma, but she really doesn’t have problems with it.

Did your parents or grandparents have asthma?

Question

07/22/22 2:13 PM MDT

Yeah. Both Nana and Poppa died about five years ago.

I’m so sorry to hear that

Empathize

07/22/22 2:14 PM MDT

Thanks for saying that.

What did your father die of?

Question

07/22/22 2:14 PM MDT

He died in a car accident.

What happened in the car accident?

Question

07/22/22 2:15 PM MDT

He was driving to work and it was raining…and his car hydroplaned. And hit a tree. So it was really sudden.

How did your grandfather die?

Question

07/22/22 2:16 PM MDT

Well, Grandpa Jones died of colon cancer, and Poppa died of a heart attack.

Does your family have a history of lung cancer?

Question

07/22/22 3:19 PM MDT

The only cancer that I know of in our family is colon cancer–Grandpa Jones died of that.

Does your family have a history of respiratory illness?

Question

07/22/22 3:19 PM MDT

My baby sister has asthma, too, but no one else in the family has lung problems, I don’t think.

Do you have a history of bronchitis, pneumonia or emphysema?

Question

07/22/22 3:20 PM MDT

Nope, never.

 Inspected anterior chest wall

Exam Action

07/22/22 3:22 PM MDT

 Inspected left side chest wall

Exam Action

07/22/22 3:22 PM MDT

 Inspected posterior chest wall

Exam Action

07/22/22 3:22 PM MDT

 Inspected right side chest wall

Exam Action

07/22/22 3:23 PM MDT

 Inspected anterior chest wall

Exam Action

07/22/22 3:23 PM MDT

 Palpated chest expansion: Both sides rise symmetrically

Exam Action

07/22/22 3:23 PM MDT

 Palpated fremitus in anterior lower chest wall: Equal bilaterally, expected vibration

Exam Action

07/22/22 3:23 PM MDT

Ninety-nine.

 Palpated fremitus in anterior upper chest wall: Equal bilaterally, expected vibration

Exam Action

07/22/22 3:23 PM MDT

Ninety-nine.

 Palpated chest expansion: Both sides rise symmetrically

Exam Action

07/22/22 3:37 PM MDT

 Percussed anterior left upper lobe

Exam Action

07/22/22 3:41 PM MDT

 Percussed anterior right upper lobe

Exam Action

07/22/22 3:41 PM MDT

 Percussed anterior left mid-chest (upper lobe)

Exam Action

07/22/22 3:41 PM MDT

 Percussed anterior right middle lobe

Exam Action

07/22/22 3:41 PM MDT

 Percussed anterior right lower lobe

Exam Action

07/22/22 3:41 PM MDT

 Percussed anterior left lower lobe

Exam Action

07/22/22 3:41 PM MDT

 Percussed posterior right upper lobe

Exam Action

07/22/22 3:42 PM MDT

 Percussed posterior left upper lobe

Exam Action

07/22/22 3:42 PM MDT

 Percussed posterior left mid-back (lower lobe)

Exam Action

07/22/22 3:42 PM MDT

 Percussed posterior right mid-back (lower lobe)

Exam Action

07/22/22 3:42 PM MDT

 Percussed posterior right lower lobe

Exam Action

07/22/22 3:42 PM MDT

 Percussed posterior left mid-back (lower lobe)

Exam Action

07/22/22 3:42 PM MDT

 Percussed posterior left lower lobe

Exam Action

07/22/22 3:42 PM MDT

 Percussed posterior left lower lobe on side

Exam Action

07/22/22 3:42 PM MDT

 Percussed posterior left lower lobe near spine

Exam Action

07/22/22 3:42 PM MDT

 Percussed posterior right lower lobe

Exam Action

07/22/22 3:42 PM MDT

 Percussed posterior right lower lobe near spine

Exam Action

07/22/22 3:42 PM MDT

 Percussed posterior right lower lobe on side

Exam Action

07/22/22 3:42 PM MDT

 Percussed posterior right lower lobe on side

Exam Action

07/22/22 3:42 PM MDT

 Auscultated breath sounds in anterior left upper lobe

Exam Action

07/22/22 3:43 PM MDT

 Auscultated breath sounds in anterior right upper lobe

Exam Action

07/22/22 3:43 PM MDT

 Auscultated breath sounds in anterior right middle lobe

Exam Action

07/22/22 3:43 PM MDT

 Auscultated breath sounds in anterior left upper lobe

Exam Action

07/22/22 3:43 PM MDT

 Auscultated breath sounds in anterior left mid-chest (upper lobe)

Exam Action

07/22/22 3:43 PM MDT

 Auscultated breath sounds in anterior left lower lobe

Exam Action

07/22/22 3:43 PM MDT

 Auscultated breath sounds in anterior right lower lobe

Exam Action

07/22/22 3:43 PM MDT

 Auscultated breath sounds in posterior left upper lobe

Exam Action

07/22/22 3:44 PM MDT

 Auscultated breath sounds in posterior right upper lobe

Exam Action

07/22/22 3:44 PM MDT

 Auscultated breath sounds in posterior right mid-back (lower lobe)

Exam Action

07/22/22 3:44 PM MDT

 Auscultated breath sounds in posterior left mid-back (lower lobe)

Exam Action

07/22/22 3:44 PM MDT

 Auscultated breath sounds in posterior left lower lobe

Exam Action

07/22/22 3:44 PM MDT

 Auscultated breath sounds in posterior right lower lobe

Exam Action

07/22/22 3:45 PM MDT

 Auscultated breath sounds in posterior left lower lobe on side

Exam Action

07/22/22 3:45 PM MDT

 Auscultated breath sounds in posterior left lower lobe near spine

Exam Action

07/22/22 3:46 PM MDT

 Auscultated breath sounds in posterior right lower lobe near spine

Exam Action

07/22/22 4:01 PM MDT

 Auscultated breath sounds in posterior right lower lobe on side

Exam Action

07/22/22 4:01 PM MDT

 Auscultated breath sounds in posterior right lower lobe

Exam Action

07/22/22 4:01 PM MDT

 Auscultated breath sounds in posterior left lower lobe

Exam Action

07/22/22 4:01 PM MDT

 Auscultated breath sounds in posterior right mid-back (lower lobe)

Exam Action

07/22/22 4:01 PM MDT

 Auscultated breath sounds in posterior left mid-back (lower lobe)

Exam Action

07/22/22 4:01 PM MDT

 Auscultated breath sounds in posterior left upper lobe

Exam Action

07/22/22 4:01 PM MDT

 Auscultated breath sounds in posterior left mid-back (lower lobe)

Exam Action

07/22/22 4:01 PM MDT

 Auscultated breath sounds in anterior left upper lobe

Exam Action

07/22/22 4:02 PM MDT

 Auscultated breath sounds in anterior right upper lobe

Exam Action

07/22/22 4:02 PM MDT

 Auscultated breath sounds in anterior right middle lobe

Exam Action

07/22/22 4:02 PM MDT

 Auscultated breath sounds in anterior left mid-chest (upper lobe)

Exam Action

07/22/22 4:02 PM MDT

 Auscultated breath sounds in anterior left lower lobe

Exam Action

07/22/22 4:02 PM MDT

 Auscultated breath sounds in anterior right lower lobe

Exam Action

07/22/22 4:02 PM MDT

 Auscultated breath sounds in anterior left lower lobe

Exam Action

07/22/22 4:03 PM MDT

 Auscultated breath sounds in anterior right lower lobe

Exam Action

07/22/22 4:04 PM MDT

 Auscultated voice sounds in anterior right upper lobe

Exam Action

07/22/22 4:04 PM MDT

Ninety-nine.

Ninety-nine.

 Auscultated voice sounds in anterior right upper lobe

Exam Action

07/22/22 4:05 PM MDT

Ninety-nine.

Ninety-nine.

Ninety-nine.

 Auscultated voice sounds in anterior left upper lobe

Exam Action

07/22/22 4:05 PM MDT

Ninety-nine.

Ninety-nine.

Ninety-nine.

 Auscultated voice sounds in anterior left mid-chest (upper lobe)

Exam Action

07/22/22 4:06 PM MDT

Ninety-nine.

Ninety-nine.

 Auscultated voice sounds in anterior right middle lobe

Exam Action

07/22/22 4:06 PM MDT

Ninety-nine.

Ninety-nine.

Ninety-nine.

 Auscultated voice sounds in anterior left lower lobe

Exam Action

07/22/22 4:06 PM MDT

Ninety-nine.

Ninety-nine.

Ninety-nine.

 Auscultated voice sounds in anterior right lower lobe

Exam Action

07/22/22 4:06 PM MDT

Ninety-nine.

Ninety-nine.

Ninety-nine.

 Auscultated voice sounds in posterior right upper lobe

Exam Action

07/22/22 4:06 PM MDT

Ninety-nine.

Ninety-nine.

Ninety-nine.

 Auscultated voice sounds in posterior right mid-back (lower lobe)

Exam Action

07/22/22 4:09 PM MDT

Ninety-nine.

Ninety-nine.

Ninety-nine.

 Auscultated voice sounds in posterior right lower lobe

Exam Action

07/22/22 4:10 PM MDT

Ninety-nine.

 Auscultated voice sounds in posterior left lower lobe

Exam Action

07/22/22 4:10 PM MDT

Ninety-nine.

Ninety-nine.

Ninety-nine.

 Auscultated voice sounds in posterior right lower lobe on side

Exam Action

07/22/22 4:10 PM MDT

Ninety-nine.

Ninety-nine.

 Auscultated voice sounds in posterior right lower lobe near spine

Exam Action

07/22/22 4:10 PM MDT

Ninety-nine.

Ninety-nine.

 Auscultated voice sounds in posterior left lower lobe near spine

Exam Action

07/22/22 4:10 PM MDT

Ninety-nine.

Ninety-nine.

Ninety-nine.

 Auscultated voice sounds in posterior left lower lobe on side

Exam Action

07/22/22 4:11 PM MDT

Ninety-nine.

Ninety-nine.

Ninety-nine.

 Auscultated voice sounds in anterior left lower lobe

Exam Action

07/22/22 4:15 PM MDT

Ninety-nine.

Ninety-nine.

Ninety-nine.

 Auscultated voice sounds in anterior right lower lobe

Exam Action

07/22/22 4:15 PM MDT

Ninety-nine.

Ninety-nine.

Ninety-nine.

 Check pulse oximetry using right hand

Exam Action

07/22/22 4:20 PM MDT

 Checked pulse oximetry using left hand

Exam Action

07/22/22 4:20 PM MDT

Ms. Jones can you please blow into the spirometer?

Question

07/22/22 4:22 PM MDT

 Checked spirometer

Exam Action

07/22/22 4:22 PM MDT

 Checked patient’s inhaler

Exam Action

07/22/22 4:23 PM MDT

Do you see an asthma specialist?

Question

07/22/22 4:25 PM MDT

I used to go to Dr. Dewitt, but she moved her practice recently. Luckily she’s still been able to call in refills of my inhaler, but I haven’t actually been in to see her in about two years.

Have you had any hospitalizations?

Question

07/22/22 4:26 PM MDT

I went to the hospital a bunch of times when I was growing up, for asthma attacks. And I went for a foot injury a few months ago, but my foot is fine now.

At the time of your asthma attack, how severe was it?

Question

07/22/22 7:03 PM MDT

My asthma used to be really scary. I haven’t had a full attack in years, and if you had asked me before this I would have said my asthma wasn’t that bad anymore, but the last couple days I’ve had a lot of trouble breathing.

What number on a scale of 0 to 10 would you rate the severity? (Clarified to How would you rate the severity of your asthma on a scale from one to ten?.)

Question

07/22/22 7:04 PM MDT

At its worst it’s been like a 7 or 8 out of 10, probably. (Clarified to how I would rate my asthma on a scale.)

How you rate your shortness of breath from a scale of 0 to 10?

NURS 6512 FINAL EXAM

May 30, | nursing, med, NURS, Paper

NURS 6512 FINAL EXAM
NURS 6512 FINAL EXAM

Costovertebral angle tenderness should be assessed whenever you suspect the patient may have: – Polynephritis
In older adults, overflow fecal incontinence is commonly due to: -Fecal impaction
A 1 month old boy has been vomiting for 2 weeks. How is this symptom of GERD and pyloric stenosis further differentiated in this child’s assessment? – The infant has regurgitation with pyloric stenosis
ORDER A PLAGIARISM-FREE PAPER HERE

Auscultation of borborygmi is associated with: – Gastroenteritis, early intestinal obstruction, or hunger
When auscultating the abdomen, which finding would indicate collateral circulation between the portal and systemic venous systems? – Venous hum. nurs 6512 final exam.
Conversion of fat-soluble wastes to water-soluble material for renal excretion is a function of the: – Liver
The major function of the large intestine is: -Water absorption
Which structure is located in the hypogastric region of the abdomen? –Ileum, bladder, and pregnant uterus
A 45 year old man relates a several week history of severe intermittent abdominal burning sensations. He relates that the pain is relieved with small amounts of food. Before starting the physical examination, you review his laboratory work, anticipating a (n): -Positive Helicobacter pylori result
You are caring for a patient with trigeminal neuralgia. During the assessment, the patient would describe the pain as: – Burning or shocklike
Your 85 year old patient is complaining of right knee pain. She has a history of osteoarthritis for which she is given anti-inflammatory medication. To assess her right knee pain, you should ask her if: – The pain gets better when she sits
A 5 year old is complaining of nondescriptive “belly pain.” Your next action should be to ask him to: – Point to the area of pain nurs 6512 final exam
The perception of pain: – Is variable and is affected by emotions, and cultural background
Patients presenting with ascites, jaundice, cutaneous spider veins, and nonpalpable liver exhibit signs of: – Cirrhosis
A patient presents to the emergency department after a motor vehicle accident. The patient sustained blunt trauma to the abdomen and complains of pain in the upper left quadrant that radiates to the left shoulder. What organ is most likely injured? – Spleen
Imaging studies reveal that a patient has dilation of the renal pelvis from an obstruction in the ureter, what condition will be documented in this patient’s health record? – Hydronephrosis
Visible intestinal peristalsis may indicate: – Intestinal obstruction nurs 6512 final exam
Infants born weighing less than 1500g are at higher risk for: – Necrotizing enterocolitis
Which of the following factors is not known to affect patient compliance with his or her treatment regimen? – The patient’s age and social status
One of the most important aspects to consider in the orthopedic screening examination is: – Symmetry
The sequence of the physical examination should be individualized to: – Minimize the number of times the patient has to change positions to conserve the patient’s energy
As you greet the patient, which examination technique is first implemented? – Inspection
Which of the following is most likely to enhance examiner reliability? – The examiner attempts to qualify data
A 7 year old boy is brought to your office with a chief complaint of possible fracture to his left third finger. He jammed it while playing basketball 2 days ago. The mother states that she really does not think it is broken because he can move it. What is your best response? – This is common misconception, and the finger may be broken. An x-ray is indicated nurs 6512 final exam.
A patient presenting for the first time with typical low back pain should receive which of the following diagnostic tests? – None of the above. X-ray is not indicated because lumbar pain is usually musculoskeletal etiology.
Skeletal changes in older adults are the result of: -Increased bone resorption
A positive straight leg raise test usually indicates: – Lumbar nerve root irritation
What technique is performed at every infant examination during the first year of life to detect hip dislocation? – Barlow-Ortolani maneuvers
Expected normal findings during inspection of spinal alignment include: – Convex lumbar curve
Temporalis and masseter muscles are evaluated by: – Having the patient clench his or her teeth
When palpating joints, crepitus may be caused when: – Irregular bony surfaces rub together
A 3 year old is brought to the clinic complaining of a painful right elbow. He is holding the right arm slightly flexed and pronated and refuses to move it. the mother states that symptoms started right after his older brother had been swinging him around by his arms. This presentation supports a diagnosis of: – Radial head subluxation. nurs 6512 final exam.
Light skin and thin body habitus are risk factors for: – Osteoporosis
Risk factors for sports-related injuries include: – Failure to warm up before activity
Injuries to long bones and joints are more likely to result in fractures than in sprains until: – Adolescence
Ligaments are stronger than bone until: – Adolescence
The family history for a patient with joint pain should include information about siblings with: -Genetic disorders nurs 6512 final exam.
The Thomas test is used to detect: – Flexion contractures of the hip
A goniometer is used to assess: – Range of motion
During a football game, a player was struck on the lateral side of the left leg while his feet were firmly planted. He is complaining of left knee pain. To examine the left knee you should initially perform the ­­­­­­­­­­­­­­­­________ test. – Valgus stress
You note that a child has a positive Gower Sign. You know that this indicates generalized: – Muscle weakness
The dowager hump is: – The hallmark of osteoporosis
What temporary disorder may be experienced by pregnant women during the third trimester because of fluid retention? –Carpal tunnel syndrome
A common finding in markedly obese and pregnant women is: – Lordosis
A 45-year-old laborer presents with low back pain, stating that the pain comes from the right buttock and shoots down and across the right anterior thigh, down the shin to the ankle. Which examination finding is considered more indicative of nerve root compression?A 45 year old laborer presents with low back pain, stating that the pain comes from the right buttock and shoots down and across the right anterior thigh, down the shin to the ankle. Which examination finding is considered more indicative of nerve root compression? – Positive straight leg raise result nurs 6512 final exam.
Mrs. Bower is a 57 year old patient who comes in for an office visit. Which of the following disorders is known to be hereditary? – Huntington chorea
Testing of cranial nerve ­­­­________ is not routinely performed unless a problem is suspected. – I
The patient is able to rapidly touch each finger to his thumb in rapid sequence. What does this finding mean? – The patient has appropriate cerebellar function
Which question asked by the examiner may hellp to determine prevention strategies for seizures that a patient is experiencing? – “Are there any factors or activities that seem to start the seizures?”
A patient has a complaint of dizziness. The patient makes the following statement: “I sometimes feel as if the whole room is spinning.” What type of neurologic dysfunction should the examiner suspect? – Inner ear dysfunction affecting the acoustic nerve
The examiner asks the patient to close her eyes, then places a vibrating tuning fork on the patient’s ankle and asks her to indicate what is felt. What is being assessed? – Peripheral nerve sensory function
Which of the following findings should an examiner consider a normal finding if associated with pregnancy? – Acroparesthesia nurs 6512 final exam.
Jack is a 52 year old obese man with a history of poorly controlled diabetes. He also smokes. Based on the above data, the examiner should recognize that Jack has several risk factors for: – Cerebrovascular accident
Mrs. Jones is a 24 year old patient who presents to your office 2 days postpartum. She complains that she is experiencing foot drop. Which of the following problems should the examiner consider? – Lumbosacral plexopathy
The examiner is assessing deep tendon reflex response in a 12 year old boy. The response is an expected reflex response. Which of the following scores should be documented? – 2+
A 68 year old patient presents to your office for follow-up. He tells you, “I have a hard time finding the right words when I am talking;” he also is experiencing numbness. On examination, you note postural instability. This symptom may be: – A late symptom of Parkinson’s disease nurs 6512 final exam.
Motor maturation proceeds in an orderly progression from: – Head to toe
The thalamus is the major integration center for perception of: – Pain
The examiner should be concerned about neurologic competence if a social smile cannot be elicited by the time a child is ________old. – 3 months
Normal changes of the aging brain include: – Diminished perception of touch. — this is by process of elimination/educated guess. I could not find direct information addressing this in Seidel
When interviewing a 70 year old female clinic patient, she tells you that she takes ginkgo biloba and St. John’s Wort. You make a short note to check for results of the: -Mini-mental state examination
The area of body surface innervated by a particular spinal nerve is called a: – Dermatome
If a patient cannot shrug the shoulders against resistance, which cranial nerve (CN) requires further evaluation? – CN XI, spinal accessory nurs 6512 final exam.
The finger-to-nose test allows assessment of: – Coordination and fine motor function
You ask the patient to follow a series of short commands to assess: – Attention span
As Mr. B. enters the room, you observe that his gait is wide based and he staggers from side to side while swaying his trunk. You would document Mr. B.’s pattern as: – Cerebellar ataxia
When is the mental status portion of the neurologic system examination performed? – Constantly throughout the entire interaction with a client
An aversion to touch or being held, along with delayed or absent language development, is a characteristic of: -Autism
The autonomic nervous system coordinates which of the following? – Internal environment of the body
The major function of the sympathetic nervous system is to: – Orchestrate the stress response
The parasympathetic nervous system maintains the day-to-day function of: – Digestion
Cerebrospinal fluid serves as a: – Shock absorber
You are performing a two-point discrimination test as part of a well physical examination. The area with the ability to discern two points in the shortest distance is the: -Finger tips
Which type of hallucination is most commonly associated with alcohol withdrawal? – Visual-bugs, pink elephants. nurs 6512 final exam,
On a scale of 0 to 4+, which deep tendon reflex score is appropriate for a finding of clonus in a patient? –3+
Which statement is true regarding mental status changes in older adults? – There is an increased risk of delirium with acute illness or metabolic derangement.
A characteristic related to syphilis or diabetic neuropathy is testicular: -Insensitivity to painful stimulation
When collecting personal and social history data from a woman complaining of breast discomfort, you should question her regarding: – Alcohol, tobacco, and caffeine use
What risk factor is associated with cervical cancer? – HPV
A 23 year old female presents with severe right lower quadrant tenderness. All of the following should be considered in the differential except: – Classis diverticulitis
What is the initial diagnostic radiology test that should be ordered if you suspect a ruptured ovarian cyst? – Abdominal and transvaginal ultrasound
A 17 year old male was brought into the emergency room with testicular/scrotal pain. The differential diagnosis should include all except: – Inguinal herniation
The nursing mother complains that her breasts are tender. You assess hard, shiny, and erythremic breasts bilaterally. You should advise the patient to: – Massage gently and continue nursing
A normal vas deferens should feel: – Smooth
In a woman complaining of a breast lump, it is most important to ask about: – Its relationship to menses
The finding of a painless indurated lesion on the glans penis is most consistent with: – Chancre
Thrombosed hemorrhoids are: – Blue, shiny, painful masses
Pregnancy-related cervical changes include: – Softening and bluish coloring
You are inspecting the genitalia of an uncircumcised adult male. The foreskin is tight and cannot be easily retracted. You should: – Inquire about previous penile infections. nurs 6512 final exam.
An adolescent male is being seen for acute onset of left testicular pain. The pain started 3 hours ago. He complains of nausea and denies dysuria or fever. Your prioritized assessment should be to: – Establish absent cremasteric reflex
A 23 year old white woman has come to the clinic because she has missed two menstrual periods. She states that her breasts have enlarged and that her nipples have turned a darker color. nurs 6512 final exam Your further response to this finding is: – Suggest pregnancy testing
What accommodations should be used in the position of a hearing-impaired woman for a pelvic examination? – The head of the table should be elevated
Sexual differentiation in the fetus has occurred by ­­­_______weeks gestation. – 12
You are performing a clinical breast examination for a 55 year old woman. While palpating the supraclavicular area, you suspect that you felt a node. In order to improve your hooked technique, you should: -Ask the patient to turn her head toward that side
If a firm, transverse ridge of compressed tissue is felt bilaterally along the lower edge of a 40 year old patient’s breast, you should: -Record the finding in the patient’s record
A therapeutic technique for dealing with grieving individuals is to: – Tell them that is good to cry and to share feelings
The examination of the newborn should begin with: – Inspection noting skin color, flaccidity, tension, gross deformities, or distortions of facies
Which one of the following patient characteristics is most likely to limit patient reliability during history taking? – Patient is sleep and sensory deprived
In crying infants, it is often difficult to: – Auscultate heart sounds
Which of the following statements accurately reflects the sensitivity and specificity of laboratory tests? – No test has 100% sensitivity and specificity
Which medical condition would exclude one from sports participation? – Fever
Your 15 year old patient is athletic and thin. Radiography of an ankle injury reveals a stress fracture. You question this patient about her: – Menstrual cycles
Which of the following are examined with the patient in a reclining 45 degree position? –Jugular venous pulsation and pressure. nurs 6512 final exam,
Functional assessment is most important during the examination of a(n): -Older adult
The best way to ease the apprehension of a 3 year old child before a physical examination is to: – Encourage child’s participation
An ophthalmoscopic eye examination involves: – Lens inspection
When conducting a geriatric assessment, basic activities of daily living (ADLs) include: – Bathing
The checkout station for preparticipation physical evaluation (PPE) is critical because at this point: – The coordination of follow-ups is reviewed
Which of the following is true regarding the relationship between the examiner and the patient? – The patient is a full partner with the examiner. nurs 6512 final exam,
Which of the following factors is not known to affect patient compliance with his or her treatment regimen? – The patient’s age and social status
One of the most important aspects to consider in the orthopedic screening examination is: – To look for symmetry of muscle, stature, and joint movement
As you greet the patient, which examination technique is first implemented? – Inspection
Which portion of the physical examination is best done with the patient standing? –Spinal
Which patient position facilitates inspection of the chest and shoulders? – Sitting
The least reliable indicator of newborn distress is: – Color
Proprioception should be assessed while the patient is: – Standingnurs 6512 final exam.
Part of the screening orthopedic component of the examination includes evaluating the person while: – Duck walking nurs 6512 final exam.