Nur Quiz #2 Unit 6,7,8

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Nur Quiz #2 Unit 6,7,8 - Quiz

Questions and Answers
  • 1. 

    The examiner is palpating the apical impulse. The normal size of this impulse:

    • A.

      Is less than 1 cm

    • B.

      Is about 2 cm

    • C.

      Is 3 cm

    • D.

      Varies depending on the size of the person

    Correct Answer
    B. Is about 2 cm
    Explanation
    The apical impulse refers to the pulsation felt over the apex of the heart during palpation. The normal size of this impulse is about 2 cm. This means that when the examiner places their hand on the chest, they should feel a slight, gentle pulsation that measures approximately 2 cm in diameter. It is important to note that the size of the apical impulse can vary depending on the size of the person, but on average, it is about 2 cm.

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  • 2. 

    The examiner wishes to listen in the pulmonic valve area. To do this, the stethascope would be placed at the:

    • A.

      Second right interspace

    • B.

      Second left interspace

    • C.

      Left lower sternal border

    • D.

      Fifth interspace, left midclavicular line

    Correct Answer
    B. Second left interspace
    Explanation
    The correct answer is the second left interspace. This is the correct placement for listening to the pulmonic valve area. The pulmonic valve is located in the second left interspace, which is the area between the second and third ribs on the left side of the sternum. Placing the stethoscope in this area allows for optimal auscultation of the pulmonic valve sounds.

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  • 3. 

    When auscultating the heart, your first step is to

    • A.

      Identify S1 and S2

    • B.

      Listen for S3 and S4

    • C.

      Listen for murmurs

    • D.

      Identify all four sounds on the first round

    Correct Answer
    A. Identify S1 and S2
    Explanation
    When auscultating the heart, the first step is to identify S1 and S2. S1 is the first heart sound, which is caused by the closure of the mitral and tricuspid valves. S2 is the second heart sound, which is caused by the closure of the aortic and pulmonic valves. By identifying these two sounds, healthcare professionals can determine if there are any abnormalities in the timing or intensity of the heart sounds, which can help in diagnosing various cardiac conditions.

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  • 4. 

    When you have your patient squat, the venous return to the heart increasesand the peripheral vascular resistance increases.The blood pressure, stroke volume, and the volume of blood in the left ventricle all rise.This helps to identify a mitral valve prolapse and to distinguishhypertrophic cardiomyopathy from aortic stenosis.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    When a patient squats, the venous return to the heart increases due to increased pressure in the abdomen. This increased venous return leads to an increase in stroke volume and the volume of blood in the left ventricle. Additionally, squatting also increases peripheral vascular resistance, which further contributes to an increase in blood pressure. These changes in blood pressure, stroke volume, and left ventricular volume can help in identifying certain cardiac conditions. For example, in a mitral valve prolapse, squatting may cause a significant increase in left ventricular volume, while in hypertrophic cardiomyopathy, the increase in blood pressure may be more pronounced compared to aortic stenosis.

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  • 5. 

    You are auscultating at the 5th intercostal space at the midclavicular line. You are most likely to hear which valve?

    • A.

      Aortic

    • B.

      Pulmonic

    • C.

      Mitral

    • D.

      Tricuspid

    Correct Answer
    C. Mitral
    Explanation
    When auscultating at the 5th intercostal space at the midclavicular line, the most likely valve to be heard is the mitral valve. The mitral valve is located between the left atrium and left ventricle, and it is best heard at the apex of the heart, which is in the 5th intercostal space at the midclavicular line. The aortic valve is heard best at the 2nd intercostal space at the right sternal border, the pulmonic valve is heard best at the 2nd intercostal space at the left sternal border, and the tricuspid valve is heard best at the 4th intercostal space at the left sternal border.

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  • 6. 

    Concerning symptoms of the peripheral vascular system would include?

    • A.

      Edema of the calves, legs, or feet

    • B.

      Pain

    • C.

      Numbness of the legs

    • D.

      Hair loss on the lower extremities

    Correct Answer(s)
    B. Pain
    C. Numbness of the legs
    D. Hair loss on the lower extremities
    Explanation
    Symptoms of the peripheral vascular system can include pain, numbness of the legs, and hair loss on the lower extremities. Edema of the calves, legs, or feet can also be a symptom of peripheral vascular disease, but it is not mentioned in the answer choices. These symptoms can indicate a decrease in blood flow to the legs and feet, which may be caused by conditions such as peripheral artery disease or peripheral neuropathy.

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  • 7. 

    Which lung sound possesses the characteristics of being louder and higher in pitch, with a short silence between inspiration and expiration and with expiration being longer than inspiration?

    • A.

      Bronchovesicular

    • B.

      Vesicular

    • C.

      Bronchial

    • D.

      Tracheal

    Correct Answer
    C. Bronchial
    Explanation
    Bronchial lung sounds possess the characteristics described in the question. These sounds are louder and higher in pitch compared to other lung sounds. There is a short silence between inspiration and expiration, and expiration is longer than inspiration. Bronchovesicular sounds have a mix of characteristics from bronchial and vesicular sounds, but they do not match the specific characteristics mentioned in the question. Vesicular sounds are softer and lower in pitch, while tracheal sounds are louder and harsher.

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  • 8. 

    When crackles, wheezes, or rhonchi clear with a cough, which of the following is a likely etiology?

    • A.

      Bronchitis

    • B.

      Simple asthma

    • C.

      Cystic fibrosis

    • D.

      Heart failure

    Correct Answer
    A. Bronchitis
    Explanation
    When crackles, wheezes, or rhonchi clear with a cough, bronchitis is a likely etiology. Bronchitis is an inflammation of the bronchial tubes, which can cause excess mucus production and airway obstruction. The crackles, wheezes, or rhonchi are indicative of airway congestion and inflammation. When a person with bronchitis coughs, it helps to clear the airways and temporarily alleviate the symptoms. Simple asthma and cystic fibrosis are chronic conditions that may not be relieved with a cough, while heart failure typically presents with different symptoms such as fluid retention and shortness of breath.

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  • 9. 

    A 13 year old boy presents in your office.he denies any symptoms, shortness of breathe, chest pains, or lightheadedness on exertion. yet his grandmother thinks his chest looks funny. upon visual exam of the chest, you note that the lower portion of the sternum is depressed. what disorder of the thorax would best describe it?

    • A.

      Barrel chest

    • B.

      Funnel chest (pectus excavatum)

    • C.

      Pigeon Chest (pectus carinatum)

    • D.

      Thoracic kyphoscoliosis

    Correct Answer
    B. Funnel chest (pectus excavatum)
    Explanation
    The correct answer is Funnel chest (pectus excavatum). Funnel chest, also known as pectus excavatum, is a condition where the lower portion of the sternum is depressed, causing the chest to have a sunken or caved-in appearance. This condition is usually asymptomatic and may only be noticed by others, such as in this case where the boy's grandmother observed it. Funnel chest can be present from birth or develop during adolescence. It is a common congenital deformity of the chest and can be corrected with surgery if it causes significant cosmetic or functional concerns.

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  • 10. 

    A common cause of chronic cough in adults is GERD

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    GERD, or gastroesophageal reflux disease, is a condition where stomach acid flows back into the esophagus, causing irritation and inflammation. This can lead to symptoms such as heartburn and regurgitation, but it can also cause a chronic cough. The acid irritates the nerves in the throat, triggering a cough reflex. Therefore, it is true that GERD is a common cause of chronic cough in adults.

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  • 11. 

    Order of examination for the lungs should be: 

    • A.

      Auscultation, inspection, palpation, percussion

    • B.

      Palpation, percussion, auscultation, inspection

    • C.

      Percussion, palpation, auscultation, inspection

    • D.

      Inspection, palpation, percussion, and auscultation

    Correct Answer
    D. Inspection, palpation, percussion, and auscultation
    Explanation
    The correct order of examination for the lungs is inspection, palpation, percussion, and auscultation. This order allows the healthcare provider to first visually assess the patient's breathing pattern, chest symmetry, and any visible abnormalities. Palpation follows, where the provider uses their hands to feel for any tenderness, masses, or abnormal movements. Percussion is then performed, involving tapping on the chest to assess the density and resonance of underlying structures. Finally, auscultation is conducted using a stethoscope to listen to the breath sounds, which provides information about air movement and possible abnormalities. This sequential approach allows for a comprehensive assessment of the lungs.

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  • 12. 

    Common or concerning symptoms for respiratory health include:

    • A.

      Shortness of breath (dyspnea)

    • B.

      Wheezing

    • C.

      Hemoptysis

    • D.

      All of the above

    Correct Answer
    D. All of the above
    Explanation
    All of the above symptoms are common or concerning for respiratory health. Shortness of breath (dyspnea) can indicate various respiratory conditions, such as asthma or chronic obstructive pulmonary disease (COPD). Wheezing is a high-pitched whistling sound that occurs during breathing and can be a sign of asthma or bronchitis. Hemoptysis refers to coughing up blood, which can be a symptom of lung infections, tuberculosis, or even lung cancer. Therefore, experiencing any of these symptoms should be taken seriously and prompt medical attention should be sought.

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  • 13. 

    The lateral diameter of the adult chest should be larger than its anteroposterior diameter

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    The lateral diameter of the adult chest should be larger than its anteroposterior diameter because the lungs are positioned more towards the sides of the chest, resulting in a wider chest width. This allows for greater lung expansion during breathing and accommodates the heart, which is located more towards the center of the chest. Additionally, a larger lateral diameter provides more space for the ribs to move during respiration, facilitating efficient breathing.

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  • 14. 

    Adventitious breath sounds may include?

    • A.

      Wheezes

    • B.

      Rhonchi

    • C.

      Crackles

    • D.

      All of the above

    Correct Answer
    D. All of the above
    Explanation
    Adventitious breath sounds refer to abnormal sounds heard during breathing. Wheezes, rhonchi, and crackles are all examples of adventitious breath sounds. Wheezes are high-pitched, musical sounds typically heard during expiration and indicate narrowed airways. Rhonchi are low-pitched sounds caused by airway obstruction or mucus accumulation. Crackles are discontinuous, popping sounds heard during inspiration and suggest fluid or inflammation in the lungs. Therefore, all of the above options are correct as they are examples of adventitious breath sounds.

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  • 15. 

    You are auscultating Mr. Campbells lungs with your stethoscope. you ask him to say "99" each time you place your stethoscope on his back. what test is this?

    • A.

      Egophony

    • B.

      Bronchophony

    • C.

      Whispered pectoriloquy

    • D.

      Tactile fremitus

    Correct Answer
    B. Bronchophony
    Explanation
    Bronchophony is a test where the patient is asked to say a specific phrase, such as "99," while the healthcare provider listens to their lungs with a stethoscope. This test helps to assess the clarity and intensity of the patient's spoken sounds, which can indicate abnormalities in the lungs, such as consolidation or fluid accumulation. In this case, the question describes the exact procedure of asking Mr. Campbell to say "99" while auscultating his lungs, which aligns with the bronchophony test.

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  • 16. 

    Structures in the right upper quadrant include:

    • A.

      Liver

    • B.

      Gallbaldder

    • C.

      Ascending colon

    • D.

      All of the above

    Correct Answer
    D. All of the above
    Explanation
    The structures mentioned in the right upper quadrant include the liver, gallbladder, and ascending colon. The liver is a large organ located in the upper right side of the abdomen, responsible for detoxification, metabolism of nutrients, and production of bile. The gallbladder is a small organ located beneath the liver, which stores and concentrates bile produced by the liver. The ascending colon is the part of the large intestine that runs vertically on the right side of the abdomen. Therefore, all of the above structures are found in the right upper quadrant.

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  • 17. 

    Inferior wall myocardial infraction angina commonly presents as indigestion and is precipitated by exertion

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Inferior wall myocardial infarction angina commonly presents as indigestion and is precipitated by exertion. This means that when someone experiences an inferior wall myocardial infarction, they may mistake the symptoms for indigestion. Additionally, the symptoms are often triggered or worsened by physical exertion. Therefore, the statement is true.

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  • 18. 

    The order of examination of the abdomen is:

    • A.

      Inspection, auscultation, percussion, and palpation

    • B.

      Percussion, auscultation, palpation, and inspection

    • C.

      Auscultation, inspection, palpation, and percussion

    • D.

      Inspection, palpation, auscultation, and percussion

    Correct Answer
    A. Inspection, auscultation, percussion, and palpation
    Explanation
    The correct order of examination of the abdomen is inspection, auscultation, percussion, and palpation. This sequence allows for a systematic approach to assess the abdomen. Inspection involves visually observing the abdomen for any abnormalities such as scars, distention, or masses. Auscultation involves listening to the bowel sounds using a stethoscope to assess for any abnormal sounds or absence of bowel sounds. Percussion involves tapping on the abdomen to assess the density of underlying organs and detect any abnormal fluid or masses. Palpation involves gently pressing on the abdomen to assess for tenderness, organ enlargement, or abnormal masses. This order ensures that the examiner does not disrupt bowel sounds or create false percussion sounds by palpating before auscultation and percussion.

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  • 19. 

    In diagnosing acute appendicitis, deep palpation on the LLQ produces pain in the RLQ. This is called

    • A.

      Russel's sign

    • B.

      Rovsing sign

    • C.

      Patrick's sign

    • D.

      Goodman's sign

    Correct Answer
    B. Rovsing sign
    Explanation
    Rovsing sign is a clinical finding in which deep palpation on the left lower quadrant (LLQ) of the abdomen causes pain in the right lower quadrant (RLQ). This is indicative of acute appendicitis, as the inflammation and irritation of the appendix can cause pain to radiate to the RLQ. Russel's sign, Patrick's sign, and Goodman's sign are not associated with this specific finding.

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  • 20. 

    Lymph from the breasts drains from the central axillary nodes to the infraclavicular and supraclavicular nodes 

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Lymph from the breasts drains from the central axillary nodes to the infraclavicular and supraclavicular nodes. This is because the lymphatic vessels in the breasts drain into the axillary lymph nodes, which are located in the armpit region. From there, the lymph flows towards the infraclavicular and supraclavicular nodes, which are located below and above the collarbone respectively. This lymphatic drainage pathway helps in the removal of waste products and toxins from the breast tissue.

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  • 21. 

    Common causes of adult chronic cough could be caused by?

    • A.

      Cancer

    • B.

      Asthma/allergies

    • C.

      Gastro-esophageal reflux disease

    • D.

      All of the above

    Correct Answer
    D. All of the above
    Explanation
    The correct answer is "all of the above." This means that all the options listed, including cancer, asthma/allergies, and gastro-esophageal reflux disease, can be common causes of adult chronic cough. Chronic cough is often a symptom of these conditions, and it is important to consider all possibilities when diagnosing and treating a patient with a persistent cough.

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  • 22. 

     Periumbilical pain could be an early sign of an inflamed appendix

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Periumbilical pain is pain that occurs around the belly button. This type of pain can be an early sign of inflammation in the appendix, a condition known as appendicitis. Appendicitis is a medical emergency that requires immediate attention and possible surgical removal of the appendix. Therefore, the statement "Periumbilical pain could be an early sign of an inflamed appendix" is true.

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  • 23. 

    The straight leg raise is a good test to assess peritoneal inflammation

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    The straight leg raise test is not used to assess peritoneal inflammation. It is a physical examination maneuver used to evaluate for nerve impingement or irritation in the lower back and legs. Peritoneal inflammation is typically assessed through other methods such as physical examination findings, medical history, and imaging studies.

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  • 24. 

    Important questions to ask the patient concerning the gastrointestinal area include?

    • A.

      Have you had any change in your bowel habits?

    • B.

      Have you experienced any blood in your stool?

    • C.

      Have you recently been coughing and/or wheezing?

    • D.

      All of the above

    Correct Answer
    D. All of the above
    Explanation
    The correct answer is "All of the above". When assessing the gastrointestinal area, it is important to ask the patient about any changes in bowel habits, as this can indicate potential issues such as constipation or diarrhea. Asking about blood in the stool is also crucial, as it can be a sign of gastrointestinal bleeding. Lastly, inquiring about coughing and wheezing is important because it can suggest potential respiratory issues that may be related to the gastrointestinal system.

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  • 25. 

    Traveling and eating in areas of poor sanitation, or the ingestion of contaminated water or food can increase one's exposure to?

    • A.

      Hepatitis A

    • B.

      Hepatitis B

    • C.

      Hepatitis C

    • D.

      Hepatitis E

    Correct Answer
    A. Hepatitis A
    Explanation
    Traveling and eating in areas of poor sanitation or consuming contaminated water or food can increase the risk of exposure to Hepatitis A. Hepatitis A is a viral infection that primarily spreads through the fecal-oral route, meaning that it is transmitted through contact with the feces of an infected person. In areas with poor sanitation, the risk of contamination of water and food with the virus is higher, leading to an increased likelihood of contracting Hepatitis A.

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