Question 1

The nurse considers several new female patients to receive additional health education on the need for more frequent Pap smears and gynecological examinations.Which of the following assessment findings reveals the patient at highest risk for cervical cancer and thus having the greatest need for patient education?

Accepted Answer

A)   Nonsmoker, 13 years old, not sexually active
B)   Social smoker, 15 years old, celibate
C)   22 years old, smokes 1 pack of cigarettes per day, has multiple sexual partners
D)   50 years old, stopped smoking 30 years ago, history of hysterectomy C

Question 2

An advanced practice nurse is preparing to assess the external genitalia of a 25-year-old American woman of Chinese descent.Which of the following nursing actions does the nurse do first?

Accepted Answer

A)   Place the patient in the lithotomy position.
B)   Drape the patient to enhance patient comfort.
C)   Assess the patient's feelings and explain the purpose of the examination.
D)   Ask the patient if she would like her mother to be present in the room during the examination. C

Question 3

A nurse identifies Pediculosis humananus capitis.Considering the possible complications of treatment,the nurse knows to not use which of the following treatment products?

Accepted Answer

A)   Fine-toothed comb
B)   Pediculicide
C)   Lindane-based shampoo
D)   Vinegar hair rinse C

Question 4

The paramedics transport an adult involved in a motor vehicle accident to the emergency department.On physical examination,the patient's level of consciousness is reported as opening eyes to pain and responding with inappropriate words and flexion withdrawal to painful stimuli.The nurse correctly identifies the patient's Glasgow Coma Scale score as

Accepted Answer

A)   5.
B)   7.
C)   9.
D)   11.

Question 5

The patient is a 50-year-old African American male who has come in for his routine annual physical.Which of the following preventive screenings does the nurse recommend?

Accepted Answer

A)   Digital rectal examination of the prostate (DR
E)   annually
B)   Ca125 blood test once a year
C)   Complete eye examination every year
D)   Colonoscopy every 3 years

Question 6

During a preschool readiness examination,the nurse prepares to perform visual acuity screenings.Given the children's age,the best equipment to test central vision is which of the following?

Accepted Answer

A)   Snellen test
B)   E chart
C)   Reading test
D)   Penlight

Question 7

A teen patient is tearful and reports locating lumps in her breasts.Other history obtained is that she is currently menstruating.Physical examination reveals soft and movable cysts in both breasts that are painful to palpation.The nurse also notes that the patient's nipples are erect,but the areolae are wrinkled.The next nursing step is which of the following?

Accepted Answer

A)   Reassure patient that her symptoms are normal.
B)   Consult a breast surgeon because of the abnormal nipples and areolae.
C)   Discuss fibrocystic disease as the likely cause.
D)   Tell the patient that the symptoms may get worse when her period ends.

Question 8

An elderly patient is being seen for a chronic entropion.The nurse realizes that entropion places the patient at risk for which of the following?

Accepted Answer

A)   Ectropion
B)   Infection
C)   Exophthalmos
D)   Strabismus

Question 9

The patient has had a stroke that has affected her ability to speak,and she becomes extremely frustrated when she tries to speak.She responds correctly to questions and instructions but cannot form words coherently.This patient is showing signs of _____ aphasia.

Accepted Answer

A)   Expressive
B)   Receptive
C)   Sensory
D)   Combination

Question 10

A school nurse recognizes a belt buckle-shaped ecchymosis on a 7-year-old student.When privately asked about how the injury occurred,the student described falling on the playground.Upon suspecting abuse,the school nurse's best next action is which of the following?

Accepted Answer

A)   Interviewing the patient in the presence of his/her teacher
B)   Ignoring the findings because child abuse is a declining problem
C)   Realizing that abuse victims usually report abusive situations
D)   Contacting Social Services and reporting suspected abuse

Question 11

A male student comes to the college health clinic.He hesitantly describes that his testis has lumps.The nurse recognizes this as a potential sign of which of the following?

Accepted Answer

A)   Inguinal hernia
B)   Sexually transmitted infection
C)   Testicular cancer
D)   Diuretic use

Question 12

During a sexually transmitted illness presentation to high school students,the nurse recommends the HPV vaccine series to prevent

Accepted Answer

A)   Cervical cancer.
B)   Genital lesions.
C)   Vaginal discharge.
D)   Swollen perianal tissues.

Question 13

During a genitourinary examination of a 30-year-old male patient,the nurse identifies a small amount of a white,thick substance on the patient's uncircumcised glans penis.The nurse's next step is to

Accepted Answer

A)   Notify his provider about a suspected STI.
B)   Recognize this as a normal finding.
C)   Tell the patient to avoid doing self-examinations until symptoms clear.
D)   Avoid embarrassing questions about sexual activity.

Question 14

A nurse is a preceptor for a nurse who just graduated from nursing school.When caring for a patient,the new graduate nurse begins to explain to the patient the purpose of completing a physical assessment.Which of the following statements made by the new graduate nurse requires the preceptor to intervene?

Accepted Answer

A)   "I will use the information from my assessment to figure out if your antihypertensive medication is working effectively."
B)   "Nursing assessment data are used only to provide information about the effectiveness of your medical care."
C)   "Nurses use data from their patient's physical assessment to determine a patient's educational needs."
D)   "Information gained from physical assessment helps nurses better understand their patients' emotional needs."

Question 15

A head and neck physical examination is completed on a 50-year-old female patient.All physical findings are normal except for fine brittle hair.Based on the physical findings,which of the following laboratory tests would the nurse expect to be ordered?

Accepted Answer

A)   Liver function test
B)   Lead level
C)   Thyroid-stimulating hormone test
D)   Complete blood count

Question 16

During a routine pediatric history and physical,the parents report that their child was a premature infant and was so small that he had to stay in the neonatal intensive care unit longer than usual.They state that the infant was yellow when born,and that he developed an infection that required "every antibiotic under the sun" to cure him.Considering the neonatal history,the nurse determines that it is especially important to perform a focused _____ examination.

Accepted Answer

A)   Cardiac
B)   Respiratory
C)   Ophthalmic
D)   Hearing acuity

Question 17

A febrile preschool-aged child presents to the after-hours clinic.Varicella is diagnosed on the basis of the illness history and the presence of small,circumscribed skin lesions filled with serous fluid.The nurse documents the varicellar lesions as which type of skin lesion?

Accepted Answer

A)   Vesicle
B)   Wheal
C)   Papule
D)   Pustule

Question 18

An elderly patient has been on high doses of antibiotics and is experiencing a sudden loss of hearing.The nurse should contact the health care provider and

Accepted Answer

A)   Stop antibiotic use until the physician responds.
B)   Tell the patient that older patients often lose low-frequency hearing.
C)   Explain that hearing loss usually occurs with thinning of the eardrum.
D)   Assure the patient that rapid hearing loss is normal in the elderly.

Question 19

A parent calls the school nurse with questions regarding the recent school vision screening.Snellen chart examination revealed 20/60 for both eyes.Considering the visual acuity results,the nurse informs the parent that the child

Accepted Answer

A)   Should have an optometric examination.
B)   Is suffering from strabismus.
C)   May have presbyopia.
D)   Has vision issues most likely due to cataracts.

Question 20

A teen female patient reports intermittent abdominal pain for 12 hours.No dysuria is present.When performing an abdominal assessment,the nurse should

Accepted Answer

A)   Recommend that the patient take more laxatives.
B)   Ask the patient about the color of her stools.
C)   Avoid sexual references such as possible pregnancy.
D)   Assess first the spots that are most tender.

Exam 78: Health Assessment and Physical Examination