Physical Examination And Health Assessment Test

Clinically Reviewed by Nicolette Natale
Nicolette Natale, DO (Medicine) |
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Nicolette Natale is a dedicated healthcare professional with a diverse background in medicine and education. She holds a Doctor of Osteopathic Medicine degree from Nova Southeastern University, as well as Bachelor's degrees in English Literature and Psychology from the University of Miami. With over 6 years of experience, Nicolette is a physician, research coordinator, and medical writer who is committed to advancing medical research and providing quality patient care.
 , DO (Medicine)
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Arnoldjr2
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  • 1/45 Questions

    A patient reports feeling dizzy when standing up. What should be assessed first?

    • Color of their clothing
    • Orthostatic blood pressure
    • Their preference for room decorations
    • Latest social media updates
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About This Quiz

Take our "Physical Examination and Health Assessment Test" and see if you have got what it takes to understand the basics of a physical check-up! This quiz is all about the steps and tools doctors use to examine patients. You will answer questions about the different parts of a physical assessment, like checking your heartbeat, measuring blood pressure, and looking at how your eyes react to light.

Each question helps you understand what health professionals look for during a routine exam and why these checks are important. Whether you are curious about healthcare or just want to test your knowledge, this "Physical Examination and Health Assessment Test" will give you a clearer picture of the medical procedures.

Physical Examination And Health Assessment Test - Quiz

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  • 2. 

    When collecting a patient's health history, which of the following categories is most relevant to the consumption of alcohol, tobacco, caffeine, or herbal products?

    • Illegal activity

    • Habits and lifestyle patterns

    • Fun and pleasure

    • Rest and recreation

    Correct Answer
    A. Habits and lifestyle patterns
    Explanation
    Alcohol, tobacco, caffeine, and herbal products can significantly impact a person's health.  These substances can affect various body systems and contribute to different health conditions.  When healthcare providers ask about these habits, they are trying to understand potential risks or contributing factors to your health.  This information helps them make better decisions about your care and provide appropriate advice or treatment.

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  • 3. 

    Which of the following is a priority when assessing a patient with a suspected stroke?

    • Check their shoe size

    • Assess their cognitive function

    • Ask about their dietary preferences

    • Evaluate their fashion sense

    Correct Answer
    A. Assess their cognitive function
    Explanation
    Assessing cognitive function is critical when evaluating a patient with a suspected stroke. This involves checking for signs of neurological impairment such as altered speech, disorientation, and inability to understand simple commands. These symptoms help pinpoint the affected area of the brain and determine the severity of the stroke, guiding urgent care and treatment decisions.

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  • 4. 

    A patient has been admitted, and during the physical assessment, decreased skin turgor and dry lips were observed. What is the most appropriate action to take while the assessment is ongoing?

    • A chair to sit on

    • Medication

    • Water

    • Some snacks

    Correct Answer
    A. Water
    Explanation
    Decreased skin turgor and dry lips are signs of dehydration. Offering water is the most appropriate immediate action to help rehydrate the patient, improving comfort and potentially enhancing the accuracy of ongoing assessments. Ensuring hydration is a simple yet essential step in managing dehydration while continuing with the physical evaluation.

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  • 5. 

    When performing a head-to-toe assessment, after the neurologic evaluation, what is the next step?

    • Skin, hair, head, and neck, including eyes, ear, nose, and mouth

    • Chest, back, arm, abdomen

    • Perineal area, legs, and feet

    • Eyes and ears alone

    Correct Answer
    A. Skin, hair, head, and neck, including eyes, ear, nose, and mouth
    Explanation
    After starting a head-to-toe assessment with a neurologic evaluation, the next step is to assess the skin, hair, head, and neck, including the sensory organs such as the eyes, ears, nose, and mouth. This order allows for a systematic examination of areas that can provide key health insights. Conditions such as dehydration, jaundice, or infection can be detected during this portion of the assessment, helping healthcare providers identify potential health issues early in the evaluation process.

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  • 6. 

    Is it necessary to wash your hands during the interview portion of a physical assessment if you are not touching the patient?

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Hand hygiene is a crucial component of infection control, even during non-contact interactions such as patient interviews. While physical contact may not occur, healthcare providers should still wash their hands before and after each patient interaction to prevent the spread of germs and infections. Hand washing demonstrates a commitment to maintaining a sterile environment, which protects both the patient and the healthcare provider. It is a fundamental standard of care and an essential part of ensuring patient safety and maintaining trust in the healthcare setting, even during seemingly low-risk activities such as interviews.

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  • 7. 

    In a person with good cardiac function and distal perfusion, how long should capillary refill take?

    • Less than 3 seconds

    • More than 3 seconds

    • More than 5 seconds

    • Around 5 seconds

    Correct Answer
    A. Less than 3 seconds
    Explanation
    Capillary refill time is a key measure of circulatory efficiency. When pressing on a nail or skin, the return of color should occur within less than 3 seconds in individuals with good cardiac output and adequate peripheral perfusion. Delayed capillary refill may indicate poor perfusion, dehydration, or shock, warranting further evaluation of the patient’s circulatory and cardiac health.

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  • 8. 

    What standardized tool is used to objectively measure a patient's level of consciousness?

    • Glasgow Coma Scale

    • PERRLA

    • Rhomberg Test

    • Motor function assessment

    Correct Answer
    A. Glasgow Coma Scale
    Explanation
    The Glasgow Coma Scale (GCS) is a standardized tool used to measure a patient’s level of consciousness. It evaluates three key areas: eye-opening, verbal response, and motor response to stimuli. The GCS provides a score between 3 and 15, with lower scores indicating deeper unconsciousness and higher scores representing full alertness. This tool is widely used in emergency and trauma care to assess brain injury severity and guide treatment decisions based on a patient’s neurological function.

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  • 9. 

    Which statement indicates that a nurse understands the appropriate timing for a physical assessment?

    • "I will do it as soon as possible."

    • "I think the next shift will have to do it."

    • "I will do it after I give the medication." 

    • "Maybe later, when I am done with others."

    Correct Answer
    A. "I will do it as soon as possible."
    Explanation
    Physical assessments give nurses important information about a patient's health.  Doing it as soon as possible is important because it helps identify any problems or changes in the patient's condition quickly. This allows the nurse to take action right away, if needed, and provide the best possible care. Delaying the assessment could mean missing important signs or symptoms, which might put the patient's well-being at risk.

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  • 10. 

    A patient presents with increased skin turgor in the lower extremities, characterized by smooth, taut, and shiny skin that cannot be grasped or raised. What condition is most likely?

    • Enema

    • Decubitus

    • Edema

    • Infection

    Correct Answer
    A. Edema
    Explanation
    Increased skin turgor with smooth, taut, and shiny skin typically indicates edema, a condition caused by fluid accumulation in the tissues. It can result from heart failure, kidney disease, or other underlying health issues. The skin's inability to be easily grasped or raised is a key characteristic of fluid retention, which needs to be evaluated further to determine its cause.

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  • 11. 

    Teaching patients to perform breast self-exams is only directly related to females. True or False?

    • True

    • False

    Correct Answer
    A. False
    Explanation
    It is a common misconception that breast self-exams are only relevant for females. However, both males and females can benefit from performing regular breast self-exams. Men also have breast tissue and can develop breast cancer, albeit at much lower rates than women. By performing regular self-exams, both men and women can become familiar with the normal state of their breast tissue, making it easier to notice any unusual changes such as lumps, thickening, or changes in size or shape. Early detection of these changes can lead to earlier diagnosis and treatment, improving outcomes.

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  • 12. 

    What is the medical term for a lateral curvature of the spine?

    • Spina Bifida

    • Kyphosis

    • Lordosis

    • Scoliosis

    Correct Answer
    A. Scoliosis
    Explanation
    Scoliosis is a lateral or sideways curvature of the spine that often develops during adolescence but can also result from neuromuscular conditions or congenital abnormalities. In idiopathic scoliosis, the cause is unknown. The curvature can vary in severity, and more pronounced cases may lead to physical deformities or impairments in breathing. Scoliosis is diagnosed through physical examination and imaging, such as X-rays. Treatment may involve observation for mild cases, bracing for moderate curves, and surgical intervention in severe cases to correct the spinal alignment and prevent progression.

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  • 13. 

    Where is S1 auscultated most clearly?

    • Apex of the heart

    • Base of heart

    • Around the heart

    • All over the heart

    Correct Answer
    A. Apex of the heart
    Explanation
    The first heart sound, S1, is most clearly auscultated at the apex of the heart. The apex is located at the lower left side of the chest, near the fifth intercostal space at the midclavicular line. This location is closest to the mitral valve, one of the atrioventricular valves involved in producing the S1 sound when it closes. Auscultation at the apex allows for the best auditory detection of S1, providing valuable information about the function of the mitral and tricuspid valves as they close at the start of ventricular systole.

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  • 14. 

    Which of the following is indicative of acute or chronic respiratory distress?

    • Height

    • Posture

    • Weight

    • Hair loss

    Correct Answer
    A. Posture
    Explanation
    Posture can be indicative of both acute and chronic respiratory distress. Individuals experiencing respiratory difficulties often adopt specific positions to ease their breathing. For instance, in acute respiratory distress, a person might lean forward and use their arms to support their upper body (known as the tripod position), which helps to maximize air intake by enlarging the chest cavity. Similarly, those with chronic respiratory conditions may display a hunched posture to relieve discomfort. Recognizing these postural adaptations is important in assessing respiratory function and the severity of respiratory distress.

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  • 15. 

    Before beginning a physical examination, what should be done to make the patient more comfortable?

    • Give patient a warm blanket

    • Ask if patient wants a glass of water

    • Offer patient to empty his/her bladder

    • Provide a small

    Correct Answer
    A. Offer patient to empty his/her bladder
    Explanation
    Before beginning a physical examination, it is essential to offer the patient the opportunity to empty their bladder. This practice enhances the patient's comfort during the examination, which can involve palpation and pressing on the abdominal area. An empty bladder not only makes the patient more comfortable but also facilitates a more accurate and easier examination, particularly for abdominal assessments. Addressing this basic comfort need can also help reduce anxiety and promote a more cooperative environment during the examination process.

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  • 16. 

    Which two significant alterations in bowel sounds indicate possible gastrointestinal dysfunction?

    • Hyperactive and hypoactive bowel sounds

    • Loud and quiet bowel sounds

    • Fetid and scentless bowel sounds

    • Noisy and loud bowel sounds

    Correct Answer
    A. Hyperactive and hypoactive bowel sounds
    Explanation
    In the assessment of gastrointestinal function, significant alterations in bowel sounds include hyperactive and hypoactive sounds. Hyperactive bowel sounds can indicate conditions such as diarrhea or gastroenteritis, where there is increased intestinal activity. Hypoactive bowel sounds, on the other hand, might be noted in cases of ileus or obstruction, where there is decreased activity in the intestines. These distinctions in bowel sound activity are crucial for diagnosing various gastrointestinal conditions and determining the appropriate interventions. The other options, such as loud, quiet, fetid, scentless, noisy, and loud, do not specifically describe the clinical relevance of bowel sound activity.

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  • 17. 

    When conducting a respiratory assessment, which of the following techniques is most appropriate?

    • Use a stethoscope over the clothing of a patient who feels cold

    • Instruct patient to breathe through his or her mouth quietly and more deeply and slowly than in a usual respiration

    • Allow a patient with a slight lower back pain to lie supine on bed

    • Listen to the heart sound at the same time that your are listening to the lung sounds

    Correct Answer
    A. Instruct patient to breathe through his or her mouth quietly and more deeply and slowly than in a usual respiration
    Explanation
    During a respiratory assessment, instructing the patient to breathe through their mouth quietly and more deeply and slowly than usual is the most appropriate technique. This method helps to maximize lung expansion and allows the healthcare provider to clearly hear the lung sounds, facilitating the detection of any abnormalities such as wheezes, crackles, or diminished breath sounds. This technique ensures a thorough assessment of lung function and is crucial for diagnosing respiratory conditions accurately. Other options may interfere with the quality of the sounds obtained during the auscultation.

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  • 18. 

    What does PERRLA refer to?

    • Motor function

    • Order of assessment

    • Level of consciousness

    • Pupillary response

    Correct Answer
    A. Pupillary response
    Explanation
    PERRLA stands for "Pupils Equal, Round, Reactive to Light and Accommodation." This term is used in medical assessments to describe a healthy pupillary response, which is a critical component of the neurological examination. The evaluation of PERRLA helps determine if the pupils are functioning correctly, indicating the health of the optic nerves and overall brain function. It assesses pupil size, shape, equality, and their responsiveness to light and accommodation (focusing on objects at different distances). This test is essential for identifying potential neurological issues.

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  • 19. 

    When auscultating lung sounds, which part of the stethoscope is designed to transmit higher-pitched abnormal sounds?

    • Ear piece

    • Bell

    • Diaphragm

    • Tubes

    Correct Answer
    A. Diaphragm
    Explanation
    The diaphragm of the stethoscope is the part specifically designed to transmit higher-pitched sounds, which is ideal for auscultating lung sounds. This larger, flat side of the stethoscope is more sensitive to high-frequency sounds such as breath sounds, wheezes, and crackles, which are crucial in evaluating respiratory function. The diaphragm’s design allows for better acoustic coupling with the skin, providing clearer and more detailed sounds of respiratory activity. In contrast, the bell of the stethoscope is used for lower-pitched sounds, such as certain heart murmurs.

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  • 20. 

    What is the first step in conducting a physical assessment of the cardiovascular system?

    • Listen to the patient's family history

    • Measure the blood pressure

    • Check the patient's email for recent health updates

    • Review the patient's latest tweets

    Correct Answer
    A. Measure the blood pressure
    Explanation
    The first step in cardiovascular assessment is measuring blood pressure, a fundamental diagnostic tool. It provides crucial insights into cardiac output and vascular resistance, which are indicators of cardiovascular health. High or low blood pressure can indicate underlying health issues, guiding further cardiovascular evaluation and treatment.

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  • 21. 

    Which technique is used to assess liver size during a physical examination?

    • Percussion

    • Auscultation

    • Visualization

    • Speculation

    Correct Answer
    A. Percussion
    Explanation
    Percussion is the standard method for assessing liver size and condition. By tapping on the abdominal surface, sound waves are produced that help identify the liver's boundaries and any abnormalities in size or texture. This method is particularly effective in diagnosing liver enlargement or abnormalities in its structure and function, aiding in further medical evaluation.

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  • 22. 

    A nurse tells a 75-year-old patient she will perform a "head-to-toe" assessment. What is the best explanation?

    • "I will need to identify any symptoms or causes of illness."

    • "It is just something we do."

    • "It is a way for us to understand how to take care of you."

    • "Maybe you can tell me how you got here."

    Correct Answer
    A. "It is a way for us to understand how to take care of you."
    Explanation
    When explaining a "head-to-toe" assessment to an older patient, clear, concise, and reassuring language is essential. The explanation, “It is a way for us to understand how to take care of you,” communicates that the assessment is a comprehensive evaluation necessary to determine the patient’s overall health and specific care needs. This approach helps the patient feel included and informed, reducing anxiety. By avoiding technical jargon and emphasizing patient-centered care, the nurse promotes understanding, trust, and cooperation during the assessment, ensuring that the patient feels comfortable and engaged in their healthcare process.

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  • 23. 

    What is the rubbing, grating, or squeaky sound upon auscultation, resembling two pieces of leather being rubbed together, called?

    • Pulmonary friction

    • Pleural friction rub

    • Pulmonary bruising

    • Whooping cough

    Correct Answer
    A. Pleural friction rub
    Explanation
    A pleural friction rub is the correct term for the rubbing, grating, or squeaky sound heard upon auscultation, which resembles the sound of two pieces of leather being rubbed together. This sound occurs when the pleural layers (the thin membranes that line the lungs and chest cavity) become inflamed and rub against each other during breathing movements. Conditions such as pleurisy, pneumonia, or other inflammatory processes can lead to this distinctive sound. Identifying a pleural friction rub is crucial for diagnosing conditions involving pleural inflammation and guiding appropriate treatment.

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  • 24. 

    What abnormal respiration pattern begins with slow, shallow breaths, progresses to rapid breathing, and then becomes slower, followed by periods of apnea, often associated with conditions like heart failure or opioid overdose?

    • Kussmaul

    • Cheyne-stokes

    • Botte's

    • Whooping sneeze

    Correct Answer
    A. Cheyne-stokes
    Explanation
    Cheyne-Stokes respiration is characterized by a cyclic pattern of breathing which begins with slow, shallow breaths that gradually increase to rapid, deeper breaths before tapering off and leading to a period of apnea (temporary cessation of breathing). This type of breathing pattern is commonly associated with conditions such as heart failure, renal failure, traumatic brain injury, and drug overdoses, particularly opioids. It can also occur during sleep at high altitudes or as a result of other neurological conditions. The presence of Cheyne-Stokes respiration is significant as it may indicate severe underlying medical issues requiring immediate attention.

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  • 25. 

    Which of the following statements is true regarding cultural sensitivity in healthcare?

    • All members of a cultural group share identical behaviors and beliefs.

    • Healthcare providers should be aware of their own cultural biases.

    • Cultural and ethnic diversity has no impact on healthcare.

    • Patients' responses to illness are not influenced by their cultural values.

    Correct Answer
    A. Healthcare providers should be aware of their own cultural biases.
    Explanation
    Cultural sensitivity means understanding and respecting that people from different backgrounds may have different beliefs, values, and practices that influence their healthcare experiences. It's important for nurses and other healthcare providers to recognize their own cultural biases so they can provide care that is respectful and responsive to each individual's needs.  Not everyone from the same culture is the same, and culture can significantly impact how people experience and respond to illness.

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  • 26. 

    What is an increased inward curvature of the lumbar spine commonly known as?

    • Spina Bifida

    • Kyphosis

    • Lordosis

    • Scoliosis

    Correct Answer
    A. Lordosis
    Explanation
    Lordosis, also known as swayback, is characterized by an exaggerated inward curve of the lumbar spine. It is commonly seen in conditions such as obesity, pregnancy, or poor posture, and can also arise from congenital spinal abnormalities. This excessive curvature puts extra strain on the lower back, leading to discomfort or pain. Lordosis is distinct from kyphosis (a backward curvature in the thoracic spine) and scoliosis (a sideways curvature). Treatment options include physical therapy to strengthen the muscles around the spine and, in severe cases, surgery to correct the curvature.

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  • 27. 

    What happens when there is a decreased supply of oxygenated blood to the tissues, often caused by a narrowing of an artery?

    • Ischemia

    • Claudication

    • Hypoventilation

    • Atelactesis

    Correct Answer
    A. Ischemia
    Explanation
    Ischemia occurs when the supply of oxygenated blood to tissues is reduced, often due to a narrowed or blocked artery. This may result in severe complications such as tissue damage, pain, or dysfunction, depending on the affected area. Conditions like atherosclerosis contribute to the narrowing of arteries, impairing blood flow and leading to ischemia in organs like the heart or brain, increasing the risk of heart attacks or strokes.

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  • 28. 

    How should a nurse proceed when a patient expresses pain during a musculoskeletal assessment?

    • Continue the assessment as usual

    • Stop the assessment immediately

    • Modify the assessment to avoid causing further pain

    • Record the patient's pain as irrelevant

    Correct Answer
    A. Modify the assessment to avoid causing further pain
    Explanation
    When a patient experiences pain during a musculoskeletal assessment, the nurse should modify the techniques to prevent further discomfort. This can involve using gentle movements, supporting the affected area, or discontinuing painful maneuvers. The patient’s comfort is a priority, and their pain should be respected while obtaining necessary diagnostic information.

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  • 29. 

    Which of the following is not a peripheral pulse?

    • Ulnar

    • Femoral

    • Brachial

    • Humoral

    Correct Answer
    A. Humoral
    Explanation
    The term "humoral" does not refer to a type of peripheral pulse. Instead, "humoral" is related to humors, an ancient concept of body fluids, or it pertains to the immune system's humoral response, which involves antibodies in body fluids. In contrast, ulnar, femoral, and brachial are all names of arteries where peripheral pulses are commonly assessed. These pulses are vital for checking the circulation in different parts of the body, such as the wrist (ulnar), groin (femoral), and arm (brachial).

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  • 30. 

    What is the term for a vibrating sensation felt when palpating an artery, which is not a normal finding when examining the carotid pulse?

    • Bruit

    • Thrill

    • Crackles

    • Rhonci

    Correct Answer
    A. Thrill
    Explanation
    A thrill is a vibrating sensation felt when palpating an artery, often indicating turbulent blood flow within the vessel. This is not a normal finding when examining a carotid pulse or any other artery. A thrill usually suggests significant cardiovascular abnormalities such as valvular heart disease or arterial obstructions. It can be associated with conditions that produce loud heart murmurs, where the vibration is palpable due to the forceful or irregular flow of blood. Detecting a thrill is crucial for further diagnostic evaluation to determine the underlying cause and assess the severity of the vascular or cardiac condition.

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  • 31. 

    When does the first heart sound, S1, occur?

    • Closure of the AV valves and signals the start of systole

    • Closure of the AV valves and signals the end of systole

    • Opening of the AV valves and signals the start of systole

    • Opening of the AV valves and signlas the end of systole

    Correct Answer
    A. Closure of the AV valves and signals the start of systole
    Explanation
    The first heart sound, S1, is primarily associated with the closure of the atrioventricular (AV) valves, which are the mitral and tricuspid valves. This event marks the beginning of ventricular systole, the phase of the cardiac cycle when the ventricles contract to pump blood out of the heart. The closure of these valves prevents the backflow of blood into the atria and produces a sound that can be auscultated as the "lubb" of the familiar "lubb-dubb" heart sounds. This sound is an important indicator of normal cardiac function and valve integrity.

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  • 32. 

    Abnormal swishing sounds heard over organs, glands, and arteries result from abnormalities in the arteries, often due to narrowing or partial occlusion. What are these sounds called?

    • Thrill

    • Crackles

    • Bruits

    • Wheezes

    Correct Answer
    A. Bruits
    Explanation
    Bruits are abnormal swishing sounds heard during auscultation, typically over arteries. These sounds indicate turbulence in blood flow, which often results from narrowing or partial obstruction of the artery, such as can occur with atherosclerosis. Bruits are an important clinical sign because they can signal the presence of significant vascular disease that may require further investigation or intervention. They are particularly common in arteries that are susceptible to atherosclerosis, like the carotid in the neck or the abdominal aorta. Identifying bruits helps in assessing the risk of vascular complications, including strokes and aneurysms.

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  • 33. 

    What is the difference between a "head-to-toe" assessment and a "focused" assessment?

    • Head-to-toe is systemic, while focused targets specific areas

    • Head-to-toe is done on admission; focused targets specific body parts

    • Head-to-toe is performed on every shift; focused is done at admission

    • Both RNs and LPNs must perform both assessments regularly

    Correct Answer
    A. Head-to-toe is systemic, while focused targets specific areas
    Explanation
    A head-to-toe assessment is a comprehensive, systematic evaluation of a patient's entire body, conducted from the head to the toes. It is typically performed to establish a baseline of the patient’s health and detect any systemic issues. Conversely, a focused assessment concentrates on a particular area or system of the body based on the patient's specific complaint or condition. For instance, a patient with chest pain will have a focused cardiovascular and respiratory examination. Focused assessments are quicker, target-specific, and provide in-depth information on particular health concerns that require immediate attention.

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  • 34. 

    Cramp-like pain in the lower extremities, usually after walking, is called:

    • Ischemia

    • Claudication

    • Hypoventilation

    • Atelactesis

    Correct Answer
    A. Claudication
    Explanation
    Claudication is a condition characterized by cramp-like pain in the lower extremities during physical activities like walking. It is typically caused by peripheral artery disease (PAD), where blood flow to the muscles is restricted due to narrowed arteries. The pain subsides with rest, as the muscles' demand for oxygen decreases. This symptom is essential in diagnosing PAD and evaluating its severity, aiding in the treatment of vascular conditions.

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  • 35. 

    What is the exaggeration of the posterior curvature of the thoracic spine called?

    • Spina Bifida

    • Kyphosis

    • Lordosis

    • Scoliosis

    Correct Answer
    A. Kyphosis
    Explanation
    Kyphosis refers to the exaggeration of the posterior curvature of the thoracic spine, creating a pronounced rounding of the upper back, often described as a hunchback. This condition can result from developmental issues, degenerative diseases, osteoporosis with compression fractures, poor posture, or other spinal abnormalities. Kyphosis can lead to back pain, stiffness, and in severe cases, breathing difficulties. It is distinct from lordosis, which involves an inward curvature of the lumbar spine, and scoliosis, which is characterized by a lateral curvature of the spine. Identifying and treating kyphosis is important for managing symptoms and improving quality of life.

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  • 36. 

    Vital signs are reliable even when there is a central nervous system deficit. 

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Vital signs may not be reliable in the presence of a central nervous system (CNS) deficit. The CNS plays a crucial role in regulating key bodily functions like heart rate, blood pressure, and respiration. In conditions affecting the CNS, such as brain injury or stroke, these functions can become impaired, leading to abnormal or unreliable vital signs. For this reason, healthcare providers must use additional tools and assessments to accurately evaluate a patient’s health status in the presence of CNS deficits.

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  • 37. 

    Which of the following is not a symptom? 

    • Soreness

    • Pruritus

    • Flatus

    • Pain

    Correct Answer
    A. Flatus
    Explanation
     Flatus, or passing gas, is considered a normal digestive process rather than a symptom of a health condition. It results from gas accumulation in the gastrointestinal tract due to digestion or air intake. Although it may accompany symptoms like bloating or discomfort, flatus itself is not indicative of disease. In contrast, soreness, pruritus (itching), and pain are all symptoms that can signify underlying health issues.

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  • 38. 

    What causes the characteristic "lubb-dubb" heart sounds?

    • Closure of the atrioventricular and semilunar valves respectively

    • Closure of the semilunar and atrioventricular valves respectively

    • Closure of the atrioventricular and semilunar valves simultaneously

    • Closure of the atrioventricular valve and opening of the semilunar valve respectively

    Correct Answer
    A. Closure of the atrioventricular and semilunar valves respectively
    Explanation
    The "lubb-dubb" heart sounds are produced by the closure of the heart's valves during the cardiac cycle. The first sound, "lubb" (S1), occurs with the closure of the atrioventricular (AV) valves (mitral and tricuspid), marking the beginning of ventricular systole as the ventricles contract. The second sound, "dubb" (S2), follows when the semilunar valves (aortic and pulmonary) close, indicating the end of systole and the start of ventricular relaxation. These heart sounds are crucial for assessing normal cardiac function and valve integrity.

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  • 39. 

    Which neurological examination focuses on the sensations of body movements, awareness of posture, and cerebellar function?

    • Deep tendon reflexes

    • Coordination and Sensory Examination

    • Cranial nerve assessment

    • Pupillary reflex

    Correct Answer
    A. Coordination and Sensory Examination
    Explanation
    The coordination and sensory examination assesses how well a patient can control movements and how their body senses touch, pain, and position. This type of evaluation tests cerebellar function, which governs balance and fine motor skills, along with sensory perception, which includes proprioception (awareness of body position). These assessments are critical for detecting neurological dysfunction, especially in conditions affecting motor control and sensory pathways.

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  • 40. 

    When does normal heart sound S2 occur?

    • With the closure of the AV valve and signals the end of systole

    • With the opening of the AV valve and signals opening of systole

    • With the opening of the semilunar valves and signals the beginning of systole.

    • With the closure of the semilunar valves and signals the end of systole

    Correct Answer
    A. With the closure of the semilunar valves and signals the end of systole
    Explanation
    The second heart sound, S2, occurs with the closure of the semilunar valves, which are the aortic and pulmonary valves. This event marks the end of ventricular systole, the phase during which the heart's ventricles contract and eject blood into the aorta and pulmonary artery. The closure of these valves prevents the backflow of blood from the arteries into the ventricles as they begin to relax and refill during diastole. The sound produced by this closure is known as S2 and is an essential indicator of the normal function of the semilunar valves.

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  • 41. 

    A patient being admitted complains of right foot pain. How should the nurse proceed with the physical assessment?

    • Perform a focused assessment of the foot first, then the complete examination

    • Complete the full physical assessment first, then address the painful area

    • Focus on providing comfort before proceeding with any assessment

    • Only perform a general physical assessment

    Correct Answer
    A. Perform a focused assessment of the foot first, then the complete examination
    Explanation
    When a patient complains of pain in a specific area, such as the right foot, the most appropriate approach is to initially perform a focused assessment on that area. This allows the healthcare provider to directly address the patient's immediate concern, identify any signs of injury or disease in the foot, and determine the urgency and type of intervention required. Following this focused assessment, a complete physical examination can be conducted to ensure no other health issues are overlooked. This strategy ensures that the patient's most pressing needs are prioritized while still providing a comprehensive evaluation of their overall health.

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  • 42. 

    Heard in patients with coronary artery disease after MI (myocardial infarction), this sound is heard late in diastole when the atria contracts:

    • S1

    • S2

    • S3

    • S4

    Correct Answer
    A. S4
    Explanation
    The heart sound referred to as S4, also known as the atrial gallop, occurs late in diastole when the atria contract. It is typically heard just before S1 and is associated with the atria pushing blood into a stiff or hypertrophic ventricle, causing vibrations. S4 is often heard in patients with conditions that increase resistance to ventricular filling, such as coronary artery disease or hypertensive heart disease, especially after a myocardial infarction (MI). This sound can indicate diminished compliance of the ventricle and is a significant clinical finding, suggesting underlying cardiac pathology.

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  • 43. 

    Which of the following are components of a neurologic assessment?

    • Motor function

    • Range of motion

    • Level of consciousness

    • Pupillary response

    Correct Answer(s)
    A. Motor function
    A. Level of consciousness
    A. Pupillary response
    Explanation
    A neurologic assessment encompasses evaluations of motor function, level of consciousness, and pupillary response. Motor function tests examine the strength, coordination, and any involuntary movements, vital for detecting neurological impairments. The level of consciousness is assessed to understand cognitive function and responsiveness, indicating overall brain activity and potential issues. Pupillary response checks for the pupils' reaction to light, providing insights into neurological status and brainstem function. Range of motion, while significant in overall physical assessments, does not specifically pertain to the neurological examination but rather assesses joint and muscle health.

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  • 44. 

    When auscultating lung sounds, should the stethoscope be placed firmly on the skin, and should you listen for one full inspiratory-expiratory cycle at each point? True or False?

    • True

    • False

    Correct Answer
    A. False
    Explanation
    When auscultating for lung sounds, it is essential to place the stethoscope firmly and directly on the skin to ensure the best possible acoustic transmission of lung sounds. Listening through clothing can muffle or distort these sounds. Furthermore, listening for a full inspiratory and expiratory cycle at each auscultation point is critical for accurately assessing the presence, quality, and any abnormalities in the breath sounds. This comprehensive approach allows the healthcare provider to detect variations in lung sounds that could indicate respiratory conditions such as obstructions, infections, or fluid accumulation.

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  • 45. 

    What are the signs and symptoms of Cushing’s triad, typically seen in someone with a traumatic brain injury?

    • Increase in systolic blood pressure

    • Bradycardia

    • Irregular breathing pattern

    • Widening pulse pressure

    Correct Answer(s)
    A. Increase in systolic blood pressure
    A. Bradycardia
    A. Irregular breathing pattern
    A. Widening pulse pressure
    Explanation
    Cushing’s triad consists of three key signs: increased systolic blood pressure (often accompanied by a widening pulse pressure), bradycardia (slower than normal heart rate), and irregular breathing patterns. These signs are indicative of elevated intracranial pressure, which can result from traumatic brain injury or other conditions that affect the brain. Cushing’s triad is a medical emergency, as it suggests significant pressure on the brainstem and requires immediate intervention to prevent further neurological damage.

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Nicolette Natale |DO (Medicine) |
Physician and Medical Writer
Nicolette Natale is a dedicated healthcare professional with a diverse background in medicine and education. She holds a Doctor of Osteopathic Medicine degree from Nova Southeastern University, as well as Bachelor's degrees in English Literature and Psychology from the University of Miami. With over 6 years of experience, Nicolette is a physician, research coordinator, and medical writer who is committed to advancing medical research and providing quality patient care.

Quiz Review Timeline (Updated): Oct 17, 2024 +

Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Oct 17, 2024
    Quiz Edited by
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    Expert Reviewed by
    Nicolette Natale
  • Feb 23, 2013
    Quiz Created by
    Arnoldjr2
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