Test Bank for Advanced Health Assessment and Diagnostic Reasoning 4th Edition by Rhoads Jacqueline a

Test Bank for Advanced Health Assessment and Diagnostic Reasoning 4th Edition by Rhoads Jacqueline and Petersen Sandra Wiggins

Jacqueline Rhoads Sandra Wiggins Petersen

Test Bank for Advanced Health Assessment and Diagnostic Reasoning 4th Edition by Rhoads Jacqueline and Petersen Sandra Wiggins

Test Bank for Advanced Health Assessment and Diagnostic Reasoning 4th Edition by Rhoads Jacqueline and Petersen Sandra Wiggins

Import Settings: Base Settings: Brownstone Default Information Field: Complexity Information Field: Ahead Information Field: Subject Information Field: Advanced Health Assessment and Diagnostic Reasoning Information Field: Taxonomy Highest Answer Letter: D Multiple Keywords in Same Paragraph: No NAS ISBN13: 9781284171228, add to Ahead, Title tags

Chapter: Chapter 01 - Quiz

Multiple Choice

1. Which of the following is an example of subjective data that may be collected during a health assessment?

A) Height and weight B) A patient’s recall of his or her past health conditions C) Results from an abdominal CT scan D) Complete blood count Ans: B Complexity: Moderate Ahead: Functions of the Interview and Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Application

2. Which of the following is true regarding the data taken in a health history?

A) Most health history data are objective and measurable.

B) Objective data are error-free, quantifiable data.

C) Subjective data, being inherently less accurate, are of less value than objective data.

D) A successful individualized plan of care must incorporate subjective data.

Ans: D Complexity: Difficult Ahead: Functions of the Interview and Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Analysis

3. What do Coulehan and Block define as “listening to the total communication . . . and letting the patient know that you are really hearing”?

A) Cultural competence B) Patience C) Empathy D) Top-tier communication

Test Bank for Advanced Health Assessment and Diagnostic Reasoning 4th Edition by Rhoads Jacqueline and Petersen Sandra Wiggins

Ans: C Complexity: Moderate Ahead: Interviewing Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Recall

4. The provider is preparing to take a health history for a new patient. He takes the patient to a private room and asks the patient to don a hospital gown. After stepping outside to give the patient sufficient time to change, he then comes back in and asks permission to conduct the history. He sits next to the patient at eye level, discreetly observes the patient for any sensory deficits, and asks the patient if he may take brief notes of the conversation. During the conversation, he gives the patient time to answer questions fully. He makes sure that his questions do not contain technical terms and quietly observes the patient’s nonverbal behaviors throughout. Which mistake did the provider make?

A) He should have allowed the patient to remain fully clothed in their own clothing for their comfort.

B) He should not have omitted technical terminology. Patients like having a chance to learn.

C) He should have seated himself slightly above eye level to give the patient nonverbal reassurance of his experience and professionalism.

D) He should have asked explicitly about the nonverbal changes he was noticing in order to gain a deeper level of understanding of the patient’s current condition.

Ans: A Complexity: Difficult Ahead: Taking a Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Analysis

5. Which of the following is true of both comprehensive and focused health histories?

A) They both include identifying data.

B) They both include a social history.

C) They both include a family history.

D) They are both conducted in emergency situations.

Ans: A Complexity: Moderate Ahead: Taking a Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Application

6. In the mnemonic devise PQRST, which of the following includes describing the location of the symptoms?

A) Precipitating factors B) Quality C) Radiation D) Severity Ans: B Complexity: Difficult Ahead: Taking a Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies

Test Bank for Advanced Health Assessment and Diagnostic Reasoning 4th Edition by Rhoads Jacqueline and Petersen Sandra Wiggins

Taxonomy: Analysis

7. What is the current mnemonic device for taking a health history?

A) PQRST B) CLIENT OUTCOMES C) PRACTICE D) GOOD MEDICINE Ans: B Complexity: Easy Ahead: Taking a Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Recall

8. When taking a PMI, which of the following is correct?

A) Do not take the statement “I’m allergic to. . . ” at face value.

B) Ask the patient for a very brief summary of their current health.

C) If a patient states that they have been vaccinated with BCG, make sure to administer a PPD test.

D) CAM documentation is no longer a requirement.

Ans: A Complexity: Difficult Ahead: Taking a Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Remember

9. Which of the following is a first-degree relative to the patient who has experienced premature onset of CVD? A) Sister at 62 B) Cousin at 62 C) Aunt at 59 D) Grandfather at 44 Ans: A Complexity: Difficult Ahead: Taking a Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Analysis

10. Recording the patient’s occupation falls under which category?

A) PHI B) FH C) SH D) ROS Ans: C Complexity: Easy Ahead: Taking a Health History Subject: Chapter 1

Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

Title: Interview and History-Taking Strategies Taxonomy: Recall

11. A focused ROS: A) involves a wider range and shallower level of questions than a comprehensive ROS. B) includes questions directed toward the systems most likely to be involved in the patient’s symptoms.

C) includes questions seeking significant positives to narrow down the body systems affected.

D) covers all body systems.

Ans: B Complexity: Moderate Ahead: Taking a Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Application

12. A patient comes to the clinic complaining of repeated headaches and lightheadedness. As the provider takes a health history, he or she should: A) perform a comprehensive ROS. B) skip the social history in order to focus on the current issue.

C) focus her interest and questions on the patient’s neurologic system.

D) spend a good deal of time assessing the reliability of the information she is getting.

Ans: C Complexity: Difficult Ahead: Taking a Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Analysis

True/False

1. True or False? A patient’s recall of his or her current health needs and past health is subject to error and is also a critical component in the caregiving process.

Ans: True Complexity: Moderate Ahead: Functions of the Interview and Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Recall

2. True or False? Ethnocentrism, belief in the superiority of one’s own beliefs and values, is a major barrier to establishing effective patient–provider relationships.

Ans: True Complexity: Easy Ahead: Interviewing Subject: Chapter 1 Title: Interview and History-Taking Strategies

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Taxonomy: Recall

3. True or False? A 58-year-old man at risk of diabetes, with a sedentary lifestyle and unhealthy diet, is unwilling to follow his provider’s recommendations to modify his routine. Because he has not yet experienced the negative health consequences of his actions, he cannot be classified as resistant.

Ans: False Complexity: Moderate Ahead: Interviewing Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Application

4. True or False? When taking a patient’s chief complaint, rephrase the stated reason using standard medical terminology for clarity.

Ans: False Complexity: Easy Ahead: Taking a Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Recall

5. True or False? Family history should include both parents and grandparents, if information is known.

Ans: True Complexity: Moderate Ahead: Taking a Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Application

6. True or False? Social history includes a detailed diet history, best performed as a record of food and beverage intake by the patient for a typical week, that includes things like use of salt and oil in food preparation and methods of cooking.

Ans: True Complexity: Moderate Ahead: Taking a Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Application

Essay

1. What does PQRST stand for?

Ans: Precipitating factors, quality, radiation, severity, and timing Complexity: Difficult

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Ahead: Taking a Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Analysis

2. What are 10 body systems that compose a comprehensive review of systems?

Ans: 10 of the following: general/constitutional, skin, eyes, ears, nose, mouth/throat, cardiovascular, respiratory, gastrointestinal, genitourinary, breast, musculoskeletal, neurologic, mental/psychiatric, lymphatic, hematologic, and endocrine Complexity: Difficult Ahead: Taking a Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Analysis

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

Import Settings: Base Settings: Brownstone Default Information Field: Complexity Information Field: Ahead Information Field: Subject Information Field: Advanced Health Assessment and Diagnostic Reasoning Information Field: Taxonomy Highest Answer Letter: D Multiple Keywords in Same Paragraph: No NAS ISBN13: 9781284171228, add to Ahead, Title tags

Chapter: Chapter 02 - Quiz

Multiple Choice

1. What are the two main general considerations of physical examinations listed in the text?

A) Preparation and sequence B) Medical and financial C) Patient interaction and scope D) Inspection and palpation Ans: C Complexity: Moderate Ahead: General Considerations Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Application

2. The physician has begun her first physical examination on a new patient who has come to the clinic for a well-patient visit. Which of the following is true?

A) The first thing the physician will do as part of the physical examination is perform the history.

B) This will likely be a head-to-toe examination.

C) As a first exam, this will likely be brief and focused.

D) The patient, on his first visit, will likely be disoriented and unaware of the physician’s tone and expressions.

Ans: B Complexity: Difficult Ahead: General Considerations Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Analysis

3. The physician records a sound as “tympanic.” The physician has just performed which assessment technique?

A) Palpation B) Auscultation C) Percussion

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D) Compression Ans: C Complexity: Moderate Ahead: Assessment Techniques Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Application

4. A physician is listening to a patient’s heart, but something has negatively impacted the sound. Which of the following has most likely caused this?

A) Indirect rather than direct percussion B) A double-lumen stethoscope C) Lack of palpation D) Loose-fitting ear tips Ans: D Complexity: Difficult Ahead: Assessment Techniques Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Analysis

5. Which of the following is included on the list of basic equipment needed for a physical examination?

A) Syringe B) Measuring tape C) Occult blood testing materials D) Culture media Ans: B Complexity: Easy Ahead: Head-to-Toe Examination Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Recall

6. What does a physician use the Weber and/or Rinne tests for?

A) Assessing the lungs B) Performing an abdominal fluid wave text C) Testing hearing D) Observing posture and balance Ans: C Complexity: Difficult Ahead: Head-to-Toe Examination Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Analysis

7. The red reflex is a test of: A) the abdomen.

B) the spine.

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

C) the eyes.

D) the mouth.

Ans: C Complexity: Easy Ahead: Head-to-Toe Examination Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Recall

8. If the physician is evaluating thoracic expansion, percussing the kidneys, and inspecting the skin for lesions, the patient is in which position?

A) Patient seated and facing examiner B) Patient seated and facing away from examiner with back exposed C) Patient standing D) Patient supine with chest exposed Ans: B Complexity: Difficult Ahead: Head-to-Toe Examination Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Analysis

9. Which position is only performed on female patients?

A) Reclining 45 degrees B) Lithotomy position C) Leaning forward reaching for toes D) Supine with abdomen exposed Ans: B Complexity: Easy Ahead: Head-to-Toe Examination Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Recall

10. Which part of the body of a neonate should be studied first?

A) Abdomen B) Chest C) Hands and feet D) Head Ans: D Complexity: Difficult Ahead: Head-to-Toe Examination Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Analysis

11. Which of the following assessments is specific to the geriatric patient?

A) Functional

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

B) General C) Physical D) Developmental Ans: A Complexity: Moderate Ahead: Head-to-Toe Examination Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Application

12. A functional assessment includes which of the following components?

A) Abdominal assessment B) Visual assessment C) Assessment of flaccidity, tension, and spasticity D) Assessment of mental status and mood impairment Ans: D Complexity: Difficult Ahead: Head-to-Toe Examination Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Analysis

True/False

1. True or False? The history should be performed separately from the physical examination.

Ans: False Complexity: Moderate Ahead: Function of the Physical Examination Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Analysis

2. True or False? When the patient is already under the ongoing care of the clinician and presents with a specific problem-oriented complaint, the physician performs a focused physical examination.

Ans: True Complexity: Easy Ahead: General Considerations Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Recall

3. True or False? Indirect percussion involves touch by instrument or object and requires no physical contact between the physician and patient.

Ans: False Complexity: Moderate Ahead: Assessment Techniques

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Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Application

4. True or False? The physical exam begins as the patient enters the room.

Ans: True Complexity: Easy Ahead: Head-to-Toe Examination Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Recall

5. True or False? Jugular venous pressure is measured when the patient is reclining 45 degrees.

Ans: True Complexity: Moderate Ahead: Head-to-Toe Examination Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Application

6. True or False? The kidneys should be examined both while the patient is supine and while the patient is seated facing away from the examiner.

Ans: True Complexity: Moderate Ahead: Head-to-Toe Examination Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Application

Essay

1. What are the positions that all adult patients will be asked to assume during a physical examination?

Ans: Seated and facing examiner (without chest exposed and with chest exposed); seated facing examiner while reclining 45 degrees; seated and facing away; supine (with chest exposed, with abdomen exposed, with legs exposed); standing Complexity: Difficult Ahead: Head-to-Toe Examination Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Analysis

2. What methods are mentioned in the text to win cooperation of pediatric patients of different ages?

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Ans: Take a few minutes to establish a relaxed environment. Give a 1-year-old an object to hold in his hands. With a toddler, use a gentle pat, pleasing words, or interactive play. Allow children to touch the equipment used during the examination.

Complexity: Difficult Ahead: Head-to-Toe Examination Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Analysis

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

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Chapter: Chapter 03 - Quiz

Multiple Choice

1. Which of the following is true of healthcare institutions regarding documentation?

A) To comply with HIPAA regulations, institutions must ensure that computer monitors with sensitive patient data are not left unattended.

B) All institutions must follow a standard policy for posting abbreviations in documentation drawn from the AMA. C) Institutions consider drawings a fairly inaccurate way to represent a patient’s systems or picture of the patient’s condition.

D) As of 2003, faxes may no longer be used to share patient medical information between institutions.

Ans: A Complexity: Moderate Ahead: General Considerations Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Application

2. SOAP stands for: A) standard operating and admitting procedures.

B) sanitation, observation, auscultation, palpation.

C) surgeons, officials, administrators, patients.

D) subjective, objective, assessment, plan, Ans: D Complexity: Easy Ahead: SOAP Approach Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Recall

3. Which of the following is recorded in documentation as direct patient quotes?

A) The chief complaint and follow-up responses B) The chief complaint only

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C) Nothing; everything is written in precise medical terminology D) The objective information Ans: B Complexity: Moderate Ahead: Documentation Tips Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Application

4. A patient is examined according to , and documentation is recorded according to .

A) PQRST, CLIENT OUTCOMES B) body region, system C) subjective data, objective data D) the institution’s system, the physician’s system Ans: B Complexity: Difficult Ahead: Documentation Tips Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Analysis

5. Which of the following is true of reporting history of present illness?

A) If a patient describes having pain in the arm and numbness in the fingertips, the physician should examine these as a single unit.

B) The opening sentence should contain the results from pertinent test results and test dates.

C) All recent pertinent diagnostic tests and the outcomes of recent pertinent interventions should be summarized and included in the HPI. D) Medical tests that are unrelated to their current complaint should be included in the HPI. Ans: A Complexity: Moderate Ahead: Subjective Data Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Application

6. Which is the preferred order of taking down a patient’s subjective information?

A) Family history, physical exam, diagnostic tests, assessment B) SOAP C) HPI, past medical history, family history, social history D) HPI, family history, physical exam, assessment Ans: C Complexity: Difficult Ahead: Subjective Data Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Analysis

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7. What is a genogram?

A) A genetic test performed in a doctor’s office B) A visual representation or chart of a patient’s family history C) A biometric monitor worn during a physical exam D) A computer report correlating information from the patient’s history, exam, and diagnostic tests Ans: B Complexity: Easy Ahead: Subjective Data Subject: Chapter 3 Title: Documentation Strategies Taxonomy Recall

8. In a physical examination, the physician spends the most attention on the patient’s musculoskeletal and neurological systems. What can we deduce from this?

A) The same systems were likely not explored in the review of systems.

B) This is a comprehensive examination.

C) Documentation from the subjective component of the patient’s visit has pointed the physician to these systems.

D) The diagnosis will be firmly established after assessment of both systems.

Ans: C Complexity: Difficult Ahead: Objective Data Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Analysis

9. Which of the following is the last component of gathering objective data?

A) Review of systems B) Physical examination C) Assessment D) Diagnostic tests Ans: D Complexity: Easy Ahead: Objective Data Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Recall

10. Which of the following is true of a problem list that is created during the final assessment?

A) It outlines the educational needs of the patient.

B) It includes additional findings that are directly related to the history of present illness.

C) It may include other issues that are not true diagnoses.

D) Items on the problem list typically cannot be treated.

Ans: C Complexity: Difficult Ahead: Assessment Subject: Chapter 3 Title: Documentation Strategies

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Taxonomy: Analysis

11. In the “Plan” section, the text singles out which component of the plan as critical for legal reasons?

A) Education B) Nonpharmacological interventions C) “Rule outs” D) Follow-up Ans: A Complexity: Moderate Ahead: Plan Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Application

12. Which component of the treatment plan is typically reserved for hospitalized patients?

A) Pharmacological interventions B) Referrals C) Nonpharmacological interventions D) Follow-ups Ans: C Complexity: Easy Ahead: Plan Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Recall

True/False

1. True or False? Documentation that just indicates that the healthcare provider found “no problems” is unacceptable because of lack of precision and clarity of what was asked and what was assessed.

Ans: True Complexity: Moderate Ahead: Functions of Documentation Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Application

2. True or False? HIPAA regulations permit healthcare institutions to share a patient’s information without their consent, but only to other accredited healthcare institutions and only if strict security measures are in place.

Ans: False Complexity: Easy Ahead: General Considerations Subject: Chapter 3

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

Title: Documentation Strategies Taxonomy: Recall

3. True or False? The format and extent of information gathered are different for each subclassification of the SOAP approach.

Ans: False Complexity: Moderate Ahead: SOAP Approach Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Application

4. True or False? If the patient reports that 5 years ago she had a “heart attack,” it is important for the physician to note this using the patient’s own terminology.

Ans: False Complexity: Difficult Ahead: Documentation Tips Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Analysis

5. True or False? “Patient holds an M.A. in art history and curates a small museum; occupation calls for standing 6–7 hours a day” is an example of documentation of a patient’s social history.

Ans: True Complexity: Moderate Ahead: Subjective Data Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Application

6. True or False? The assessment plan for all patients will contain new diagnoses, differential diagnoses, and a problem list.

Ans: False Complexity: Moderate Ahead: Assessment Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Application

Essay

1. Explain what each step of SOAP stands for and why they appear in the particular order they do.

Ans: Subjective: Any information or facts that the patient presents or that the chart provides. Objective: Data and information obtained by the examiner with his or her eyes, ears, and hands. Assessment: Pulls

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together the findings presented in the subjective and objective sections to form a diagnosis. Plan: Outlines the treatment plan. Each step builds chronologically on the previous one.

Complexity: Difficult Ahead: SOAP Approach Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Analysis

2. What are the five broad categories usually explored in a patient’s family history?

Ans: Cancer, diabetes, cerebrovascular accidents, myocardial infarctions, and genetic defects Complexity: Difficult Ahead: Subjective Data Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Analysis

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

Import Settings: Base Settings: Brownstone Default Information Field: Complexity Information Field: Ahead Information Field: Subject Information Field: Advanced Health Assessment and Diagnostic Reasoning Information Field: Taxonomy Highest Answer Letter: D Multiple Keywords in Same Paragraph: No NAS ISBN13: 9781284171228, add to Ahead, Title tags

Chapter: Chapter 04 - Quiz

Multiple Choice

1. Which of the following is true of implicit bias in health care?

A) It does not influence patient health outcomes.

B) It improves the use of empathy.

C) It is associated with disparities in treatment recommendations.

D) It is rarely exhibited by providers.

Ans: C Complexity: Difficult Ahead: Introduction Subject: Chapter 4 Title: Cultural and Spiritual Assessments Taxonomy: Analysis

2. The is used in the field of psychology as a way to identify implicit bias.

A) Campinha-Bacote Model B) Implicit Association Test C) Cultural Bias Questionnaire D) Gottlieb Test Ans: B Complexity: Moderate Ahead: Self-Assessment Subject: Chapter 4 Title: Cultural and Spiritual Assessments Taxonomy: Application

3. Where should a healthcare professional look to determine how to properly treat a patient?

A) Formal education B) Textbook C) Patient D) Caregiver of the patient Ans: C Complexity: Moderate

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Ahead: Patient Assessment Subject: Chapter 4 Title: Cultural and Spiritual Assessments Taxonomy: Application

4. During which component of the mnemonic ETHNIC does the healthcare provider facilitate putting the plan into action?

A) T B) H C) N D) I Ans: D Complexity: Moderate Ahead: Patient Assessment Subject: Chapter 4 Title: Cultural and Spiritual Assessments Taxonomy: Application

5. Which of the following questions might a clinician ask to understand the economic needs of a patient?

A) “Are you allergic to anything in the environment that you are aware of?”

B) “How will this illness affect your life and the life of your family?”

C) “Where do you most often receive care when you are feeling ill or for routine checkups?”

D) “How do you normally get medications or treatments that you need?”

Ans: D Complexity: Difficult Ahead: Patient Assessment Subject: Chapter 4 Title: Cultural and Spiritual Assessments Taxonomy: Analysis

6. Which of the following skin conditions would be of greater concern with an African American male patient?

A) Scleroderma B) Traction alopecia C) Pseudofolliculitis barbate D) Keloids Ans: C Complexity: Difficult Ahead: Patient Assessment Subject: Chapter 4 Title: Cultural and Spiritual Assessments Taxonomy: Analysis

7. You are performing an endocrine assessment on an Asian patient. Which of the following conditions would be of greatest concern?

A) Diabetes B) Hyperthyroidism C) Hypothyroidism

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D) Diabetic retinopathy Ans: B Complexity: Difficult Ahead: Patient Assessment Subject: Chapter 4 Title: Cultural and Spiritual Assessments Taxonomy: Analysis

True/False

1. True or False? It is imperative that a healthcare provider use a reliable and valid tool to assess their awareness and acceptance of diversity.

Ans: False Complexity: Moderate Ahead: Introduction Subject: Chapter 4 Title: Cultural and Spiritual Assessments Taxonomy: Analysis

2. True or False? Asian Americans and Pacific Islanders have less incidence of cardiovascular disease than Caucasians.

Ans: True Complexity: Moderate Ahead: Patient Assessment Subject: Chapter 4 Title: Cultural and Spiritual Assessments Taxonomy: Application

Essay

1. What are the three categories of questions in the text that may be helpful in assessing cultural and lifestyle values? Give an example of a question that may be asked in each category.

Ans: Nutrition, Environment, Sleep. How many meals do you eat per day? Are you allergic to anything in your environment? What is your usual bedtime?

Complexity: Difficult Ahead: Patient Assessment Subject: Chapter 4 Title: Cultural and Spiritual Assessments Taxonomy: Analysis

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Import Settings: Base Settings: Brownstone Default Information Field: Complexity Information Field: Ahead Information Field: Subject Information Field: Advanced Health Assessment and Diagnostic Reasoning Information Field: Taxonomy Highest Answer Letter: D Multiple Keywords in Same Paragraph: No NAS ISBN13: 9781284171228, add to Ahead, Title tags

Chapter: Chapter 05 - Quiz

Multiple Choice

1. According to Vilter & Thompson, the incidence of diabetes is are obese compared to those who are of average weight.

A) 2 B) 2.5 C) 3 D) 4 Ans: B Complexity: Easy Ahead: Nutritional Assessment Rationale Subject: Chapter 5 Title: Nutritional Assessment Taxonomy: Recall

2. What is the function of hydrochloric acid in the stomach?

A) To release hormones and cytokines B) To regulate lipoprotein metabolism C) To lower the resting pH of the stomach D) To divert blood flow away from the gastrointestinal systems Ans: C Complexity: Moderate Ahead: Anatomy and Physiology Subject: Chapter 5 Title: Nutritional Assessment Taxonomy: Application

3. What happens when the sympathetic nervous system is activated?

A) Saliva production increases B) Pancreatic enzymes are released C) Peristalsis is initiated D) Gallbladder function is inhibited Ans: D

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times greater in those who

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Complexity: Difficult Ahead: Anatomy and Physiology Subject: Chapter 5 Title: Nutritional Assessment Taxonomy: Analysis

4. Which of the following malnutrition risk assessment tools would be most appropriate for ambulatory subacute and ambulatory patients?

A) Malnutrition Screening Tool B) Nutritional Risk Screening C) Mini-Nutritional Assessment Short Form D) Subjective Global Assessment Ans: C Complexity: Difficult Ahead: Methods of Nutritional Assessment Subject: Chapter 5 Title: Nutritional Assessment Taxonomy: Analysis

5. During which domain of assessing nutritional status would a clinician assess the mid-arm muscle circumference?

A) Domain 1 B) Domain 2 C) Domain 3 D) Domain 4 Ans: B Complexity: Moderate Ahead: Methods of Nutritional Assessment Subject: Chapter 5 Title: Nutritional Assessment Taxonomy: Application

6. Which of the following was proposed by Soeters et al. as a comprehensive way to assess nutritional status?

A) Nutritional Risk Screening B) Five Assessment Domains C) Malnutrition Screening Tool D) Subjective Global Assessment Ans: B Complexity: Moderate Ahead: Methods of Nutritional Assessment Subject: Chapter 5 Title: Nutritional Assessment Taxonomy: Application

7. Which of the following assessments of nutrient balance would be used to indicate typical consumption over a period of one month?

A) Food diary

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B) 24-hour diet recall C) Food frequency questionnaire D) Indirect calorimetry Ans: C Complexity: Difficult Ahead: Methods of Nutritional Assessment Subject: Chapter 5 Title: Nutritional Assessment Taxonomy: Analysis

True/False

1. True or False? Adipose tissue functions as an endocrine organ in the body.

Ans: True Complexity: Moderate Ahead: Anatomy and Physiology Subject: Chapter 5 Title: Nutritional Assessment Taxonomy: Application

2. True or False? The Weiss urochrome test is used to evaluate urine sediment volume in relationship to total urine calcium.

Ans: False Complexity: Moderate Ahead: Methods of Nutritional Assessment Subject: Chapter 5 Title: Nutritional Assessment Taxonomy: Application

Essay

1. What are three measures used to assess body composition and what do they assess?

Ans: Mid-arm muscle circumference measures the distance around the biceps and other muscles of the arm, triceps skinfold measures with width of a fold of skin taken over the triceps muscle, bioelectrical impedance analysis/bioimpedance spectroscopy estimates body composition and body fat, BMI is a measure of weight and height.

Complexity: Difficult Ahead: Methods of Nutritional Assessment Subject: Chapter 5 Title: Nutritional Assessment Taxonomy: Analysis

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Chapter: Chapter 06 - Quiz

Multiple Choice

1. Which of the following is involved in emotions?

A) Limbic system B) Cranial nerves C) Cerebellum D) Hippocampus Ans: A Complexity: Moderate Ahead: Anatomy and Physiology of the Brain Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Application

2. Which of the following structures is responsible for sensory and motor functions of the head and upper body?

A) Hippocampus B) Amygdala C) Frontal lobe D) Cranial nerves Ans: D Complexity: Easy Ahead: Anatomy and Physiology Review of the Brain Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Recall

3. A patient reports having trouble falling asleep many nights, waking up very early many nights, and difficulty concentrating. Which of the following is most closely associated with this pattern?

A) Depression B) General anxiety C) Bipolar disorder

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D) PTSD Ans: B Complexity: Moderate Ahead: Health History Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Application

4. The physician has discovered that the patient is unable to concentrate, claims a sense of superiority, appears to have thoughts that move faster than her ability to articulate them, sleeps little, and has added a number of hobbies and personal projects to her routine. What mnemonic did the physician most likely use to uncover this information?

A) SIGECAPS B) PQRST C) DIGFAST D) SAFE Ans: C Complexity: Difficult Ahead: Health History Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Analysis

5. Which component of the SAFE acronym would be used to assess if a patient feels safe with their partner?

A) S B) A C) F D) E Ans: A Complexity: Easy Ahead: Health History Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Recall

6. Use of alcohol and recreational drugs is information discussed as part of which of the following?

A) The past medical history B) Family history C) Social history D) Assessment Ans: C Complexity: Easy Ahead: Health History Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Recall

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7. A patient who is unsure of where they are and what’s happening, can’t pay attention to questions for long, and seems to give odd or unusual responses to certain stimuli is in what level of consciousness?

A) Lethargy B) Stupor C) Confusion D) Delirium Ans: D Complexity: Easy Ahead: Mental Status Examination Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Recall

8. A patient presents wearing inappropriate clothing for the season and having lost weight since his last visit. He is somewhat uncooperative, with a labile affect. His motor behavior is rigid and he appears to have difficulty with short-term memory. Which of these illnesses does this most closely suggest?

A) Dementia B) Depression C) Delirium D) Bipolar disorder Ans: A Complexity: Difficult Ahead: Mental Status Examination Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Analysis

9. A patient who presents as underweight and with fine, dry skin and downy hair on his or her hands and face shows signs of which disorder?

A) Bulimia B) Dementia C) Generalized anxiety disorder D) Anorexia Ans: D Complexity: Moderate Ahead: Mental Status Examination Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Application

10. A Folstein Mini-Mental Status Examination score of 18 signifies which of the following?

A) Dementia B) A healthy cognitive score C) An affective disorder D) Cognitive impairment Ans: B Complexity: Difficult Ahead: Mental Status Examination

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Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Analysis

11. What appears in new mothers as anxiety, tearfulness, irritability, and depression and usually lasts 10 days or less?

A) The “baby blues” B) Postpartum depression C) Postpartum psychosis D) SIGECAPS Ans: A Complexity: Easy Ahead: Diagnostic Reasoning Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Recall

12. Which of the following statements represents a typical change that aging brings to a geriatric patient?

A) Patients are more adept at identifying and verbalizing their feelings.

B) Patient is taking multiple medications for multiple diseases, complicating assessment of mental status.

C) In younger years, patient was charming and cheerful; now presents as abrasive and disillusioned.

D) Patient is more willing to ask questions about items not understood.

Ans: B Complexity: Difficult Ahead: Diagnostic Reasoning Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Analysis

True/False

1. True or False? Observing a patient’s facial tone and facial muscle strength can give initial clues to the condition of their cranial nerves.

Ans: True Complexity: Moderate Ahead: Anatomy and Physiology Review of the Brain Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Application

2. True or False? A patient showing four symptoms of SIGECAPS and anhedonia over the past 10 days may be diagnosed as having major depression.

Ans: False Complexity: Difficult Ahead: Health History

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Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Analysis

3. True or False? Delirium sets in rapidly, whereas dementia takes time and increases slowly.

Ans: True Complexity: Moderate Ahead: Health History Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Application

4. True or False? The acronym ADL represents a guide to assessment of domestic abuse and risk of danger.

Ans: False Complexity: Easy Ahead: Health History Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Recall

5. True or False? Patients with schizophrenia present with a flat or inappropriate affect, paranoid thoughts, hallucinations, rigid or withdrawn motor behavior, and disorganized speech.

Ans: True Complexity: Moderate Ahead: Mental Status Examination Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Application

6. True or False? Only adults should participate in interviews with open-ended questions as part of a mental status examination.

Ans: False Complexity: Moderate Ahead: Diagnostic Reasoning Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Application

Essay

1. What four major topics should be discussed with the patient to gain a past medical history (PMI)?

Ans: Past health conditions/surgeries, trauma, abuse, and medications Complexity: Difficult

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Ahead: Health History Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Recall

2. A physician notes that a patient’s skin, mouth, gastrointestinal, and musculoskeletal systems show symptoms of a mental health disorder. What is the likely disorder, and what are the likely symptoms?

Ans: Bulimia; abrasions on hands, tooth erosion, self-induced vomiting, and muscular weakness Complexity: Difficult Ahead: Health History Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Analysis

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Chapter: Chapter 07 - Quiz

Multiple Choice

1. Which layer of epidermis is mostly found in the skin on hands and feet?

A) Stratum corneum B) Stratum lucidum C) Stratum granulosum D) Stratum germinativum Ans: B Complexity: Moderate Ahead: Anatomy and Physiology Review of the Integumentary System Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Application

2. Most hair follicles originate in which level of the skin?

A) Epidermis B) Subcutaneous layer C) Adipose layer D) Dermis Ans: D Complexity: Moderate Ahead: Anatomy and Physiology Review of the Integumentary System Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Application

3. A patient’s chart mentions that their particular skin ailment is “confluent.” What does this describe?

A) Morphology B) Structure C) Distribution D) Turgor Ans: C

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Complexity: Difficult Ahead: Physical Examination Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Analysis

4. A patient presents with red papules and areas of plaque on her skin and irregular formations of exfoliated, keratinized cells. What is the most likely ailment?

A) Psoriasis B) Eczema C) Acne D) Discoid lupus Ans: A Complexity: Difficult Ahead: Physical Examination Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Analysis

5. The physician has determined that plaque on a patient’s skin is less likely granuloma annulare and more likely a dermatophyte. How did she make this determination?

A) Noticed the red papules B) Tested the apocrine secretions C) Scraped the skin with a #15 blade D) Pared the surface Ans: C Complexity: Difficult Ahead: Physical Examination Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Analysis

6. An area of the patient’s arm has very smooth skin and lacks any apparent superficial features. This is likely what?

A) Psoriasis B) Hypokeratinization C) A scar D) A skin tag Ans: C Complexity: Moderate Ahead: Physical Examination Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Recall

7. A patient with greasy, adherent scales on coalescing macules along the brow and scalp most likely has what form of dermatitis?

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A) Allergic contact B) Seborrheic C) Stasis D) Atopic Ans: B Complexity: Easy Ahead: Physical Examination Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Recall

8. Which of the following typically appears on the head or face ?

A) Verruca B) Dermatofibroma C) Actinic keratosis D) Neurofibroma Ans: D Complexity: Moderate Ahead: Physical Examination Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Application

9. Which of the following is a premalignant disease?

A) Actinic keratosis B) Paget’s disease C) Lipoma D) Granuloma annulare Ans: A Complexity: Easy Ahead: Physical Examination Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Recall

10. The physician has used the Wood’s light exam to look more closely at a patient’s skin. What did this tell the physician?

A) Whether the disease is M. canis or M. distortum B) The exact pathology of a skin finding C) Whether the disease was contact-related or internal D) Whether the disorder lies in the epidermis or dermis Ans: D Complexity: Difficult Ahead: Diagnostic Reasoning Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Analysis

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11. Which of the following is the least common pruritic condition of pregnancy?

A) PUPP B) Pemphigoid gestationis C) Prurigo gravidarum D) ICP Ans: B Complexity: Moderate Ahead: Diagnostic Reasoning Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Application

12. A patient is suspected to have allergic or contact dermatitis. Which of the following diagnostic tests should be used?

A) Patch testing B) Biopsy C) Serum total IgE D) KOH scraping Ans: C Complexity: Difficult Ahead: Diagnostic Reasoning Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Analysis

True/False

1. True or False? Eccrine glands originate in the dermis and open directly to the surface of the skin.

Ans: True Complexity: Moderate Subject: Chapter 7 Title: Integumentary Disorders Ahead: Anatomy and Physiology Review of the Integumentary Systems Taxonomy: Application

2. True or False? “Histologic evaluation” is another term for biopsy.

Ans: True Complexity: Easy Ahead: Health History Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Recall

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3. True or False? Keratinization is an inherited skin disorder linked to the father’s side of the family.

Ans: False Complexity: Moderate Ahead: Health History Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Application

4. True or False? Hirsutism is a medical condition related to females rather than males.

Ans: True Complexity: Easy Ahead: Physical Examination Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Recall

5. True or False? Seborrheic keratosis, moles, and hemangiomas can generally appear anywhere on a person’s body.

Ans: False Complexity: Difficult Ahead: Physical Examination Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Analysis

6. True or False? Shave biopsies, punch biopsies, and excisional biopsies require suturing for closure.

Ans: False Complexity: Moderate Ahead: Diagnostic Reasoning Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Application

Essay

1. What is the mnemonic for evaluating pigmented lesions through surface microscopy, and what do the letters stand for?

Ans: ABCDE: Asymmetry, border irregularity, color variegation, diameter > 6 mm, and elevation/enlargement Complexity: Difficult Ahead: Diagnostic Reasoning Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Analysis

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2. The text lists five general varieties of common skin conditions in pediatric patients. Name them and give an example.

Ans: Bacterial infections; viral infections; superficial fungal infections; infestations; and chronic relapsing conditions. (Examples will vary.)

Complexity: Difficult Ahead: Diagnostic Reasoning Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Analysis

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Chapter: Chapter 08 - Quiz

Multiple Choice

1. Which of the following is true of aqueous humor?

A) It fills the anterior chamber while the fetus is developing and remains unchanged throughout a person’s life.

B) It is a clear liquid that is found between the lens and retina.

C) It receives nutrients from the vitreous humor.

D) It is continuously produced by the ciliary body.

Ans: D Complexity: Moderate Ahead: Anatomy and Physiology Review of the Eye Subject: Chapter 8 Title: Eye Disorders Taxonomy: Application

2. What causes benign floaters?

A) Bits of vitreous tugging on retinal tissue B) Retinal trauma C) Unbalanced intraocular pressure D) Damaged optic nerve Ans: A Complexity: Easy Ahead: Anatomy and Physiology Review of the Eye Subject: Chapter 8 Title: Eye Disorders Taxonomy: Recall

3. Which of the following is true of the optic disc?

A) It contains the fovea and macula.

B) It lacks retinal receptors.

C) It is protected by the cornea.

D) It is the only part of the internal eye with nerve fibers.

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Ans: B Complexity: Difficult Ahead: Anatomy and Physiology Review of the Eye Subject: Chapter 8 Title: Eye Disorders Taxonomy: Analysis

4. A healthcare provider asks a patient whether or not he or she wears contact lenses. This is part of which section of the patient’s health history?

A) Past medical history B) Chief complaint C) Social history D) Family history Ans: A Complexity: Moderate Ahead: Health History Subject: Chapter 8 Title: Eye Disorders Taxonomy: Application

5. Why is asking about tobacco use important as part of a social history?

A) Smoke can scar the cornea.

B) The chemicals in tobacco smoke can cloud the vitreous humor.

C) Cigarette use is associated with the appearance and frequency of floaters.

D) Long-term tobacco use causes predictable vascular changes in the fundus.

Ans: D Complexity: Moderate Ahead: Health History Subject: Chapter 8 Title: Eye Disorders Taxonomy: Application

6. A farmer working in wind-blown fields is most susceptible to what ailment?

A) Viral conjunctivitis B) Pterygium C) Myasthenia gravis D) Proptosis Ans: B Complexity: Difficult Ahead: Physical Examination Subject: Chapter 8 Title: Eye Disorders Taxonomy: Analysis

7. Presbyopia is a failure of the eye to accommodate what?

A) Bright light B) Very near vision

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C) Distant vision D) Subtle color shifts Ans: B Complexity: Easy Ahead: Physical Examination Subject: Chapter 8 Title: Eye Disorders Taxonomy: Recall

8. Using a slit lamp biomicroscope, the physician is most likely to find evidence of what?

A) Hyphema B) Obstructed lacrimal ducts C) Nystagmus D) Papilledema Ans: A Complexity: Difficult Ahead: Physical Examination Subject: Chapter 8 Title: Eye Disorders Taxonomy: Analysis

9. The physician tests a patient’s corneal reflex. One eye closes. Which of the following is most likely true?

A) The patient was awake and conscious.

B) This is a normal response.

C) Intracranial pressure may be elevated.

D) The physician used an ultra-thin 31-gauge needle.

Ans: C Complexity: Difficult Ahead: Physical Examination Subject: Chapter 8 Title: Eye Disorders Taxonomy: Analysis

10. Which of the following is not true regarding an ophthalmoscopic examination?

A) The room should be darkened to dilate the patient’s pupil.

B) The patient should focus on a distant object on the wall.

C) Glasses and contact lenses should be removed.

D) To examine a patient’s right eye, the physician should hold the scope in the right hand.

Ans: C Complexity: Easy Ahead: Physical Examination Subject: Chapter 8 Title: Eye Disorders Taxonomy: Remember

11. Which of the following differential diagnoses requires observation and referral to ophthalmology?

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A) Hyphema B) Foreign body C) Corneal abrasion D) Herpetic lesion Ans: A Complexity: Moderate Ahead: Diagnostic Reasoning Subject: Chapter 8 Title: Eye Disorders Taxonomy: Application

12. Parents bring a 5-month-old infant for an examination. Which of the following will be true?

A) The infant’s peripheral vision will not fully have developed yet.

B) The infant’s eyes are now able to perceive a single, undoubled image.

C) It is appropriate for the physician to perform the cover-uncover test.

D) The infant likely cannot distinguish colors yet.

Ans: D Complexity: Difficult Ahead: Diagnostic Reasoning Subject: Chapter 8 Title: Eye Disorders Taxonomy: Analysis

True/False

1. True or False? The sclera merges with the cornea at the limbus.

Ans: True Complexity: Moderate Ahead: Anatomy and Physiology Review of the Eye Subject: Chapter 8 Title: Eye Disorders Taxonomy: Application

2. True or False? A person reading a book looks up and focuses on something in the distance. To do this, the eyes must decrease lens curvature, relax the pupils, and reduce convergence.

Ans: True Complexity: Difficult Ahead: Anatomy and Physiology Review of the Eye Subject: Chapter 8 Title: Eye Disorders Taxonomy: Analysis

3. True or False? The testing of visual fields is the “vital sign” in ophthalmology.

Ans: False Complexity: Moderate

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Ahead: Physical Examination Subject: Chapter 8 Title: Eye Disorders Taxonomy: Application

4. True or False? Paleness of conjunctiva may indicate severe anemia.

Ans: True Complexity: Moderate Ahead: Physical Examination Subject: Chapter 8 Title: Eye Disorders Taxonomy: Application

5. True or False? Fundoscopy in the primary-care setting generally offers a complete and fully adequate examination.

Ans: False Complexity: Moderate Ahead: Physical Examination Subject: Chapter 8 Title: Eye Disorders Taxonomy: Application

6. True or False? A pregnant woman’s eyes tend to be more sensitive and dry.

Ans: True Complexity: Easy Ahead: Diagnostic Reasoning Subject: Chapter 8 Title: Eye Disorders Taxonomy: Recall

Essay

1. What steps are involved in inspecting the eyelids and eyelashes? During which step may ptosis be noticed?

Ans: (1) Assess symmetry, position, closure; (2) inspect eyelids for color, swelling, lesions, nodules, styes, discharge; (3) inspect for entropion or ectropion; and (4) assess blinking. Ptosis may be noted in the first step.

Complexity: Difficult Ahead: Physical Examination Subject: Chapter 8 Title: Eye Disorders Taxonomy: Analysis

2. What is cupping, what test and instrument discovers it, and what disease does it suggest?

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Ans: Cupping is an irregularity in the physiological cup. It may be larger than normal or asymmetric. This is discovered using an ophthalmoscope during fundoscopic assessment and suggests glaucoma.

Complexity: Difficult Ahead: Physical Examination Subject: Chapter 8 Title: Eye Disorders Taxonomy: Analysis

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Chapter: Chapter 09 - Quiz

Multiple Choice

1. Which of the following parts of the outer ear is composed of fat and subcutaneous tissue?

A) Lobule B) Sebaceous glands C) Posterior muscles D) Tragus Ans: A Complexity: Easy Ahead: Anatomy and Physiology Review of the Ear Subject: Chapter 9 Title: Ear Disorders Taxonomy: Recall

2. Which of the following is true of the eustachian tube in infants?

A) The tube is more vertical compared to that of the adult.

B) The bony portion is never open.

C) The cartilaginous portion lies higher compared to that of the adult.

D) The bony portion is relatively longer and wider compared to that of the adult.

Ans: D Complexity: Moderate Ahead: Anatomy and Physiology Review of the Ear Subject: Chapter 9 Title: Ear Disorders Taxonomy: Application

3. Which of the following is most likely associated with BPPV? A) An unsettled/unbalanced sensation lasting for hours at a time B) Brief episodes of dizziness associated with head movement C) Clear discharge D) Otalgia Ans: B Complexity: Moderate

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Ahead: Health History Subject: Chapter 9 Title: Ear Disorders Taxonomy: Application

4. Which form of otorrhea is most likely associated with physical trauma?

A) Clear, watery fluid B) Yellow fluid C) Clear, mucoid fluid D) Brown fluid Ans: A Complexity: Difficult Ahead: Health History Subject: Chapter 9 Title: Ear Disorders Taxonomy: Analysis

5. Which of the following syndromes or illnesses is not associated with ear conditions?

A) Stickler syndrome B) Leukemia C) Trisomy 13 D) CHARGE association Ans: B Complexity: Moderate Ahead: Health History Subject: Chapter 9 Title: Ear Disorders Taxonomy: Application

6. A patient arrives complaining of significant vertigo, which began after a sneezing fit and is persisting.

Before the fit, the patient had not experienced notable ear problems. What most likely happened?

A) The mastoid bone, deteriorated by anaerobic infection, broke.

B) The patient is showing early symptoms of Meniere’s disease.

C) The patient aggravated latent otitis media.

D) The patient ruptured the round window in one or both inner ears.

Ans: C Complexity: Difficult Ahead: Health History Subject: Chapter 9 Title: Ear Disorders Taxonomy: Analysis

7. The physician observes the patient and notes that his head is not rotated toward either side, his head is tilted toward the left ear, and he shows no reluctance to move his head in various directions. What does this most likely suggest?

A) A well patient B) Otalgia in the left ear

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C) Hearing loss in the right ear D) Vertigo Ans: B Complexity: Moderate Ahead: Physical Examination Subject: Chapter 9 Title: Ear Disorders Taxonomy: Application

8. During the physical examination, the physician notices visible blood vessels in the center of the patient’s tympanic membrane. What is the likeliest diagnosis?

A) Acute or chronic otitis B) Bone exostoses C) A normal, healthy tympanic membrane D) Tympanosclerosis Ans: A Complexity: Difficult Ahead: Physical Examination Subject: Chapter 9 Title: Ear Disorders Taxonomy: Analysis

9. What hearing test is specifically designed to compare air conduction to bone conduction?

A) Rinne B) Weber C) Whisper D) Tympanic Ans: A Complexity: Easy Ahead: Physical Examination Subject: Chapter 9 Title: Ear Disorders Taxonomy: Recall

10. Lateralization of intensity of tone in a tuning fork test to the patient’s right ear is most likely symptomatic of what?

A) Normal functioning B) Conductive hearing loss in left ear C) Sensorineural hearing loss in the right ear D) Conductive hearing loss in the right ear Ans: D Complexity: Difficult Ahead: Physical Examination Subject: Chapter 9 Title: Ear Disorders Taxonomy: Analysis

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11. Which type of otalgia can be tested using a is?media tAy)mApcaunte o gortaitm B) Serous otitis C) Chronic otitis media D) Trauma Ans: B Complexity: Moderate Ahead: Diagnostic Reasoning Subject: Chapter 9 Title: Ear Disorders Taxonomy: Application

12. Which of the following is typical or common in a geriatric patient?

A) Shortened pinna B) Decreased amount and coarseness of hair growth on external ear canal C) Decreasing prevalence of tinnitus D) Presbycusis Ans: D Complexity: Easy Ahead: Diagnostic Reasoning Subject: Chapter 9 Title: Ear Disorders Taxonomy: Recall

True/False

1. True or False? Sound waves affect and interact with the pars tensa, malleus, incus, stapes, and the fluid of the inner ear.

Ans: True Complexity: Moderate Ahead: Anatomy and Physiology Review of the Ear Subject: Chapter 9 Title: Ear Disorders Taxonomy: Application

2. True or False? Tinnitus affects nearly one-third of the adult population.

Ans: False Complexity: Easy Ahead: Health History Subject: Chapter 9 Title: Ear Disorders Taxonomy: Recall

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3. True or False? Exposures to rubella, cytomegalovirus, and herpes simplex in utero are linked to later hearing loss.

Ans: True Complexity: Moderate Ahead: Health History Subject: Chapter 9 Title: Ear Disorders Taxonomy: Application

4. True or False? A patient’s pinnae are fully below the level of an imaginary line drawn from the outer canthus of her ipsilateral eye to the occiput. This may be associated with congenital hearing loss in the patient.

Ans: True Complexity: Difficult Ahead: Physical Examination Subject: Chapter 9 Title: Ear Disorders Taxonomy: Analysis

5. True or False? The bulb of an otoscope is used to apply both positive and negative pressure to the tympanic membrane so its movement can be studied.

Ans: True Complexity: Moderate Ahead: Physical Examination Subject: Chapter 9 Title: Ear Disorders Taxonomy: Application

6. True or False? Neonates can discriminate a full spectrum of sounds, but respond best to low and midrange tones, or “brown noise.”

Ans: False Complexity: Moderate Ahead: Diagnostic Reasoning Subject: Chapter 9 Title: Ear Disorders Taxonomy: Application

Essay

1. What are the six categories of questions to ask and information to gain in the health history of a patient whose chief complaint is vertigo?

Ans: Onset, duration, frequency/regularity, severity, precipitating factors, aggravating/alleviating factors Complexity: Difficult Ahead: Health History Subject: Chapter 9 Title: Ear Disorders

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Taxonomy: Analysis

2. What behaviors and medical conditions in a pregnant patient are noted to cause ear abnormalities and problems in the developing fetus?

Ans: Smoking, exposure to viral infections, maternal diabetes, Rh incompatibility, toxemia of pregnancy Complexity: Difficult Ahead: Diagnostic Reasoning Subject: Chapter 9 Title: Ear Disorders Taxonomy: Analysis

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Chapter: Chapter 10 - Quiz

Multiple Choice

1. A physician has just directly examined a patient’s sinuses. Which sinuses could these have been?

A) Ethmoidal B) Superciliary C) Sphenoidal D) Maxillary Ans: D Complexity: Difficult Ahead: Advanced Assessment of Nose and Sinus Disorders Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Analysis

2. Where are olfactory receptors located?

A) The mucosa in the upper part of the nasal cavity B) The nasal vestibule C) The inferior nasal turbinate D) The nasopharynx Ans: A Complexity: Easy Ahead: Advanced Assessment of Nose and Sinus Disorders Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Recall

3. Which of the following best describes diphenhydramine?

A) A pain reliever B) A decongestant C) An expectorant D) An antihistamine Ans: D Complexity: Moderate

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Ahead: Health History Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Application

4. A patient complains of nasal congestion. Which medication is most likely responsible?

A) Beta blockers B) Aspirin C) Ginkgo biloba D) Hormone replacement therapy Ans: A Complexity: Difficult Ahead: Health History: Nose and Sinus Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Analysis

5. A patient presents with pale, boggy turbinates. What is the most likely reason?

A) Scratching B) Infection C) Allergies D) A healthy patient Ans: C Complexity: Moderate Ahead: Physical Examination Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Application

6. A patient presents with congestion, clear rhinorrhea, sinus pain, and patches of eczema. Knowing that there is a risk of anaphylaxis, what test can the physician recommend that will be safe for the patient and help target the specific reason for the symptoms?

A) RAST B) The TSH test C) Eosinophil counts D) Ultrasound of the facial sinuses Ans: A Complexity: Difficult Ahead: Diagnostic Reasoning Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Analysis

7. Which of the following is related to nosebleeds in a pregnant patient?

A) Drop in progesterone B) Increased vascularity C) Increased circulation fluid volume

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D) Normal spikes in blood pressure Ans: B Complexity: Moderate Ahead: Diagnostic Reasoning Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Application

8. Which of the following is true?

A) The oropharynx contains the pharyngeal tonsils.

B) The nasopharynx leads to the oropharynx, which leads to the laryngopharynx.

C) The laryngopharynx grasps food and moves it toward the esophagus.

D) The oropharynx connects with the submandibular gland to promote salivation and swallowing.

Ans: B Complexity: Difficult Ahead: Advanced Assessment of Mouth and Throat Disorders Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Analysis

9. Sore throats associated with bacterial infections are described as what?

A) A mild and untroubling soreness B) Scratchy or itchy C) Very sore, and may interfere with swallowing D) Ticklish Ans: C Complexity: Easy Ahead: Health History: Mouth and Throat Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Recall

10. Which of the following is true of bacterial pharyngitis?

A) There are no diagnostic tests.

B) It is associated with rapid onset.

C) It most often presents in the winter or early spring.

D) A quick beta strep can be used for diagnosis.

Ans: B Complexity: Difficult Ahead: Health History: Mouth and Throat Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Analysis

11. How can smoking affect the gums?

A) Through vasoconstriction B) By finely coating them with tar so saliva cannot clean them

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C) Through sloughing by the physical action of smoking D) Dilating the blood vessels and increasing likelihood of bleeding Ans: A Complexity: Moderate Ahead: Health History: Mouth and Throat Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Application

12. Which of the following is a common consideration for the geriatric patient?

A) Varicose veins on the underside of the tongue B) Increased saliva production C) Heightened sense of taste D) Overly moist oral mucosa Ans: A Complexity: Easy Ahead: Diagnostic Reasoning: Mouth and Throat Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Recall

True/False

1. True or False? Only the nasal cavity is lined with cilia.

Ans: False Complexity: Moderate Ahead: Advanced Assessment of Nose and Sinus Disorders Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Application

2. True or False? Nasal sprays, if used more than three days, may lead to “rebound congestion.”

Ans: True Complexity: Easy Ahead: Health History: Nose and Sinuses Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Recall

3. True or False? Cocaine use may lead to nasal polyps.

Ans: False Complexity: Moderate Ahead: Physical Examination Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders

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Taxonomy: Application

4. True or False? A typical physical examination of a patient’s mouth includes palpation of lips, gums, tongue, and lymph nodes.

Ans: False Complexity: Difficult Ahead: Physical Examination: Mouth and Throat Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Analysis

5. True or False? Rhinitis is the most frequent cause of tooth and mouth pain.

Ans: False Complexity: Moderate Ahead: Health History: Mouth and Throat Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Application

6. True or False? Asymmetrical movement of the uvula is a normal response in Caucasian populations.

Ans: False Complexity: Moderate Ahead: Physical Examination: Mouth and Throat Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Application

Essay

1. Describe how to palpate a patient’s sinuses.

Ans: Place your thumbs on the patient’s forehead at the orbital ridge (eyebrow) and press upward on the eyebrow to palpate the frontal sinuses. Then move your thumbs to each side of the patient’s cheeks and apply gentle pressure upward just below the cheekbones, on the maxillary area. Note any evidence of a crackling sensation during palpation.

Complexity: Difficult Ahead: Physical Examination: Nose and Sinus Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Analysis

2. At approximately what age should a physician expect to find a pediatric patient’s first tooth? At what age should they expect to find all deciduous teeth? How many deciduous teeth in total are there?

Ans: Six months; 3 years; 20 teeth

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Complexity: Difficult Ahead: Diagnostic Reasoning: Mouth and Throat Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Analysis

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Chapter: Chapter 11 - Quiz

Multiple Choice

1. Under normal conditions, an adult takes how many breaths in a minute?

A) 6 to 10 B) 12 to 20 C) 4 to 8 D) 10 to 15 Ans: B Complexity: Easy Ahead: Anatomy and Physiology Review of the Respiratory Systems Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Recall

2. Which of the following is true of the respiratory system?

A) The larynx is part of the upper respiratory tract.

B) Exhalation leads to the increase of blood acid levels.

C) Breathing is controlled by the cerebellum.

D) Breathing is initiated by the brain stem.

Ans: D Complexity: Difficult Ahead: Anatomy and Physiology Review of the Respiratory Systems Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Analysis

3. What does a low-pitched cough signify?

A) Secretions or inflammation B) Airway constriction C) Cardiac problems D) Tuberculosis Ans: A Complexity: Moderate

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Ahead: Health History Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Application

4. Which of the following respiratory rates is seen with hyperventilatory states?

A) Eupnea B) Tachypnea C) Bradypnea D) Hyperpnea Ans: B Complexity: Difficult Ahead: Health History Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Analysis

5. Which of the following is a potentially normal breathing pattern for children in their sleep?

A) Kussmaul B) Cheyne-Stokes C) Sigh D) Biot Ans: B Complexity: Moderate Ahead: Health History Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Application

6. According to the text, bronchiolitis is correlated with respiratory symptoms that affect which body system?

A) Skin B) Cardiovascular C) Gastrointestinal D) Neurological Ans: B Complexity: Difficult Ahead: Health History Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Analysis

7. What symptom of high thoracic pressure can be found by visual inspection?

A) Retracted chest wall B) Venous patterns on the chest C) Kyphosis D) Clubbing of fingers

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Ans: B Complexity: Moderate Ahead: Physical Exam Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Application

8. Fremitus is examined during which part of the physical exam?

A) Palpation B) Auscultation C) Percussion D) Inspection Ans: A Complexity: Difficult Ahead: Physical Examination Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Analysis

9. What is the palpable vibration of the chest wall resulting from speech?

A) Fremitus B) Thoracic expansion C) Diaphragmatic excursion D) Lordosis Ans: A Complexity: Easy Ahead: Physical Exam Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Recall

10. Which type of breath sound can be described as hollow and low-pitched?

A) Vesicular B) Bronchovesicular C) Bronchial D) Amphoric Ans: D Complexity: Moderate Ahead: Physical Exam Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Application

11. In the third trimester of pregnancy, a woman’s costal angle is about how many degrees greater than it typically was before pregnancy?

A) 35 degrees B) 103 degrees C) 45 degrees

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D) 27 degrees Ans: A Complexity: Difficult Ahead: Diagnostic Reasoning Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Analysis

12. A pregnant patient’s tidal volume typically changes by how much?

A) Decreases by 20% B) Increases by 40% C) Doubles D) Is halved Ans: B Complexity: Easy Ahead: Diagnostic Reasoning Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Recall

True/False

1. True or False? Respiration is a four-step process: two inhalation steps and two exhalation steps.

Ans: False Complexity: Moderate Ahead: Anatomy and Physiology Review of the Respiratory Systems Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Application

2. True or False? If sputum onset is acute, the cause is probably an infection.

Ans: True Complexity: Easy Ahead: Health History Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Recall

3. True or False? Hepatitis, Marburg, yellow fever, cholera, and meningitis are all travel-related diseases.

Ans: True Complexity: Moderate Ahead: Health History Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Application

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4. True or False? It is considered normal for the trachea to have a slight deviation to the patient’s right side.

Ans: True Complexity: Difficult Ahead: Physical Examination Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Analysis

5. True or False? Emphysema is associated with barrel chest and absent fremitus.

Ans: True Complexity: Moderate Ahead: Physical Exam Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Application

6. True or False? Because their respiratory systems are not fully developed, the breath sounds of young pediatric patients are often quieter, higher-pitched, and more nasal than those of an adult.

Ans: False Complexity: Moderate Ahead: Diagnostic Reasoning Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Application

Essay

1. What are the common chief complaints of the respiratory system examined in the text?

Ans: Cough, chest pain, sputum production, dyspnea, abnormal respiratory rate Complexity: Difficult Ahead: Health History Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Analysis

2. What are the four ways breath sounds are characterized, and what are the three classifications?

Ans: Pitch, intensity, quality, and relative duration; vesicular, bronchovesicular, bronchial Complexity: Difficult Ahead: Physical Examination Subject: Chapter 11 Title: Respiratory Disorders

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Taxonomy: Analysis

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Chapter: Chapter 12 - Quiz

Multiple Choice

1. Which of the following is true of the cardiac cycle?

A) The ventricles are nearly emptied during the systole.

B) S1 and S2 are related to diastole; S3 and S4 are related to systole.

C) Atrial contraction occurs late in the systole.

D) During the diastole, the atria fill with blood.

Ans: A Complexity: Difficult Ahead: Anatomy and Physiology Review of the Cardiovascular System Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Analysis

2. Which of the following layers of cardiac muscle is the thin, outermost protective layer of the heart?

A) Bronchocardium B) Endocardium C) Myocardium D) Epicardium Ans: D Complexity: Easy Ahead: Anatomy and Physiology Review of the Cardiovascular System Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Recall

3. Which of the following waveforms on an ECG represents the wave of depolarization?

A) P B) PR C) QRS complex D) ST segment Ans: A Complexity: Moderate

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Ahead: Anatomy and Physiology Review of the Cardiovascular System Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Application

4. The patient complains of chest pain that comes on when he vacuums the house or mows the lawn. It comes in a fairly consistent pattern, usually lasting about 1 minute. When he feels it, he drinks a glass of water, sits quietly on the couch, and it typically goes away. What is the most likely type of problem?

A) Anginal B) Musculoskeletal C) Pleural D) Gastrointestinal Ans: A Complexity: Difficult Ahead: Health History Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Analysis

5. Calf tenderness and warmth, swelling and ankle edema, and an otherwise unexplained fever are symptoms of what?

A) Congestive heart failure B) Deep vein thrombosis C) Arteriosclerosis D) Obstructed cardiac valves Ans: B Complexity: Moderate Ahead: Health History Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Application

6. Which of the following examples of JVP activity is related to the tricuspid opening normally?

A) The Y descent B) Prominent V wave C) Large A wave D) C wave Ans: A Complexity: Difficult Ahead: Physical Examination Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Analysis

7. Edema is caused by poor function of which part of the heart?

A) Right ventricle B) Left ventricle

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C) Right atrium D) Left atrium Ans: B Complexity: Moderate Ahead: Physical Examination Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Application

8. Which of the following is true about palpation of the cardiovascular system?

A) The PMI should be palpated within a 2-centimeter radius.

B) Both carotid arteries should be palpated gently and simultaneously to determine a balance of flow.

C) Palpating a thrill around the aorta may indicate left ventricular hypertrophy.

D) It is important to note pitting edema of the extremities, as this may indicate heart failure.

Ans: D Complexity: Difficult Ahead: Physical Examination Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Analysis

9. How is the patient positioned when palpating the precordium and the carotid pulse?

A) Supine B) Standing C) Sitting up D) Resting on right side Ans: A Complexity: Easy Ahead: Physical Examination Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Recall

10. Who would be a likely candidate for receiving an ultrasound of the abdomen as part of a cardiovascular exam?

A) A 66-year-old man with suspected AAA B) A pregnant woman in her second or third trimester C) An 8-year-old girl who complains of not being able to catch her breath D) All 18- to 45-year-old males on well-patient checkups Ans: A Complexity: Difficult Ahead: Diagnostic Reasoning Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Analysis

11. Which of the following traditional auscultatory areas is in the mitral area (PMI)?

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A) Second right intercostal B) First right intercostal C) Third left intercostal D) Fifth left intercostal Ans: D Complexity: Moderate Ahead: Physical Examination Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Application

12. Which of the following is an invasive diagnostic test?

A) EKG B) Ultrasound of abdomen C) Hematologic study D) Chest X-ray Ans: C Complexity: Easy Ahead: Diagnostic Reasoning Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Recall

True/False

1. True or False? Arteries are less flexible than veins.

Ans: True Complexity: Moderate Ahead: Anatomy and Physiology Review of the Cardiovascular System Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Application

2. True or False? LSD and ecstasy are the most important recreational drugs to ask a patient about in terms of cardiac health.

Ans: False Complexity: Easy Ahead: Health History Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Recall

3. True or False? Arcus senilis in the eye is never a normal finding in a patient.

Ans: False Complexity: Moderate

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Ahead: Physical Examination Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Application

4. True or False? When percussing the borders of the heart, an unexpected change from resonance to dullness is usually indicative of pathology.

Ans: False Complexity: Difficult Ahead: Physical Examination Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Analysis

5. True or False? S3 is the sound that results from the passive flow of blood from the atria.

Ans: True Complexity: Moderate Ahead: Physical Examination Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Application

6. True or False? For the neonatal patient, count the apical pulse for at least 30 seconds.

Ans: False Complexity: Moderate Ahead: Diagnostic Reasoning Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Application

Essay

1. What visible markers on a patient’s legs suggest peripheral vascular disease, especially in conjunction with leg pain?

Ans: Temperature changes, color changes, loss of hair, redness, sores Complexity: Difficult Ahead: Health History Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Analysis

2. What are the four heart sounds, and what do they relate to?

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Ans: S1 is the first heart sound. It results from closure of the mitral and tricuspid valves. S2 is the second heart sound. It results from closure of the aortic and pulmonic valves. S3 is an early diastolic sound that results from passive flow of blood from the atria. S4 is a late diastolic sound immediately preceding S1.

Complexity: Difficult Ahead: Physical Examination Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Analysis

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Chapter: Chapter 13 - Quiz

Multiple Choice

1. The endocrine system consists of a number of: A) muscle groups.

B) neural networks.

C) adipose layers.

D) glands.

Ans: D Complexity: Easy Ahead: Anatomy and Physiology Review of the Endocrine System Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Recall

2. Which part of the endocrine system creates chemicals that speed up metabolism?

A) Pituitary gland B) Thyroid gland C) Pancreas D) Hypothalamus Ans: B Complexity: Difficult Ahead: Anatomy and Physiology Review of the Endocrine System Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Analysis

3. What gland secretes cortisol?

A) Pituitary B) Adrenal C) Thyroid D) Pancreas Ans: B Complexity: Moderate

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Ahead: Anatomy and Physiology Review of the Endocrine System Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Application

4. A sudden onset of fatigue, heart palpitations, a constant state of wakefulness, and weight loss together suggest what ailment?

A) Adrenal disease B) Hyperthyroidism C) Diabetes D) Addison’s disease Ans: C Complexity: Difficult Ahead: Health History Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Analysis

5. Lid lag and the presence of a rim of sclera are symptoms of what?

A) Adrenal disorder B) Thyrotoxicosis C) Graves’ disease D) Cushing’s syndrome Ans: B Complexity: Moderate Ahead: Physical Exam Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Application

6. Which of the following symptoms are associated with hypothyroidism?

A) Increased irritability B) Exophthalmos C) Weight loss D) Lethargy Ans: D Complexity: Difficult Ahead: Health History Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Analysis

7. Upon inspecting the skin of a patient, you notice purple striae over the abdomen. Which of the following diseases may be indicated by this finding?

A) Cushing’s syndrome B) Addison’s disease C) Diabetes mellitus

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D) Hypothyroidism Ans: A Complexity: Moderate Ahead: Physical Exam Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Application

8. Plummer’s nails are a sign of what?

A) Thyroid disease B) Adrenal nonfunction C) Renal failure D) Hyperpituitary syndrome Ans: A Complexity: Difficult Ahead: Physical Exam Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Analysis

9. Compression of the jugular removes which of the following?

A) Only a venous hum B) Only a bruit C) Both a venous hum and a bruit D) None of these answers is correct.

Ans: A Complexity: Moderate Ahead: Physical Exam Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Application

10. Which is commonly measured when investigating thyroid function?

A) FT4 B) TT4 C) TT3 D) FT3 Ans: B Complexity: Difficult Ahead: Physical Exam Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Analysis

11. What imaging study is used in diagnosing tumors of various endocrine glands?

A) MRI B) Thyroid ultrasound

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C) TSH test D) Radioactive iodine Ans: A Complexity: Easy Ahead: Physical Exam Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Recall

12. Which of the following is true of congenital hypothyroidism?

A) Clinical manifestations tend to be evident at around 1 month of age.

B) It is not fatal.

C) There is an increased risk in children with Down syndrome.

D) Excessive wakefulness is a clinical manifestation.

Ans: D Complexity: Difficult Ahead: Diagnostic Reasoning Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Analysis

True/False

1. True or False? The tissue in the anterior pituitary gland secretes six different hormones.

Ans: True Complexity: Easy Ahead: Anatomy and Physiology Review of the Endocrine System Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Recall

2. True or False? The heart and stomach produce chemicals that could make them considered part of the endocrine system.

Ans: True Complexity: Moderate Ahead: Anatomy and Physiology Review of the Endocrine System Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Application

3. True or False? An excess of thyroid hormones causes an overabundance of proteins within blood vessels.

Ans: False Complexity: Moderate Ahead: Health History

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Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Application

4. True or False? Asymmetry of the neck muscles potentially suggests an enlarged thyroid.

Ans: True Complexity: Difficult Ahead: Physical Exam Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Analysis

5. True or False? A slight deviation of the trachea to the right is considered normal in palpation; under inspection the trachea should be midline and appear symmetrical.

Ans: True Complexity: Moderate Ahead: Physical Exam Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Application

6. True or False? Pregnant women with hypothyroidism are at increased risk of preeclampsia.

Ans: False Complexity: Moderate Ahead: Diagnostic Reasoning Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Application

Essay

1. How might hypothyroidism manifest in the gastrointestinal, female genitourinary, and musculoskeletal systems?

Ans: Gastrointestinal: constipation; genitourinary: menorrhagia; musculoskeletal: lethargy, with good muscle strength Complexity: Difficult Ahead: Health History Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Analysis

2. Describe the posterior approach to palpating the thyroid.

Ans: Place the fingers of both of your hands on the patient’s neck so that your index fingers are just below the cricoid cartilage. Ask the patient to sip water; as the patient swallows, you should feel the thyroid

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isthmus rise up under your fingers. Sometimes it is not palpable. Displace the trachea to the right with the fingers of your left hand. With the fingers of your right hand, palpate the right lobe of the thyroid between the trachea and the sternomastoid muscle. Examine the left lobe of the thyroid in the same manner.

Complexity: Difficult Ahead: Physical Exam Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Analysis

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Chapter: Chapter 14 - Quiz

Multiple Choice

1. Which of the following is true?

A) Pancreatic secretions promote fat digestion, while liver bile aids in absorption of glucose.

B) Solid organs in the abdominal cavity include the liver, pancreas, gallbladder, and kidneys.

C) Peristalsis pushes food from the duodenum into the central part of the stomach.

D) Most digestion occurs before food reaches the jejunum.

Ans: D Complexity: Difficult Ahead: Anatomy and Physiology Review of the Gastrointestinal System Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Analysis

2. The stomach, spleen, and body of the pancreas all reside in which abdominal quadrant?

A) RUQ B) LUQ C) RLQ D) LLQ Ans: B Complexity: Easy Ahead: Anatomy and Physiology Review of the Gastrointestinal System Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Recall Subject:

3. Periumbilical or epigastric pain that starts as colicky and then localizes to RLQ may be a sign of which of the following gastrointestinal diseases?

A) Diverticulitis B) Biliary stones C) Cholecystitis D) Appendicitis

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Ans: D Complexity: Moderate Ahead: Health History Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Application

4. A patient suffers from severe pain that seems to radiate from the abdomen up into her shoulder. Which of the following are possible?

A) Cholecystitis or biliary stones B) Appendicitis or intestinal obstruction C) Pancreatitis or perforated duodenal ulcer D) Abdominal aneurysm or diverticulitis Ans: C Complexity: Difficult Ahead: Health History Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Analysis

5. Esophageal, stomach, and small bowel resections are all associated with what?

A) Insufficient secretion of insulin B) Malabsorption C) Steatorrhea D) Dumping syndrome Ans: B Complexity: Moderate Ahead: Health History Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Application

6. Which disorder may manifest itself in the largest number of body systems outside the gastrointestinal system?

A) Electrolyte imbalance B) Cancer C) Cirrhosis D) Hepatitis Ans: A Complexity: Difficult Ahead: Health History Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Analysis

7. What do melanin deposits around the oral cavity indicate?

A) Cancer

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B) Peutz-Jeghers syndrome C) Jaundice D) Malnutrition Ans: B Complexity: Moderate Ahead: Physical Examination Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Application

8. Which test requires the patient to place his or her own hand in the middle of the abdomen while the physician performs the test?

A) Test for ascites B) Test for appendicitis C) Test for cholecystitis D) Test for aortic aneurysm Ans: A Complexity: Difficult Ahead: Physical Examination Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Analysis

9. When should a physician touch a patient’s area of known pain and why?

A) Last, because otherwise the pain will reflect and mask other areas B) Last, because inflicting pain causes a patient’s muscles to tense and tighten in anticipation of more pain C) First, to get “the worst” out of the way so the patient can relax D) First, to set the pain in motion and see where it radiates to Ans: B Complexity: Easy Ahead: Physical Examination Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Recall

10. Which of the following is a concern when prescribing gastrointestinal treatments for a geriatric patient?

A) Lipid-soluble drugs can last longer in the patient’s body.

B) An aging body’s tendency toward diarrhea may cause quality-of-life issues.

C) As the number of stomach glands continues to grow, drug absorption becomes increasingly swift.

D) Wear in esophageal valves promotes reflux and heartburn.

Ans: A Complexity: Difficult Ahead: Gastrointestinal Assessment of Special Populations Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Analysis

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11. A patient has mild epigastric tenderness, normal bowel sounds, and signs of peritonitis. What do these symptoms suggest?

A) Cholecystitis B) Peptic ulcer disease C) Pancreatitis D) Cirrhosis Ans: B Complexity: Moderate Ahead: Diagnostic Reasoning Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Application

12. Which of the following is true regarding geriatric patients?

A) Constipation becomes less of a problem.

B) Esophageal reflux can be caused by weakening of the cardiac sphincter.

C) Pancreatic atrophy is rare.

D) The number of stomach glands decreases.

Ans: B Complexity: Easy Ahead: Diagnostic Reasoning Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Recall

True/False

1. True or False? All parts of the human colon reside in the two lower quadrants of the abdomen.

Ans: False Complexity: Moderate Ahead: Anatomy and Physiology Review of the Gastrointestinal System Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Application

2. True or False? The color of vomitus may help determine the cause.

Ans: True Complexity: Easy Ahead: Health History Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Recall

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3. True or False? Polydipsia, polyuria, and asthenia are all related to ulcerative colitis.

Ans: False Complexity: Moderate Ahead: Health History Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Application

4. True or False? Spider angiomas are a progressive and degenerative disease associated with the liver.

Ans: False Complexity: Difficult Ahead: Physical Examination Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Analysis

5. True or False? Murphy’s sign is inspiratory arrest.

Ans: True Complexity: Moderate Ahead: Physical Examination Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Application

6. True or False? Umbilical hernias are typically surgically corrected.

Ans: False Complexity: Moderate Ahead: Gastrointestinal Assessment of Special Populations Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Application

Essay

1. What ailments of the skin may be related to gastrointestinal disorders?

Ans: Rash, itching, pigmentation changes, moisture or dryness, texture, changes in hair growth or loss, nail changes, jaundice Complexity: Difficult Ahead: Health History Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Analysis

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2. The physician is auscultating and hears what sounds like sandpaper being rubbed. Which organ is involved? What are the possible conditions causing this sound?

Ans: Liver; hepatoma, cholangiocarcinoma, viral hepatitis, alcoholic hepatitis Complexity: Difficult Ahead: Apply Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Analysis

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Chapter: Chapter 15 - Quiz

Multiple Choice

1. Which of the following is true?

A) Electrical synapses are more common than chemical synapses.

B) Synaptic transmission is an electrical response.

C) Chemical synapses allow currents to travel in either direction.

D) The release of neurotransmitters allows unidirectional conduction of an impulse.

Ans: D Complexity: Moderate Ahead: Anatomy and Physiology Review of the Nervous System Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Application

2. Of the following, which cranial nerves are only of motor type, not sensory?

A) I, VII, and X B) IV, V, and VI C) III, XI, XII D) I, VIII, IX Ans: C Complexity: Difficult Ahead: Anatomy and Physiology Review of the Nervous System Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Analysis

3. Which of the following often present with intermittent neurological deficit, vertigo, and weakness?

A) Migraines B) Cluster headaches C) Transient ischemic attacks D) Tension headaches Ans: C Complexity: Moderate

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Ahead: Health History Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Application

4. What kind of vertigo/loss of equilibrium also may include sensory disturbances?

A) Vestibular neuronitis B) Meniere’s disease C) Multiple sclerosis D) Acoustic neuroma Ans: C Complexity: Difficult Ahead: Health History Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Analysis

5. Palpating the masseter and temporal muscles tests which cranial nerve?

A) II B) IV C) V D) VIII Ans: C Complexity: Moderate Ahead: Physical Exam Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Application

6. A patient’s pupils are not the correct size for the amount of light. Damage to which cranial nerve is suspected?

A) I B) VI C) III D) II Ans: C Complexity: Difficult Ahead: Physical Exam Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Analysis

7. Which of the following is a sign of LMN lesion?

A) Muscle spasticity B) Absent Babinski reflex C) No fasciculations D) Diminished strength, but no atrophy

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Ans: B Complexity: Moderate Ahead: Physical Exam Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Application

8. Having a patient identify a physical object by touch with the eyes closed tests what?

A) Graphesthesia B) Vibratory sense C) Extinction D) Stereognosis Ans: D Complexity: Easy Ahead: Physical Exam Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Recall

9. A patient has trouble maintaining balance when walking normally, either with eyes open or closed. This suggests what?

A) Cerebellar disease B) MS C) Romberg’s test D) Guillain-Barre syndrome Ans: A Complexity: Difficult Ahead: Physical Exam Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Analysis

10. Which of the following assessments reflect the ability of the parasympathetic or sympathetic nervous system to innervate CN III? A) Pupillary function B) Decorticate posturing C) Verbal response D) Motor response Ans: A Complexity: Difficult Ahead: Physical Exam Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Analysis

11. Which of the following tests is used to diagnosis meningitis?

A) CT scan

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B) Lumbar puncture C) Carotid angiography D) Ultrasound Ans: B Complexity: Moderate Ahead: Physical Exam Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Application

12. Stimulating a newborn’s lips to test deviation of the head toward the stimulus tests what?

A) Babinski B) Placing C) Rooting D) Stepping Ans: C Complexity: Easy Ahead: Diagnostic Reasoning Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Recall

True/False

1. True or False? Damage to the temporal lobe of the brain may leave a patient with impaired hearing as well as emotional/behavioral abnormalities.

Ans: True Complexity: Difficult Ahead: Anatomy and Physiology Review of the Nervous System Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Analysis

2. True or False? The descending RAS is essential for arousal from sleep.

Ans: False Complexity: Easy Ahead: Anatomy and Physiology Review of the Nervous System Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Recall

3. True or False? Meningitis may mimic the symptoms of rupture of an intracranial aneurysm or AVM. Ans: False Complexity: Moderate Ahead: Health History

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Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Application

4. True or False? Strabismus may be a symptom of damage to the third cranial nerve.

Ans: False Complexity: Moderate Ahead: Physical Exam Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Application

5. True or False? The physician asks the patient to lie supine. The physician flexes the patient’s neck and the patient involuntarily bends his knees. This is known as Brudzinski’s sign.

Ans: True Complexity: Moderate Ahead: Physical Exam Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Application

6. True or False? Cranial nerves are directly evaluated in the neonate.

Ans: False Complexity: Moderate Ahead: Diagnostic Reasoning Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Application

Essay

1. What are the numbers and names of the cranial nerves that function to bring the sense of taste to the brain?

Ans: VII, facial; IX, glossopharyngeal Complexity: Difficult Ahead: Anatomy and Physiology Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Analysis

2. Which DTRs are tested in a reflex test?

Ans: Biceps, brachioradialis, triceps, patellar, achilles Complexity: Difficult Ahead: Physical Exam

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Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Analysis

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Chapter: Chapter 16 - Quiz

Multiple Choice

1. What is true of the vas deferens?

A) It is where sperm matures.

B) It contains the cells of Leydig.

C) It ends at the tip of the penis.

D) Normally there are two.

Ans: D Complexity: Difficult Ahead: Anatomy and Physiology Review of the Male Genitourinary System Subject: Chapter 16 Title: Male Genitourinary Disorders Taxonomy: Analysis

2. What produces sperm?

A) The penis B) The epididymes C) The testicles D) The prostate gland Ans: C Complexity: Easy Ahead: Anatomy and Physiology Review of the Male Genitourinary System Subject: Chapter 16 Title: Male Genitourinary Disorders Taxonomy: Recall

3. Which of the following is true of the kidneys?

A) The right kidney usually lies slightly higher than the left.

B) The renal cortex is the outer portion of the kidney.

C) The renal medulla contains nephrons.

D) Nephrons are considered the functioning units of the kidney.

Ans: D Complexity: Moderate

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Ahead: Anatomy and Physiology Review of the Male Genitourinary System Subject: Chapter 16 Title: Male Genitourinary Disorders Taxonomy: Application

4. Orchitis is likely to present as what?

A) Pain in the genital region B) A thick, greenish discharge C) Nocturia D) Frequent urination Ans: A Complexity: Difficult Ahead: Health History Subject: Chapter 16 Title: Male Genitourinary Disorders Taxonomy: Analysis

5. Which of the following may be a sign or symptom of prostate cancer?

A) Body aches B) A rash C) Nausea D) Lower extremity edema Ans: C Complexity: Moderate Ahead: Health History Subject: Chapter 16 Title: Male Genitourinary Disorders Taxonomy: Application

6. Which of the following is a sexual dysfunction?

A) Peyronie’s disease B) Pyelonephritis C) Dysuria D) Prostatitis Ans: A Complexity: Difficult Ahead: Health History Subject: Chapter 16 Title: Male Genitourinary Disorders Taxonomy: Analysis

7. To percuss the kidneys, the physician must strike what?

A) The base of the spine B) The soft tissue of the abdomen C) The costovertebral angle D) The vertebral column Ans: C

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Complexity: Moderate Ahead: Physical Examination Subject: Chapter 16 Title: Male Genitourinary Disorders Taxonomy: Application

8. Which of the following is generally palpable?

A) The left kidney B) The right kidney C) The bladder D) The ureter Ans: B Complexity: Difficult Ahead: Physical Examination Subject: Chapter 16 Title: Male Genitourinary Disorders Taxonomy: Analysis

9. Which of the following would be an abnormal finding when palpating the testes?

A) Ridged B) Smooth C) Oval D) Rubbery Ans: A Complexity: Difficult Ahead: Physical Examination Subject: Chapter 16 Title: Male Genitourinary Disorders Taxonomy: Analysis

10. Which of the following is true of palpation of the prostate gland?

A) It is not done.

B) It is part of a patient’s self-examination routine.

C) It is usually done externally.

D) It is usually done during a rectal examination.

Ans: D Complexity: Easy Ahead: Physical Examination Subject: Chapter 16 Title: Male Genitourinary Disorders Taxonomy: Recall

11. Which test assesses the kidneys, ureter, and bladder?

A) IVP B) BMP C) Routine urinalysis D) 24-hour collection

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Ans: A Complexity: Moderate Ahead: Physical Examination Subject: Chapter 16 Title: Male Genitourinary Disorders Taxonomy: Application

12. Which of the following is true of UTIs in pediatric Aa)tTiehnetys?can occur before the age of 2 years. p B) Children younger than age 6 years do not get UTIs. C) In adolescents, increased UTIs suggest sexual activity.

D) They may have decreased urinary output.

Ans: C Complexity: Easy Ahead: Diagnostic Reasoning Subject: Chapter 16 Title: Male Genitourinary Disorders Taxonomy: Recall

True/False

1. True or False? The urethra carries urine from the bladder to the outside of the body, and extends through the length of the penis.

Ans: True Complexity: Easy Ahead: Anatomy and Physiology Review of the Male Genitourinary System Subject: Chapter 16 Title: Male Genitourinary Disorders Taxonomy: Recall

2. True or False? Urinary urgency/frequency, combined with dysuria, fever, and chills, indicates urethritis.

Ans: False Complexity: Moderate Ahead: Health History Subject: Chapter 16 Title: Male Genitourinary Disorders Taxonomy: Application

3. True or False? Herpes simplex presents with a single chancre.

Ans: False Complexity: Moderate Ahead: Physical Examination Subject: Chapter 16 Title: Male Genitourinary Disorders Taxonomy: Application

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4. True or False? The epididymis feels softer than the testes.

Ans: True Complexity: Moderate Ahead: Physical Examination Subject: Chapter 16 Title: Male Genitourinary Disorders Taxonomy: Application

5. True or False? During the physical exam, the physician will ask the patient to cough while the physician palpates the prostate gland.

Ans: False Complexity: Difficult Ahead: Physical Examination Subject: Chapter 16 Title: Male Genitourinary Disorders Taxonomy: Analysis

6. True or False? A newborn’s urine is usually colorless and odorless.

Ans: True Complexity: Moderate Ahead: Diagnostic Reasoning Subject: Chapter 16 Title: Male Genitourinary Disorders Taxonomy: Application

Essay

1. What do balantitis, urethritis, and epididymitis often present with?

Ans: Balantitis: pain and prepuce swelling; urethritis: edema, dysuria, and pruritis; epididymitis: scrotal pain, edema, possible fever Complexity: Difficult Ahead: Health History Subject: Chapter 16 Title: Male Genitourinary Disorders Taxonomy: Analysis

2. What does routine urinalysis test for? What are the normal ranges?

Ans: pH (4.5 to 8); specific gravity (1.003 to 1.025); sodium level (20 mEq/L); urine osmolality (300-900 mOsm/kg of water) Complexity: Difficult Ahead: Diagnostic Reasoning Subject: Chapter 16 Title: Male Genitourinary Disorders

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Taxonomy: Analysis

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Chapter: Chapter 17 - Quiz

Multiple Choice

1. The internal os is contained within what?

A) The uterus B) The vagina C) The ovaries D) The clitoris Ans: A Complexity: Difficult Ahead: Advanced Assessment of the Female Genitourinary System Subject: Chapter 17 Title: Female Genitourinary and Breast Disorders Taxonomy: Analysis

2. Nicotine can contribute to which of the following?

A) Urinary problems B) Sexual dysfunction C) Allergic vaginitis D) Amenorrhea Ans: A Complexity: Easy Ahead: Health History: Genitourinary Subject: Chapter 17 Title: Female Genitourinary and Breast Disorders Taxonomy: Recall

3. Which of the following findings would indicate Nabothian cysts on a patient’s cervix?

A) Small, translucent, yellow nodules B) Columnar epithelium from endo-cervix is everted C) Bright red, soft protrusions D) Hard ulcers Ans: A Complexity: Moderate

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Ahead: Physical Exam: Genitourinary Subject: Chapter 17 Title: Female Genitourinary and Breast Disorders Taxonomy: Application

4. A bluish hue noted in the cervix is most likely indicative of what?

A) Early pregnancy B) Anemia C) Malignancy D) Hypoxia Ans: A Complexity: Difficult Ahead: Physical Exam: Genitourinary Subject: Chapter 17 Title: Female Genitourinary and Breast Disorders Taxonomy: Analysis

5. A bluish hue to a cervix is considered normal in which of the following?

A) A prepubescent girl B) A pregnant woman C) Any woman of child-bearing age D) A geriatric patient Ans: B Complexity: Moderate Ahead: Physical Exam: Genitourinary Subject: Chapter 17 Title: Female Genitourinary and Breast Disorders Taxonomy: Application

6. A patient’s os is slit-like in appearance. This indicates what?

A) The patient has borne a child or children.

B) The patient has not yet engaged in sexual activity.

C) A pathology may be present.

D) The patient is likely using hormone therapy.

Ans: A Complexity: Difficult Ahead: Physical Exam: Genitourinary Subject: Chapter 17 Title: Female Genitourinary and Breast Disorders Taxonomy: Analysis

7. What is the purpose of the areola?

A) An extended visual marker for a newborn or infant to latch onto B) Contains glands that secrete a lipid to lubricate the area during lactation C) No known physiological purpose D) Contains the mammary glands Ans: B

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Complexity: Moderate Ahead: Anatomy and Physiology: Breasts Subject: Chapter 17 Title: Female Genitourinary and Breast Disorders Taxonomy: Application

8. Cooper’s ligaments are found in which kind of breast tAis)sFuieb?rous B) Glandular C) Adipose D) Nervous Ans: A Complexity: Difficult Ahead: Anatomy and Physiology: Breasts Subject: Chapter 17 Title: Female Genitourinary and Breast Disorders Taxonomy: Analysis

9. Which of the following is true regarding nipple discharge?

A) Discharge emanating from multiple ducts suggests cancer.

B) A bloody discharge suggests intraductal papilloma.

C) Oral contraceptives and steroids can cause a greenish discharge.

D) Duct ectasia produces a clear or milky discharge.

Ans: B Complexity: Easy Ahead: Health History: Breasts Subject: Chapter 17 Title: Female Genitourinary and Breast Disorders Taxonomy: Recall

10. What would be a normal finding when inspecting the breasts?

A) A unilateral predominant venous system B) Montgomery tubercles C) Dimpling D) Eccymosis Ans: B Complexity: Difficult Ahead: Physical Exam: Breasts Subject: Chapter 17 Title: Female Genitourinary and Breast Disorders Taxonomy: Analysis

11. What would be an abnormal finding when inspecting the breasts?

A) Supernumerary nipples B) Discharge without palpation in a nonpregnant patient C) Seborrheic keratosis D) Nevi and striae

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Ans: B Complexity: Moderate Ahead: Physical Exam: Breasts Subject: Chapter 17 Title: Female Genitourinary and Breast Disorders Taxonomy: Application

12. Which of the following is true regarding pregnant Aa)tIi ne cnrtes ?a s e d estrogen and progesterone cause increased sensitivity in late pregnancy. p B) Nipples and areolae become less pigmented.

C) Breasts will feel softer and smoother on palpation as the pregnancy progresses.

D) Palpation of the nipple may produce colostrum.

Ans: D Complexity: Easy Ahead: Diagnostic Reasoning: Breasts Subject: Chapter 17 Title: Female Genitourinary and Breast Disorders Taxonomy: Recall

True/False

1. True or False? The uterus is largely muscle.

Ans: True Complexity: Moderate Ahead: Advanced Assessment of the Female Genitourinary System Subject: Chapter 17 Title: Female Genitourinary and Breast Disorders Taxonomy: Application

2. True or False? The female urinary system contains two kidneys, one ureter, one bladder, and one urethra.

Ans: False Complexity: Easy Ahead: Advanced Assessment of the Female Genitourinary System Subject: Chapter 17 Title: Female Genitourinary and Breast Disorders Taxonomy: Recall

3. True or False? Bubble baths and regular douching can prevent allergic vaginitis.

Ans: False Complexity: Moderate Ahead: Health History: Genitourinary Subject: Chapter 17 Title: Female Genitourinary and Breast Disorders Taxonomy: Application

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4. True or False? The nipple should be palpated while the patient is seated.

Ans: False Complexity: Difficult Ahead: Physical Exam: Breasts Subject: Chapter 17 Title: Female Genitourinary and Breast Disorders Taxonomy: Analysis

5. True or False? A patient who has begun menopause at 55 years has a higher risk of breast cancer.

Ans: True Complexity: Moderate Ahead: Health History: Breasts Subject: Chapter 17 Title: Female Genitourinary and Breast Disorders Taxonomy: Application

6. True or False? The wedged palpation technique is the most effective in detecting abnormalities.

Ans: False Complexity: Moderate Ahead: Physical Exam: Breasts Subject: Chapter 17 Title: Female Genitourinary and Breast Disorders Taxonomy: Application

Essay

1. What cultures and smears should be performed during the pelvic examination, and in which order?

Ans: (1) Culture samples for STDs; (2) cultures for infection; (3) Pap smear Complexity: Difficult Ahead: Physical Exam: Genitourinary Subject: Chapter 17 Title: Female Genitourinary and Breast Disorders Taxonomy: Analysis

2. What different medical problems can cause a breast lump?

Ans: Fibroadenoma, fibrocystic disease, fat necrosis, abscess, or cancer Complexity: Difficult Ahead: Health History: Breasts Subject: Chapter 17 Title: Female Genitourinary and Breast Disorders Taxonomy: Analysis

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Chapter: Chapter 18 - Quiz

Multiple Choice

1. How many bones make up the vertebral column?

A) 37 B) 24 C) 12 D) 26 Ans: D Complexity: Difficult Ahead: Anatomy and Physiology Review of the Musculoskeletal System Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Analysis

2. Which of the following bones is part of the wrist?

A) Ulna B) Scaphoid C) Phalanges D) Metacarpals Ans: A Complexity: Easy Ahead: Anatomy and Physiology Review of the Musculoskeletal System Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Recall

3. Which is the major weight-bearing bone in the foot?

A) Calcaneus B) Talus C) Malleoleus D) Navicular Ans: B Complexity: Moderate

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Ahead: Anatomy and Physiology Review of the Musculoskeletal System Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Application

4. A patient complains of unrelenting back pain. Resting does not help; neither do stretching and exercise. What is most likely?

A) A nonmusculoskeletal issue B) A herniated disc C) Muscular rupture D) Osteoporosis Ans: A Complexity: Difficult Ahead: Health History Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Analysis

5. Which of the following is a sign or symptom of juvenile rheumatoid arthritis?

A) Fractures B) Changes in pulses and sensation C) Bowel/bladder dysfunction D) Dyspnea Ans: D Complexity: Moderate Ahead: Health History Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Application

6. Which of the following is one of the “Five Ps” of musculoskeletal examination?

A) Petrification B) Problem C) Pulselessness D) Position Ans: C Complexity: Difficult Ahead: Physical Exam Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Analysis

7. A 55-year-old diabetic woman complains of a complete restriction of motion in her shoulder. What should be suspected?

A) Myofascial injury B) AC joint separation C) Fractured clavicle

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D) Adhesive capsulitis Ans: D Complexity: Moderate Ahead: Physical Exam Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Application

8. Injury to which part of the body does the text explicitly state carries a high likelihood of damage to nerves and/or blood vessels?

A) Knee B) Shoulder C) Elbow D) Hip/pelvis Ans: C Complexity: Difficult Ahead: Physical Exam Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Analysis

9. When assessing range of motion, a patient’s ulnar deviation and radial deviation should be , respectively.

A) 20 degrees and 55 degrees B) 55 degrees and 20 degrees C) 70 degrees and 70 degrees D) 25 degrees and 40 degrees Ans: B Complexity: Easy Ahead: Physical Exam Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Recall

10. When palpating, what does localized warmth indicate?

A) Blood leaking into the joints B) Synovial fluid leaking into the tissue C) Vascular constriction D) Infection Ans: A Complexity: Difficult Ahead: Physical Exam Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Analysis

11. The Thomas test is used in assessing what?

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A) Shoulder range of motion B) Hip/pelvis range of motion C) Arm sensory loss D) Foot pain Ans: B Complexity: Moderate Ahead: Physical Exam Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Application

12. A CBC test can be used to diagnose which of the following?

A) Hip fracture B) Sciatica C) Bursitis D) Osteoarthritis Ans: C Complexity: Easy Ahead: Diagnostic Reasoning Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Recall

True/False

1. True or False? The hand has two types of muscles and three major nerves.

Ans: True Complexity: Moderate Ahead: Anatomy and Physiology Review of the Musculoskeletal System Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Application

2. True or False? Pain that is sharp and reproduced only when the patient raises the right arm suggests bursitis.

Ans: False Complexity: Difficult Ahead: Health History Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Analysis

3. True or False? Decreased muscle mass increases the risk of damage to connective tissue and bones.

Ans: True

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Complexity: Moderate Ahead: Health History Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Application

4. True or False? A patient’s elbow should not be able to flex to 90 degrees.

Ans: False Complexity: Easy Ahead: Physical Exam Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Recall

5. True or False? From flexion to extension, a patient should have a 160-degree range of motion in the wrist.

Ans: True Complexity: Moderate Ahead: Physical Exam Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Application

6. True or False? The Barlow-Ortolani maneuver tests for dislocation of an adolescent’s hip.

Ans: False Complexity: Moderate Ahead: Diagnostic Reasoning Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Application

Essay

1. What are the three likely assessment findings for a patient with a dislocated shoulder?

Ans: Any trauma to the shoulder with a mechanism of injury involving external rotation with abduction; loss of the normal contour of the shoulder (X-rays will confirm); marked instability: when moving anteriorly, the shoulder moves too far forward and when moved posteriorly, it moves too far back Complexity: Difficult Ahead: Physical Exam Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Analysis

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2. What are the six common back problems listed in the text?

Ans: Compression fracture/back pain; low back strain; malignancy/tumor; ankylosing spondylitis; cauda equina syndrome; herniated disc Complexity: Difficult Ahead: Physical Exam Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Analysis

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Chapter: Midterm

Multiple Choice

1. A family member serves as a translator for a patient who does not speak English. The answers to the provider’s questions reflect the opinion of the family member, and not the patient. What is this phenomenon called?

A) Translator bias B) Family member bias C) Caregiver bias syndrome D) Two patient syndrome Ans: D Complexity: Difficult Ahead: Interviewing Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Analysis

2. Which component of the mnemonic device PQRST would involve asking the patient to assess their pain level on a scale from 0 to 10?

A) P B) Q C) R D) S Ans: D Complexity: Moderate Ahead: Taking a Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Application

3. Which of the following sections of the health history involves collecting information about a patient’s surgical procedures and hospitalizations?

A) Past medical history B) Family history

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

C) Social history D) Review of systems Ans: A Complexity: Moderate Ahead: Taking a Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Application

4. Which of the following is true of a comprehensive review of systems?

A) It is conducted when a patient presents with a specific chief complaint.

B) Questions are directed toward the system(s) most likely to be involved in producing the patient’s symptoms.

C) The patient would not be questioned about symptoms in nonrelated body systems.

D) It is conducted when a patient presents for general health maintenance or disease prevention care.

Ans: D Complexity: Difficult Ahead: Taking a Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Analysis

5. Which of the following is considered best practice when taking a health history?

A) Use closed-ended questions.

B) Help the patient choose the best words to describe his or her symptoms.

C) Put all of your focus on taking good notes during the interview.

D) If using a translator, address the questions to the patient, not the translator.

Ans: D Complexity: Difficult Ahead: Taking a Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Analysis

6. Using the mnemonic device CLIENT OUTCOMES, which component involves asking the patient what precipitates, aggravates, or alleviates the symptoms?

A) Impact B) Complementary C) Modulating D) Exposure Ans: C Complexity: Moderate Ahead: Taking a Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Application

7. Which of the following is best practice when taking a family history?

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

A) The family history should extend back for three generations.

B) Cases of intermarriage do not need to be reported.

C) Patients should only report the history of first-degree relatives.

D) The age of onset should be reported for each of the conditions.

Ans: D Complexity: Moderate Ahead: Taking a Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Application

8. Which of the following pieces of equipment is used to gather specimens?

A) Nasal speculum B) Sphygmomanometer C) Occult blood testing materials D) Taste-testing substances Ans: C Complexity: Easy Ahead: Head-to-Toe Examination Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Recall

9. The patient examination begins: A) when the patient enters the room.

B) after the patient has changed into the gown.

C) when the patient describes the chief complaint.

D) after vital signs have been recorded.

Ans: A Complexity: Easy Ahead: Head-to-Toe Examination Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Recall

10. Collecting data through sight and smell is known as: A) inspection.

B) palpation.

C) percussion.

D) auscultation.

Ans: A Complexity: Easy Ahead: Assessment Techniques Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Recall

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

11. Which of the following components of the physical exam would be assessed using the Hirschberg test?

A) Skin characteristics B) Corneal light reflex for symmetry C) Pinnae symmetry D) Hearing acuity Ans: B Complexity: Difficult Ahead: Head-to-Toe Examination Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Analysis

12. What is the preferred position for examining a pregnant patient?

A) Supine B) Knee-chest C) Lithotomy D) Side-lying Ans: D Complexity: Moderate Ahead: Head-to-Toe Examination Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Application

13. Which of the following should be done when examining a pediatric patient?

A) You should use the same sequence of assessments for every pediatric patient.

B) Do invasive procedures first.

C) Don’t allow him or her to play with medical equipment.

D) Allow the child to be examined on his or her parent’s lap.

Ans: D Complexity: Difficult Ahead: Head-to-Toe Examination Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Analysis

14. The Weber or Rinne tests are used to test: A) corneal symmetry.

B) hearing acuity.

C) sense of smell.

D) thoracic expansion.

Ans: B Complexity: Moderate Ahead: Head-to-Toe Examination Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Application

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

15. Which of the following is considered best practice when documenting health history and the physical examination?

A) Include notes about your opinion B) Use your own abbreviations C) Do not include drawings D) Record only facts Ans: D Complexity: Moderate Ahead: General Considerations Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Application

16. Using the SOAP approach, which section would include the chief complaint and history of present illness?

A) S B) O C) A D) P Ans: A Complexity: Moderate Ahead: SOAP Approach Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Application

17. When documenting notes from a patient encounter, what information should be recorded first?

A) Chief complaint B) Health history C) Patient identifiers D) Treatment plan Ans: C Complexity: Difficult Ahead: Subjective Data Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Analysis

18. Which of the following is best practice when documenting the history of present illness (HPI)?

A) Only record the symptoms related to the chief complaint.

B) Details related to previous diagnostic tests are not necessary to include.

C) If signs and symptoms appear to be related, spend time on the component that is related to the chief complaint.

D) Pertinent test results and test dates should be included.

Ans: D Complexity: Difficult Ahead: Subjective Data Subject: Chapter 3 Title: Documentation Strategies

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

Taxonomy: Analysis

19. What is the purpose of a genogram?

A) To show the patient’s health history B) To identify genetic disorders C) To explore family history D) To understand social history Ans: C Complexity: Difficult Ahead: Subjective Data Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Analysis

20. The nutritional history falls under which of the following assessments?

A) Social history B) Family history C) Past medical history D) History or present illness Ans: A Complexity: Moderate Ahead: Subjective Data Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Application

21. Which component of the final assessment plan is frequently reserved for hospitalized patients?

A) Nonpharmacological interventions B) Pharmacological interventions C) Education D) Follow-up Ans: A Complexity: Moderate Ahead: Plan Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Application

22. A patient discloses that they have received acupuncture treatments to provide relief from their symptoms. Which component of the mnemonic ETHNIC may have been used to elicit this information?

A) E B) T C) H D) N Ans: C Complexity: Moderate Ahead: Patient Assessment Subject: Chapter 4

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

Title: Cultural and Spiritual Assessments Taxonomy: Application

23. is a nonprofit initiative where professionals can explore and identify their implicit biases.

A) Implicit Association Test B) Project Implicit C) Georgetown University National Center for Cultural Competence D) ETHNIC Ans: B Complexity: Moderate Ahead: Self-Assessment Subject: Chapter 4 Title: Cultural and Spiritual Assessments Taxonomy: Application

24. Which of the following spiritual assessment tools assesses the use of spiritual rituals?

A) FICA B) HOPE C) SPIRITual D) Royal College of Psychiatry Instrument Ans: C Complexity: Moderate Ahead: Patient Assessment Subject: Chapter 4 Title: Cultural and Spiritual Assessments Taxonomy: Application

25. A non-English speaking patient is having trouble communicating with a health provider. What is the best way to overcome this barrier?

A) Have the patient bring an English-speaking family member to the next visit.

B) Hire a translator.

C) Hire an interpreter.

D) Use a translation device.

Ans: C Complexity: Difficult Ahead: Patient Assessment Subject: Chapter 4 Title: Cultural and Spiritual Assessments Taxonomy: Application

26. Which of the following conditions should be considered when conducting a skin assessment for a Native American?

A) Traction alopecia B) Hot comb folliculitis C) Pseudofolliculitis barbate D) Scleroderma Ans: D Complexity: Difficult

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

Ahead: Cultural Considerations for a Comprehensive Health Assessment Subject: Chapter 4 Title: Cultural and Spiritual Assessments Taxonomy: Analysis

27. Which of the following should be a consideration when performing a gastrointestinal assessment on a Native American patient?

A) This population has a higher incidence of colon cancer than the general population.

B) This population has a higher incidence of H. pylori than Caucasians.

C) Gastroesophageal reflux is more prevalent in this population.

D) This population tends to buy foods high in fat and sodium because they are less expensive.

Ans: A Complexity: Difficult Ahead: Cultural Considerations for a Comprehensive Health Assessment Subject: Chapter 4 Title: Cultural and Spiritual Assessments Taxonomy: Analysis

28. According to Betty Neuman’s systems theory of nursing, which of the following subsystems transcends all others?

A) Physiologic B) Psychologic C) Spiritual D) Developmental Ans: C Complexity: Moderate Ahead: Cultural Considerations for a Comprehensive Health Assessment Subject: Chapter 4 Title: Cultural and Spiritual Assessments Taxonomy: Application

29. According to the World Health Organization, diet is a major causative factor of: A) Parkinson’s disease.

B) congestive heart failure.

C) lipid profile abnormalities.

D) rheumatoid arthritis.

Ans: C Complexity: Easy Ahead: Introduction Subject: Chapter 5 Title: Nutritional Assessment Taxonomy: Recall

30. What is the prevalence of malnutrition in today’s healthcare landscape?

A) 5 to 10% B 10 to 15% C) 20 to 30% D) 30 to 50%

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

Ans: D Complexity: Easy Ahead: Introduction Subject: Chapter 5 Title: Nutritional Assessment Taxonomy: Recall

31. Patients taking pharmacologic agents to decrease production of stomach acid may have: A) increased metabolic rates.

B) protein deficits.

C) dysregulation of lipoproteins.

D) decreased appetite.

Ans: B Complexity: Moderate Ahead: Anatomy and Physiology Subject: Chapter 5 Title: Nutritional Assessment Taxonomy: Application

32. Which of the following is the main storage organ involved with energy homeostasis?

A) Stomach B) Small intestine C) Adipose tissue D) Protein Ans: C Complexity: Moderate Ahead: Anatomy and Physiology Subject: Chapter 5 Title: Nutritional Assessment Taxonomy: Application

33. The performs better than anthropometry and laboratory data as an assessment method for nutritional status.

A) Malnutrition Screening Tool B) Nutritional Risk Screening C) Mini-Nutritional Assessment Short Form D) Subjective Global Assessment Ans: D Complexity: Moderate Ahead: Anatomy and Physiology Subject: Chapter 5 Title: Nutritional Assessment Taxonomy: Application

34. Which of the following tests would be used to assess the use of fat for energy production?

A) Urine indicant B) Urine ketones C) Urine sediment analysis

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

D) Serum Ca:PO4 ratio Ans: B Complexity: Difficult Ahead: Methods of Nutritional Assessment Subject: Chapter 5 Title: Nutritional Assessment Taxonomy: Analysis

35. The Weiss urochrome test is used to indicate: A) protein breakdown.

B) catabolism.

C) metabolism.

D) level of physical activity.

Ans: B Complexity: Difficult Ahead: Methods of Nutritional Assessment Subject: Chapter 5 Title: Nutritional Assessment Taxonomy: Analysis

36. The is primarily responsible for processing sensory data.

A) frontal lobe B) temporal lobe C) parietal lobe D) occipital lobe Ans: C Complexity: Moderate Ahead: Anatomy and Physiology Review of the Brain Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Application

37. Which of the following mediates certain patterns of behavior that determine survival, such as fear, aggression, and mating?

A) Cranial nerves B) Limbic system C) Temporal lobe D) Occipital lobe Ans: B Complexity: Moderate Ahead: Anatomy and Physiology Review of the Brain Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Application

38. Which of the following sleep patterns may be indicative of anxiety?

A) Not experiencing deep levels of sleep B) Falling asleep too easily

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

C) Feeling tired after a full night’s sleep D) Having difficulty falling asleep Ans: D Complexity: Difficult Ahead: Health History Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Analysis

39. Which component of the mnemonic SIGECAPS would be used to determine if the patient is still taking time to enjoy their hobbies?

A) S B) I C) G D) E Ans: B Complexity: Difficult Ahead: Moderate Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Analysis

40. The assessment of talkativeness would be used to diagnose which of the following mental health disorders?

A) Depression B) Generalized anxiety disorder C) Bipolar disorder D) Dysthymia Ans: C Complexity: Difficult Ahead: Health History Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Analysis

41. A patient presents with tachycardia and complains of heart palpitations. Which of the following may be the cause of these symptoms?

A) Generalized anxiety disorder B) Bipolar disorder C) Schizophrenia D) Delirium Ans: A Complexity: Difficult Ahead: Health History Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Analysis

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42. A patient can be aroused for short periods of time to visual, verbal, or painful stimuli. Which level of consciousness would be used to characterize the patient?

A) Confused B) Lethargy C) Delirium D) Stupor Ans: D Complexity: Difficult Ahead: Health History Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Analysis

43. Secretions from which of the following are released under cholinergic and hormonal control?

A) Eccrine glands B) Apocrine glands C) Sweat glands D) Sebaceous gland Ans: B Complexity: Difficult Ahead: Anatomy and Physiology Review of the Integumentary System Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Analysis

44. Keratinocytes can be found on the basal layer of the: A) epidermis.

B) dermis.

C) subcutaneous layer.

D) apocrine glands.

Ans: A Complexity: Moderate Ahead: Anatomy and Physiology Review of the Integumentary System Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Application

45. Which of the following is most often found on the face?

A) Herpes zoster B) Impetigo C) Varicella D) Rubella Ans: B Complexity: Difficult Ahead: Health History Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Analysis

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

46. A patient reports that he rarely burns when exposed to sun and that he tans easily. What type would he be characterized as using the Fitzpatrick Skin Type Classification?

A) I B) III C) IV D) V Ans: D Complexity: Moderate Ahead: Health History Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Application

47. A patient presents with fever and malaise. Which of the following may be associated with these symptoms?

A) Varicella B) Atopic dermatitis C) Psoriasis D) Erythema infectious Ans: A Complexity: Moderate Ahead: Health History Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Application

48. A patient complains of anorexia and abdominal pain. Which of the following diseases may be the cause of these symptoms?

A) Roseola B) Stasis dermatitis C) Psoriasis D) Rubeola Ans: A Complexity: Difficult Ahead: Health History Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Analysis

49. Which of the following should be used when identifying lesions of vascular origin?

A) Squeezing B) Palpation C) Diascopy D) Paring Ans: C Complexity: Difficult Ahead: Physical Examination Subject: Chapter 7 Title: Integumentary Disorders

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Taxonomy: Analysis

50. The innervate(s) the levator palpebrae muscle.

A) tarsal plates B) palpebral fissure C) oculomotor nerve D) sympathetic nerve Ans: C Complexity: Moderate Ahead: Anatomy and Physiology Review of the Eye Subject: Chapter 8 Title: Eye Disorders Taxonomy: Application

51. Which of the following translates light images into a series of impulses or visual stimuli to the brain?

A) Fundus B) Inner retina C) Iris D) Anterior chamber Ans: A Complexity: Difficult Ahead: Anatomy and Physiology Review of the Eye Subject: Chapter 8 Title: Eye Disorders Taxonomy: Analysis

52. Soft contact wearers are at higher risk for: A) glaucoma.

B) Pseudomonas infection.

C) corneal trauma.

D) diplopia.

Ans: B Complexity: Difficult Ahead: Health History Subject: Chapter 8 Title: Eye Disorders Taxonomy: Analysis

53. A patient presents with acquired nystagmus. Which of the following may explain this symptom?

A) Papilledema B) Glaucoma C) Multiple sclerosis D) Ocular hemorrhage Ans: C Complexity: Difficult Ahead: Health History Subject: Chapter 8 Title: Eye Disorders

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Taxonomy: Analysis

54. During an eye exam, you notice that the patient has mydriasis. Which of the following recreational drugs may the patient be taking to cause this finding?

A) Heroin B) Alcohol C) Benzodiazepines D) Cocaine Ans: D Complexity: Difficult Ahead: Health History Subject: Chapter 8 Title: Eye Disorders Taxonomy: Analysis

55. When testing central vision, which of the following should be done?

A) Position the patient 5 feet away from the chart.

B) Allow the patient to keep both eyes open.

C) Face the patient, gazing eye to eye.

D) Ask the patient to cover one eye with a card.

Ans: D Complexity: Moderate Ahead: Physical Examination Subject: Chapter 8 Title: Eye Disorders Taxonomy: Application

56. To diagnose a corneal abrasion, which of the following diagnostic tests should be used?

A) Fluorescein stain B) Observation C) Referral to ophthalmology D) Visual fields test Ans: A Complexity: Moderate Ahead: Diagnostic Reasoning Subject: Chapter 8 Title: Eye Disorders Taxonomy: Application

57. The lies just in front of the opening to the external ear.

A) pinnae B) tragus C) tympanic membrane D) vestibular nerve Ans: B Complexity: Moderate Ahead: Anatomy and Physiology Review of the Ear Subject: Chapter 9

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Title: Ear Disorders Taxonomy: Application

58. Which of the following lies between the tympanic membrane and the oval window of the cochlea?

A) Tympanic cavity B) Pinna C) Ear canal D) Auditory tube Ans: A Complexity: Moderate Ahead: Anatomy and Physiology Review of the Ear Subject: Chapter 9 Title: Ear Disorders Taxonomy: Application

59. Which of the following results from disorders of the inner ear or central vestibular pathways?

A) Vertigo B) Tinnitus C) Otorrhea D) Hearing loss Ans: A Complexity: Moderate Ahead: Health History Subject: Chapter 9 Title: Ear Disorders Taxonomy: Application

60. A patient complains of yellow discharge coming from the ear. What could this indicate?

A) Tympanic membrane perforation B) Fungal infection C) Liquefied cerumen D) Infection in the external or middle ear Ans: D Complexity: Difficult Ahead: Health History Subject: Chapter 9 Title: Ear Disorders Taxonomy: Analysis

61. A patient presents with sore throat and periodontal pain. Which of the following may be responsible for these symptoms?

A) Otomycosis B) Serous otitis C) Vertigo D) Tinnitus Ans: B Complexity: Difficult Ahead: Health History

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

Subject: Chapter 9 Title: Ear Disorders Taxonomy: Analysis

62. Which of the following should be considered when performing an ear assessment on a pregnant patient?

A) Pregnancy is associated with a decreased incidence of otosclerosis.

B) Maternal diabetes is associated with hearing abnormalities in the offspring.

C) Pregnancy is associated with a decreased ability to hear high-pitched sounds.

D) Pregnancy is associated with slowing of preexisting otosclerosis.

Ans: B Complexity: Difficult Ahead: Diagnostic Reasoning Subject: Chapter 9 Title: Ear Disorders Taxonomy: Analysis

63. A tympanogram may be used to diagnose: A) acute otitis media.

B) chronic otitis media.

C) serous otitis.

D) trauma.

Ans: C Complexity: Difficult Ahead: Diagnostic Reasoning Subject: Chapter 9 Title: Ear Disorders Taxonomy: Analysis

True/False

1. True or False? Both subjective and objective data are subject to error.

Ans: True Complexity: Moderate Ahead: Functions of the Interview and Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Application

2. True or False? Ethnocentrism supports effective patient–provider relationships.

Ans: False Complexity: Moderate Ahead: Interviewing Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Application

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

3. True or False? When you recognize a communication barrier with a patient, you should stop the usual routine of the visit and share these perceptions with the patient.

Ans: True Complexity: Moderate Ahead: Interviewing Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Application

4. True or False? Comprehensive physical examinations should be performed in emergency situations.

Ans: False Complexity: Moderate Ahead: General Considerations Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Application

5. True or False? When performing a physical examination on a geriatric patient, it is important to consider that their reaction time may be longer.

Ans: True Complexity: Moderate Ahead: Assessment Techniques Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Application

6. True or False? Stethoscope tubing should be double lumen so sound is magnified.

Ans: True Complexity: Moderate Ahead: Assessment Techniques Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Application

7. True or False? The SOAP format for documentation can only be used for focused examinations.

Ans: False Complexity: Moderate Ahead: SOAP Approach Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Application

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

8. True or False? Any physical findings that the provider identifies should be documented in the objective component.

Ans: True Complexity: Moderate Ahead: Documentation Tips Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Application

9. True or False? When collecting a nutritional history as part of a social history assessment, it is always recommended to perform a 24-hour recall.

Ans: False Complexity: Difficult Ahead: Subjective Data Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Analysis

10. True or False? According to Campinha-Bacote, cultural competence is an ongoing process.

Ans: True Complexity: Easy Ahead: Introduction Subject: Chapter 4 Title: Cultural and Spiritual Assessments Taxonomy: Recall

11. True or False? It is best to have a family member translate for a non-English speaking patient because they know the patient most intimately.

Ans: False Complexity: Moderate Ahead: Patient Assessment Subject: Chapter 4 Title: Cultural and Spiritual Assessments Taxonomy: Application

12. True or False? The key focus of the cultural assessment is to determine the level of mistrust a patient may have with the provider.

Ans: False Complexity: Moderate Ahead: Patient Assessment Subject: Chapter 4 Title: Cultural and Spiritual Assessments Taxonomy: Application

13. True or False? When the sympathetic nervous system is activated, saliva production is inhibited.

Ans: True

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

Complexity: Moderate Ahead: Anatomy and Physiology Subject: Chapter 5 Title: Nutritional Assessment Taxonomy: Application

14. True or False? The Nutritional Risk Screening (NRS) is valid and reliable for ambulatory subacute and ambulatory patients.

Ans: False Complexity: Moderate Ahead: Anatomy and Physiology Subject: Chapter 5 Title: Nutritional Assessment Taxonomy: Application

15. True or False? A low level of serum PO4 is an indicator of malnutrition.

Ans: True Complexity: Moderate Ahead: Methods of Nutritional Assessment Subject: Chapter 5 Title: Nutritional Assessment Taxonomy: Application

16. True or False? Delirium has an acute onset.

Ans: True Complexity: Moderate Ahead: Health History Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Application

17. True or False? Some conditions, such as HIV or AIDS, may contribute to mental health disorders.

Ans: True Complexity: Moderate Ahead: Health History Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Application

18. True or False? Postpartum psychosis typically occurs months after delivery.

Ans: False Complexity: Moderate Ahead: Diagnostic Reasoning Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Application

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

19. True or False? The dermis is composed of two layers.

Ans: True Complexity: Moderate Ahead: Anatomy and Physiology Review of the Integumentary Systems Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Application

20. True or False? The apocrine glands are under control of the hypothalamus.

Ans: False Complexity: Moderate Ahead: Anatomy and Physiology Review of the Integumentary Systems Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Application

21. True or False? Herpes simplex is an example of a fissure.

Ans: False Complexity: Easy Ahead: Physical Examination Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Recall

22. True or False? The sclera forms the outer layer of the globe of the eye.

Ans: True Complexity: Moderate Ahead: Anatomy and Physiology Review of the Eye Subject: Chapter 8 Title: Eye Disorders Taxonomy: Application

23. True or False? Light enters the eye and is refracted by the pupil through the cornea to the lens.

Ans: False Complexity: Difficult Ahead: Anatomy and Physiology Review of the Eye Subject: Chapter 8 Title: Eye Disorders Taxonomy: Analysis

24. True or False? Herpetic lesions on the cornea may start with a painful dermatitis surrounding the eye.

Ans: True Complexity: Difficult

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

Ahead: Health History Subject: Chapter 8 Title: Eye Disorders Taxonomy: Analysis

25. True or False? The walls of the tympanic membrane are bony.

Ans: False Complexity: Moderate Ahead: Anatomy and Physiology Review of the Ear Subject: Chapter 9 Title: Ear Disorders Taxonomy: Application

26. True or False? Infections and inflammations of middle and external ear structures are considered to be secondary otaligia.

Ans: False Complexity: Moderate Ahead: Health History Subject: Chapter 9 Title: Ear Disorders Taxonomy: Application

27. True or False? Pain in the pinna only or pinna and external ear canal suggests external otitis.

Ans: True Complexity: Difficult Ahead: Health History Subject: Chapter 9 Title: Ear Disorders Taxonomy: Analysis

28. True or False? You should insert the speculum alone into the canal before attaching it to the otoscope.

Ans: True Complexity: Difficult Ahead: Physical Examination Subject: Chapter 9 Title: Ear Disorders Taxonomy: Analysis

Essay

1. When should a comprehensive review of systems and focused review of systems be conducted?

Ans: Comprehensive ROS is conducted when a patient presents for general health maintenance/disease prevention care. Focused ROS is documented when a patient presents with a specific chief complaint.

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Complexity: Difficult Ahead: Taking a Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Analysis

2. When a patient first enters the room, what should you assess?

Ans: General appearance, physical structure, mobility, speech pattern, hearing deficits or aids Complexity: Moderate Ahead: Head-to-Toe Examination Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Application

3. What are the five components of the plan section of the final assessment findings?

Ans: Nonpharmacological interventions, pharmacological interventions, educational needs for both the patient and family, follow-up, and referrals.

Complexity: Moderate Ahead: Plan Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Application

4. When performing musculoskeletal assessments, what should be kept in mind when assessing risk factors?

Ans: The highest incidence of rheumatoid arthritis is in some groups of North American Indians, gout is more prevalent in Pacific Islanders and least prevalent in African Americans, primary osteoarthritis is more prevalent in Native Americans than the general population, sarcoidosis is most prevalent in African American females.

Complexity: Difficult Ahead: Cultural Considerations for a Comprehensive Health Assessment Subject: Chapter 4 Title: Cultural and Spiritual Assessments Taxonomy: Analysis

5. When using the Domain 4 to assess nutritional status, what assessments are included and what do they measure?

Ans: Muscle function (hand-grip strength), immune function (known inflammatory processes, known immune-suppressive processes, TLC), cognitive function (mini-mental status exam).

Complexity: Difficult Ahead: Methods of Nutritional Assessment Subject: Chapter 5 Title: Nutritional Assessment Taxonomy: Analysis

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

6. A patient presents with sleep disturbances. What are some possible associated mental health disorders?

Ans: Depression, generalized anxiety disorder, bipolar disorder Complexity: Moderate Ahead: Health History Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Application

7. What are the differential diagnoses for pruritic rash, and what diagnostic tests can be used for each?

Ans: Allergic or contact dermatitis (patch testing), atopic dermatitis (biopsy, serum total IgE, KOH scraping), arthropod bites (no test).

Complexity: Difficult Ahead: Physical Examination Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Analysis

8. You are performing an eye exam on a diabetic patient. What diseases/disorders should you examine the patient for?

Ans: Diabetic retinopathy, vascular disease Complexity: Moderate Ahead: Health History Subject: Chapter 8 Title: Eye Disorders Taxonomy: Application

9. Describe the Weber and Rinne tuning fork tests. What are they used for? How are they conducted?

Ans: Weber: tests for adequacy of bone conduction. Place the base of the tuning fork firmly against the patient’s skull on the forehead and ask the patient to identify whether the tone is heard equally in both ears. Rinne: tests for comparison of air conduction to bone conduction in each ear separately. Press the tuning fork to the mastoid bone of each ear and assess how long the patient hears the sound.

Complexity: Difficult Ahead: Physical Examination Subject: Chapter 9 Title: Ear Disorders Taxonomy: Analysis

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

Import Settings: Base Settings: Brownstone Default Information Field: Complexity Information Field: Ahead Information Field: Subject Information Field: Advanced Health Assessment and Diagnostic Reasoning Information Field: Taxonomy Highest Answer Letter: D Multiple Keywords in Same Paragraph: No NAS ISBN13: 9781284171228, add to Ahead, Title tags

Chapter: Final Exam

Multiple Choice

1. What is the main goal of obtaining the history of present illness (HPI)?

A) To get a comprehensive description of the characteristics and progression of symptoms for which the patient seeks care B) To prioritize differential diagnoses C) To assess the reliability of the individual providing the historical data D) To elicit and record any conditions requiring psychological intervention Ans: A Complexity: Moderate Ahead: Taking a Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Application

2. Which of the following assessment techniques involves using tapping to assess underlying structures?

A) Inspection B) Palpation C) Percussion D) Auscultation Ans: C Complexity: Moderate Ahead: Assessment Techniques Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Application

3. When using the SOAP format, which component includes current comorbidities and additional problems that may have become evident during the examination?

A) S B) O C) A D) P

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

Ans: D Complexity: Moderate Ahead: SOAP Approach Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Application

4. Which of the following should you consider when performing a cardiovascular assessment?

A) Cardiovascular disease is the number one killer of Asian Americans.

B) Pacific Islanders have a greater incidence of cardiovascular disease than Caucasians.

C) Among Mexican Americans, about half of males and females have cardiovascular disease.

D) Asian Americans have lower incidence of cardiovascular disease than Caucasians.

Ans: D Complexity: Difficult Ahead: Patient Assessment Subject: Chapter 4 Title: Cultural and Spiritual Assessments Taxonomy: Analysis

5. Which of the following is assessed to determine nutrient and organic compounds in excreta?

A) Serum PO4 B) Urine ketones C) Emesis D) Indirect calorimetry Ans: C Complexity: Difficult Ahead: Methods of Nutritional Assessment Subject: Chapter 5 Title: Nutritional Assessment Taxonomy: Analysis

6. A family member reports that a patient has been exhibiting flat and inappropriate emotion, as well as paranoia. Which of the following may these symptoms be indicative of?

A) Dementia B) Bipolar disorder C) Schizophrenia D) Depression Ans: C Complexity: Difficult Ahead: Health History Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Analysis

7. is caused by defects of keratin proteins and collagen genes that are responsible for structural integrity of cells.

A) Epidermolysis bullosa B) Atopic dermatitis

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

C) Psoriasis D) Seborrheic dermatitis Ans: A Complexity: Difficult Ahead: Health History Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Analysis

8. The lies behind the iris and refracts and focuses light into the retina.

A) pupil B) cornea C) lens D) fundus Ans: C Complexity: Moderate Ahead: Anatomy and Physiology Review of the Eye Subject: Chapter 8 Title: Eye Disorders Taxonomy: Application

9. Which of the following should be done when performing an ear assessment on a pediatric patient?

A) Perform the invasive portion of the examination first.

B) For children younger than 3 years, pull the ear downward, outward, and backward C) Inspect for skin cancer because sun-induced skin cancer on the pinna is more common in the pediatric population D) Observe an increased amount and coarseness of hair growth in the cartilaginous portion of the external ear canal Ans: B Complexity: Difficult Ahead: Diagnostic Reasoning Subject: Chapter 9 Title: Ear Disorders Taxonomy: Analysis

10. A patient reports that their sinus congestion is reduced in air-conditioned environments. Which of the following may be the cause of their symptoms?

A) An allergy to pollens B) Acute infection C) An allergy to pets D) Decreased humidity Ans: A Complexity: Difficult Ahead: Health History: Nose and Sinus Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Analysis

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

11. Which of the following tests is a blood assay of IgE antibodies that is used to identify specific allergens that are causing symptoms?

A) Thyroid-stimulating hormone (TSH) test B) Radioallergosorbent test (RAST) C) Coagulation studies D) Intradermal sensitivity studies Ans: B Complexity: Difficult Ahead: Diagnostic Reasoning: Nose and Sinus Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Analysis

12. Dysphagia associated with dyspnea or a cough may suggest: A) anxiety.

B) a neuromuscular disorder.

C) airway obstruction.

D) a bacterial infection.

Ans: C Complexity: Difficult Ahead: Health History: Mouth and Throat Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Analysis

13. Which of the following is part of the upper respiratory tract?

A) Pharynx B) Larynx C) Trachea D) Bronchioles Ans: A Complexity: Easy Ahead: Anatomy and Physiology Review of the Respiratory Systems Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Recall

14. The breathing pattern is always deep and most often rapid breathing.

A) sigh B) Biot C) Cheyne-Stokes D) Kussmaul Ans: D Complexity: Moderate Ahead: Health History Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Application

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

15. Upon examining a patient, you notice hollow, low-pitched breath sounds. Which of the following breath sounds would you record in their chart?

A) Vesicular B) Bronchial C) Amphoric D) Cavernous Ans: C Complexity: Difficult Ahead: Physical Examination Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Application

16. Which of the following ECG waves represents the time between the onset of atrial depolarization and ventricular depolarization?

A) P B) PR C) QRS D) ST Ans: B Complexity: Difficult Ahead: Anatomy and Physiology Review of the Cardiovascular System Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Analysis

17. A patient reports sharp chest pain that occurs when they breathe and cough. How would you characterize this type of pain?

A) Anginal B) Pleural C) Gastrointestinal D) Musculoskeletal Ans: B Complexity: Moderate Ahead: Health History Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Application

18. Upon performing a cardiovascular examination, you notice that the patient has a thin, lightly colored, circumferential ring around the iris. The patient is 35 years old. What does this finding suggest?

A) Congestive heart failure B) Central cyanosis C) Hyperlipidemia D) Anemia Ans: C Complexity: Difficult Ahead: Physical Examination Subject: Chapter 12

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

Title: Cardiovascular Disorders Taxonomy: Analysis

19. Which of the following hormones stimulates protein synthesis and growth of most cells and tissues?

A) GH B) TSH C) ACTH D) FSH Ans: A Complexity: Moderate Ahead: Anatomy and Physiology Review of the Endocrine System Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Application

20. A patient presents with profuse perspiration and moist, warm skin. Which of the following endocrine disorders may be causing these symptoms?

A) Thyrotoxicosis B) Hypothyroidism C) Hyperthyroidism D) Cushing’s syndrome Ans: C Complexity: Difficult Ahead: Health History Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Analysis

21. Upon examining a patient’s thyroid, you notice that the thyroid is diffusely enlarged. What may this indicate?

A) Graves’ disease B) Benign tumor C) Cyst D) Cancerous tumor Ans: A Complexity: Difficult Ahead: Physical Examination Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Analysis

22. Which abdominal quadrant contains the spleen?

A) Right upper quadrant B) Right lower quadrant C) Left upper quadrant D) Left lower quadrant Ans: C Complexity: Moderate

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

Ahead: Health History Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Application

23. A patient reports headaches, vertigo, and double vision. Which gastrointestinal condition may be causing these symptoms?

A) Ulcerative colitis B) Fluid and electrolyte imbalance C) GERD D) Liver carcinoma Ans: B Complexity: Difficult Ahead: Health History Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Analysis

24. A patient complains of RUQ pain that radiates to the right scapular region. The pain usually starts hours after a meal. You suspect the patient may be exhibiting signs of cholecystis. Which diagnostic tests should be run?

A) WBC B) Chest X-ray C) Upper gastrointestinal endoscopy D) Amylase levels Ans: A Complexity: Difficult Ahead: Physical Examination Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Analysis

25. Which of the following components of a neuron is responsible for the metabolic properties of the cell?

A) Cytoplasmic organelles B) Cell body C) Dendrites D) Axon Ans: B Complexity: Moderate Ahead: Anatomy and Physiology Review of the Nervous System Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Application

26. A patient complains of a headache that causes sudden, severe, and brief episodes of unilateral facial pain. Which of the following may be causing these symptoms?

A) Migraine B) Cluster headaches

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

C) Transient ischemic attacks D) Trigeminal neuralgia Ans: D Complexity: Difficult Ahead: Health History Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Analysis

27. A patient presents with a sudden severe headache and impaired motor ability on one side of the body. What diagnostic test should be run?

A) Lumbar puncture B) MRI C) CT scan D) Skull films Ans: C Complexity: Moderate Ahead: Physical Examination Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Application

28. The mainly function(s) to produce sperm and to secrete testosterone.

A) penis B) testicles C) scrotum D) urethra Ans: B Complexity: Moderate Ahead: Anatomy and Physiology Review of the Male Genitourinary System Subject: Chapter 16 Title: Male Genitourinary Disorders Taxonomy: Application

29. Nausea or vomiting may be a sign of which of the following genitourinary diseases/disorders?

A) Epididymitis B) Renal cell carcinoma C) Syphilis D) Bladder cancer Ans: A Complexity: Moderate Ahead: Health History Subject: Chapter 16 Title: Male Genitourinary Disorders Taxonomy: Application

30. The A) pelvis

separates the uterus from the abdominal cavity.

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

B) endometrium C) myometrium D) peritoneum Ans: D Complexity: Moderate Ahead: Advanced Assessment of the Female Genitourinary System Subject: Chapter 17 Title: Female Genitourinary and Breast Disorders Taxonomy: Application

31. Fevers and chills may be a sign of which of the following genitourinary diseases/disorders?

A) Uterine cancer B) Pyelonephritis C) Bacterial cystitis D) Urinary tract infection Ans: B Complexity: Moderate Ahead: Health History: Genitourinary Subject: Chapter 17 Title: Female Genitourinary and Breast Disorders Taxonomy: Application

32. Which of the following should be a consideration when performing a breast exam on a geriatric patient?

A) The nipples may secrete a white fluid.

B) Nipples and areolae will be more pigmented.

C) Upon palpation, the breasts will feel more granular.

D) Richer blood supply causes the venous system to become more noticeable.

Ans: C Complexity: Difficult Ahead: Diagnostic Reasoning: Breasts Subject: Chapter 17 Title: Female Genitourinary and Breast Disorders Taxonomy: Analysis

33. Which of the following ligaments attaches the styloid process of the ulna to the pisiform?

A) Collateral B) Radial collateral C) Transverse carpal D) Distal Ans: A Complexity: Moderate Ahead: Anatomy and Physiology Review of the Musculoskeletal System Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Application

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34. Upon performing a comprehensive review of symptoms, you notice that the patient has also experienced weight loss. Which of the following could this symptom indicate?

A) Osteomyelitis B) Septic arthritis C) Osteomalacia D) Gout Ans: C Complexity: Moderate Ahead: Health History Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Application

35. When assessing a patient’s shoulder pain, she mentions that the pain is most noticeable at night and pain is elicited with the internal and external rotation at 90 degrees and abduction greater than 30 degrees. What may these assessment findings indicate?

A) Subacromial bursitis B) Acromioclavicular joint separation C) Frozen shoulder D) Clavicle fracture Ans: A Complexity: Difficult Ahead: Physical Examination Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Analysis

Short Answer

1. Providing a legal record of impressions, perceptions, and functions of interviewing and taking a health history.

Ans: observable Complexity: Moderate Ahead: Functions of the Interview and Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Application

data is one of the five major

2. Coulehan and Block define as “listening to the total communication . . . and letting the patient know that you are really hearing.”

Ans: empathy Complexity: Moderate Ahead: Interviewing Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Application

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

3. Recording the patient’s occupation falls under the Ans: social history; SH Complexity: Easy Ahead: Taking a Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Recall

category.

4. and are the two main general considerations of a physical examination listed in the text.

Ans: Patient interaction, scope Complexity: Moderate Ahead: General Considerations Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Application

5. A physician uses the Weber and/or Rinne tests to test Ans: hearing Complexity: Difficult Ahead: Head-to-Toe Examination Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Analysis

6. The red reflex is a test of the Ans: eyes Complexity: Moderate Ahead: Head-to-Toe Examination Subject: Chapter 2 Title: Physical Examination Strategies Taxonomy: Application

.

.

7. To comply with regulations, institutions must ensure that computer monitors with sensitive patient data are not left unattended.

Ans: HIPAA Complexity: Moderate Ahead: General Considerations Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Application

8. In a physical examination, the physician spends the most attention on the patient’s musculoskeletal and neurological systems, making this a(n) type of examination.

Ans: focused

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

Complexity: Difficult Ahead: Objective Data Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Analysis

9. is the last component of the objective component of SOAP. Ans: Diagnostic tests; Diagnostic testing Complexity: Easy Ahead: Objective Data Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Recall

10. According to Braverman and Bluementhal-Barby, is the cognitive tendency to make systematic decisions based on cognitive factors rather than evidence.

Ans: bias Complexity: Moderate Ahead: Introduction Subject: Chapter 4 Title: Cultural and Spiritual Assessments Taxonomy: Application

11. The field of psychology utilizes the Ans: Implicit Association Test, IAT Complexity: Moderate Ahead: Self-Assessment Subject: Chapter 4 Title: Cultural and Spiritual Assessments Taxonomy: Application

as a way to identify implicit bias.

12. The purpose of hydrochloric acid is to lower the resting pH of the stomach to the level required for activating pepsinogen to .

Ans: pepsin Complexity: Moderate Ahead: Anatomy and Physiology Subject: Chapter 5 Title: Nutritional Assessment Taxonomy: Application

13. A finite list of foods and beverages prompting the individual to indicate typical consumption over a define time period is known as a(n) .

Ans: food frequency questionnaire, FFQ Complexity: Moderate Ahead: Methods of Nutritional Assessment Subject: Chapter 5

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

Title: Nutritional Assessment Taxonomy: Application

14. A patient reports having trouble falling asleep many nights, waking up very early many nights, and difficulty concentrating. The disorder known as is most closely associated with this pattern.

Ans: general anxiety; anxiety Complexity: Moderate Ahead: Chief Complaint and HPI Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Application

15. The physician has discovered that the patient is unable to concentrate, claims a sense of superiority, appears to have thoughts that move faster than her ability to articulate them, sleeps little, and has added a number of hobbies and personal projects to her routine. The physician most likely used the mnemonic.

Ans: DIGFAST Complexity: Difficult Ahead: Chief Complaint and HPI Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Analysis

16. A patient who is unsure of where they are and what’s happening, cannot pay attention to questions for long, and seems to give odd or unusual responses to certain stimuli is in the level of consciousness.

Ans: delirium Complexity: Easy Ahead: Mental Status Examination Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Recall

17. The layer of epidermis is mostly found in the skin on hands and feet.

Ans: stratum lucidum Complexity: Moderate Ahead: Anatomy and Physiology of the Integumentary System Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Application

18. Most hair follicles originate in the level of the skin.

Ans: dermis Complexity: Moderate Ahead: Anatomy and Physiology of the Integumentary System Subject: Chapter 7

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

Title: Integumentary Disorders Taxonomy: Application

19. An area of the patient’s arm has very smooth skin and lacks any apparent superficial features. This is likely .

Ans: a scar; scarring Complexity: Moderate Ahead: Physical Examination Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Application

20. Iris color is due to variable amounts of and Ans: eumelanin, pheomelanin Complexity: Difficult Ahead: Anatomy and Physiology Review of the Eye / Vision Subject: Chapter 8 Title: Eye Disorders Taxonomy: Analysis

.

21. A healthcare provider asks a patient whether he or she wears contact lenses. This is part of the section of the patient’s health history.

Ans: past medical history; PMI Complexity: Moderate Ahead: Health History Subject: Chapter 8 Title: Eye Disorders Taxonomy: Application

22. is a failure of the eye to accommodate very near vision.

Ans: Presbyopia Complexity: Easy Ahead: Physical Examination Subject: Chapter 8 Title: Eye Disorders Taxonomy: Recall

23. Otorrhea that takes the form of physical trauma.

Ans: clear, watery Complexity: Difficult Ahead: Health History Subject: Chapter 9 Title: Ear Disorders Taxonomy: Analysis

and

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fluid is most likely associated with

Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

24. During the physical examination, the physician notices visible blood vessels in the center of the patient’s tympanic membrane. The likeliest diagnosis is .

Ans: acute or chronic otitis; otitis Complexity: Difficult Ahead: Physical Examination Subject: Chapter 9 Title: Ear Disorders Taxonomy: Analysis

25. The hearing test is specifically designed to compare air conduction to bone conduction.

Ans: Rinne Complexity: Easy Ahead: Physical Examination Subject: Chapter 9 Title: Ear Disorders Taxonomy: Recall

26. The and sinuses cannot be directly examined.

Ans: ethmoidal, sphenoidal Complexity: Difficult Ahead: Anatomy and Physiology Review of the Nose and Sinuses Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Analysis

27. Diphenhydramine is a type of medication known as a(n) Ans: antihistamine Complexity: Moderate Ahead: Health History: Nose and Sinus Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Application

.

28. A patient presents with congestion, clear rhinorrhea, sinus pain, and patches of eczema. Knowing that there is a risk of anaphylaxis, the physician recommends the test, which will be safe for the patient and help target the specific reason for the symptoms.

Ans: RAST Complexity: Difficult Ahead: Diagnostic Reasoning: Nose and Sinus Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Analysis

29. Under normal conditions, an adult takes

breaths in a minute.

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

Ans: 12 to 20 Complexity: Easy Ahead: Anatomy and Physiology Review of the Respiratory Systems Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Recall

30. Paradoxical breathing suggests Ans: pneumothorax Complexity: Moderate Ahead: Physical Exam Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Application

31. Fremitus is examined during the Ans: palpation Complexity: Difficult Ahead: Physical Examination Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Analysis

.

part of the physical exam.

32. Calf tenderness and warmth, swelling and ankle edema, and an otherwise unexplained fever are symptoms of .

Ans: deep vein thrombosis Complexity: Moderate Ahead: Health History Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Application

33. The patient is positioned Ans: supine Complexity: Easy Ahead: Physical Examination Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Recall

when palpating the precordium and the carotid pulse.

34. A sudden onset of fatigue, heart palpitations, a constant state of wakefulness, and weight loss together suggest .

Ans: diabetes Complexity: Difficult Ahead: Health History Subject: Chapter 13

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

Title: Endocrine Disorders Taxonomy: Analysis

35. Lid lag and the presence of a rim of sclera are symptoms of Ans: thyrotoxicosis Complexity: Moderate Ahead: Physical Exam Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Application

.

36. Pancreatic secretions promote absorption of in the cells.

Ans: glucose Complexity: Difficult Ahead: Anatomy and Physiology Review of the Gastrointestinal System Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Analysis

37. The stomach, spleen, and body of the pancreas all reside in the Ans: LUQ, left upper quadrant Complexity: Easy Ahead: Anatomy and Physiology Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Recall

38. Melanin deposits around the oral cavity indicate Ans: Peutz-Jeghers syndrome Complexity: Moderate Ahead: Physical Examination Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Application

.

.

39. synapses are more common than synapses.

Ans: Chemical, electrical Complexity: Moderate Ahead: Anatomy and Physiology Review of the Nervous System Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Application

40. Palpating the masseter and temporal muscles tests the

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cranial nerve.

Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

Ans: fifth; V; 5th Complexity: Moderate Ahead: Physical Exam Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Application

41. Having a patient identify a physical object by touch with the eyes closed tests Ans: stereognosis Complexity: Easy Ahead: Physical Exam Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Recall

42. are considered to be the functioning units of the kidney.

Ans: Nephrons Complexity: Moderate Ahead: Anatomy and Physiology Review of the Male Genitourinary System Subject: Chapter 16 Title: Male Genitourinary Disorders Taxonomy: Application

43. is likely to present as pain in the genital region.

Ans: Orchitis Complexity: Difficult Ahead: Health History Subject: Chapter 16 Title: Male Genitourinary Disorders Taxonomy: Analysis

44. The internal os is contained within the .

Ans: uterus Complexity: Difficult Ahead: Anatomy and Physiology: Female Genitourinary System Genitourinary System Subject: Chapter 17 Taxonomy: Understand

45. A bluish hue to a cervix is considered normal in a(n) Ans: pregnant Complexity: Moderate Ahead: Physical Exam: Genitourinary Genitourinary System Subject: Chapter 17 Taxonomy:

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patient.

.

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46. A slit-like indicates that a patient has borne a child or children.

Ans: os Complexity: Difficult Ahead: Physical Exam: Genitourinary Genitourinary System Subject: Chapter 17 Taxonomy: Analyze

47. A bloody discharge from the nipples suggests Ans: cancer Complexity: Easy Ahead: Health History: Breasts Genitourinary System Subject: Chapter 17 Taxonomy: Remember

48. Increased and pregnancy.

Ans: estrogen, progesterone Complexity: Easy Ahead: Diagnostic Reasoning: Breasts Genitourinary System Subject: Chapter 17 Taxonomy: Recall

.

cause increased sensitivity of the nipples in early

49. The “Five Ps” of musculoskeletal examination include pain, pallor, paralysis, .

Ans: paresthesia, pulselessness Complexity: Moderate Ahead: Physical Exam Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Application

,and

50. A 55-year-old diabetic woman complains of a complete restriction of motion in her shoulder. should be suspected.

Ans: Adhesive capsulitis, frozen shoulder Complexity: Moderate Ahead: Physical Exam Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Application

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

Essay

1. Why is it important to assess the reliability of health history data? What are some factors that can negatively impact the reliability?

Ans: To determine the accuracy of the data. Language barriers and emotions such as fear and shame may negatively impact the reliability of data.

Complexity: Moderate Ahead: Taking a Health History Subject: Chapter 1 Title: Interview and History-Taking Strategies Taxonomy: Application

2. What is the purpose of a genogram?

Ans: To provide a rapid way to condense family history data; indicates whether immediate relatives are alive or have died, and what type of comorbidities each individual has or had.

Complexity: Moderate Ahead: Subjective Data Subject: Chapter 3 Title: Documentation Strategies Taxonomy: Application

3. Describe what happens in the gastrointestinal system when the sympathetic nervous system is activated.

Ans: Blood flow is diverted away from the gastrointestinal system. Saliva production, gallbladder function, pancreatic enzyme release, digestive organ functions, and peristalsis are inhibited.

Complexity: Difficult Ahead: Anatomy and Physiology Subject: Chapter 5 Title: Nutritional Assessment Taxonomy: Analysis

4. Upon conducting a mental health examination, you suspect that the patient may have bipolar disorder.

What is a key screening question to ask the patient? What mnemonic may be used to assist you in assessing the patient?

Ans: Ask whether the patient experiences times of feeling so happy or full of energy that friends of the patient report that the patient talks to fast or displays hyperactivity. The mnemonic is DIGFAST. Complexity: Difficult Ahead: Health History Subject: Chapter 6 Title: Mental Health Disorders Taxonomy: Analysis

5. What are the functions of the eccrine and apocrine glands?

Ans: Eccrine: regulate body temperature through water secretion and evaporation under control of the hypothalamus. Apocrine: Released under cholinergic and hormonal control; when mixed with bacteria on the surface, produce body odor.

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

Complexity: Difficult Ahead: Anatomy and Physiology Review of the Integumentary System Subject: Chapter 7 Title: Integumentary Disorders Taxonomy: Analysis

6. A patient reports gradual hearing loss. What are potential causes of this symptom?

Ans: Presbycusis, ototoxic drugs, chronic infection, otosclerosis, brain attack.

Complexity: Difficult Ahead: Health History Subject: Chapter 9 Title: Ear Disorders Taxonomy: Analysis

7. A pregnant patient complain of a sore throat. What are some considerations when assessing the mouth and throat of a pregnant patient?

Ans: Inspect carefully for dental caries, because pregnant patients may be at risk for dental caries related to the increased nutritional demands of pregnancy. Note any gingival hyperplasia or bleeding, because this is a common finding associated with pregnancy.

Complexity: Difficult Ahead: Diagnostic Reasoning: Mouth and Throat Subject: Chapter 10 Title: Nose, Sinus, Mouth, and Throat Disorders Taxonomy: Analysis

8. Describe three abnormal respiratory rates. How are they defined?

Ans: Tachypnea is a rapid, persistent respiratory rate of 25 or more respirations per minute. Bradypnea is a slow respiration rate, fewer than 12 breaths per minute. Hyperpnea is breathing that is deeper and more rapid than is normal at rest.

Complexity: Moderate Ahead: Health History Subject: Chapter 11 Title: Respiratory Disorders Taxonomy: Application

9. What are the four basic heart sounds? Describe what causes each of the sounds.

Ans: S1 (results from closure of the mitral and tricuspid valves), S2 (results from the closure of the aortic and pulmonic valves), S3 (results from passive flow of blood from the atria), S4 (a late diastolic sound immediately preceding S1).

Complexity: Difficult Ahead: Physical Examination Subject: Chapter 12 Title: Cardiovascular Disorders Taxonomy: Analysis

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10. A patient reports fatigue, weight loss, dehydration, and gastrointestinal issues. You believe the patient’s symptoms may be due to adrenocortical insufficiency. What diagnostic tests should you run?

Ans: CBC, 24-hour urine studies Complexity: Difficult Ahead: Physical Exam Subject: Chapter 13 Title: Endocrine Disorders Taxonomy: Analysis

11. What is the most common cause of acute abdomen pain for children younger than 2 years of age?

What are symptoms of this condition?

Ans: Intussusception; tense abdomen, vomiting, colicky pain.

Complexity: Difficult Ahead: Diagnostic Reasoning Subject: Chapter 14 Title: Gastrointestinal Disorders Taxonomy: Analysis

12. How do you assess cranial nerve I function? What are some abnormal findings?

Ans: Test the patient’s recognition of familiar, nonirritating odors, such as coffee or cloves. Test each nostril independently. The loss of the sense of smell may result from compression of the olfactory tract or bulb by an intracranial neoplasm. It may also be caused by sinusitis or trauma to the cribriform plate.

Complexity: Difficult Ahead: Physical Exam Subject: Chapter 15 Title: Neurological Disorders Taxonomy: Analysis

13. A patient complains of pain with urination. What does pain before urination, at the beginning, during the entire urination, or at the end of urination suggest?

Ans: Before (bladder irritation), beginning (bladder outlet obstruction or gonococcal urethritis), during (pyelonephritis), at the end (bladder spasm).

Complexity: Difficult Ahead: Health History Subject: Chapter 16 Title: Male Genitourinary Disorders Taxonomy: Analysis

14. Describe the phases of the menstrual cycle.

Ans: Day 1 is the preovulatory phase, low estrogen and progesterone levels in the bloodstream stimulate the hypothalamus to secrete gonadotropin-releasing hormone. Days 6–14 is the follicular phase when LH and FSH cause estrogen secretion. Days 15–28 is the luteal or secretory phase when FSH and LH levels decline.

Complexity: Difficult Ahead: Advanced Assessment of the Female Genitourinary System Subject: Chapter 17 Title: Female Genitourinary and Breast Disorders Taxonomy: Analysis

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Advanced Health Assessment and Diagnostic Reasoning, Fourth Edition Test Bank

15. What does sharp, aching, or burning musculoskeletal pain indicate?

Ans: Sharp: seen with injuries to the skin, tendon, superficial muscles or ligaments, and bursae. Aching: seen with deep tissue problems. Burning: seen with skin injuries such as blisters, fungal foot infections, or nerve injury.

Complexity: Difficult Ahead: Health History Subject: Chapter 18 Title: Musculoskeletal Disorders Taxonomy: Analysis

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