NURS 6512 FINAL EXAM
1. Costovertebral angle tenderness should be assessed whenever you suspect the patient may
have:
Answer: Polynephritis
2. In older adults, overflow fecal incontinence is commonly due to:
Answer: Fecal impaction
3. A 1 month old boy has been vomiting for 2 weeks. How is this symptom of GERD and pyloric
stenosis further differentiated in this child’s assessment?
Answer: The infant has regurgitation with pyloric stenosis
4. Auscultation of borborygmi is associated with:
Answer: Gastroenteritis, early intestinal obstruction, or hunger
5. When auscultating the abdomen, which finding would indicate collateral circulation between
the portal and systemic venous systems?
Answer: Venous hum
6. Conversion of fat-soluble wastes to water-soluble material for renal excretion is a function of
the:
Answer: Liver
7. The major function of the large intestine is:
Answer: Water absorption
8. Which structure is located in the hypogastric region of the abdomen?
Answer: Ileum, bladder, and pregnant uterus
9. A 45 year old man relates a several week history of severe intermittent abdominal burning
sensations.He relates that the pain is relieved with small amounts of food. Before starting the
physical examination, you review his laboratory work, anticipating a (n):
Answer: Positive Helicobacter pylori result
10. You are caring for a patient with trigeminal neuralgia. During the assessment, the patient
would describe the pain as:
Answer: Burning or shock like
11. Your 85 year old patient is complaining of right knee pain. She has a history of osteoarthritis
for which she is given anti-inflammatory medication. To assess her right knee pain, you should
ask her if:
Answer: The pain gets better when she sits
12. A 5 year old is complaining of nondescriptive “belly pain.” Your next action should be to ask
him to:
Answer: Point to the area of pain
13. The perception of pain:
Answer: Is variable and is affected by emotions, and cultural background
14. Patients presenting with ascites, jaundice, cutaneous spider veins, and nonpalpable liver
exhibit signs of:
Answer: Cirrhosis
15. A patient presents to the emergency department after a motor vehicle accident. The patient
sustained blunt trauma to the abdomen and complains of pain in the upper left quadrant that
radiates to the left shoulder. What organ is most likely injured?
Answer: Spleen
16. Imaging studies reveal that a patient has dilation of the renal pelvis from an obstruction in the
ureter, what condition will be documented in this patient’s health record?
Answer: Hydronephrosis
17. Visible intestinal peristalsis may indicate:
Answer: Intestinal obstruction
18. Infants born weighing less than 1500g are at higher risk for:
Answer: Necrotizing enterocolitis
19. Which of the following factors is not known to affect patient compliance with his or her
treatment regimen?
Answer: The patient’s age and social status
20. One of the most important aspects to consider in the orthopedic screening examination is:
Answer: Symmetry
21. The sequence of the physical examination should be individualized to:
Answer: Minimize the number of times the patient has to change positions to conserve the
patient’s energy
22. As you greet the patient, which examination technique is first implemented?
Answer: Inspection
23. Which of the following is most likely to enhance examiner reliability?
Answer: The examiner attempts to qualify data
24. A 7 year old boy is brought to your office with a chief complaint of possible fracture to his
left third finger. He jammed it while playing basketball 2 days ago. The mother states that she
really does not think it is broken because he can move it. What is your best response?
Answer: This is common misconception, and the finger may be broken. An x-ray is indicated.
25. A patient presenting for the first time with typical low back pain should receive which of the
following diagnostic tests?
Answer: None of the above. X-ray is not indicated because lumbar pain is usually
musculoskeletal etiology.
26. Skeletal changes in older adults are the result of:
Answer: Increased bone resorption
27. A positive straight leg raise test usually indicates:
Answer: Lumbar nerve root irritation
28. What technique is performed at every infant examination during the first year of life to detect
hip dislocation?
Answer: Barlow-Ortolani maneuvers
29. Expected normal findings during inspection of spinal alignment include:
Answer: Convex lumbar curve
30. Temporalis and masseter muscles are evaluated by:
Answer: Having the patient clench his or her teeth
31. When palpating joints, crepitus may be caused when:
Answer: Irregular bony surfaces rub together
32. A 3 year old is brought to the clinic complaining of a painful right elbow. He is holding the
right arm slightly flexed and pronated and refuses to move it. the mother states that symptoms
started right after his older brother had been swinging him around by his arms. This presentation
supports a diagnosis of:
Answer: Radial head subluxation
33. Light skin and thin body habitus are risk factors for:
Answer: Osteoporosis
34. Risk factors for sports-related injuries include:
Answer: Failure to warm up before activity
35. Injuries to long bones and joints are more likely to result in fractures than in sprains until:
Answer: Adolescence
36. Ligaments are stronger than bone until:
Answer: Adolescence
37. The family history for a patient with joint pain should include information about siblings
with:
Answer: Genetic disorders
38. The Thomas test is used to detect:
Answer: Flexion contractures of the hip
39. A goniometer is used to assess:
Answer: Range of motion
40. During a football game, a player was struck on the lateral side of the left leg while his feet
were firmly planted. He is complaining of left knee pain. To examine the left knee you should
initially perform the ________ test.
Answer: Valgus stress
41. You note that a child has a positive Gower Sign. You know that this indicates generalized:
Answer: Muscle weakness
42. The dowager hump is:
Answer: The hallmark of osteoporosis
43. What temporary disorder may be experienced by pregnant women during the third trimester
because of fluid retention?
Answer: Carpal tunnel syndrome
44. A common finding in markedly obese and pregnant women is:
Answer: Lordosis
45. A 45 year old laborer presents with low back pain, stating that the pain comes from the right
buttock and shoots down and across the right anterior thigh, down the shin to the ankle. Which
examination finding is considered more indicative of nerve root compression?
Answer: Positive straight leg raise result
46. Mrs. Bower is a 57 year old patient who comes in for an office visit. Which of the following
disorders is known to be hereditary?
Answer: Huntington chorea
47. Testing of cranial nerve ________ is not routinely performed unless a problem is suspected.
Answer: I
48. The patient is able to rapidly touch each finger to his thumb in rapid sequence. What does
this finding mean?
Answer: The patient has appropriate cerebellar function
49. Which question asked by the examiner may help to determine prevention strategies for
seizures that a patient is experiencing?
Answer: “Are there any factors or activities that seem to start the seizures?”
50. A patient has a complaint of dizziness. The patient makes the following statement: “I
sometimes feel as if the whole room is spinning.” What type of neurologic dysfunction should
the examiner suspect?
Answer: Inner ear dysfunction affecting the acoustic nerve
51. The examiner asks the patient to close her eyes, then places a vibrating tuning fork on the
patient’s ankle and asks her to indicate what is felt. What is being assessed?
Answer: Peripheral nerve sensory function
52. Which of the following findings should an examiner consider a normal finding if associated
with pregnancy?
Answer: Acroparesthesia
53. Jack is a 52 year old obese man with a history of poorly controlled diabetes. He also smokes.
Based on the above data, the examiner should recognize that Jack has several risk factors for:
Answer: Cerebrovascular accident
54. Mrs. Jones is a 24 year old patient who presents to your office 2 days postpartum. She
complains that she is experiencing foot drop. Which of the following problems should the
examiner consider?
Answer: Lumbosacral plexopathy
55. The examiner is assessing deep tendon reflex response in a 12 year old boy. The response is
an expected reflex response. Which of the following scores should be documented?
Answer: 2+
56. A 68 year old patient presents to your office for follow-up. He tells you, “I have a hard time
finding the right words when I am talking;” he also is experiencing numbness. On examination,
you note postural instability. This symptom may be:
Answer: A late symptom of Parkinson’s disease
57. Motor maturation proceeds in an orderly progression from:
Answer: Head to toe
58. The thalamus is the major integration center for perception of:
Answer: Pain
59. The examiner should be concerned about neurologic competence if a social smile cannot be
elicited by the time a child is ________old.
Answer: 3 months
60. Normal changes of the aging brain include:
Answer: • Diminished perception of touch.
• This is by process of elimination/educated guess.
• I could not find direct information addressing this in Seidel
61. When interviewing a 70 year old female clinic patient, she tells you that she takes ginkgo
biloba and St. John’s Wort. You make a short note to check for results of the:
Answer: Mini-mental state examination
62. The area of body surface innervated by a particular spinal nerve is called a:
Answer: Dermatome
63. If a patient cannot shrug the shoulders against resistance, which cranial nerve (CN) requires
further evaluation?
Answer: CN XI, spinal accessory
64. The finger-to-nose test allows assessment of:
Answer: Coordination and fine motor function
65. You ask the patient to follow a series of short commands to assess:
Answer: Attention span
66. As Mr. B. enters the room, you observe that his gait is wide based and he staggers from side
to side while swaying his trunk. You would document Mr. B.’s pattern as:
Answer: Cerebellar ataxia
67. When is the mental status portion of the neurologic system examination performed?
Answer: Constantly throughout the entire interaction with a client
68. An aversion to touch or being held, along with delayed or absent language development, is a
characteristic of:
Answer: Autism
69. The autonomic nervous system coordinates which of the following?
Answer: Internal environment of the body
70. The major function of the sympathetic nervous system is to:
Answer: Orchestrate the stress response
71. The parasympathetic nervous system maintains the day-to-day function of:
Answer: Digestion
72. Cerebrospinal fluid serves as a:
Answer: Shock absorber
73. You are performing a two-point discrimination test as part of a well physical examination.
The area with the ability to discern two points in the shortest distance is the:
Answer: Finger tips
74. Which type of hallucination is most commonly associated with alcohol withdrawal?
Answer: Visual-bugs, pink elephants
75. On a scale of 0 to 4+, which deep tendon reflex score is appropriate for a finding of clonus in
a patient?
Answer: 3+
76. Which statement is true regarding mental status changes in older adults?
Answer: There is an increased risk of delirium with acute illness or metabolic derangement.
77. A characteristic related to syphilis or diabetic neuropathy is testicular:
Answer: Insensitivity to painful stimulation
78. When collecting personal and social history data from a woman complaining of breast
discomfort, you should question her regarding:
Answer: Alcohol, tobacco, and caffeine use
79. What risk factor is associated with cervical cancer?
Answer: HPV
80. A 23 year old female presents with severe right lower quadrant tenderness. All of the
following should be considered in the differential except:
Answer: Classis diverticulitis
81. What is the initial diagnostic radiology test that should be ordered if you suspect a ruptured
ovarian cyst?
Answer: Abdominal and transvaginal ultrasound
82. A 17 year old male was brought into the emergency room with testicular/scrotal pain. The
differential diagnosis should include all except:
Answer: Inguinal herniation
83. The nursing mother complains that her breasts are tender. You assess hard, shiny, and
erythremic breasts bilaterally. You should advise the patient to:
Answer: Massage gently and continue nursing
84. A normal vas deferens should feel:
Answer: Smooth
85. In a woman complaining of a breast lump, it is most important to ask about:
Answer: Its relationship to menses
86. The finding of a painless indurated lesion on the glans penis is most consistent with:
Answer: Chancre
87. Thrombosed hemorrhoids are:
Answer: Blue, shiny, painful masses
88. Pregnancy-related cervical changes include:
Answer: Softening and bluish coloring
89. You are inspecting the genitalia of an uncircumcised adult male. The foreskin is tight and
cannot be easily retracted. You should:
Answer: Inquire about previous penile infections
90. An adolescent male is being seen for acute onset of left testicular pain. The pain started 3
hours ago. He complains of nausea and denies dysuria or fever. Your prioritized assessment
should be to:
Answer: Establish absent cremasteric reflex
91. A 23 year old white woman has come to the clinic because she has missed two menstrual
periods. She states that her breasts have enlarged and that her nipples have turned a darker color.
Your further response to this finding is:
Answer: Suggest pregnancy testing
92. What accommodations should be used in the position of a hearing-impaired woman for a
pelvic examination?
Answer: The head of the table should be elevated
93. Sexual differentiation in the fetus has occurred by _______ weeks gestation.
Answer: 12
94. You are performing a clinical breast examination for a 55 year old woman. While palpating
the supraclavicular area, you suspect that you felt a node. In order to improve your hooked
technique, you should:
Answer: Ask the patient to turn her head toward that side
95. If a firm, transverse ridge of compressed tissue is felt bilaterally along the lower edge of a 40
year old patient’s breast, you should:
Answer: Record the finding in the patient’s record
96. A therapeutic technique for dealing with grieving individuals is to:
Answer: Tell them that is good to cry and to share feelings When a patient dies, the grieving
family and friends need attention for their emotional needs. It is often difficult to find words, and
often the words may be cliché and not seem appropriate for the moment. It is all right to tell
them that it is good to cry and to share feelings. It is permissible to talk about what has been lost
and what will not be realized for the future. All of the other answers are not therapeutic for a
grieving family member or friend.
97. The examination of the newborn should begin with:
Answer: Inspection noting skin color, flaccidity, tension, gross deformities, or distortions of
facies
98. Which one of the following patient characteristics is most likely to limit patient reliability
during history taking?
Answer: Patient is sleep and sensory deprived
99. In crying infants, it is often difficult to:
Answer: Auscultate heart sounds
100. Which of the following statements accurately reflects the sensitivity and specificity of
laboratory tests?
Answer: No test has 100% sensitivity and specificity
101. Which medical condition would exclude one from sports participation?
Answer: Fever
102. Your 15 year old patient is athletic and thin. Radiography of an ankle injury reveals a stress
fracture. You question this patient about her:
Answer: Menstrual cycles
103. Which of the following are examined with the patient in a reclining 45 degree position?
Answer: Jugular venous pulsation and pressure
104. Functional assessment is most important during the examination of a(n):
Answer: Older adult
105. The best way to ease the apprehension of a 3 year old child before a physical examination is
to:
Answer: Encourage child’s participation
106. An ophthalmoscopic eye examination involves:
Answer: Lens inspection
107. When conducting a geriatric assessment, basic activities of daily living (ADLs) include:
Answer: Bathing
108. The checkout station for preparticipation physical evaluation (PPE) is critical because at
this point:
Answer: The coordination of follow-ups is reviewed
109. Which of the following is true regarding the relationship between the examiner and the
patient?
Answer: The patient is a full partner with the examiner
110. Which of the following factors is not known to affect patient compliance with his or her
treatment regimen?
Answer: The patient’s age and social status
111. One of the most important aspects to consider in the orthopedic screening examination is:
Answer: To look for symmetry of muscle, stature, and joint movement
112. As you greet the patient, which examination technique is first implemented?
Answer: Inspection
113. Which portion of the physical examination is best done with the patient standing?
Answer: Spinal
114. Which patient position facilitates inspection of the chest and shoulders?
Answer: Sitting
115. The least reliable indicator of newborn distress is:
Answer: Color
116. Proprioception should be assessed while the patient is:
Answer: Standing
117. Part of the screening orthopedic component of the examination includes evaluating the
person while:
Answer: Duck walking
Part of the screening orthopedic component of the examination includes evaluating the person
while he or she is:
Question 3
The difference in blood pressure readings between the right and the left arms is considered
normal up to _____ mm Hg.
Answer: 10 mm Hg.
Question 4
You are assessing Mr. Z.'s fluid volume status as a result of heart failure. If your finger depresses
a patient's edematous ankle to a depth of 6 mm, you should record this pitting as:
Answer: 2+ pitting edema.
Question 5
Kawasaki disease is suspected when assessments of a child reveal:
Answer: Fever, rash, and conjunctival injection.
Question 6
The finger-to-nose test allows assessment of:
Answer: Cerebellar function and coordination.
Question 7
In the adult, the apical impulse should be most visible when the patient is in what position?
Answer: Left lateral decubitus position.
Question 8
The strength of the trapezius muscle is evaluated by having the patient:
Answer: Shrug both shoulders against resistance.
Question 9
When palpating joints, crepitus may occur when:
Answer: There is roughened cartilage or bone surfaces rubbing together.
Question 10
Palpation of a normal prostate in an older adult is likely to feel:
Answer: Slightly enlarged, firm, and smooth.
Question 11
You are conducting a preparticipation physical examination for a 10-year-old girl with Down
syndrome who will be playing basketball. She has slight torticollis and mild ankle clonus. What
additional diagnostic testing would be required for her?
Answer: Cervical spine X-ray to rule out atlantoaxial instability..
Question 12
Which one of the following techniques is used to detect a torn meniscus?
Answer: McMurray test.
Question 13
The reliability of health-related findings and observations is the responsibility of the:
Answer: Health care provider conducting the examination.
Question 14
Loss of immediate and recent memory with retention of remote memory suggests:
Answer: Dementia.
Question 15
Which condition is considered progressive rather than reversible?
Answer: Alzheimer's disease.
Question 16
When assessing a 17-year-old for nuchal rigidity, you gently raise his head off the examination
table. He involuntarily flexes his hips and knees. To confirm your suspicions associated with this
positive test, you would also perform a test for the _____ sign.
Answer: Brudzinski sign.
Question 17
An idiopathic spasm of arterioles in the digits is termed:
Answer: Raynaud phenomenon.
Question 18
Which portion of the physical examination is best done with the patient standing?
Answer: Inspection of the spine and gait.
Question 19
While collecting personal and social history data from a woman complaining of breast
discomfort, you should question her regarding:
Answer: Menstrual history, use of contraception, and family history of breast cancer.
Question 20
A finding that is indicative of osteoarthritis is:
Answer: Joint pain with morning stiffness, relieved with activity.
Question 21
One of the most important aspects to consider in the orthopedic screening examination is:
Answer: Range of motion and strength of joints.
Question 22
When is the mental status portion of the neurologic system examination performed?
Answer: During the general examination, often early in the assessment.
Question 23
Breath odors may clue the examiner to certain underlying metabolic conditions. The odor of
ammonia on the breath may signify:
Answer: Uremia (kidney failure).
Question 24
If pitting edema is unilateral, you would suspect occlusion of a:
Answer: Deep vein thrombosis (DVT).
Question 25
When the Goodenough-Harris Drawing Test is administered to a child, the evaluator principally
observes the:
Answer: Child’s cognitive and motor development.
Question 26
A grade IV mitral regurgitation murmur would:
Answer: Be loud, holosystolic, and possibly radiate to the axilla.
Question 27
A pulsation that is diminished to the point of being barely palpable would be graded as:
Answer: 1+ (barely palpable).
Question 28
Postural hypotension is defined as a _____ when the patient stands, compared with sitting or
supine readings.
Answer: Systolic drop of 20 mm Hg or diastolic drop of 10 mm Hg.
Question 29
In the most effective percussion technique of the posterior lung fields, the patient cooperates by:
Answer: Sitting up with arms resting on a support.
Question 30
Bimanual examination of the uterus includes:
Answer: Palpation of the uterus with one hand on the abdomen and the other in the vaginal
canal.
Question 31
A cervical polyp usually appears as a:
Answer: Smooth, round, red, or pink growth on the cervix.
Question 32
The physical assessment technique most frequently used to assess joint symmetry is:
Answer: Palpation.
Question 33
Inspection of the scrotum should reveal:
Answer: Symmetry, size, and the absence of lumps or swelling.
Question 34
A patient you are seeing in the emergency department for chest pain is suspected of having a
myocardial infarction. During the health history interview of his family history, he relates that
his father had died of "heart trouble." The most important follow-up question you should pose is
which of the following?
Answer: "Did your father have a history of heart disease, such as high blood pressure or a heart
attack?"
Question 35
The adnexa of the uterus are composed of the:
Answer: Ovaries, fallopian tubes, and ligaments.
Question 36
The musculoskeletal examination should begin when:
Answer: After a thorough history is obtained.
Question 37
The family history for a patient with joint pain should include information about siblings with:
Answer: Conditions like arthritis, lupus, or other autoimmune disorders.
Question 38
Which medical condition would exclude a person from sports participation?
Answer: Uncontrolled cardiovascular conditions, such as severe hypertension or arrhythmias.
Question 39
The examiner percusses for diaphragmatic excursion along the:
Answer: Between the 6th and 8th intercostal spaces, posteriorly.
Question 40
As Mr. B. enters the room, you observe that his gait is wide based and he staggers from side to
side while swaying his trunk. You would document Mr. B.'s pattern as:
Answer: Ataxic gait.
Question 41
The Denver II is a tool used to determine:
Answer: Developmental milestones and delays in children.
Question 42
Tarry black stool should make you suspect:
Answer: Upper gastrointestinal bleeding (e.g., peptic ulcer).
Question 43
Palpation of epitrochlear nodes is part of the:
Answer: Lymphatic system examination.
Question 44
To hear diastolic heart sounds, you should ask patients to:
Answer: Lean forward or lie on their left side.
Question 45
Assessing orientation to person, place, and time helps determine:
Answer: Cognitive function and potential neurologic impairment.
Question 46
Montgomery tubercles are most prominent in the breasts of:
Answer: Pregnant or lactating women.
Question 47
Temporalis and masseter muscles are evaluated by:
Answer: Palpation and assessing strength of the muscles by clenching teeth.
Question 48
A red, hot swollen joint in a 40-year-old man should lead you to suspect:
Answer: Septic arthritis or gout.
Question 49
You are examining a patient in the emergency department who has recently sustained head
trauma. In order to initially assess this patient's neurologic status, you would:
Answer: Perform a Glasgow Coma Scale assessment.
Question 50
Which cranial nerves are usually evaluated during the examination of the eyes?
Answer: Cranial nerves II (optic), III (oculomotor), IV (trochlear), and VI (abducens).
Question 51
An ophthalmoscopic eye examination involves:
Answer: Inspecting the retina, optic disc, blood vessels, and macula.
Question 52
While interviewing a 70-year-old female clinic patient, she tells you that she takes ginkgo biloba
and St. John's wort. You make a short note to check for results of the:
Answer: INR (International Normalized Ratio) for potential interactions with blood thinners,
and possible drug interactions with antidepressants.
Question 53
For purposes of examination and communication of physical findings, the breast is divided into:
Answer: Quadrants or clock-face divisions for easier description.
Question 54
Ulnar deviation and boutonniere deformities are characteristic of:
Answer: Rheumatoid arthritis.
Question 55
You are conducting an examination of Mr. Curtis's heart and blood vessels and auscultate a grade
III murmur. The intensity of this murmur is:
Answer: Moderate intensity, easily heard but not as loud as a grade IV.
Question 56
At your first meeting with a patient, it is usually best to say:
Answer: "Hello, my name is [Your Name], and I’ll be taking care of you today."
Question 57
The best way to ease the apprehension of a 3-year-old child before a physical examination is to:
Answer: Engage in play or use toys to demonstrate examination tools.
Question 58
Breath sounds normally heard over the trachea are called:
Answer: Bronchial breath sounds.
Question 59
The goals of preparticipation sports evaluation include:
Answer: To assess health status, identify risk factors, and ensure fitness for participation.
Question 60
Throughout the history and physical examination, the clinician should:
Answer: Be systematic, thorough, and considerate in gathering information.
Question 61
When assessing superficial pain, touch, vibration, and position perceptions, you are testing:
Answer: Sensory (somatosensory) function, assessing the spinothalamic and posterior columns.
Question 62
The foramen ovale should close:
Answer: Shortly after birth, typically within the first few hours to days.
Question 63
A parent is advised to restrict contact or collision sports participation for their child. An example
of a sport in which this child could participate is:
Answer: Swimming, tennis, or track.
Question 64
The checkout station for preparticipation physical evaluation (PPE) is critical because at this
point:
Answer: It ensures that all required components of the PPE have been completed and any issues
are addressed before clearance.
Question 65
An apical PMI palpated beyond the left fifth intercostal space may indicate:
Answer: Left ventricular hypertrophy or displacement due to conditions like cardiomegaly.
Question 66
The spread of the impulse through the ventricles (ventricular depolarization) is depicted on the
ECG as the:
Answer: QRS complex.
Question 67
Your older clinic patient is being seen today as a follow-up for a 2-day history of pneumonia.
The patient continues to have a productive cough, shortness of breath, and lethargy and has been
spending most of the day lying in bed. You should begin the chest examination by:
Answer: Inspection for respiratory effort and symmetry, followed by palpation and auscultation.
Question 68
Your patient's chief complaint is repeated pencil-like stools. Further examination should include:
Answer: A thorough gastrointestinal examination, including a digital rectal exam and potentially
a colonoscopy.
Question 69
When palpating breast tissue, the examiner should use the _____ at each site.
Answer: Pads of the fingers.
Question 70
Normal changes of the aging brain include:
Answer: Mild memory loss, slower processing speed, and reduced attention span.
Question 71
You are inspecting the genitalia of an uncircumcised adult male. The foreskin is tight and cannot
be easily retracted. You should:
Answer: Gently attempt to retract the foreskin, but if it is tight, advise the patient to seek
medical advice for possible treatment such as circumcision or stretching exercises.
Question 72
You are examining Mr. S., a 79-year-old diabetic man complaining of claudication. Which of the
following physical findings is consistent with the diagnosis of arterial occlusion?
Answer: Decreased or absent pulses, cool extremities, and shiny skin.
Question 73
Which one of the following is a proper technique for use of a speculum during a vaginal
examination?
Answer: Inserting the speculum at a 45-degree angle, gently rotating it as it enters, and ensuring
it is not too wide.
Question 74
A positive straight leg raise test usually indicates:
Answer: Lumbar radiculopathy, often from a herniated disk.
Question 75
Examination of the patient in the lithotomy, or knee-chest, position includes:
Answer: Palpation of the uterus, cervix, and vaginal wall.
Question 76
A common finding in markedly obese and pregnant women is:
Answer: Striae (stretch marks) and varicose veins.
Question 77
To assess a cremasteric reflex, the examiner strokes the:
Answer: Inner thigh, which stimulates the reflex causing the testicle to rise.
Question 78
When conducting a geriatric assessment, basic activities of daily living (ADLs) include:
Answer: Eating, dressing, bathing, grooming, and toileting.
Question 79
You are interviewing a 20-year-old patient with a new-onset psychotic disorder. The patient is
apathetic and has disturbed thoughts and language patterns. The nurse recognizes this behavior
pattern as consistent with a diagnosis of:
Answer: Schizophrenia.
Question 80
Nerves that arise from the brain rather than the spinal cord are called:
Answer: Cranial nerves.
Question 81
During a routine prenatal visit, Ms. T. was noted as having dependent edema, varicosities of the
legs, and hemorrhoids. She expressed concern about these symptoms. You explain to Ms. T. that
her enlarged uterus is compressing her pelvic veins and her inferior vena cava. You would
further explain that these findings:
Answer: Are common during pregnancy due to increased venous pressure, and generally
improve after delivery.
Question 82
The Mini-Mental State Examination:
Answer: Assesses cognitive function, particularly orientation, memory, and attention.
Question 83
Facial muscle or tongue weakness may result in:
Answer: Difficulty speaking (dysarthria), swallowing (dysphagia), or articulating clearly.
Question 84
To assess spinal levels L2, L3, and L4, which deep tendon reflex should be tested?
Answer: Patellar reflex.
Question 85
Which of the following statements is true regarding the examination of peripheral arteries?
Answer: Palpation should assess for pulse, temperature, and symmetry to evaluate for
abnormalities.
Question 86
Recent unilateral inversion of a previously everted nipple suggests:
Answer: Possible breast malignancy.
Question 87
A 12-year-old boy relates that his left scrotum has a soft swollen mass. The scrotum is not
painful upon palpation. The left inguinal canal is without masses. The mass does transilluminate
with a penlight. This collection of symptoms is consistent with:
Answer: A hydrocele.
Question 88
A 23-year-old white woman has come to the clinic because she has missed two menstrual
periods. She states that her breasts have enlarged and that her nipples have turned a darker color.
Your further response to this finding is to:
Answer: Confirm pregnancy with a test and further assess for signs of early pregnancy.
Question 89
The presence of cervical motion tenderness may indicate:
Answer: Pelvic inflammatory disease (PID) or ectopic pregnancy.
Question 90
Nancy Walker is a 16-year-old girl who presents to the clinic with complaints of severe, acute
chest pain.
Her mother reports that Nancy, apart from occasional colds, Nancy is not prone to respiratory
problems. What potential risk factor is most important to assess with regards to Nancy's current
problem?
Answer: Family history of heart disease or other cardiovascular risks.
Question 91
Cranial nerve XII may be assessed in an infant by:
Answer: Observing for tongue movement or sucking reflex, as it involves the hypoglossal nerve.
Question 92
When you attempt to move a 10-month-old child from his mother's lap to the examination table,
he screams loudly. Your best action is to:
Answer: Allow the child to stay in the mother's lap while continuing the examination from there,
as separation may cause distress.
Question 93
It is especially important to test for ankle clonus if:
Answer: Hyperreflexia, possible upper motor neuron lesions, or signs of neurological
involvement.
Question 94
To spread the breast tissue evenly over the chest wall, you should ask the woman to lie supine
with:
Answer: Her arms extended over her head, which allows the breast tissue to fall more evenly.
Question 95
Diabetic peripheral neuropathy will likely produce:
Answer: Numbness, tingling, or loss of sensation in the feet and hands.
Question 96
Your 15-year-old patient is athletic and thin. Radiography of an ankle injury reveals a stress
fracture. You should question this patient about her:
Answer: Eating habits, calcium and vitamin D intake, and the possibility of an eating disorder.
Question 97
You are performing a two-point discrimination test as part of a well physical examination. The
area with the ability to discern two points in the shortest distance is the:
Answer: Fingertips, especially the distal fingers.
Question 98
While examining a 30-year-old woman, you note that one breast is slightly larger than the other.
In response to this finding, you should:
Answer: Reassure the patient that slight asymmetry is normal, but further assessment may be
needed if there are signs of abnormality.
Question 99
A patient in the deepest coma would be scored a _____ on the Glasgow Coma Scale.
Answer: 3, indicating no eye opening, verbal response, or motor response.
Question 100
You are initially evaluating the equilibrium of Ms. Q. You ask her to stand with her feet together
and arms at her sides. She loses her balance. Ms. Q. has a positive:
Answer: Romberg sign, indicating a possible issue with proprioception or balance.
Question 101
Functional assessment is most important during the examination of a(n):
Answer: Older adults, especially those with chronic health conditions or functional limitations.
