Physical Assessment Practice Exam 1

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4. Which of the following may include: clinical signs/symptoms, behavioral/cognitive status, documentation of care/nursing interventions, room transfers, and discharge plans?

Labs and Imaging

Procedures/Operative Reports

Nursing Notes

Medications or Medication Administration Record

Initial Admission SOAP Note and Progress Notes

5. Which of the following should be included in the blood pressure documentation? SELECT ALL THAT APPLY

Odd numbers (the numbers on the dial)

Units (mmHg)

Location (which extremity; right/left arm)

Position (sitting/laying/standing)

Cuff size (child, small adult, adult, large adult, thigh)

Submit

6. Which of the following is a mnemonic that can aid the pharmacist in gathering vital information related to the patient's pain process?

PQRST

ABCDE

ASDF

QWERTY

IHOP

7. Hypertension has no symptoms but can cause damage to many different organs systems, and is therefore called the 'silent killer.'

True

False

8. A proper cuff size should have a length that is 40% of arm circumference and width that is 80% of arm circumference.

True

False

length: 80%; width 40%

Explanation

length: 80%; width 40%

9. Which of the following has a list of current medications, date/time of administration, missed doses, start and stop dates and PRN medication administration?

Medications or Medication Administration Record

Labs and Imaging

Nursing Notes

Procedures/Operative Reports

Initial Admission SOAP Note and Progress Notes

Submit

11. When trying to measure a pulse accurately, using shortcuts will decrease errors.

True

False

pulse accuracy: using shortcuts increases errors

Explanation

pulse accuracy: using shortcuts increases errors

Submit

13. This type of thermometer is available for oral, rectal, and auxiliary temperature measurements.

Electronic probe thermometers

Infrared thermometers

Color-change thermometers

Temporal touch thermometers

No-touch infrared thermometers

14. Which of the following would NOT be in the demographic data of an outpatient medical chart?

Name/gender/race/DOB

Room/Bed Number

Physician

Pharmacy used

Medical Record Number (MRN)

Inpatient and Outpatient* Medical Chart Demographic Data
Name/gender/race/DOB
Medical Record Number (MRN)
Room/Bed Number (not included in the demographic of outpatient medical chart)*
Physician
Pharmacy used
Forms (consent, advanced directives, etc)
Contact Information
Insurance
Social History
Language
Religion

Explanation

Inpatient and Outpatient* Medical Chart Demographic Data
Name/gender/race/DOB
Medical Record Number (MRN)
Room/Bed Number (not included in the demographic of outpatient medical chart)*
Physician
Pharmacy used
Forms (consent, advanced directives, etc)
Contact Information
Insurance
Social History
Language
Religion

15. Which of the following has the initial history and physical (H&P) obtained on admission?

Labs and Imaging

Procedures/Operative Reports

Medications or Medication Administration Record

Nursing Notes

Initial Admission SOAP Note and Progress Notes

16. Which of the following is medication history, medical history, and patient lifestyle habits, beliefs, goals and other factors that affect aspects of care a part of in the Pharmacist's Patient Care Process?

Collect

Assess

Plan

Implement

Follow-Up

17. Which of the following is part of setting the stage when beginning a physical exam? SELECT ALL THAT APPLY

Avoid saying anything to alarm the patient

Show distaste or other negative reactions to findings

Do not explain to the patient what you will be doing

Maintain a calm demeanor

Wash your hands after seeing patient

Provide good lighting and a calm environment

Show concern for privacy or modesty

Submit

18. Which of the following is a normal heart rate?

75 bpm

55 bpm

115 bpm

59 bpm

19. This type of thermometer is placed on the side of the forehead directly over the temporal artery and moved across the forehead.

Electronic probe thermometer

Infrared thermometer

Color change thermometer

Temporal touch thermometer

No touch infrared thermometer

20. Which of the following occurs when the systolic blood pressure > 180 mmHg OR diastolic blood pressure > 110 mmHg?

Hypertensive Crisis

White coat hypertension

Auscultatory Gap

Stage 1 hypertension

Stage 2 hypertension

21. Which of the following detects HIV antibodies in saliva or blood sample?

HIV Tests

Pregnancy Tests

Hepatitis C Tests

Fecal Occult Blood Tests

STD Tests

22. Home monitoring is recommended for patients with arrhythmias.

True

False

not recommended, will not be accurate

Explanation

not recommended, will not be accurate

23. This type of thermometer does not require contact with the patient for measurement. Temperature is measured by aiming the thermometer at the center of the forehead.

Electronic probe thermometer

Infrared thermometer

Color change thermometer

Temporal touch thermometer

No touch thermometer

24. This type of thermometer is an adhesive strip containing heat-sensitive material that changes color in response to different temperature gradients.

Electronic probe thermometers

Infrared thermometers

Color change thermometers

Temporal touch thermometers

No touch infrared thermometers

25. Which of the following includes information such as chemistries, blood counts, microbiology, drug levels, X-rays, CT or MRI results, and EKG?

Labs and Imaging

Medications or Medication Administration Record

Nursing Notes

Procedures/Operative Reports

Initial Admission SOAP Note and Progress Notes

26. Which of the following in the Pharmacist's Patient Care Process assess medications for appropriateness, effectiveness, safety and patient adherence?

Collect

Assess

Implement

Plan

Follow-up

27. When checking blood pressure, the last sound heard is the systolic pressure.

True

False

28. Which of the following in the Pharmacist's Patient Care Process involves initiating, modifying, discontinuing, or administering medication therapies as authorized?

Collect

Assess

Plan

Follow-up

Implement

29. Which of the following is a normal respiratory rate?

19 rpm

11 rpm

21 rpm

50 rpm

30. Which of the following tests involves a chemical reaction and equation that convents whole blood sample to estimated serum glucose?

Glucometers

Fecal Occult Blood Tests

Microalbumin

Vaginal pH

Hepatitis C

31. Which of the following detects HCG in the urine (usually present 1-2 weeks after fertilization or about 15 days after ovulation)

Pregnancy Tests

Glucometers

HIV Tests

Paternity Tests

Ovulation Tests

32. Which of the following is false regarding evaluation of respiratory rate?

All of statements are true.

Evaluate by maintaining position of radial pulse evaluation to remain unknown to the patient

Watch chest or abdomen movement

Record as respirations per minute

Count respirations in 30-60 seconds

33. Physical assessment skills are used only to diagnosis problems.

True

False

We (pharmacists) are managing medications for disease states that are already diagnose (by the physician).

Explanation

We (pharmacists) are managing medications for disease states that are already diagnose (by the physician).

34. Which of the following is true regarding radial pulse?

Pressure wave of the heart beat felt in the periphery

Allows assessment of heart rate

Allows assessment of heart rhythm

Normally evaluated by palpation of the radial artery

All of the statements are true.

35. Which of the following is stated in the Pharmacy and Medically Underserved Areas Enhancement Act? SELECT ALL THAT APPLY

Amends Social Security Act to define payment of "pharmacist services"

Reimbursement equal to 80% of the lesser of the actual charge or 85% of the physician fee schedule amount.

Reimbursement equal to 85% of the lesser of the actual charge or 80% of the physician fee schedule amount.

Amends Social Security Act to define payment of "physician services"

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36. Which of the following is false regarding blood pressure?

Force of blood pushing against arterial walls

Dependent on cardiac output and peripheral vascular resistance

BP = CO X PVR

Measure directly by auscultation

37. Which of the following is false when assessing the radial pulse?

Palpate over radial artery on anterior wrist using 2nd and 3rd fingers

Too much pressure may occlude the artery

Count pulsations felt in 30-60 seconds

Use a clock or watch with a second hand

Record in the chart as breaths per minute (bpm)

38. Abnormal findings should be confirmed after addressing them with patient.

True

False

39. Which of the following is a type of Single-Dimension Instrument? SELECT ALL THAT APPLY

Visual analog scale (VAS)

Verbal numerical scale (VNS)

Verbal rating scale (VRS)

Pain diary

Pain drawings

Face pain scale

Wisconsin Brief Pain Questionnaire

McGill Pain Questionnaire

Submit

40. Which of the following is a criteria when searching for a FDA approved product/device/kit on the FDA database? SELECT ALL THAT APPLY

Safe

Effective

Reliable

Proper use is dependent on user intelligence or technique

Complex and lengthy instructions

Submit

41. Which of the following is true regarding POC INR? SELECT ALL THAT APPLY

Measures international normalized ratio

Ratio that estimates clotting ability of the patient

Coagucheck is a type of POC INR

Disadvantage is the speed

Very inexpensive

Very accurate

Submit

42. Which of the following is vital to providing patient-centered care? SELECT ALL THAT APPLY

Cultural self assessment

Get to know your patients

Passively listen (note verbal/non-verbal cues)

Accept and respect cultural differences

Avoid asking questions about cultural differences

Take a judgmental approach

Be empathetic

Be sympathetic

Vital to providing patient-centered care
-Cultural self assessment
-Get to know your patients
-Actively listen (note verbal/non-verbal cues)
-Accept and respect cultural differences
-Ask questions about cultural differences to gain a better understanding
-Take a nonjudgmental approach
-Be empathetic

Explanation

Vital to providing patient-centered care
-Cultural self assessment
-Get to know your patients
-Actively listen (note verbal/non-verbal cues)
-Accept and respect cultural differences
-Ask questions about cultural differences to gain a better understanding
-Take a nonjudgmental approach
-Be empathetic

Submit

43. Gain and use knowledge of various cultures to make assumptions regarding your patients' beliefs.

True

False

REMEMBER: gain and use knowledge of various cultures to guide you in asking constructive questions – NOT to make assumptions regarding your patients’ beliefs

Explanation

REMEMBER: gain and use knowledge of various cultures to guide you in asking constructive questions – NOT to make assumptions regarding your patients’ beliefs

44. Which of the following has details of any events occurring during procedures or surgeries including any complications encountered?

Labs and Imaging

Medications or Medication Administration Record

Nursing Notes

Initial Admission SOAP Note and Progress Notes

Procedures/Operative Reports

45. Which of the following statements is false?

The data contained within the medical record belongs to the patient.

The physical form the data takes belongs to the entity responsible for maintaining the record.

Patients have the right to ensure information contained in their record is accurate.

Patients cannot petition to remedy factually incorrect information in their records.

All statements listed are true.

46. Which of the following is true regarding POC Cholesterol? SELECT ALL THAT APPLY

Measures usually total cholesterol, high-density cholesterol, and triglycerides

May also measure LDL and blood glucose

Not easily obtain, requires a lab test

Advantage: requires only 1 microliter of blood

Disadvantage: Fasting is required for this test

Submit

47. Which of the following in the Pharmacist's Patient Care Process evaluate adherence, physical assessment findings, and subjective information?

Collect

Assess

Plan

Implement

Follow-up

48. The McGill Pain Questionnaire consist of four parts: SELECT ALL THAT APPLY

Pain drawing

Pain rating index (PRI)

Questions about previous pain experience and location of pain

The present pain intensity index

Pain diary

Pain scale

Submit

49. Which of the following acts amends Social Security Act to define payment of "pharmacist services" and enables patient access to (and pharmacist payment for) Medicare Part B services by licensed pharmacists in medically underserved communities?

Pharmacist Prescriptive Act

Clinical Pharmacist Practitioner Act

Pharmacy and Medically Underserved Areas Enhancement Act

Social Security Act

None of the above

50. Which of the following can be heard with the diaphragm of the stethoscope? SELECT ALL THAT APPLY

High-pitched sounds

Breath sounds

Bowel sounds

Regular heart sounds

Low-pitched sounds

Heart murmurs

Bruits

Venous turbulence

Extra heart sounds

Submit

51. Which of the following is a component of the in-patient medical chart? SELECT ALL THAT APPLY

Admit orders

Demographic data

History/Physical (H&P)

Physician orders

Progress notes

Nursing notes

Medications

Lab results

Imaging

Procedures/Operations

Submit

52. Which of the following FDA definitions of home testing kits is false?

Monitor conditions to allow frequent changes in treatment

Detect nonspecific conditions when there are signs so that you can take immediate action

All statements are true.

53. Which of the following in the Pharmacist's Patient Care Process address health and medication-related problems?

Collect

Assess

Plan

Implement

Follow-up

54. Which of the following is included in the Inpatient Chart - Admit Orders? SELECT ALL THAT APPLY

Reason of admission

Date of admission

Service the patient is admitted to (ICU, cardiology, medicine, etc.)

Diet orders

Initial labs

Nursing orders (vitals, activity, etc.)

Submit

55. Which of the following may be included in Nursing Notes? SELECT ALL THAT APPLY

Social History

Clinical signs/symptoms

Behavioral/cognitive status

Documentation of care/nursing interventions

Room transfers

Discharge plans

Room/bed Number

CT or MRI results

Submit

56. Which of the following is a risk associated with high blood pressure? SELECT ALL THAT APPLY

Stroke

Kidney damage

Angina

Congestive heart failure

Heart attack

Atherosclerosis

Vision loss

Peripheral artery disease

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57. Which of the following is included in the "AP" portion of the Initial Admission SOAP Note? SELECT ALL THAT APPLY

CC (Chief complaint)

HPI (History of Present Illness)

PMH (Pertinent Medical History)

SH/FH (Social History/Family History)

Medication History

Review of Systems

Physical Examination

Admission Tests and Labs

Initial Assessment and Plan

58. Which of the following blood pressure cuffs can be used for obese patients? SELECT ALL THAT APPLY

Wrist cuffs

Finger cuffs

Arm cuffs

Forearm cuffs

Ankle cuffs

Waist cuffs

Submit

59. Which of the following describes the history of pharmacy as being product driven to service driven? SELECT ALL THAT APPLY

Currently recognized as providers under Title 18 of the SSA

Lack of reimbursement under Medicare Part B

No longer just products and dispensing

Collaborative Practice recognized by 50 states

Collaborative Practice recognized by Department of Legislative Affairs

Collaborative Practice recognized by Indian Health Service

Delivery of comprehensive, clinical ad educational patient care services

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60. Which of the following is a type of Multi-Dimension Instrument? SELECT ALL THAT APPLY

Visual analog scale (VAS)

Verbal numerical scale (VNS)

Verbal rating scale (VRS)

Pain diary

Pain drawings

Face pain scale

Wisconsin Brief Pain Questionnaire

McGill Pain Questionnaire

Submit

61. This type of thermometer is available for tympanic artery and temporal artery temperature measurements.

Electronic probe thermometers

Infrared thermometers

Color-change thermometers

Temporal touch thermometers

No-touch infrared thermometers

62. In the Pharmacist's Patient Care Process, Collect involves: SELECT ALL THAT APPLY

Medication history (from multiple resources)

Test results

Physical exam findings

Health and wellness information

Physical assessment findings

Medical history

Patient lifestyle habits, beliefs, goals, and other factors that affect aspects of care

Patient adherence

Submit

63. Per JNC8 Guidelines for blood pressure treatment: Which of the following is correct for MOST patient > 60 years old? SELECT ALL THAT APPLY

Initiate treatment if systolic blood pressure is > 140 mmHg

Initiate treatment if diastolic blood pressure is > 90 mmHg

Treat to a goal blood pressure of < 140/90 mmHg

Initiate treatment if systolic blood pressure is > 150 mmHg

Initiate treatment if diastolic blood pressure is > 90 mmHg

Treat to a goal blood pressure of < 150/90 mmHg

Submit

64. Which of the following statements is true?

Washing your hands in front of the patient is a subtle way to show concern for the patient's welfare

Wearing gloves when appropriate shows professionalism and concern for the patient's welfare (and helps prevent possible spread of disease)

Any adjustments to lighting should be made to maintain patient comfort and allow for appropriate visualization of any findings

Have the patient seated comfortably in an exam room to maintain privacy. Closed any doors or curtains to maintain privacy.

All of statements are true.

65. Which of the following can be heard with the bell of the stethoscope? SELECT ALL THAT APPLY

Breath sounds

Bowel sounds

Regular heart sounds

High-pitched sounds

Low-pitched sounds

Heart murmurs

Bruits

Venous turbulence

Extra heart sounds

Submit

66. Which of the following is included in the "S" (subjective) portion of the Initial Admission SOAP Note? SELECT ALL THAT APPLY

CC (Chief complaint)

HPI (History of Present Illness)

PMH (Pertinent Medical History)

SH/FH (Social History/Family History)

Medication History

Review of Systems

Physical Examination

Admission Tests and Labs

Initial Assessment and Plan

Submit

67. Which of the following is included in the "O" (objective) portion of the Initial Admission SOAP Note? SELECT ALL THAT APPLY

CC (Chief complaint)

HPI (History of Present Illness)

PMH (Pertinent Medical History)

SH/FH (Social History/Family History)

Medication History

Review of Systems

Physical Examination

Admission Tests and Labs

Initial Assessment and Plan

Submit

68. Which of the following are errors that can lead to inaccurate blood pressure measurement? SELECT ALL THAT APPLY

Using a cuff that is too big could overestimate by 10-50 mmHg

White coat hypertension

If the patient is cold, blood pressure can be decreased

If the arm is positioned above heart level, the blood pressure can be decreased by 10-12 mmHg

Anxiety, pain, discomfort, and strenuous activity

Halting during deflation and reinflating the cuff too soon

Underinflation of the cuff can lead to underestimation of systolic blood pressure

A cuff that is too large could produce a falsely low reading

Arm positioned below heart level can underestimate blood pressure

review errors leading to inaccurate blood pressure measurement

Explanation

review errors leading to inaccurate blood pressure measurement

Submit

69. Which of the following is NOT a component of the outpatient medical chart? SELECT ALL THAT APPLY

Demographic data

Clinical visit notes (SOAP notes)

Allergies

Immunizations

Admit orders

Nursing notes

Labs

Procedures

Appointments

Medications (prescription history, electronic prescribing)

Vitals (BP, pulse, temperature, respiratory rate, weight/height, pain level)

Submit

70. Which of the following is true regarding OSHA Bloodborne Pathogens Standard? SELECT ALL THAT APPLY

Requires training with annual updates

Requires use of universal precautions

Requires an exposure communication plan*

Requires employer to provide hepatitis C vaccine to employees with potential risk*

Mandates use of unsafe devices (needles)*

Requires documentation of safety device evaluation

Requires a sharps injury log

Requires employees to sanitize hands after removal of gloves

Requires an exposure [control] plan*
Requires employer to provide hepatitis [B] vaccine to employees with potential risk*
Mandates use of [safer] devices ([safety] needles)*

Explanation

Requires an exposure [control] plan*
Requires employer to provide hepatitis [B] vaccine to employees with potential risk*
Mandates use of [safer] devices ([safety] needles)*

Submit

71. Per JNC8 Guidelines for blood pressure treatment: Which of the following is correct for MOST patients < 60 years old? SELECT ALL THAT APPLY

Initiate treatment if systolic blood pressure is > 140 mmHg

Initiate treatment if diastolic blood pressure is > 90 mmHg

Treat to a goal blood pressure of < 140/90 mmHg

Initiate treatment if systolic blood pressure is > 150 mmHg

Initiate treatment if diastolic blood pressure is > 90 mmHg

Treat to a goal blood pressure of < 150/90 mmHg

Submit

72. Which of the following is true regarding Central DEXA? SELECT ALL THAT APPLY

DEXA stands for Dual-Energy X-Ray Absorptiometry

Also known as Central DXA, DEXA, and Peripheral DEXA

Measures bone mineral density

Measurement output is the T-score (age) and the Z-score (sex)

Disadvantage is the cost to the clinic and the patient.

Disadvantage is not able to determine if therapy is needed.

Measurement output is the T-score (age) and the Z-score (sex) --> False because T-score (sex), Z-score (age), listen to the panopto for confirmation

Explanation

Measurement output is the T-score (age) and the Z-score (sex) --> False because T-score (sex), Z-score (age), listen to the panopto for confirmation

Submit

73. Which of the following should always ask before taking a patient's blood pressure? SELECT ALL THAT APPLY

Have you smoked or had caffeine in the past 30 minutes?

Have you taken your blood pressure medicine today?

Do you take any medicines, vitamins, or herbals over the counter?

May I use your left arm to take your blood pressure?

Will you please cross your legs?

Have you been seated for at least 5 minutes?

Submit

74. Which of the following is true regarding POC A1c? SELECT ALL THAT APPLY

Measures Hemoglobin A1c

3 month estimate of blood glucose values

Very inexpensive

Advantage: Speed

Disadvantage: requires 40 microliters of blood

Submit

75. Match the following regarding Single-dimension instrument:

Visual Analog Scale

Verbal Numberical Scale

Verbal Rating Scale

Submit

76. CLIA waivers allow for laboratory tests to be conducted in physician offices or pharmacies; must be in place before conducting test(s).

True

False

*non-laboratory

Explanation

*non-laboratory

77. Match the following regarding blood pressure classification:

Normal

Pre-hypertension

Stage 1 Hypertension

Stage 2 Hypertension

Submit

78. Match the following components of the Pharmacist's Patient Care Process

Collect

Assess

Plan

Implement

Follow-up

Submit

79. Match the following for Respiratory Rate

Normal

Bradypnea

Tachypnea

Submit

80. Match the following:

Pregnancy Tests

HIV Tests

Glucometers

Submit

81. Match the following for Heart Rate

Normal

Bradycardia

Tachycardia

Submit

82. Match the following regarding Multi-dimension instrument:

Pain diary

Pain drawings

Faces pain scale

Wisconsin Brief Pain Questionnaire

McGill Pain Questionnaire

Submit

83. Match the following

Ethnocentrisms

Prejudice

Stereotypes

Submit

84. Match the following:

absent pulse amplitude (force)

weak pulse amplitude (force)

normal pulse amplitude (force)

full, bounding pulse amplitude (force)

Submit

85. Match the following:Measures international normalized ratio; ratio that estimates clotting ability of the patientMeasures Hemoglobin A1c; 3 month estimate of blood glucose valuesMeasures usually total cholesterol, high-density cholesterol, and triglycerides; may also measure LDL and blood glucoseMeasures bone mineral density; T-score and Z-score

POC INR

POC A1c

POC Cholesterol

Central DEXA

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