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nurs 6501 – week 10 quiz.

NURS-6501N-4/NURS-6501C-4-Advanced Pathophysiology2018 Summer Qtr 05/29-08/19-PT27
 

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Review Test Submission: Quiz – Week 10

NURS-6501N-4/NURS-6501C-4-Advanced Pathophysiology2018 Summer Qtr 05/29-08/19-PT27

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Review Test Submission: Quiz – Week 10

 

User

Course

NURS-6501N-4/NURS-6501C-4-Advanced Pathophysiology2018 Summer Qtr 05/29-08/19-PT27

Test

Quiz – Week 10

Started

Due Date

Status

Completed

Attempt Score

38 out of 40 points

Time Elapsed

27 minutes out of 45 minutes

Instructions

Please answer each question below and click 
Submit
 when you have completed the Quiz.

Results Displayed

Submitted Answers, Correct Answers, Feedback

Question 1

0 out of 0 points

When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? nurs 6501 – week 10 quiz.

Selected Answer:

 

Yes

Correct Answer:

 

Yes

Question 2

1 out of 1 points

A 15-year-old male was diagnosed with pharyngitis. Eight days later he developed acute glomerulonephritis. While reviewing the culture results, which of the following is the most likely cause of this disease?

Selected Answer:

d.

Group A ß-hemolytic streptococcus

Correct Answer:

d.

Group A ß-hemolytic streptococcus

Question 3

1 out of 1 points

A 27-year-old male has a severe kidney obstruction leading to removal of the affected kidney. Which of the following would the nurse expect to occur? nurs 6501 – week 10 quiz.

Question 4

1 out of 1 points

A 25-year-old female is diagnosed with urinary tract obstruction. While planning care, the nurse realizes that the patient is expected to have hydronephrosis and a decreased glomerular filtration rate caused by:

Selected Answer:

Correct Answer:

Question 5

1 out of 1 points

A 42-year-old female is diagnosed with chronic renal failure, and the nurse is discussing dietary treatment. Which information indicates the nurse understands dietary regimen? Treatment includes restricting:

Selected Answer:

Correct Answer:

nurs 6501 – week 10 quiz

Question 6

1 out of 1 points

A 30-year-old male is demonstrating hematuria with red blood cell casts and proteinuria exceeding 3 to 5 g/day, with albumin being the major protein. The most probable diagnosis the nurse will see documented on the chart is:

Selected Answer:

c.

Acute glomerulonephritis

Correct Answer:

c.

Acute glomerulonephritis

nurs 6501 – week 10 quiz

Question 7

0 out of 1 points

A 5-year-old male was diagnosed with glomerulonephritis. History reveals that he had an infection 3 weeks before the onset of this condition. The infection was most likely located in the:

Selected Answer:

t

Correct Answer:

Question 8

1 out of 1 points

A 3-year-old female presents with recurrent urinary tract infections (UTIs), fever, poor growth and development, and feeding problems. Tests reveal a retrograde flow of urine from the urinary bladder into the ureters. When giving report to the oncoming shift, the nurse will call this condition: nurs 6501 – week 10 quiz

Selected Answer:

.

 

Correct Answer:

Question 9

1 out of 1 points

While turning a patient with chronic renal failure, which principle should the nurse recall? Bone fractures are a risk factor in chronic renal failure because:

Selected Answer:

c.

The kidneys fail to activate vitamin D.

Correct Answer:

c.

The kidneys fail to activate vitamin D.

Question 10

1 out of 1 points

The urologist is teaching about the nephrons that determine the concentration of the urine. The urologist is discussing the _____ nephrons.

Selected Answer:

Correct Answer:

Question 11

1 out of 1 points

A 6-year-old male is experiencing urine reflux from the urinary bladder into a grossly dilated ureter and calyces. He was diagnosed with vesicoureteral reflux. This condition would be graded:

Selected Answer:

Correct Answer:

Question 12

0 out of 1 points

When a newborn is admitted with urinary tract infections (UTIs), which type of infection will the nurse look for in the newborn? nurs 6501 – week 10 quiz.

Selected Answer:

a.

Blood-borne infections

Correct Answer:

b.

Infections caused by bacteria from the gastrointestinal (GI) tract

Question 13

1 out of 1 points

If a nurse wants to obtain the best estimate of renal function, which test should the nurse monitor?

Selected Answer:

a.

Glomerular filtration rate (GFR)

Correct Answer:

a.

Glomerular filtration rate (GFR)

Question 14

1 out of 1 points

A 42-year-old male is involved in a motor vehicle accident during which he loses a lot of blood. The nurse realizes he is in acute renal failure caused by: nurs 6501 – week 10 quiz.

Selected Answer:

c.

Inadequate renal blood flow

Correct Answer:

c.

Inadequate renal blood flow

Question 15

1 out of 1 points

A 35-year-old female was severely burned and is hospitalized. She is now suffering from acute tubular necrosis (ATN). Which of the following is the most likely diagnosis the nurse will observe on the chart?

Selected Answer:

l

Correct Answer:

Question 16

1 out of 1 points

When describing the male urinary anatomy, which information should the nurse include? The portion of the male urethra that is closest to the bladder is the _____ portion.

Selected Answer:

c

Correct Answer:

Question 17

1 out of 1 points

When a nurse is preparing to teach about urine, which information should the nurse include? Just before entering the ureter, urine passes through the: nurs 6501 – week 10 quiz.

Selected Answer:

Correct Answer:

Question 18

1 out of 1 points

A 24-year-old female is diagnosed with renal calculus that is causing obstruction. Which of the following symptoms would she most likely experience?

Selected Answer:

b.

Hematuria

Correct Answer:

b.

Hematuria

Question 19

1 out of 1 points

A 7-year-old male presents to his primary care provider for incontinence. His mother indicates that he has never been continent. Which of the following is the most likely diagnosis the nurse will observe on the chart?

Selected Answer:

c.

Primary enuresis

Correct Answer:

c.

Primary enuresis

Question 20

1 out of 1 points

A 75-year-old male reports to his primary care provider loss of urine with cough, sneezing, or laughing. Which of the following is the most likely diagnosis the nurse will observe on the chart? nurs 6501 – week 10 quiz.

Selected Answer:

b.

Stress incontinence

Correct Answer:

b.

Stress incontinence

Question 21

1 out of 1 points

A 15-year-old female presents with flank pain, irritability, malaise, and fever. Tests reveal glomerulonephritis. When the parents ask what could have caused this, how should the nurse respond?

Selected Answer:

a.

Poststreptococcal infection

Correct Answer:

a.

Poststreptococcal infection

Question 22

0 out of 1 points

A urologist is discussing the phagocytic cells that lie between the layers of the renal corpuscle. What is the urologist describing?

Selected Answer:

b.

Macula densa cells

Correct Answer:

c.

Mesangial cells

Question 23

1 out of 1 points

A nurse observes on the chart that a patient is admitted with Wilms tumors. A nurse knows the tumors are found in the:

Selected Answer:

a.

Kidneys

Correct Answer:

a.

Kidneys

Question 24

1 out of 1 points

When the nurse is discussing the sodium-sensing cells of the glomerulus, what term should the nurse use?

Selected Answer:

b.

Macula densa

Correct Answer:

b.

Macula densa

Question 25

1 out of 1 points

While planning care for a patient who has acute pyelonephritis. A nurse recalls the most common condition associated with the development of acute pyelonephritis is: nurs 6501 – week 10 quiz.

Selected Answer:

c

Correct Answer:

Question 26

1 out of 1 points

A 55-year-old male presents reporting urinary retention. Tests reveal that he has a lower urinary tract obstruction. Which of the following is of most concern to the nurse?

Selected Answer:

b.

Formation of renal calculi

Correct Answer:

b.

Formation of renal calculi

Question 27

1 out of 1 points

Which of the following clusters of symptoms would make a clinician suspect a child has developed glomerulonephritis?

Selected Answer:

d.

Gross hematuria, flank pain, and hypertension

Correct Answer:

d.

Gross hematuria, flank pain, and hypertension

Question 28

1 out of 1 points

A nurse is preparing to teach about the loop of Henle. Which information should be included? The descending segment of the loop of Henle primarily allows for: nurs 6501 – week 10 quiz.

Selected Answer:

Question 29

1 out of 1 points

When the nurse discusses the glomerulus and Bowman capsule together, it is referred to as the renal:

Selected Answer:

Correct Answer:

Question 30

1 out of 1 points

A 19-year-old female was involved in a motor vehicle accident during which she sustained a closed head injury. She is now experiencing detrusor sphincter dyssynergia. Which of the following is the most beneficial medication treatment?

Selected Answer:

Correct Answer:

Question 31

1 out of 1 points

A 2-year-old male is diagnosed with Wilms tumor. Which of the following clinical conditions is often associated with this disease?

Selected Answer:

Correct Answer:

Question 32

1 out of 1 points

A nurse is reviewing urinalysis results and notices glucose is present in the urine. A nurse realizes glucose will be excreted in the urine when:

Selected Answer:

b.

The carrier molecules have reached their maximum

Correct Answer:

b.

The carrier molecules have reached their maximum

Question 33

1 out of 1 points

When a child is admitted with acute renal failure, a clinician realizes the most common cause of acute renal failure is:

Selected Answer:

d.

Hemolytic uremic syndrome (HUS)

Correct Answer:

d.

Hemolytic uremic syndrome (HUS)

Question 34

1 out of 1 points

A 45-year-old female presents with hypertension, anorexia, nausea and vomiting, and anemia. She is diagnosed with chronic renal failure. When the patient asks what caused this anemia, how should the nurse respond? Your anemia is caused by:

Selected Answer:

b.

Inadequate production of erythropoietin

Correct Answer:

b.

Inadequate production of erythropoietin

Question 35

1 out of 1 points

A 4-year-old male is diagnosed with nephrotic syndrome. Which of the following assessment findings accompanies this condition? nurs 6501 – week 10 quiz.

Selected Answer:

Correct Answer:

Question 36

1 out of 1 points

When a nurse is checking the urinalysis, plasma proteins should be absent from the urine because:

Selected Answer:

d.

The negative charge of the glomerular filtration membrane repels the plasma proteins.

Correct Answer:

d.

The negative charge of the glomerular filtration membrane repels the plasma proteins.

Question 37

1 out of 1 points

A urologist is discussing a structure that supplies blood to the medulla. What is the urologist describing?

Selected Answer:

Correct Answer:

Question 38

1 out of 1 points

A 25-year-old female presents with burning urination. nurs 6501 – week 10 quiz. She was diagnosed with a urinary tract infection. When the nurse checks the culture results, which of the following organisms is most likely infecting her urinary tract?

Selected Answer:

i

Correct Answer:

Question 39

0 out of 1 points

Anemia accompanies chronic renal failure because of:

Selected Answer:

b.

Renal insensitivity to vitamin D

Correct Answer:

c.

Inadequate production of erythropoietin

Question 40

1 out of 1 points

A 56-year-old male presents with flank pain and polyuria. Tests reveal that he has an enlarged prostate. Which of the following types of renal failure should the nurse monitor for as it is the most likely to occur?

Selected Answer:

Correct Answer:

Question 41

1 out of 1 points

A 30-year-old male is demonstrating hematuria with red blood cell casts and proteinuria exceeding 3 to 5 g/day, with albumin being the major protein. The most probable diagnosis the nurse will see documented on the chart is:

Selected Answer:

c.

Acute glomerulonephritis

Correct Answer:

c.

Acute glomerulonephritis

nurs 6501 – week 10 quiz

Diversity and Health Assessments essay discussion papers – nurs 6512 week 2

Question

Discussion 2: Diversity and Health Assessments

In May 2012, Alice Randall wrote an article for The New York Times on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012). Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

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Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the health care field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and health care professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.

In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds. Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

Case 1

Subjective Data

CC: “I came for my annual physical exam, but do not want to be a burden to my daughter.”

History of Present Illness (HPI): At-risk 86-year-old Asian male – who is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs.

PMH: hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency and chronic prostatitis

PSH: S/P cholecystectomy

Drug Hx:

Current Meds: Lisinopril 10mg daily, Prilosec 20mg daily, B12 injections monthly, and cipro 100mg daily.

Review of Systems (ROS)

General: + weight loss of 25 lbs over the past year; no recent fatigue, fever or chills.

Head, eyes, ears, nose & throat (HEENT): no changes in vision or hearing, no difficulty chewing or swallowing.

Neck: no pain or injury Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

Respiratory:

CV:

GI:

GU: no urinary hesitancy or change in urine stream

Integument: multiple bruises on his upper arms and back.

MS/Neuro: + falls x 2 within the last 6 months; no syncopal episodes or dizziness

Psych:

Objective Data

PE: B/P 188/96; Pulse 89; RR 16; Temp 99.0; Ht 5,6; wt 110; BMI 17.8

HEENT: Atraumatic, normocephalic, PERRLA, EOMI, arcus senilus bilaterally, conjunctiva and sclera clear, nares patent, ornasopharynx clear, edentulous. Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

Lungs: CTA AP&L

Cor: S1S2 without rub or gallop

Abd: benign, normoactive bowel sounds x 4

Ext: no cyanosis, clubbing or edema

Integument: multiple bruises in different stages of healing – on his upper arms and back.

Neuro: No obvious deformities, CN grossly intact II-XII

Case 2

Subjective Data

CC: “I am here for my annual physical exam and have been having vaginal discharge.”

History of Present Illness (HPI): 32-year-old pregnant lesbian – her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank.

Drug Hx:

Current Medications: prenatal vitamins and takes Tylenol over the counter for aches and pains on occasion

Family Hx: She a strong family history of diabetes. Gravida 1; Para 0; Abortions 0.

Review of Systems (ROS) Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

General: no fatigue, fever or chills.

Head, eyes, ears, nose & throat (HEENT):

Neck: no pain or injury

Respiratory:

CV:

GI:

GU:

Integument: multiple piercings, and tattoos. Old scars related to “cutting”.

Neuro: no syncopal episodes or dizziness, no change in memory or thinking patterns; no twitches or abnormal movements

Objective Data

PE: B/P 128/76; Pulse 83; RR 16; Temp 99.0; Ht 5,6; wt 128; BMI 20.98

HEENT: Atraumatic, normocephalic, PERRLA, EOMI, conjunctiva and sclera clear; nares patent, ornasopharynx clear, good dentition. Piercing in her right nostril and lower lip. Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

Lungs: CTA AP&L

Cor: S1S2 without rub or gallop

Abd: benign, normoactive bowel sounds x 4

GU: external genitalia intact, no lesions or masses. White copious discharge with an amine odor; no cervical motion tenderness; adenxa intact.

Ext: no cyanosis, clubbing or edema

Integument: intact without lesions masses or rashes.

Neuro: No obvious deficits and CN grossly intact II-XII

Case 3

Subjective Data

CC: “Annual physical exam”

History of Present Illness (HPI): 23-year-old Native American male comes in to see you because he has been having anxiety and wants something to help him. He has been smoking “pot” and says he drinks to help him too. He tells you he is afraid that he will not get into Heaven if he continues in this lifestyle.

Drug Hx:

Current medication – denied

Allergies: no allergies to food or medications.

Family history: is very positive for diabetes, hypertension, and alcoholism. Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

Review of Systems (ROS)

General: no recent weight gains of losses, fatigue, fever or chills.

Head, eyes, ears, nose & throat (HEENT):

Neck:

Respiratory:

CV: no chest discomfort or palpitations

GI:

GU:

Integument: history of eczema – not active

MS/Neuro: no syncopal episodes or dizziness, no change in memory or thinking patterns; no twitches or abnormal movements. Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

Psych:

Objective Data

PE: B/P 158/90; Pulse 88; RR 18; Temp 99.2; Ht 5,7; wt 208; BMI 32.6

General: 23 year old male appears well developed and well nourished. He is anxious – pacing in the room and fidgeting, but in no acute distress.

HEENT: Atraumatic, normocephalic, PERRLA, EOMI, sclera with mild icterus, nares patent, ornasopharynx clear, poor dentition – multiple carries.

Lungs: CTA AP&L

Cor: S1S2, +II/VI holosystolic murmur; without rub or gallop

Abd: benign, normoactive bowel sounds x 4; Hepatomegaly 2cm below the costal margin.

Ext: no cyanosis, clubbing or edema

Integument: intact without lesions masses or rashes.

Neuro: No obvious deficits and CN grossly intact II-XII

To prepare:

· Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.

· Select one of the three case studies. Reflect on the provided patient information. Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

· Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected.

· Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

· Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?

Post a 1 page paper APA format

1. explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you selected Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

2. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. 3. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks. Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

Readings

· Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

o Chapter 2, “Cultural Competency” (pp. 21–29)

This chapter highlights the importance of cultural awareness when conducting health assessments. The authors explore the impact of culture on health beliefs and practices.

o Chapter 3, “Examination Techniques and Equipment” (pp. 30-49)

This chapter explains the physical examination techniques of inspection, palpation, percussion, and auscultation. This chapter also explores special issues and equipment relevant to the physical exam process.

· Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby.

o Chapter 1, “Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis”

This chapter introduces the diagnostic process, which includes performing an analysis of the symptoms and then formulating and testing a hypothesis. The authors discuss how becoming an expert clinician takes time and practice in developing clinical judgment.

· Sullivan , D. D. (2012). Guide to clinical documentation (2nd ed.). Philadelphia, PA: F. A. Davis.

o Chapter 2, “The Comprehensive History and Physical Exam” (pp. 19–36)

o Appendices A–E (pp. 225–236)

· Laine, C. (2012). High-value testing begins with a few simple questions. Annals of Internal Medicine,156(2), 162–163. Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

Retrieved from the Walden Library databases.

This article supplies a list of questions physicians should ask themselves before ordering tests. The authors provide general guidelines for maximizing the value received from testing.

· Qaseem, A., Alguire, P., Dallas, P., Feinberg, L. E., Fitzgerald, F. T., Horwitch, C., & … Weinberger, S. (2012). Appropriate use of screening and diagnostic tests to foster high-value, cost-conscious care.Annals of Internal Medicine, 156(2), 147–150. Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

Retrieved from the Walden Library databases.

This article highlights the increasing cost of health care and stresses the need for high-value and cost-conscious testing. The authors provide a list of 37 situations in which more testing provides no benefit or may be harmful.

· Shaw, S. J., Huebner, C., Armin, J., Orzech, K., & Vivian, J. (2009). The role of culture in health literacy and chronic disease screening and management. Journal of Immigrant & Minority Health, 11(6), 460–467.

Retrieved from the Walden Library databases. Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

This article examines cultural influences on health literacy, cancer screening, and chronic disease outcomes. The authors postulate that cultural beliefs about health and illness affect a patient’s ability to comprehend and follow a health care provider’s instructions.

· Wians, F. H. (2009). Clinical laboratory tests: Which, why, and what do the results mean? LabMedicine, 40, 105–113.

Retrieved from http://labmed.ascpjournals.org/content/40/2/105.full

This article analyzes the laboratory testing cycle and its impact on diagnostic decision making. This article also examines important diagnostic performance characteristics of laboratory tests, methods of calculating performance, and tools used to assess the diagnostic accuracy of a laboratory test Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

Optional Resources

· LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2009). DeGowin’s diagnostic examination (9th ed.). New York, NY: McGraw- Hill Medical.

o Chapter 3, “The Physical Screening Examination”

o Chapter 17, “Principles of Diagnostic Testing”

o Chapter 18, “Common Laboratory Tests”

Answer Diversity and Health Assessments essay discussion papers – nurs 6512 week 2. Diversity and Health Assessments essay discussion papers – nurs 6512 week 2.

NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers

When percussing, a dull tone is expected to be heard over:

most of the abdomen.

emphysemic lungs.

the liver.

healthy lung tissue.

an empty stomach.

The dorsal surface of the hand is most often used for the assessment of:

crepitus.

thrills.

texture.

vibration.

temperature.

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A patient in the emergency department has a concussion to the head. You suspect the patient may also have a retinal hemorrhage. You are using the ophthalmoscope to examine the retina of this patient. Which aperture of the ophthalmoscope is most appropriate for this patient? NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

Strabismoscope

Red-free filter

Slit lamp

Small aperture

Grid

The use of secondary, tangential lighting is most helpful in the detection of:

variations in skin color.

enlarged tonsils.

foreign objects in the nose or ear.

variations in contour of the body surface.

variations in texture and mobility.

Tuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure:

vibratory sensations.

hearing from bone conduction.

hearing range of normal speech.

noise above the threshold level.

peripheral motor nerve damage.

Which patient is at the highest risk for the development of latex allergy?

The new patient who has no chronic illness and has never been hospitalized

The patient who has had multiple procedures or surgeries

The patient who is allergic to eggs

The patient who is allergic to contrast dye

The patient who is a vegetarian

A variant of the percussion hammer is the neurologic hammer, which is equipped with which of the following?

Brush and needle

Tuning fork and cotton swab

Penlight and goniometer

Ruler and bell

Transilluminator

Transillumination functions on the principle that:

infrared radiation is easily detected.

black light causes certain substances to fluoresce.

converging and diverging light brings structures into focus.

tangential light casts shadows that illuminate contours.

air, fluid, and tissue transmit light differentially.

Which statement is true regarding the relationship of physical characteristics and culture?

Physical characteristics should be used to identify members of cultural groups.

There is a difference between distinguishing cultural characteristics and distinguishing physical characteristics.

To be a member of a specific culture, an individual must have certain identifiable physical characteristics.

Gender and race are the two essential physical characteristics used to identify cultural groups. NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

All cultural traits can be viewed as static whereas physical traits are dynamic.

A scale used to assess patients weight should be calibrated:

when the patient tells you the weight is not correct.

by a qualified technician at regularly scheduled intervals.

each time it is used.

when necessary, with the patient standing on the scale.

only by the manufacturer.

Which technique is commonly used to elicit tenderness arising from the liver, gallbladder, or kidneys?

Finger percussion

Only indirect percussion techniques are ever used to elicit tenderness.

Fist percussion

Thumb percussion

Palmer percussion

A rubber or plastic ring should be around the bell end-piece of a stethoscope to:

prevent the transmission of static electricity.

avoid cold metal from touching the patient.

prevent the sharp edge of the stethoscope from damaging the patient s skin.

allow firm pressure to be applied without discomfort.

ensure secure contact with the body surface.

In terms of cultural communication differences, Americans are more likely to _____ than are other groups of patients.

emphasize attitudes and feelings

maintain eye contact

come quickly to the point

use silence comfortably

speak more softly than other cultures

For a woman with a small vaginal opening, the examiner should use a _____ speculum.

plastic Graves

Pederson

pediatric

nasal

metal Graves

During percussion, the downward snap of the striking fingers should originate from the:

wrist.

forearm.

shoulder.

interphalangeal joint.

elbow.

You are auscultating a patient s chest. The sounds are not clear, and you are having difficulty distinguishing between respirations and heartbeats. What technique can you use to facilitate your assessment? NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

Anticipate the next sounds.

Isolate each cycle segment.

Listen to all sounds together.

Move the stethoscope clockwise.

Ask the patient to whisper his name.

Expected normal percussion tones include:

dullness over the lungs.

hyperresonance over the lungs.

tympany over an empty stomach.

flatness over an empty stomach.

resonance over the liver.

During auscultation, you can limit your perceptual field best by:

asking patients to describe their symptoms.

listening through the patient s clothing.

closing your eyes.

performing palpation before percussion.

turning out the lights in the examination room.

Standard Precautions apply to all patients:

with bloodborne infections.

with infected, draining wounds.

in intensive care units.

receiving care in hospitals.

believed to have an infectious disease.

Which of the following describes a physical, not a cultural, differentiator?

Ritual

Rite

Race

Norm

Ethos

 

Course

NURS-6512N-28,Advanced Health Assessment.2017 Fall Qtr 08/28-11/19-PT27

Test

Quiz – Week 2

Started

9/9/17 11:22 AM

Submitted

9/9/17 11:53 AM

Due Date

9/11/17 1:59 AM

Status

Completed

Attempt Score

40 out of 40 points

Time Elapsed

30 minutes out of 30 minutes

Instructions

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Results Displayed

Feedback

Question 1

2 out of 2 points

 

When percussing, a dull tone is expected to be heard over:

 

Response Feedback:

Dull tones are expected over more dense areas such as the liver.

Question 2

2 out of 2 points NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers

 

The dorsal surface of the hand is most often used for the assessment of:

 

Response Feedback:

The dorsal surface, or back of the hand, can best feel for warmth.

Question 3

2 out of 2 points

 

A patient in the emergency department has a concussion to the head. You suspect the patient may also have a retinal hemorrhage. You are using the ophthalmoscope to examine the retina of this patient. Which aperture of the ophthalmoscope is most appropriate for this patient? NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers

 

Response Feedback:

The red-free filter permits recognition of hemorrhages. The grid estimates the size of lesions; the slit lamp examines the anterior eye and assesses the elevation of lesions; and the small aperture is used with small pupils. The strabismoscope is used for detecting strabismus.

Question 4

2 out of 2 points

 

The use of secondary, tangential lighting is most helpful in the detection of:

 

Response Feedback:

Tangential lighting is used to cast shadows in order to best observe contours and variations in body surfaces. All of the other choices are best observed with direct lighting that does not cast shadows.

Question 5

2 out of 2 points

 

Tuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure:

 

Response Feedback:

Normal speech has a range of 300 to 3000 Hz; therefore, the 500- to 1000-Hz fork is most often used because it can estimate hearing loss in the range of normal speech. NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

Question 6

2 out of 2 points

 

Which patient is at the highest risk for the development of latex allergy?

 

Response Feedback:

The patient who has had multiple procedures or surgeries has a higher exposure rate to rubber gloves and to equipment and supplies that contain latex and therefore is at a higher risk for developing an allergic response.

Question 7

2 out of 2 points

 

A variant of the percussion hammer is the neurologic hammer, which is equipped with which of the following?

 

Response Feedback:

The neurologic hammer unscrews at the handle to reveal a soft brush and the knob on the head unscrews, to which is attached a sharp needle.

Question 8

2 out of 2 points

 

Transillumination functions on the principle that:

 

Response Feedback:

Transillumination functions to differentiate between various media in a cavity. It can distinguish between air, fluid, and tissue. It consists of a strong light in the visible spectrum with a narrow beam. NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

Question 9

2 out of 2 points

 

Which statement is true regarding the relationship of physical characteristics and culture?

 

Response Feedback:

Physical characteristics do not symbolize cultural groups; there is a difference between the two, and they are considered separately. Cultures are dynamic in their evolution.

Question 10

2 out of 2 points

 

A scale used to assess patients weight should be calibrated:

 

Response Feedback:

Obtaining weight begins with a manual calibration of the scale before the patient stands on the scale. Electronic scales are automatically calibrated before each reading.

Question 11

2 out of 2 points

 

Which technique is commonly used to elicit tenderness arising from the liver, gallbladder, or kidneys?

 

Response Feedback:

The fist percussion is a direct percussion technique used to elicit tenderness over organs such as the liver, gallbladder, or kidneys.

Question 12

2 out of 2 points

 

A rubber or plastic ring should be around the bell end-piece of a stethoscope to:

 

Response Feedback:

The ring around the bell portion of the stethoscope functions to secure contact with body surfaces when placed lightly on the skin. NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

Question 13

2 out of 2 points

 

In terms of cultural communication differences, Americans are more likely to _____ than are other groups of patients.

 

Response Feedback:

In the United States, individuals are very direct in conversation and come to the point quickly. They also tend to talk more loudly and to worry less about being overheard.

Question 14

2 out of 2 points

 

For a woman with a small vaginal opening, the examiner should use a _____ speculum.

 

Response Feedback:

The Pederson speculum has blades that are as long as those of the Graves speculum but are both narrower and flatter and therefore more comfortable for women with small vaginal openings. Pediatric or nasal speculums would be too small for adult use. Plastic speculums are similar in uses to the metal counterparts. NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

Question 15

2 out of 2 points

 

During percussion, the downward snap of the striking fingers should originate from the:

 

Response Feedback:

The dominant hand s middle finger strikes the stationary finger with a wrist motion and is lifted quickly off the striking surface.

Question 16

2 out of 2 points

 

You are auscultating a patient s chest. The sounds are not clear, and you are having difficulty distinguishing between respirations and heartbeats. What technique can you use to facilitate your assessment?

 

Response Feedback:

If you are hearing everything at once, it is more difficult to distinguish different sounds. Try isolating each segment and listen to that segment intently, then move on to another segment. For example, listen only to breath sounds, then only to inspiratory breath sounds, then only expiratory breath sounds. NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

Question 17

2 out of 2 points

 

Expected normal percussion tones include:

 

Response Feedback:

A normal lung produces resonance percussion tones while an empty stomach is expected to produce tympany. Dull percussion tones are heard over the liver.

Question 18

2 out of 2 points

 

During auscultation, you can limit your perceptual field best by:

 

Response Feedback:

By closing your eyes, your sense of hearing becomes more acute and it increases your ability to isolate sounds.

Question 19

2 out of 2 points

 

Standard Precautions apply to all patients:

 

Response Feedback:

Although all of the statements are true, the best answer is 4. Standard Precautions were developed with the intent of application in the care of all hospitalized patients; however, the standard has merit to be applied to all cases of patient care regardless of the environment in which care is delivered. NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

Question 20

2 out of 2 points

 

Which of the following describes a physical, not a cultural, differentiator?

 

Response Feedback:

Race is a physical, not a cultural, differentiator.

Saturday, September 9, 2017 11:53:16 AM EDT

 

Guidelines for Standard Precautions indicate that mask and eye protection or a face mask should be worn while performing

trachea care and suctioning.

 

Standard Precautions apply to all patients

receiving care in hospitals.

 

According to the guidelines for Standard Precautions

the caregiver’s hands should be washed after touching any body fluids and contaminated items regardless of whether gloves are worn.

 

One recommendation to prevent latex allergy is to

wash hands with mild soap after removing gloves and then dry the hands thoroughly.

 

Which patient position is useful for auscultating heart tones?

Left lateral recumbent

 

Which technique is used during the history taking and the physical examination process?

Inspection

 

Which examination technique should be used first?

Inspection

 

The use of secondary, tangential lighting is most helpful in the detection of

variations in contour of the body surface. NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

 

A nonambulatory 80-year-old male patient tells the female nurse that he feels like he is having drainage from his rectum. Which initial nursing action is appropriate?

Drape the patient and observe the rectal area.

 

You are conducting a head to toe examination as part of a patient’s preventive health assessment. The room has adequate lighting, and you have access to both sides of the examining table. What position should you assume while conducting this examination?

To the right side of the patient

 

Which part of the examiner’s hand is best for palpating vibration?

Ulnar surface and base of the fingers

 

The dorsal surface of the hand is most often used for the assessment of

temperature.

 

When conducting the abdominal examination, after you inspect, you proceed next to

auscultation.

 

Expected normal percussion tones include

tympany over an empty stomach.

 

When percussing, a dull tone is expected to be heard over

the liver.

 

During percussion, the downward snap of the striking fingers should originate from the

wrist. NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

 

Which technique is commonly used to elicit tenderness arising from the liver, gallbladder, or kidneys?

Fist percussion

 

During auscultation, you can limit your perceptual field best by

closing your eyes.

 

You are auscultating a patient’s chest. The sounds are not clear, and you are having difficulty distinguishing between respirations and heartbeats. What technique can you use to facilitate your assessment?

Isolate each cycle segment.

 

When examining the abdomen, which technique should be used first?

Inspection

 

Auscultation should be carried out last except when examining

the abdomen.

 

Which of the following statements is true regarding tympanic membrane temperature?

It is an accurate measurement of body temperature because the tympanic membrane shares its blood supply with the hypothalamus. NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

 

A scale used to assess a patient’s weight should be calibrated

each time it is used.

 

The height-measuring attachment of the standing platform scale should be pulled out

before the patient steps on the scale.

 

An infant should be placed in which position to have his or her height or length measured?

Supine on a measuring board

 

The stethoscope’s diaphragm is most useful in the assessment of _____ sounds.

high-pitched

 

A rubber or plastic ring should be around the bell endpiece of a stethoscope to

ensure secure contact with the body surface.

 

Which technique should be used to stabilize the stethoscope during auscultation?

The endpiece should be held between the second and third fingers.

 

A patient in the emergency department has a concussion to the head. You suspect that the patient may also have a retinal hemorrhage. You are using the ophthalmoscope to examine the retina of this patient. Which aperture of the ophthalmoscope is most appropriate for this patient?

Red-free filter

 

The Tumbling “E” vision acuity chart would most likely be used for _____ patients.

preschool

 

The pneumatic attachment for the otoscope is used to evaluate

tympanic membrane movement.

 

The patient tells you that his ears are “stopped up.” An objective assessment of this complaint is achieved by using a(n)

tympanometer. NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

 

Tuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure

hearing range of normal speech

 

To perform a deep tendon reflex measurement, you should

briskly tap the tendon with the rubber end of the hammer.

 

A variant of the percussion hammer is a neurologic hammer, which is equipped with which of the following?

Brush and needle

 

When monitoring serial measurements, such as head circumference or abdominal girth, which procedure is best to ensure that the tape measure is placed in the same position each time?

Mark the borders of the tape at several intervals on the skin with a pen.

 

Transillumination functions on the principle that

air, fluid, and tissue transmit light differentially.

 

When performing transillumination of a body cavity, the use of which of the following could be harmful to the patient?

Halogen bulb

 

For a woman with a small vaginal opening, the examiner should use a _____ speculum.

Pederson

 

You are performing a vaginal examination on a patient with a history of spina bifida. As you insert the metal speculum, the patient suddenly feels nauseated and is sweating, and her skin turns blotchy. What is your most immediate reaction to this situation? NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

Remove the speculum.

 

Mr. Walder is a 56-year-old man who has been complaining of chest palpitations. Which position is useful for auscultating heart sounds?

Left lateral recumbent

 

Which technique is used during both the history taking and the physical examination process?

Inspection

 

Ms. Jones is a 31-year-old female patient who presents for a routine physical examination. Which examination technique will be used first?

Inspection

 

The use of secondary, tangential lighting is most helpful in the detection

variations in contour of the body surface.

 

You are caring for a nonambulatory 80-year-old male patient and he tells you, a female nurse, that he feels like he is having drainage from his rectum. Which initial nursing action is appropriate?

Drape the patient and observe the rectal area.

 

Mrs. Smalls is a 42-year-old woman who has presented to the office for a head to toe examination as part of her preventive health care assessment. The room has adequate lighting, and you have access to both sides of the examining table. What position should you assume while conducting this examination? NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

Either side of the patient

 

You are planning to palpate the abdomen of your patient. Which part of the examiner’s hand is best for palpating vibration?

Ulnar surface

 

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

 

The degree of percussion tone is determined by the density of the medium through which the sound waves travel. Which statement is true regarding the relationship between density of the medium and percussion tone?

 

The less dense the medium, the louder is the percussion tone.

Expected normal percussion tones include:

tympany over an empty stomach.

 

During percussion, a dull tone is expected to be heard over:

the liver.

 

When using mediate or indirect percussion, which technique is appropriate?

Place the palmar surface of the nondominant hand on the body surface, with the fingers slightly spread apart.

 

During percussion, the downward snap of the striking fingers should originate from the:

wrist.

 

During auscultation, you can limit your perceptual field best by:

closing your eyes.

 

You are auscultating a patient’s chest. The sounds are not clear, and you are having difficulty distinguishing between respirations and heartbeats. Which technique can you use to facilitate your assessment?

Isolate each cycle segment.

 

Auscultation should be carried out last, except when examining the:

abdomen.

 

Tympanic thermometers measure body temperature when a probe is placed:

in the auditory canal.

 

The height-measuring attachment of the standing platform scale should be pulled up:

before the patient steps on the scale.

 

Which of the following occurs when firm pressure is used to apply the stethoscope’s bell endpiece to the skin?

It functionally converts to a diaphragm endpiece.

 

Weak pulses, fetal heart activity, and vessel patency are all best assessed with which type of stethoscope?   Ultrasonic

 

You are using an ophthalmoscope to examine a patient’s inner eye. You rotate the lens selector clockwise and then counterclockwise to compensate for: NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers.

myopia.

 

A patient in the emergency department has a concussion. You suspect the patient may also have a retinal hemorrhage. You are using the ophthalmoscope to examine the retina of this patient. Which aperture of the ophthalmoscope is most appropriate for this patient?

Red-free filter

 

Which type of speculum should be used to examine a patient’s tympanic membrane?

The largest speculum that will fit comfortably in the ear

 

The pneumatic attachment for the otoscope is used to evaluate:

tympanic membrane movement.

 

Mr. Walters, 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.

 

To perform a deep tendon reflex measurement, you should:

briskly tap the tendon with the rubber end of the hammer.

 

When monitoring serial measures, such as head circumference or abdominal girth, which procedure is best to ensure that the tape measure is placed in the same position each time?

Mark the borders of the tape at several intervals on the skin with a pen.

 

The Pederson speculum has blades that:

are narrower and flatter.

 

Which of the following are causes of hyperreflexia? (Select all that apply.)

Cold stirrups

Insertion of a speculum

Pressure during bimanual exam

 

The Snellen E vision acuity chart would most likely be used for __________.

preschool children

 

The stethoscope’s diaphragm is most useful for the assessment of __________ sounds.

high-pitched

 

For a woman with a small vaginal opening, the examiner should use a __________ speculum.

Pederson NURS 6512 Advanced Health Assessment and Diagnostic Reasoning WK 2 QUIZ with answers

NURS 6512 Avanced Health Assessment Week 2 Quiz Answers

Informing a patient that he or she has a terminal illness is most likely to be discouraged in which cultural group?

Which statement is true regarding the impoverished?

The infant should be placed in which position to have his or her height or length measured?

A naturalistic or holistic approach to health care often assumes:

Which of the following describes a physical, not a cultural, differentiator?

Axillary measurement of temperature correlates best with core temperatures of:

You are performing a vaginal examination for a patient with a history of spina bifida. As you insert the metal speculum, the patient suddenly feels nauseated and is sweating, and her skin turns blotchy. What is your most immediate reaction to this situation?

ORDER A PLAGIARISM-FREE PAPER HERE

Which statement is true regarding the relationship of physical characteristics and culture?

You are auscultating a patient s chest. The sounds are not clear, and you are having difficulty distinguishing between respirations and heartbeats. What technique can you use to facilitate your assessment?

During percussion, the downward snap of the striking fingers should originate from the:

Which technique should be used to stabilize the stethoscope during auscultation?

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:

A fixed image of any group that rejects its potential for originality or individuality is known as a(n):

When monitoring serial measures, such as head circumference or abdominal girth, which procedure is best to ensure that the tape measure is placed in the same position each time? NURS 6512 Avanced Health Assessment Week 2 Quiz Answers.

Observing the rise and fall of the abdomen usually facilitates calculation of respiratory rate in the:

A patient in the emergency department has a concussion to the head. You suspect the patient may also have a retinal hemorrhage. You are using the ophthalmoscope to examine the retina of this patient. Which aperture of the ophthalmoscope is most appropriate for this patient?

Which lying position is useful for auscultating heart tones?

A nonambulatory 80-year-old male patient tells the female nurse that he feels like he is having drainage from his rectum. Which initial nursing action is appropriate? NURS 6512 Avanced Health Assessment Week 2 Quiz Answers.

Because of common cultural food preferences, avoidance of monosodium glutamate (MSG) is likely to be most problematic for the hypertensive patient of which group?

When percussing, a dull tone is expected to be heard over: NURS 6512 Avanced Health Assessment Week 2 Quiz Answers.

nurs 6512 week 6 midterm exam.

Question 1

2 out of 2 points

 

Your older clinic patient is being seen today as a follow-up for a 2-day history of pneumonia. The patient continues to have a productive cough, shortness of breath, and lethargy and has been spending most of the day lying in bed. You should begin the chest examination by:

nurs 6512 week 6 midterm exam

Response Feedback:

Because the patient has consolidation and has been recumbent and fatigued, the most appropriate first step is to listen to the lung bases before the patient gets exhausted. The lung bases would be the most likely sites for adventitious sounds.

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Question 2

2 out of 2 points

 

The difference in blood pressure readings between the right and the left arms is considered normal up to _____ mm Hg.

 

Response Feedback:

Blood pressure readings between the left and right arms may vary by as much as 10 mm Hg and tend to be higher in the right arm.

Question 3

2 out of 2 points

 

Fat deposits in the circulatory system of an older adult can lead to:

 

Response Feedback:

Atherosclerosis is a disease in which fat deposits (cholesterol) accumulate in the walls of the arteries, which can lead to heart failure or stroke. nurs 6512 week 6 midterm exam.

Question 4

2 out of 2 points

 

Which dysrhythmia is a physiologic event during childhood?

 

Response Feedback:

Sinus arrhythmia is a physiologic event during childhood. The heart rate varies in a cyclic pattern, usually faster on inspiration and slower on expiration. The heart rates of children react with wider swings to stress, exercise, fever, or tension.

Question 5

2 out of 2 points

 

Normal cardiac changes that occur during pregnancy include: nurs 6512 week 6 midterm exam.

 

Response Feedback:

The maternal blood volume increases by 40% to 50% due to an increase in plasma volume. The heart works harder to accommodate the increased heart rate and stroke volume (both equal cardiac output), therefore resulting in the increase in left ventricle wall thickness and mass. The blood volume returns to prepregnancy levels within 3 to 4 weeks after delivery. As the uterus enlarges and the diaphragm moves upward, the heart is shifted horizontally and there is a slight axis rotation.

Question 6

2 out of 2 points

 

An idiopathic spasm of arterioles in the digits is called:

 

Response Feedback:

Raynaud disease is idiopathic, intermittent spasm of the arterioles in the digits, which causes skin pallor. Arteriosclerosis obliterans is the occlusion of the blood supply to the extremities by atherosclerotic plaques. Giant cell arteritis is a generalized inflammatory disease that affects arteries of the carotid, temporal, and occipital arteries. Arteriovenous fistula is a pathologic communication between an artery and a vein. An aneurysm is dilation of an artery caused by a weakness in the arterial wall. They occur in the aorta, renal, femoral, and popliteal arteries.

Question 7

2 out of 2 points

nurs 6512 week 6 midterm exam

 

The level at which the jugular venous pulse is visible gives an indication of:

 

Response Feedback:

The level at which the jugular venous pulse is visible indicates right atrial pressure. The jugular veins empty into the superior vena cava, which empties into the right atria. The jugular venous system reflects the competency of the right side of the heart. The other four possible answers reflect the competency of the left side of the heart.

Question 8

2 out of 2 points

 

A bounding pulse in an infant may be associated with:

 

Response Feedback:

A bounding pulse is associated with a large left-to-right shunt produced by a patent ductus arteriosus. A weaker or thinner pulse represents diminished cardiac output or peripheral vasoconstriction. A difference in pulse amplitude between upper extremities, or between femoral and radial pulses, and absence of the femoral pulse suggests a coarctation of the aorta. Painful swollen extremities are usually a sign of venous occlusion. nurs 6512 week 6 midterm exam.

Question 9

2 out of 2 points

 

Chest pain in a child with an organic cause is more likely the result of:

 

Response Feedback:

Unlike chest pain in adults, children and adolescents seldom are caused by a cardiac problem. More likely the case is related to trauma, exercise-induced asthma, or cocaine use.

Question 10

2 out of 2 points

 

In the adult, the apical impulse should be most visible when the patient is in what position?

 

Response Feedback:

In most adults, the apical impulse should be visible at about the midclavicular line in the fifth left intercostal space, but it is easily obscured by obesity, large breasts, or muscularity. The apical impulse may become visible only when the patient sits upright and the heart is brought closer to the anterior wall. A visible and palpable impulse when the patient is supine suggests an intensity that may be the result of a problem. nurs 6512 week 6 midterm exam.

Question 11

2 out of 2 points

 

The best time to observe and count respirations is:

 

Response Feedback:

Respiratory patterns change as the patient speaks and sleeps. Attempting to count during weighing would make the patient self-conscious and affect respiratory rate. Counting respirations while you palpate the pulse does not make the patient self-conscious because the patient expects you to be counting the pulse.

Question 12

2 out of 2 points

 

As you take vital signs on Mr. B., age 78, you note that his respirations are 40 per minute. He has been resting and his mucosa is pink. Concerning Mr. B. s respirations, you would:

 

Response Feedback:

The normal adult respiratory rate is 12 to 20, with a ratio of respiratory to heartbeats of 1:4. Always note any variations in respiratory rate.

Question 13

2 out of 2 points

 

A musical squeaking noise heard on auscultation of the lungs is called:

 

Response Feedback:

Wheezes are continuous, high-pitched musical sounds that can be heard on inspiration and expiration.

Question 14

2 out of 2 points

 

The diaphragm of the stethoscope is better than the bell for auscultation of the lungs because it:

 

Response Feedback:

Unless specially modified, the stethoscope does not amplify sound, nor does it filter sound or pinpoint focal sounds. The stethoscope does transmit sound waves from the source to the ear. The diaphragm is the better source because it transmits the normally high-pitched sounds of the lung and it has a broader area to listen from.

Question 15

2 out of 2 points

 

An increase in heart rate during inspiration, with a decrease in this rate during expiration, is an expected finding in:

 

Response Feedback:

Sinus arrhythmia is a physiologic event during childhood. The heart rate of a child (4 year old) varies in a cyclic pattern, usually faster on inspiration and slow on expiration.

Question 16

2 out of 2 points

 

A split second heart sound is: nurs 6512 week 6 midterm exam,

 

Response Feedback:

Splitting of S2 is an expected event, because pressures are higher and depolarization occurs earlier on the left side of the heart. Ejection times on the right are longer, and the pulmonic valve closes a bit later than the aortic valve. Splitting of S2 is greatest at the peak of inspiration. During expiration, the split may disappear. It is never accompanied by a thrill.

Question 17

2 out of 2 points

 

Closure of the ductus arteriosus usually occurs:

 

Response Feedback:

Closure of the ductus arteriosus usually occurs within 24 to 48 hours after birth.

Question 18

2 out of 2 points

 

A sound similar to a murmur that is heard over arteries is a:

 

Response Feedback:

A bruit is the sound of turbulent blood flow auscultated over arteries and heard best with the bell of the stethoscope. Thrills, as well as a heave, are palpated findings. A friction rub is a distinct sound heard when two surfaces are rubbed together as occurs with pericardial or pleural inflammation. Hums are low-pitched sounds associated with the venous system.

Question 19

2 out of 2 points

 

You are examining Mr. S., a 79-year-old diabetic man complaining of claudication. Which of the following physical findings is consistent with the diagnosis of arterial occlusion?

 

Response Feedback:

An individual with peripheral artery disease or claudication will have thin skin with localized pallor and cyanosis, a loss of body warmth in the affected area, and loss of hair over the extremity. There may be collapsed superficial veins with delayed filling. nurs 6512 week 6 midterm exam.

Question 20

2 out of 2 points

 

On a CXR, which of the following is true of the diaphragm?

Monday, October 9, 2017 1:03:17 AM EDT

Question 1

2 out of 2 points

On a CXR, which of the following is true of the diaphragm?

Selected Answer:

 

The right diaphragm is usually higher.

Correct Answer:

 

The right diaphragm is usually higher.

Question 2

2 out of 2 points

Tactile fremitus is best felt:

Selected Answer:

 

posteriorly and laterally at the bifurcation of the bronchi

Correct Answer:

 

posteriorly and laterally at the bifurcation of the bronchi

 

Response Feedback:

Fremitus is best palpated at the second intercostal space, which also corresponds to the bifurcation of the bronchi. nurs 6512 week 6 midterm exam.

Question 3

2 out of 2 points

The middle lobe of the right lung is best auscultated over the:

Selected Answer:

 

axilla.

Correct Answer:

 

axilla.

 

Response Feedback:

The sounds of the middle lobe of the right lung are best heard in the right axilla.

Question 4

2 out of 2 points

Expected respiratory changes of normal aging include:

Selected Answer:

 

more prominent bony structures.

Correct Answer:

 

more prominent bony structures.

 

Response Feedback:

In older adults, chest expansion is decreased and there is less use of respiratory muscles due to muscle weakness. The dorsal curve of the thoracic spine is prominent with flattening of the lumbar curve with bony landmarks becoming more prominent due to loss of subcutaneous tissue. nurs 6512 week 6 midterm exam.

Question 5

2 out of 2 points

You are listening to a patient s heart sounds in the aortic and pulmonic areas. The sound becomes asynchronous during inspiration. The prevalent heart sound to this area is most likely which of the following?

Selected Answer:

 

S2

Correct Answer:

 

S2

 

Response Feedback:

S2 marks the closure of the semilunar valves, which indicates the end of systole, and is best heard in the aortic and pulmonic areas. It is higher pitched and shorter than S1. S2 typically splits during inspiration.

Question 6

2 out of 2 points

A bounding pulse in an infant may be associated with:

Selected Answer:

 

patent ductus arteriosus.

Correct Answer:

 

patent ductus arteriosus.

 

Response Feedback:

A bounding pulse is associated with a large left-to-right shunt produced by a patent ductus arteriosus. A weaker or thinner pulse represents diminished cardiac output or peripheral vasoconstriction. A difference in pulse amplitude between upper extremities, or between femoral and radial pulses, and absence of the femoral pulse suggests a coarctation of the aorta. Painful swollen extremities are usually a sign of venous occlusion. nurs 6512 week 6 midterm exam.

Question 7

2 out of 2 points

An apical PMI palpated beyond the left fifth intercostal space may indicate:

Selected Answer:

 

left ventricular hypertrophy.

Correct Answer:

 

left ventricular hypertrophy.

 

Response Feedback:

An apical impulse that is more forceful and widely distributed, fills systole, or is displaced laterally and downward may be indicative of left ventricular hypertrophy. Obesity, large breasts, and muscularity can obscure the visibility of the apical impulse. In dextrocardia the PMI would be displaced to the right.

Question 8

2 out of 2 points

A palpable rushing vibration over the base of the heart at the second intercostal space is called a:

Selected Answer:

 

thrill.

Correct Answer:

 

thrill.

 

Response Feedback:

A thrill is a fine, palpable, rushing vibration; a palpable murmur. Cardiac thrills generally indicate a disruption of the expected blood flow related to some defect in the closure of one of the semilunar valves (generally aortic or pulmonic stenosis), pulmonary hypertension, or atrial septal defect. A heave or lift is a more vigorous apical impulse. A thrust is to move forward suddenly and forcibly. A murmur is an auscultated sound caused by turbulent blood flow.

Question 9

2 out of 2 points

Bradypnea may accompany:

Selected Answer:

 

an excellent level of cardiovascular fitness.

Correct Answer:

 

an excellent level of cardiovascular fitness.

 

Response Feedback:

Bradypnea, a rate slower than 12 breaths per minute, may result from cardiorespiratory fitness. The other choices accompany tachypnea.

Question 10

0 out of 2 points

Ms. R., age 74, has no known health problems or diseases. You are doing a preventive health care history and examination. Which symptom is associated with intrathoracic infection?

Selected Answer:

 

Pectus carinatum

Correct Answer:

 

Malodorous breath

Question 11

2 out of 2 points

The apex of a 2-month-old baby s heart typically lies closest to the:

Selected Answer:

 

fourth left intercostal space.

Correct Answer:

 

fourth left intercostal space.

 

Response Feedback:

In infants and young children, the heart lies more horizontally in the chest. The apex of the heart is located higher, sometimes well out into the fourth left intercostal space.

Question 12

0 out of 2 points

Closure of the ductus arteriosus usually occurs:

Selected Answer:

 

24 to 48 hours after birth.

Correct Answer:

 

just prior to the initiation of labor.

Question 13

2 out of 2 points

Nancy is a 16-year-old girl who presents to the clinic with complaints of severe, acute chest pain. Her mother reports that Nancy, apart from occasional colds, is not prone to respiratory problems. What potential risk factor is most important to assess concerning Nancy s present problem?

Selected Answer:

 

Illegal drug use

Correct Answer:

 

Illegal drug use

 

Response Feedback:

Illegal drug use, particularly cocaine, is especially important to prioritize as a social history question for all adolescents and adults who complain of severe chest pain. Cocaine can lead to tachycardia, hypertension, coronary arterial spasm with infarction, and pneumothorax.

Question 14

2 out of 2 points

Laryngeal obstructions would elicit which breath sound? nurs 6512 week 6 midterm exam.

Selected Answer:

 

Stridor

Correct Answer:

 

Stridor

 

Response Feedback:

Obstructions high in the respiratory tree are characterized by stridor.

Question 15

2 out of 2 points

A patient you are seeing in the emergency department for chest pain is suspected of having a myocardial infarct. During the health history interview of his family history, he relates that his father had died of heart trouble. The most important follow-up question you should pose is which of the following?

Selected Answer:

 

What age was your father at the time of his death?

Correct Answer:

 

What age was your father at the time of his death?

 

Response Feedback:

A family history of sudden death, particularly in young and middle-aged relatives, significantly increases one s chance of a similar occurrence. nurs 6512 week 6 midterm exam.

Question 16

2 out of 2 points

In the fetus, the right ventricle pumps blood through the:

Selected Answer:

 

ductus arteriosus.

Correct Answer:

 

ductus arteriosus.

 

Response Feedback:

The right ventricle of a fetal heart pumps blood through the patent ductus arteriosus rather than into the lungs.

Question 17

2 out of 2 points

A third heart sound is created by:

Selected Answer:

 

diastolic filling.

Correct Answer:

 

diastolic filling.

 

Response Feedback:

Diastole is a relatively passive interval until ventricular filling is almost complete. Diastole occurs when the ventricle is filling with blood from the atria and the filling sometimes produces a third heart sound S3.

Question 18

2 out of 2 points

The level at which the jugular venous pulse is visible gives an indication of:

Selected Answer:

 

right atrial pressure.

Correct Answer:

 

right atrial pressure.

 

Response Feedback:

The level at which the jugular venous pulse is visible indicates right atrial pressure. The jugular veins empty into the superior vena cava, which empties into the right atria. The jugular venous system reflects the competency of the right side of the heart. The other four possible answers reflect the competency of the left side of the heart.

Question 19

2 out of 2 points

What term would you use to document a respiratory rate greater than 20 per minute in an adult?

Selected Answer:

 

Tachypnea

Correct Answer:

 

Tachypnea

 

Response Feedback:

Tachypnea is the correct term for respirations greater than 20. Dyspnea, orthopnea, and platypnea are terms that describe respiratory effort, not rate. Cheyne-Stokes refers to a particular abnormal pattern of respiration. nurs 6512 week 6 midterm exam.

Question 20

2 out of 2 points

An expected finding from chest palpation in the adult would be:

Selected Answer:

 

inflexibility of the xiphoid.

Correct Answer:

 

inflexibility of the xiphoid.

 

Response Feedback:

The sternum and xiphoid in adults are relatively inflexible, without cracking; the expected normal costal angle is 90 degrees and the chest moves symmetrically. Crepitus is always an abnormal finding.

 

Nancy is a 16-year-old girl who presents to the clinic with complaints of severe, acute chest pain. Her mother reports that Nancy, apart from occasional colds, is not prone to respiratory problems. What potential risk factor is most important to assess concerning Nancy s present problem?

 

Response Feedback:

Illegal drug use, particularly cocaine, is especially important to prioritize as a social history question for all adolescents and adults who complain of severe chest pain. Cocaine can lead to tachycardia, hypertension, coronary arterial spasm with infarction, and pneumothorax. nurs 6512 week 6 midterm exam.

Question 2

2 out of 2 points

A split second heart sound is:

 

Response Feedback:

Splitting of S2 is an expected event, because pressures are higher and depolarization occurs earlier on the left side of the heart. Ejection times on the right are longer, and the pulmonic valve closes a bit later than the aortic valve. Splitting of S2 is greatest at the peak of inspiration. During expiration, the split may disappear. It is never accompanied by a thrill.

Question 3

2 out of 2 points

During auscultation of heart tones, you are uncertain whether the sound you hear is an S2 split. You should ask the patient to inhale deeply while listening at the _____ area. nurs 6512 week 6 midterm exam.

 

Response Feedback:

Splitting results from the failure of the mitral and tricuspid valves or the pulmonic and aortic valves to close simultaneously. Splitting of S1 is usually not heard because the closing of the tricuspid valve is too faint. Rarely, it may be audible in the tricuspid area on deep inspiration. Splitting of S2 is greatest at the peak of inspiration and best heard at the pulmonic site.

Question 4

2 out of 2 points

Which finding suggests a minor structural variation?

 

Response Feedback:

Barrel chest, clubbed fingers, chest wall retractions, and tachypnea result from compromised respirations; pectus carinatum (pigeon chest) is a minor structural variation. nurs 6512 week 6 midterm exam.

Question 5

2 out of 2 points

A patient you are seeing in the emergency department for chest pain is suspected of having a myocardial infarct. During the health history interview of his family history, he relates that his father had died of heart trouble. The most important follow-up question you should pose is which of the following?

 

Response Feedback:

A family history of sudden death, particularly in young and middle-aged relatives, significantly increases one s chance of a similar occurrence.

Question 6

2 out of 2 points

Which two structures together form the primary muscle mass of the heart?

 

Response Feedback:

The ventricles are large, thick-walled chambers that pump blood to the lungs and throughout the body. The right and left ventricles together form the primary muscle mass of the heart. The left ventricle pumps blood through the aortic valve into the aorta, which provides blood to the rest of the body. The right and left atrium pumps blood through the tricuspid and mitral valves to the ventricles. The pulmonary vein pumps oxygenated blood from the lungs to the left atria.

Question 7

2 out of 2 points

In pregnancy, blood pressure is at its nadir at:

 

Response Feedback:

Nadir is the lowest measured value. In pregnancy, the lowest level of blood pressure occurs in the second trimester (16 to 20 weeks). nurs 6512 week 6 midterm exam.

Question 8

0 out of 2 points

Closure of the ductus arteriosus usually occurs:

Correct answer: 24 to 48 hours after birth

Question 9

2 out of 2 points

The pregnant woman is expected to develop:

 

Response Feedback:

In the pregnant woman, tidal volume and vital capacity increase, functional residual capacity decreases, and she breathes more deeply but not more frequently.

Question 10

2 out of 2 points

When there is consolidation in the lung tissue, the breath sounds are louder and easier to hear while healthy lung tissue produces softer sounds. This is because:

 

Response Feedback:

Air is a poor conductor of sound whereas more dense consolidation promotes louder sounds and is a better conductor of sound.

Question 11

2 out of 2 points

Normal cardiac changes that occur during pregnancy include:

 

Response Feedback:

The maternal blood volume increases by 40% to 50% due to an increase in plasma volume. The heart works harder to accommodate the increased heart rate and stroke volume (both equal cardiac output), therefore resulting in the increase in left ventricle wall thickness and mass. The blood volume returns to prepregnancy levels within 3 to 4 weeks after delivery. As the uterus enlarges and the diaphragm moves upward, the heart is shifted horizontally and there is a slight axis rotation. nurs 6512 week 6 midterm exam.

Question 12

2 out of 2 points

Which arterial pulse is most useful in evaluating heart activity?

 

Response Feedback:

Carotid arteries provide the most easily accessible arterial pulse and are closest to the heart and therefore are most useful in evaluating heart activity.

Question 13

0 out of 2 points

Which of the following statements is true regarding the examination of peripheral arteries?

Correct answer: the pulses are most readily felt on arteries that lie over bones

Question 14

0 out of 2 points

Which dysrhythmia is a physiologic event during childhood?

Correct answer: Sinus Arrhythmia

Question 15

0 out of 2 points

The earliest sign of heart failure in an infant is frequently:

Correct answer: Liver enlargement

Question 16

2 out of 2 points

The major heart sounds are normally created by:

 

Response Feedback:

At the beginning of systole, ventricular contraction raises the pressure in the ventricles and forces the mitral and tricuspid valves closed, which produces the first heart sound S1 lub. When the pressure in the ventricles falls, when the ventricles are almost empty, below that of the aorta and pulmonary artery, the aortic and pulmonic valves close, producing the second heart sound S2 dub. Valve opening is usually a silent event.

Question 17

0 out of 2 points

The American Thoracic Society suggests replacing the term rales with:

Correct Answer: Crackles

Question 18

0 out of 2 points

During chest assessment, you note the patient s voice quality while you are auscultating the lung fields. The voice sound is intensified, there is a nasal quality to the voice, and e s sound like a s. This sound described is called:

Correct answer: Egophony

Question 19

0 out of 2 points

The carotid pulse should coincide with which heart sound? nurs 6512 week 6 midterm exam.

Correct answer: S1

Question 20

0 out of 2 points

On a CXR, which of the following is true of the diaphragm?

Correct answer: The right diaphragm is usually higher

 

On a CXR, which of the following is true of the diaphragm?

Question 2

2 out of 2 points

 

A condition that is likely to present with dizziness and fainting is:

 

Response Feedback:

Sick sinus syndrome (SSS) is a sinoatrial dysfunction that occurs secondary to hypertension, arteriosclerotic heart disease, or rheumatic heart disease. SSS causes arrhythmias with subsequent fainting, transient dizzy spells, lightheadedness, seizures, palpitations, angina, or congestive heart failure (CHF). Bacterial endocarditis presents with prolonged fever, signs of neurologic dysfunctions, and sudden onset of CHF. Chest pain is an initial symptom in acute pericarditis along with a triphasic friction rub. Hyperlipidemia is a risk factor for myocardial infarction that commonly presents with chest pain. nurs 6512 week 6 midterm exam.

Question 3

2 out of 2 points

 

To hear diastolic heart sounds, you should ask patients to:

 

Response Feedback:

Left lateral recumbent is the best position to hear the low-pitched filling sounds in diastole with the bell of the stethoscope. Sitting up and leaning forward is the best position to hear relatively high-pitched murmurs with the diaphragm of the stethoscope. Right lateral recumbent position is the best position for evaluating right rotated heart of dextrocardia.

Question 4

2 out of 2 points

 

The patient tells you that she uses herbal and other alternative therapies to maintain health. This information will be recorded in the:

 

Response Feedback:

Patient data concerning the use of herbal or other remedies and other complementary or alternative therapies are recorded within the social history component of the history and physical.

Question 5

0 out of 2 points

 

Normal heart sounds are best heard:

Question 6

2 out of 2 points

 

The carotid pulse should coincide with which heart sound?

 

Response Feedback:

S1 marks the beginning of systole. S1 coincides with the rise (upswing) of the carotid pulse. Instruct patients to breathe normally and then hold their breath on expiration. Listen for S1 while you palpate the carotid pulse. S2 marks the start of diastole. S3-4 is an abnormal summation gallop sound. nurs 6512 week 6 midterm exam.

Question 7

2 out of 2 points

 

The condition in which a patient s heart is either rotated or displaced to the right or is situated as a mirror image of the expected position is called:

 

Response Feedback:

Dextrocardia occurs when the heart is displaced or rotated to the right or is a complete mirror image of the expected finding. Amyloidosis is a metabolic disorder marked by amyloid deposits in organs and tissues. Cardiomyopathy is the deterioration of heart muscle function. Coarctation is the compression of the walls of a vessel such as an aortic coarctation. Situs inversus occurs when the heart and stomach are displaced to the right and the liver is located to the left.

Question 8

0 out of 2 points

 

Ms. R., age 74, has no known health problems or diseases. You are doing a preventive health care history and examination. Which symptom is associated with intrathoracic infection?

Question 9

2 out of 2 points

 

In what position can the mediastinal crunch (Hamman sign) be heard best?

 

Response Feedback:

Hamman sign occurs with mediastinal emphysema. The adventitious breath sounds are synchronous with the heartbeat and are heard best when the patient leans to the left or lies down on the left side (these maneuvers bring the heart muscle closer to the chest wall).

Question 10

2 out of 2 points

 

Expected respiratory changes of normal aging include:

 

Response Feedback:

In older adults, chest expansion is decreased and there is less use of respiratory muscles due to muscle weakness. The dorsal curve of the thoracic spine is prominent with flattening of the lumbar curve with bony landmarks becoming more prominent due to loss of subcutaneous tissue. nurs 6512 week 6 midterm exam.

Question 11

2 out of 2 points

 

The major heart sounds are normally created by:

 

Response Feedback:

At the beginning of systole, ventricular contraction raises the pressure in the ventricles and forces the mitral and tricuspid valves closed, which produces the first heart sound S1 lub. When the pressure in the ventricles falls, when the ventricles are almost empty, below that of the aorta and pulmonary artery, the aortic and pulmonic valves close, producing the second heart sound S2 dub. Valve opening is usually a silent event.

Question 12

2 out of 2 points

 

Breath odors may clue the examiner to certain underlying metabolic conditions. The odor of ammonia on the breath may signify:

 

Response Feedback:

The breath smell described as ammonia-like suggests uremia, a renal condition; cinnamon suggests tuberculosis; musty fish or clover suggests hepatic failure; sweet and fruity suggests diabetic ketoacidosis; and foul or feculent suggests intestinal obstruction.

Question 13

2 out of 2 points

 

The respiratory rate of a sleeping newborn is expected to range from _____ breaths per minute.

 

Response Feedback:

The expected respiratory rate for infants is from 40 to 60 breaths per minute. nurs 6512 week 6 midterm exam.

Question 14

2 out of 2 points

 

Chest pain in a child with an organic cause is more likely the result of:

 

Response Feedback:

Unlike chest pain in adults, children and adolescents seldom are caused by a cardiac problem. More likely the case is related to trauma, exercise-induced asthma, or cocaine use.

Question 15

2 out of 2 points

 

Which of the following information belongs in the past medical history section related to heart and blood vessel assessment?

 

Response Feedback:

Previous unexplained fever should be included in the past medical history of a heart and blood vessel assessment. This incidence may be related to acute rheumatic fever, with potential heart valve damage.

Question 16

2 out of 2 points

 

In which patient situation would you expect to assess tachypnea?

 

Response Feedback:

In metabolic acidosis, the body compensates by increasing the respiratory rate in order to blow off the excess carbon dioxide. The other choices cause respiratory depression.

Question 17

2 out of 2 points

 

The American Thoracic Society suggests replacing the term rales with:

 

Response Feedback:

The term rales is suggested to be replaced with crackles in order for the term to more precisely describe the sound.

Question 18

2 out of 2 points

 

The spread of the impulse through the ventricles (ventricular depolarization) is depicted on the ECG as the: nurs 6512 week 6 midterm exam.

 

Response Feedback:

The QRS complex is the spread of a stimulus through the ventricles and is measured as less than 0.10 second. The P wave is the spread of a stimulus through the atria. The PR interval is the time from the initial stimulation of the atria to initiation of stimulation of the ventricles. The T wave is the return of stimulated ventricular muscle to a resting state. The U wave is a small deflection sometimes seen just after the T wave.

Question 19

2 out of 2 points

 

Contraction of the ventricles causes:

 

Response Feedback:

When the ventricles contract the semilunar valves, the pulmonic and aortic valves open, causing blood to rush into the pulmonary artery and the aorta. At this time the tricuspid and mitral valves close, preventing backflow into the atria. When the atria contract, the tricuspid and mitral valves open, allowing blood flow into the ventricles. When the ventricles relax during diastole (ventricles are filling), the aortic and pulmonic valves close, preventing backflow into the ventricles. nurs 6512 week 6 midterm exam.

Question 20

0 out of 2 points

 

Closure of the ductus arteriosus usually occurs:

nurs 6512 week 6 midterm 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

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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.

Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

Discussion 1: Assessment Tools and Diagnostic Tests

When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results.

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In this Discussion, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values.

To prepare:

·        Review this week’s Learning Resources, and consider the factors that impact the validity and reliability of various assessment tools and diagnostic tests.Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

·        Select 
one 
of the following assessment tools or diagnostic tests to explore for the purposes of this Discussion:

o   Mammogram

o   Physical tests for sore throat (inspecting the throat, palpating the head and neck lymph nodes, listening to breath sounds) Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

o   Prostate-specific antigen (PSA) test

o   Dix-Hallpike test

o   Body-mass index (BMI) using waist circumference for adults

·        Search the Walden Library and credible sources for resources explaining the tool or test you selected. What is its purpose, how is it conducted, and what information does it gather?

·        Examine the literature and resources you located for information about the validity and reliability of the test or tool you selected. What issues with sensitivity, specificity, and predictive values are related to the test or tool?

·        Are there any controversies or issues related to any of these tests or tools?

·        Consider any ethical dilemmas that could arise by using these tests or tools. Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

Post 1 page paper APA format 
a description of how the assessment tool or diagnostic test you selected is used in health care. Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting.

 
Readings

·        Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). 
Seidel’s guide to physical examination
 (8th ed.). St. Louis, MO: Elsevier Mosby.

o   Chapter 2, “Cultural Competency” (pp. 21–29)

This chapter highlights the importance of cultural awareness when conducting health assessments. The authors explore the impact of culture on health beliefs and practices. Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

o   Chapter 3, “Examination Techniques and Equipment” (pp. 30-49)

This chapter explains the physical examination techniques of inspection, palpation, percussion, and auscultation. This chapter also explores special issues and equipment relevant to the physical exam process.

·        Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). 
Advanced health assessment and clinical diagnosis in primary care 
(5th ed.). St. Louis, MO: Elsevier Mosby. Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

o   Chapter 1, “Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis”

This chapter introduces the diagnostic process, which includes performing an analysis of the symptoms and then formulating and testing a hypothesis. The authors discuss how becoming an expert clinician takes time and practice in developing clinical judgment.

·        Sullivan , D. D. (2012). 
Guide to clinical documentation
 (2nd ed.). Philadelphia, PA: F. A. Davis.

o   Chapter 2, “The Comprehensive History and Physical Exam” (pp. 19–36)

o   Appendices A–E (pp. 225–236)

·        Laine, C. (2012). High-value testing begins with a few simple questions. 
Annals of Internal Medicine
,
156
(2), 162–163.

Retrieved from the Walden Library databases.

This article supplies a list of questions physicians should ask themselves before ordering tests. The authors provide general guidelines for maximizing the value received from testing.

·        Qaseem, A., Alguire, P., Dallas, P., Feinberg, L. E., Fitzgerald, F. T., Horwitch, C., & … Weinberger, S. (2012). Appropriate use of screening and diagnostic tests to foster high-value, cost-conscious care.
Annals of Internal Medicine
, 
156
(2), 147–150. Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

Retrieved from the Walden Library databases.

This article highlights the increasing cost of health care and stresses the need for high-value and cost-conscious testing. The authors provide a list of 37 situations in which more testing provides no benefit or may be harmful.

·        Shaw, S. J., Huebner, C., Armin, J., Orzech, K., & Vivian, J. (2009). The role of culture in health literacy and chronic disease screening and management. 
Journal of Immigrant & Minority Health
,
 
11
(6), 460–467.

Retrieved from the Walden Library databases.

This article examines cultural influences on health literacy, cancer screening, and chronic disease outcomes. The authors postulate that cultural beliefs about health and illness affect a patient’s ability to comprehend and follow a health care provider’s instructions. Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

·        Wians, F. H. (2009). Clinical laboratory tests: Which, why, and what do the results mean? 
LabMedicine, 40
, 105–113.

Retrieved from 
http://labmed.ascpjournals.org/content/40/2/105.full

This article analyzes the laboratory testing cycle and its impact on diagnostic decision making. This article also examines important diagnostic performance characteristics of laboratory tests, methods of calculating performance, and tools used to assess the diagnostic accuracy of a laboratory test. Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers Optional Resources

·        LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2009). DeGowin’s diagnostic examination (9th ed.). New York, NY: McGraw- Hill Medical.

o   Chapter 3, “The Physical Screening Examination”

o   Chapter 17, “Principles of Diagnostic Testing”

 

o   Chapter 18, “Common Laboratory Tests”

 

Discussion 2: Diversity and Health Assessments

In May 2012, Alice Randall wrote an article for 
The New York Times
 on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012).

Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the health care field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and health care professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity. Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds.

Case 1

Subjective Data

CC: “I came for my annual physical exam, but do not want to be a burden to my daughter.”

History of Present Illness (HPI): At-risk 86-year-old Asian male – who is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs.

PMH: hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency and chronic prostatitis

PSH: S/P cholecystectomy

Drug Hx:

Current Meds: Lisinopril 10mg daily, Prilosec 20mg daily, B12 injections monthly, and cipro 100mg daily.

Review of Systems (ROS)

General: + weight loss of 25 lbs over the past year; no recent fatigue, fever or chills.

Head, eyes, ears, nose & throat (HEENT): no changes in vision or hearing, no difficulty chewing or swallowing.

Neck: no pain or injury

Respiratory:

CV:

GI:

GU: no urinary hesitancy or change in urine stream

Integument: multiple bruises on his upper arms and back.

MS/Neuro: + falls x 2 within the last 6 months; no syncopal episodes or dizziness

Psych: Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

Objective Data

PE: B/P 188/96; Pulse 89; RR 16; Temp 99.0; Ht 5,6; wt 110; BMI 17.8

HEENT: Atraumatic, normocephalic, PERRLA, EOMI, arcus senilus bilaterally, conjunctiva and sclera clear, nares patent, ornasopharynx clear, edentulous.

Lungs: CTA AP&L

Cor: S1S2 without rub or gallop

Abd: benign, normoactive bowel sounds x 4

Ext: no cyanosis, clubbing or edema

Integument: multiple bruises in different stages of healing – on his upper arms and back.

Neuro: No obvious deformities, CN grossly intact II-XII

Case 2

Subjective Data

CC: “I am here for my annual physical exam and have been having vaginal discharge.”

History of Present Illness (HPI): 32-year-old pregnant lesbian – her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank.

Drug Hx:

Current Medications: prenatal vitamins and takes Tylenol over the counter for aches and pains on occasion

Family Hx: She a strong family history of diabetes. Gravida 1; Para 0; Abortions 0.

Review of Systems (ROS)

General: no fatigue, fever or chills.

Head, eyes, ears, nose & throat (HEENT):

Neck: no pain or injury

Respiratory:

CV:

GI:

GU:

Integument: multiple piercings, and tattoos. Old scars related to “cutting”.

Neuro: no syncopal episodes or dizziness, no change in memory or thinking patterns; no twitches or abnormal movements Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

Objective Data

PE: B/P 128/76; Pulse 83; RR 16; Temp 99.0; Ht 5,6; wt 128; BMI 20.98

HEENT: Atraumatic, normocephalic, PERRLA, EOMI, conjunctiva and sclera clear; nares patent, ornasopharynx clear, good dentition. Piercing in her right nostril and lower lip.

Lungs: CTA AP&L

Cor: S1S2 without rub or gallop

Abd: benign, normoactive bowel sounds x 4

GU: external genitalia intact, no lesions or masses. White copious discharge with an amine odor; no cervical motion tenderness; adenxa intact.

Ext: no cyanosis, clubbing or edema

Integument: intact without lesions masses or rashes.

Neuro: No obvious deficits and CN grossly intact II-XII

Case 3

Subjective Data

CC: “Annual physical exam”

History of Present Illness (HPI): 23-year-old Native American male comes in to see you because he has been having anxiety and wants something to help him. He has been smoking “pot” and says he drinks to help him too. He tells you he is afraid that he will not get into Heaven if he continues in this lifestyle. Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

Drug Hx:

Current medication – denied

Allergies: no allergies to food or medications.

Family history: is very positive for diabetes, hypertension, and alcoholism.

Review of Systems (ROS)

General: no recent weight gains of losses, fatigue, fever or chills.

Head, eyes, ears, nose & throat (HEENT):

Neck:

Respiratory:

CV: no chest discomfort or palpitations

GI:

GU:

Integument: history of eczema – not active

MS/Neuro: no syncopal episodes or dizziness, no change in memory or thinking patterns; no twitches or abnormal movements

Psych:

Objective Data

PE: B/P 158/90; Pulse 88; RR 18; Temp 99.2; Ht 5,7; wt 208; BMI 32.6

General: 23 year old male appears well developed and well nourished. He is anxious – pacing in the room and fidgeting, but in no acute distress.

HEENT: Atraumatic, normocephalic, PERRLA, EOMI, sclera with mild icterus, nares patent, ornasopharynx clear, poor dentition – multiple carries. Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

Lungs: CTA AP&L

Cor: S1S2, +II/VI holosystolic murmur; without rub or gallop

Abd: benign, normoactive bowel sounds x 4; Hepatomegaly 2cm below the costal margin.

Ext: no cyanosis, clubbing or edema

Integument: intact without lesions masses or rashes.

Neuro: No obvious deficits and CN grossly intact II-XII

To prepare:

·        Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.

·        Select 
one
 of the three case studies. Reflect on the provided patient information.

·        Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected.

·        Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

·        Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?

Post a 1 page paper APA format
 

1.
explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you selected

Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers

2
. Explain the issues that you would need to be sensitive to when interacting with the patient, and why.
3.
Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

 

Readings

·        Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). 
Seidel’s guide to physical examination
 (8th ed.). St. Louis, MO: Elsevier Mosby.

o   Chapter 2, “Cultural Competency” (pp. 21–29)

This chapter highlights the importance of cultural awareness when conducting health assessments. The authors explore the impact of culture on health beliefs and practices.

o   Chapter 3, “Examination Techniques and Equipment” (pp. 30-49)

This chapter explains the physical examination techniques of inspection, palpation, percussion, and auscultation. This chapter also explores special issues and equipment relevant to the physical exam process. Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

·        Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). 
Advanced health assessment and clinical diagnosis in primary care 
(5th ed.). St. Louis, MO: Elsevier Mosby.

o   Chapter 1, “Clinical Reasoning, Differential Diagnosis, Evidence-Based Practice, and Symptom Analysis”

This chapter introduces the diagnostic process, which includes performing an analysis of the symptoms and then formulating and testing a hypothesis. The authors discuss how becoming an expert clinician takes time and practice in developing clinical judgment.

·        Sullivan , D. D. (2012). 
Guide to clinical documentation
 (2nd ed.). Philadelphia, PA: F. A. Davis.

o   Chapter 2, “The Comprehensive History and Physical Exam” (pp. 19–36)

o   Appendices A–E (pp. 225–236)

·        Laine, C. (2012). High-value testing begins with a few simple questions. 
Annals of Internal Medicine
,
156
(2), 162–163. Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

Retrieved from the Walden Library databases.

This article supplies a list of questions physicians should ask themselves before ordering tests. The authors provide general guidelines for maximizing the value received from testing.

·        Qaseem, A., Alguire, P., Dallas, P., Feinberg, L. E., Fitzgerald, F. T., Horwitch, C., & … Weinberger, S. (2012). Appropriate use of screening and diagnostic tests to foster high-value, cost-conscious care.
Annals of Internal Medicine
, 
156
(2), 147–150.

Retrieved from the Walden Library databases.

This article highlights the increasing cost of health care and stresses the need for high-value and cost-conscious testing. The authors provide a list of 37 situations in which more testing provides no benefit or may be harmful.

·        Shaw, S. J., Huebner, C., Armin, J., Orzech, K., & Vivian, J. (2009). The role of culture in health literacy and chronic disease screening and management. 
Journal of Immigrant & Minority Health
,
 
11
(6), 460–467.

Retrieved from the Walden Library databases.

This article examines cultural influences on health literacy, cancer screening, and chronic disease outcomes. The authors postulate that cultural beliefs about health and illness affect a patient’s ability to comprehend and follow a health care provider’s instructions. Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

·        Wians, F. H. (2009). Clinical laboratory tests: Which, why, and what do the results mean? 
LabMedicine, 40
, 105–113.

Retrieved from 
http://labmed.ascpjournals.org/content/40/2/105.full

This article analyzes the laboratory testing cycle and its impact on diagnostic decision making. This article also examines important diagnostic performance characteristics of laboratory tests, methods of calculating performance, and tools used to assess the diagnostic accuracy of a laboratory test.

Optional Resources

·        LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2009). DeGowin’s diagnostic examination (9th ed.). New York, NY: McGraw- Hill Medical.

o   Chapter 3, “The Physical Screening Examination”

o   Chapter 17, “Principles of Diagnostic Testing”

o   Chapter 18, “Common Laboratory Tests” Diversity and Health Assessment Tools and Diagnostic Tests discussions – Nurs 6512 Week 2 Essay papers.

Building a Health History Essay Discussion Post – Nurs 6512 Wk 1

Building a Health History

Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.

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For this Discussion, you will take on the role of a clinician who is building a health history for one of the following new patients:

·        76-year-old Black/African-American male with disabilities living in an urban setting Building a Health History Essay Discussion Post – Nurs 6512 Wk 1

·        Adolescent Hispanic/Latino boy living in a middle-class suburb

·        55-year-old Asian female living in a high-density poverty housing complex

·        Pre-school aged white female living in a rural community

·        16-year-old white pregnant teenager living in an inner-city neighborhood

To prepare:

With the information presented in Chapter 1 in mind, consider the following:

·        How would your communication and interview techniques for building a health history differ with each patient?

·        How might you target your questions for building a health history based on the patient’s age, gender, ethnicity, or environment?

·        What risk assessment instruments would be appropriate to use with each patient? Building a Health History Essay Discussion Post – Nurs 6512 Wk 1.

·        What questions would you ask each patient to assess his or her health risks?

·        Select 
one
 patient from the list above on which to focus for this Discussion.

·        Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.

·        Select 
one
 of the risk assessment instruments presented in Chapter 1 or Chapter 26 of the course text, or another tool with which you are familiar, related to your selected patient.

·        Develop 
at least five
targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history. Building a Health History Essay Discussion Post – Nurs 6512 Wk 1.

Post a 1 page paper APA format
 1.
a description of the interview and communication techniques you would use with your selected patient.

2.
Explain why you would use these techniques.

3
Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient.

4
Provide at least five targeted questions you would ask the patient.

 

Readings

·        Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). 
Seidel’s guide to physical examination
 (8th ed.). St. Louis, MO: Elsevier Mosby.

o   Chapter 1, “The History and Interviewing Process” (pp. 1–21)

This chapter explains the process of developing relationships with patients in order to build an effective health history. The authors offer suggestions for adapting the creation of a health history according to age, gender, and disability. Building a Health History Essay Discussion Post – Nurs 6512 Wk 1.

o   Chapter 26, “Recording Information” (pp. 616–631)

This chapter provides rationale and methods for maintaining clear and accurate records. The authors also explore the legal aspects of patient records.

·        Sullivan, D. D. (2012). 
Guide to clinical documentation
 (2nd ed.). Philadelphia, PA: F. A. Davis.

o   Chapter 1, “Medicolegal Principles of Documentation” (pp. 1–12 and abbreviations, pp. 18)

o   Chapter 2, “The Comprehensive History and Physical Exam” (pp. 19–36)

·        Deeks, A., Lombard, C., Michelmore, J., & Teede, H. (2009). The effects of gender and age on health related behaviors. 
BMC Public Health
,
 
9
, 213–220.

Retrieved from the Walden Library databases Building a Health History Essay Discussion Post – Nurs 6512 Wk 1.

This article describes a study that sought to determine the effects of gender and age on health-related behaviors. In the study, the authors also investigated the effects of screening practices, health beliefs, and perceived future health needs.

·        Delpierre, C., Lauwers-Cances, V., Datta, G. D., Berkman, L., & Lang, T. (2009). Impact of social position on the effect of cardiovascular risk factors on self-rated health. 
American Journal of Public Health
, 
99
(7), 1278–1284.

Retrieved from the Walden Library databases.

This study assessed the influence of education level on the association between self-rated health and cardiovascular risk factors. The authors explain their methods and results, and they provide recommendations for similar studies in different countries and cultures.

·        Lee, D. W., Neumann, P. J., & Rizzo, J. A. (2010). Understanding the medical and nonmedical value of diagnostic testing. 
Value in Health
, 
13
(2), 310–314.

Retrieved from the Walden Library databases. Building a Health History Essay Discussion Post – Nurs 6512 Wk 1.

The authors of this article detail their attempts to develop a framework for defining the potential value of diagnostic testing. The authors also discuss the implications of their framework for health care delivery systems.

·        University of Michigan Medical School. (2003). 
Geriatric functional assessment
.

Retrieved from 
http://www.med.umich.edu/lrc/coursepages/m1/HGD/GeriatricFunctionalAssess.pdf

This article provides an exercise that emphasizes accurate functional status assessments and effective communication with older patients. The authors recommend tools and techniques to be used when caring for older patients.

Note about Uploading Media:

Please refer to the 
Kaltura Media Uploader
 page located in the course navigation menu.. The documents on this page provide guidance on how to upload media for your Health Assessment Videos assignments for this course.

Building a Health History Essay Discussion Post – Nurs 6512 Wk 1 Optional Resources

·        LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2009). 
DeGowin’s diagnostic examination
 (9th ed.). New York, NY: McGraw- Hill Medical.

o   Chapter 2, “History Taking and the Medical Record” (pp. 15–33) Building a Health History Essay Discussion Post – Nurs 6512 Wk 1.

NURS 6512 Walden University Exam test questions

A nurse recalls an example of an immune-complex-mediated disease is:

Question 2

1 out of 1 points

When a patient asks the nurse what hypersensitivity is, how should the nurse respond? Hypersensitivity is best defined as:

Question 3

1 out of 1 points

A 35-year-old male is diagnosed with lobar pneumonia (lung infection). Which of the following exudates would be present in highest concentration at the site of this advanced inflammatory response? NURS 6512 Walden University Exam test questions.

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Question 4

1 out of 1 points

A 10-year-old male presents to his primary care provider reporting wheezing and difficulty breathing. History reveals that both of the child’s parents suffer from allergies. Which of the following terms would be used to classify the child? NURS 6512 Walden University Exam test questions.

Question 5

1 out of 1 points

A 20-year-old male shoots his hand with a nail gun while replacing roofing shingles. Which of the following cell types would be the first to aid in killing bacteria to prevent infection in his hand?

Question 6

1 out of 1 points

An 8-year-old female presents with edema of the cutaneous and mucosal tissue layers. Her mother reports that the condition is recurrent and seems to occur more often during stressful situations. The child is diagnosed with hereditary angioedema. Which of the following is deficient in this child? NURS 6512 Walden University Exam test questions.

Question 7

1 out of 1 points

Which patient will develop active immunity? A patient who:

Question 8

1 out of 1 points

A child fell off the swing and scraped the right knee. The injured area becomes painful. What else will the nurse observe upon assessment? NURS 6512 Walden University Exam test questions.

Question 9

1 out of 1 points

A 30-year-old male is having difficulty breathing and has been spitting blood. He reports that he began experiencing this reaction after cleaning his pigeons’ cages. Testing reveals he is suffering from allergic alveolitis. Which of the following is he experiencing?

Question 10

1 out of 1 points

A 45-year-old male presents with persistent, severe stomach pain. Testing reveals a peptic ulcer. Further laboratory tests reveal the presence of Helicobacter pylori. Which of the following is of concern for this patient? NURS 6512 Walden University Exam test questions

Question 11

1 out of 1 points

After teaching about stress, which information indicates a correct understanding of stress?

Question 12

0 out of 1 points

A 30-year-old female presents to her primary care provider reporting fatigue, excessive sweating, and increased appetite. Physical examination reveals protruding eyes, and laboratory testing reveals hyperthyroidism secondary to autoantibody production. This disorder falls into the category of type _____ hypersensitivity.

Question 13

1 out of 1 points

Stress induces sympathetic stimulation of the adrenal medulla. This causes the secretion of catecholamines, which include:

Question 14

1 out of 1 points

A 5-month-old child is admitted to the hospital with recurring respiratory infections. A possible cause of this condition is:

Question 15

1 out of 1 points

Which of the following patients would be at greatest risk for basal cell carcinoma?

Question 16

1 out of 1 points

An infant develops a fever secondary to a bacterial infection. Which of the following most likely triggered the fever?

Question 17

0 out of 1 points

A 50-year-old female experiences decreased blood pressure, decreased oxygen delivery, cardiovascular shock, and subsequent death. A complication of endotoxic shock is suspected. Which of the following is the most likely cause?

Question 18

1 out of 1 points

Which of the following individuals would be at greatest risk for an opportunistic infection?

Question 19

1 out of 1 points

When a patient presents at the emergency department for an allergic reaction, the nurse recognizes the most severe consequence of a type I hypersensitivity reaction is:

Question 20

1 out of 1 points

Which of the following hormones activates adrenergic receptors?

Question 21

1 out of 1 points

During inflammation, the liver is stimulated to release plasma proteins, collectively known as:

Question 22

1 out of 1 points

Exhaustion occurs if stress continues and _____ is not successful. NURS 6512 Walden University Exam test questions.

Question 23

1 out of 1 points

When the maternal immune system becomes sensitized against antigens expressed by the fetus, what type of immune reaction occurs?

Question 24

1 out of 1 points

When histamine is released in the body, which of the following responses would the nurse expect?

Question 25

1 out of 1 points

A patient presents with poison ivy on the extremities, face, and buttocks. This condition is an example of:

Question 26

1 out of 1 points

A 70-year-old female with osteoporosis fractures her leg at a location of preexisting abnormality. She reports that the fracture occurred following a minor fall. Which of the following best describes the fracture? NURS 6512 Walden University Exam test questions.

Question 27

1 out of 1 points

A 4-month-old female is diagnosed with atopic dermatitis (AD). Which of the following assessment findings by the nurse will most likely support this diagnosis?

Question 28

1 out of 1 points

A 34-year-old female was recently diagnosed with RA. Physical examination revealed that inflammation started in the:

Question 29

1 out of 1 points

The final stage of gout, characterized by crystalline deposits in cartilage, synovial membranes, and soft tissue, is called: NURS 6512 Walden University Exam test questions.

Question 30

1 out of 1 points

A 2-month-old female develops diaper dermatitis. A nurse will monitor this patient for which secondary infection that frequently accompanies diaper dermatitis?

Question 31

1 out of 1 points

A 40-year-old female is diagnosed with SLE. Which of the following findings would be considered a symptom of this disease?

Question 32

1 out of 1 points

A 30-year-old female complains of fatigue, arthritis, rash, and changes in urine color. Laboratory testing reveals anemia, lymphopenia, and kidney inflammation. Assuming a diagnosis of SLE, which of the following is also likely to be present? NURS 6512 Walden University Exam test questions.

Question 33

1 out of 1 points

Rubella, rubeola, and roseola are common communicable diseases caused by _____ infection.

Question 34

1 out of 1 points

Researchers now believe that RA is:

Question 35

1 out of 1 points

What common symptom should be assessed in individuals with immunodeficiency?

Question 36

1 out of 1 points

A 50-year-old male recently underwent a liver transplant and is taking immunosuppressive drugs. He now has painful vesicular eruptions on the face and trunk. He reports that he had chickenpox as a child. Which of the following is the most likely diagnosis based on his chicken pox history?

Question 37

1 out of 1 points

Copy of A 5-year-old female was diagnosed with seropositive juvenile rheumatoid arthritis (RA). The treatment option for this disease is termed:

Question 38

1 out of 1 points

A 70-year-old female presents with a hip fracture. She is diagnosed with osteoporosis. One factor that most likely contributed to her condition is:

Question 39

1 out of 1 points

A 42-year-old female presents with raised red lesions with a brownish scale. She was diagnosed with discoid lupus erythematosus. A clinician recalls this disorder is related to: NURS 6512 Walden University Exam test questions.

Question 40

1 out of 1 points

The nurse would expect the occurrence of scabies to occur more commonly among children who:

Sunday, March 13, 2016 6:02:30 PM EDT NURS 6512 Walden University Exam test questions

Nurs 6521 Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Discussion Assignment paper

Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe treatment that targets the cause rather than the symptom. Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Discussion, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan.

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Consider the following case study:

Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs: Nurs 6521 Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Discussion Assignment paper.

Synthroid 100 mcg daily

Nifedipine 30 mg daily

Prednisone 10 mg daily

To prepare:

·        Review this week’s media presentation on pharmacology for the gastrointestinal system.

·        Review the provided case study. Reflect on the patient’s symptoms, medical history, and drugs currently prescribed.

·        Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms are the result of a disorder from another system or other factors such as pregnancy, drugs, or a psychological disorder.

·        Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

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an explanation of your diagnosis for the patient including your rationale for the diagnosis. Nurs 6521 Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Discussion Assignment paper.

Then, describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
(Note this is a pharmacology class make sure medicine is appropriate and will work with pt’s current med list)

 

Readings

·        Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013). 
Pharmacotherapeutics for advanced practice: A practical approach
 (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.

o   Chapter 28, “Nausea and Vomiting” (pp. 392–409)

This chapter focuses on the etiology of nausea and vomiting, as well as body systems that impact or trigger nausea and vomiting. It also covers various drugs used to treat nausea and vomiting including the process of selecting, administering, and managing drug therapy for patients.

o   Chapter 29, “Gastroesophageal Reflux Disease and Peptic Ulcer Disease” (pp. 410–423)

This chapter begins with an overview of risk factors, symptoms, and clinical stages of gastroesophageal reflux disease (GERD). It then examines drugs used to treat GERD and peptic ulcer disease (PUD), including proper dosages, possible adverse reactions, contraindications, and special considerations. Nurs 6521 Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Discussion Assignment paper.

o   Chapter 30, “Constipation, Diarrhea, and Irritable Bowel Syndrome” (pp. 424–453)

This chapter begins by exploring disorders associated with constipation and diarrhea, as well as drugs used in treatment. It also covers the pathophysiology of irritable bowel syndrome and related drug therapies.

o   Chapter 31, “Inflammatory Bowel Disease” (pp. 454–471)

This chapter examines the causes, pathophysiology, and diagnostic criteria of inflammatory bowel disease (IBD), Crohn’s disease, and ulcerative colitis. It also identifies drugs used to treat IBD, including proper dosage, adverse reactions, and special considerations.

·        Starr, S., & Raines, D. (2011). Cirrhosis: Diagnosis, management, and prevention. 
American Family Physician
, 
84
(12), 1353–1359.

Retrieved from the Walden Library databases. Nurs 6521 Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Discussion Assignment paper.

This article examines the clinical presentation, pathophysiology, diagnosis, management, and prevention of cirrhosis. It also provides methods for managing complications of cirrhosis.

·        Drugs.com. (2012). Retrieved from 
http://www.drugs.com/

This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker. .