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Nursing
Q:
A man who has had gout for several years comes to the clinic with a problem with his toe. On examination, the nurse notices the presence of hard, painless nodules over the great toe; one has burst open with a chalky discharge. This finding is known as:
a. Callus.
b. Plantar wart.
c. Bunion.
d. Tophi.
Q:
A patient tells the nurse that, "All my life I"ve been called "knock knees'." The nurse knows that another term for knock knees is:
a. Genu varum.
b. Genu valgum.
c. Pes planus.
d. Metatarsus adductus.
Q:
The nurse should use which test to check for large amounts of fluid around the patella?
a. Ballottement
b. Tinel sign
c. Phalen test
d. McMurray test
Q:
The nurse is examining a 2-month-old infant and notices asymmetry of the infant's gluteal folds. The nurse should assess for other signs of what disorder?
a. Fractured clavicle
b. Down syndrome
c. Spina bifida
d. Hip dislocation
Q:
The nurse is assessing a 1-week-old infant and is testing his muscle strength. The nurse lifts the infant with hands under the axillae and notices that the infant starts to "slip" between the hands. The nurse should:
a. Suspect a fractured clavicle.
b. Suspect that the infant may have a deformity of the spine.
c. Suspect that the infant may have weakness of the shoulder muscles.
d. Conclude that this is a normal finding because the musculature of an infant at this age is undeveloped.
Q:
The nurse is examining a 6-month-old infant and places the infant's feet flat on the table and flexes his knees up. The nurse notes that the right knee is significantly lower than the left. Which of these statements is true of this finding?
a. This finding is a positive Allis sign and suggests hip dislocation.
b. The infant probably has a dislocated patella on the right knee.
c. This finding is a negative Allis sign and normal for an infant of this age.
d. The infant should return to the clinic in 2 weeks to see if his condition has changed.
Q:
When assessing muscle strength, the nurse observes that a patient has complete range of motion against gravity with full resistance. What grade of muscle strength should the nurse record using a 0- to 5-point scale?
a. 2
b. 3
c. 4
d. 5
Q:
A 14-year-old boy who has been diagnosed with Osgood-Schlatter disease reports painful swelling just below the knee for the past 5 months. Which response by the nurse is appropriate?
a. "If these symptoms persist, you may need arthroscopic surgery."
b. "You are experiencing degeneration of your knee, which may not resolve."
c. "Your disease is due to repeated stress on the patellar tendon. It is usually self-limited, and your symptoms should resolve with rest."
d. "Increasing your activity and performing knee-strengthening exercises will help decrease the inflammation and maintain mobility in the knee."
Q:
A patient's annual physical examination reveals a lateral curvature of the thoracic and lumbar segments of his spine; however, this curvature disappears with forward bending. The nurse knows that this abnormality of the spine is called:
a. Structural scoliosis.
b. Functional scoliosis.
c. Herniated nucleus pulposus.
d. Dislocated hip.
Q:
A patient who has had rheumatoid arthritis for years comes to the clinic to ask about changes in her fingers. The nurse will assess for signs of what problems?
a. Heberden nodes
b. Bouchard nodules
c. Swan-neck deformities
d. Dupuytren contractures
Q:
A woman who has had rheumatoid arthritis for years is starting to notice that her fingers are drifting to the side. The nurse knows that this condition is commonly referred to as:
a. Radial drift.
b. Ulnar deviation.
c. Swan-neck deformity.
d. Dupuytren contracture.
Q:
A 68-year-old woman has come in for an assessment of her rheumatoid arthritis, and the nurse notices raised, firm, nontender nodules at the olecranon bursa and along the ulna. These nodules are most commonly diagnosed as:
a. Epicondylitis.
b. Gouty arthritis.
c. Olecranon bursitis.
d. Subcutaneous nodules.
Q:
A young swimmer comes to the sports clinic complaining of a very sore shoulder. He was running at the pool, slipped on some wet concrete, and tried to catch himself with his outstretched hand. He landed on his outstretched hand and has not been able to move his shoulder since. The nurse suspects:
a. Joint effusion.
b. Tear of rotator cuff.
c. Adhesive capsulitis.
d. Dislocated shoulder.
Q:
A 40-year-old man has come into the clinic with complaints of extreme pain in his toes. The nurse notices that his toes are slightly swollen, reddened, and warm to the touch. His complaints would suggest:
a. Osteoporosis.
b. Acute gout.
c. Ankylosing spondylitis.
d. Degenerative joint disease.
Q:
A mother brings her newborn baby boy in for a checkup; she tells the nurse that he does not seem to be moving his right arm as much as his left and that he seems to have pain when she lifts him up under the arms. The nurse suspects a fractured clavicle and would observe for:
a. Negative Allis test.
b. Positive Ortolani sign.
c. Limited range of motion during the Moro reflex.
d. Limited range of motion during Lasgue test.
Q:
During a neonatal examination, the nurse notices that the newborn infant has six toes. This finding is documented as:
a. Unidactyly.
b. Syndactyly.
c. Polydactyly.
d. Multidactyly.
Q:
The nurse is examining a 3-month-old infant. While the nurse holds his or her thumbs on the infant's inner mid thighs and the fingers on the outside of the infant's hips, touching the greater trochanter, the nurse adducts the legs until the his or her thumbs touch and then abducts the legs until the infant's knees touch the table. The nurse does not notice any "clunking" sounds and is confident to record a:
a. Positive Allis test.
b. Negative Allis test.
c. Positive Ortolani sign.
d. Negative Ortolani sign.
Q:
During an examination, the nurse asks a patient to bend forward from the waist and notices that the patient has lateral tilting. When his leg is raised straight up, the patient complains of a pain going down his buttock into his leg. The nurse suspects:
a. Scoliosis.
b. Meniscus tear.
c. Herniated nucleus pulposus.
d. Spasm of paravertebral muscles.
Q:
The nurse has completed the musculoskeletal examination of a patient's knee and has found a positive bulge sign. The nurse interprets this finding to indicate:
a. Irregular bony margins.
b. Soft-tissue swelling in the joint.
c. Swelling from fluid in the epicondyle.
d. Swelling from fluid in the suprapatellar pouch.
Q:
An 80-year-old woman is visiting the clinic for a checkup. She states, "I can"t walk as much as I used to." The nurse is observing for motor dysfunction in her hip and should ask her to:
a. Internally rotate her hip while she is sitting.
b. Abduct her hip while she is lying on her back.
c. Adduct her hip while she is lying on her back.
d. Externally rotate her hip while she is standing.
Q:
The nurse suspects that a patient has carpal tunnel syndrome and wants to perform the Phalen test. To perform this test, the nurse should instruct the patient to:
a. Dorsiflex the foot.
b. Plantarflex the foot.
c. Hold both hands back to back while flexing the wrists 90 degrees for 60 seconds.
d. Hyperextend the wrists with the palmar surface of both hands touching, and wait for 60 seconds.
Q:
A professional tennis player comes into the clinic complaining of a sore elbow. The nurse will assess for tenderness at the:
a. Olecranon bursa.
b. Annular ligament.
c. Base of the radius.
d. Medial and lateral epicondyle.
Q:
A patient is able to flex his right arm forward without difficulty or pain but is unable to abduct his arm because of pain and muscle spasms. The nurse should suspect:
a. Crepitation.
b. Rotator cuff lesions.
c. Dislocated shoulder.
d. Rheumatoid arthritis.
Q:
A patient states, "I can hear a crunching or grating sound when I kneel." She also states that "it is very difficult to get out of bed in the morning because of stiffness and pain in my joints." The nurse should assess for signs of what problem?
a. Crepitation
b. Bone spur
c. Loose tendon
d. Fluid in the knee joint
Q:
A patient is complaining of pain in his joints that is worse in the morning, better after he moves around for a while, and then gets worse again if he sits for long periods. The nurse should assess for other signs of what problem?
a. Tendinitis
b. Osteoarthritis
c. Rheumatoid arthritis
d. Intermittent claudication
Q:
A teenage girl has arrived complaining of pain in her left wrist. She was playing basketball when she fell and landed on her left hand. The nurse examines her hand and would expect a fracture if the girl complains of a:
a. Dull ache.
b. Deep pain in her wrist.
c. Sharp pain that increases with movement.
d. Dull throbbing pain that increases with rest.
Q:
The nurse is teaching a class on preventing osteoporosis to a group of perimenopausal women. Which of these actions is the best way to prevent or delay bone loss in this group?
a. Taking calcium and vitamin D supplements
b. Taking medications to prevent osteoporosis
c. Performing physical activity, such as fast walking
d. Assessing bone density annually
Q:
A patient has been diagnosed with osteoporosis and asks the nurse, "What is osteoporosis?" The nurse explains that osteoporosis is defined as:
a. Increased bone matrix.
b. Loss of bone density.
c. New, weaker bone growth.
d. Increased phagocytic activity.
Q:
An 85-year-old patient comments during his annual physical examination that he seems to be getting shorter as he ages. The nurse should explain that decreased height occurs with aging because:
a. Long bones tend to shorten with age.
b. The vertebral column shortens.
c. A significant loss of subcutaneous fat occurs.
d. A thickening of the intervertebral disks develops.
Q:
A woman who is 8 months pregnant comments that she has noticed a change in her posture and is having lower back pain. The nurse tells her that during pregnancy, women have a posture shift to compensate for the enlarging fetus. This shift in posture is known as:
a. Lordosis.
b. Scoliosis.
c. Ankylosis.
d. Kyphosis.
Q:
The nurse is explaining the mechanism of the growth of long bones to a mother of a toddler. Where does lengthening of the bones occur?
a. Bursa
b. Calcaneus
c. Epiphyses
d. Tuberosities
Q:
The ankle joint is the articulation of the tibia, fibula, and:
a. Talus.
b. Cuboid.
c. Calcaneus.
d. Cuneiform bones.
Q:
The nurse is examining the hip area of a patient and palpates a flat depression on the upper, lateral side of the thigh when the patient is standing. The nurse interprets this finding as the:
a. Ischial tuberosity.
b. Greater trochanter.
c. Iliac crest.
d. Gluteus maximus muscle.
Q:
The nurse is assessing a patient's ischial tuberosity. To palpate the ischial tuberosity, the nurse knows that it is best to have the patient:
a. Standing.
b. Flexing the hip.
c. Flexing the knee.
d. Lying in the supine position.
Q:
A patient is visiting the clinic for an evaluation of a swollen, painful knuckle. The nurse notices that the knuckle above his ring on the left hand is swollen and that he is unable to remove his wedding ring. This joint is called the _________ joint.
a. Interphalangeal
b. Tarsometatarsal
c. Metacarpophalangeal
d. Tibiotalar
Q:
The nurse is checking the range of motion in a patient's knee and knows that the knee is capable of which movement(s)?
a. Flexion and extension
b. Supination and pronation
c. Circumduction
d. Inversion and eversion
Q:
During an interview the patient states, "I can feel this bump on the top of both of my shouldersit doesn"t hurt but I am curious about what it might be." The nurse should tell the patient that it is his:
a. Subacromial bursa.
b. Acromion process.
c. Glenohumeral joint.
d. Greater tubercle of the humerus.
Q:
The nurse is providing patient education for a man who has been diagnosed with a rotator cuff injury. The nurse knows that a rotator cuff injury involves the:
a. Nucleus pulposus.
b. Articular processes.
c. Medial epicondyle.
d. Glenohumeral joint.
Q:
The nurse is explaining to a patient that there are shock absorbers in his back to cushion the spine and to help it move. The nurse is referring to his:
a. Vertebral column.
b. Nucleus pulposus.
c. Vertebral foramen.
d. Intervertebral disks.
Q:
An imaginary line connecting the highest point on each iliac crest would cross the __________ vertebra.
a. First sacral
b. Fourth lumbar
c. Seventh cervical
d. Twelfth thoracic
Q:
Of the 33 vertebrae in the spinal column, there are:
a. 5 lumbar.
b. 5 thoracic.
c. 7 sacral.
d. 12 cervical.
Q:
To palpate the temporomandibular joint, the nurse's fingers should be placed in the depression __________ of the ear.
a. Distal to the helix
b. Proximal to the helix
c. Anterior to the tragus
d. Posterior to the tragus
Q:
The articulation of the mandible and the temporal bone is known as the:
a. Intervertebral foramen.
b. Condyle of the mandible.
c. Temporomandibular joint.
d. Zygomatic arch of the temporal bone.
Q:
The nurse notices that a woman in an exercise class is unable to jump rope. The nurse is aware that to jump rope, one's shoulder has to be capable of:
a. Inversion.
b. Supination.
c. Protraction.
d. Circumduction.
Q:
Fibrous bands running directly from one bone to another that strengthen the joint and help prevent movement in undesirable directions are called:
a. Bursa.
b. Tendons.
c. Cartilage.
d. Ligaments.
Q:
When reviewing the musculoskeletal system, the nurse recalls that hematopoiesis takes place in the:
a. Liver.
b. Spleen.
c. Kidneys.
d. Bone marrow.
Q:
The functional units of the musculoskeletal system are the:
a. Joints.
b. Bones.
c. Muscles.
d. Tendons.
Q:
A patient tells the nurse that she is having a hard time bringing her hand to her mouth when she eats or tries to brush her teeth. The nurse knows that for her to move her hand to her mouth, she must perform which movement?
a. Flexion
b. Abduction
c. Adduction
d. Extension
Q:
A patient is being assessed for range-of-joint movement. The nurse asks him to move his arm in toward the center of his body. This movement is called:
a. Flexion.
b. Abduction.
c. Adduction.
d. Extension.
Q:
The nurse suspects that a patient has appendicitis. Which of these procedures are appropriate for use when assessing for appendicitis or a perforated appendix? Select all that apply.
a. Test for the Murphy sign
b. Test for the Blumberg sign
c. Test for shifting dullness
d. Perform the iliopsoas muscle test
e. Test for fluid wave
Q:
During a health history, the patient tells the nurse, "I have pain all the time in my stomach. It's worse 2 hours after I eat, but it gets better if I eat again!" Based on these symptoms, the nurse suspects that the patient has which condition?
a. Appendicitis
b. Gastric ulcer
c. Duodenal ulcer
d. Cholecystitis
Q:
The nurse is preparing to examine a patient who has been complaining of right lower quadrant pain. Which technique is correct during the assessment?
The nurse should:
a. Examine the tender area first.
b. Examine the tender area last.
c. Avoid palpating the tender area.
d. Palpate the tender area first, and then auscultate for bowel sounds.
Q:
During an abdominal assessment, the nurse tests for a fluid wave. A positive fluid wave test occurs with:
a. Splenomegaly.
b. Distended bladder.
c. Constipation.
d. Ascites.
Q:
During an assessment, the nurse notices that a patient's umbilicus is enlarged and everted. It is positioned midline with no change in skin color. The nurse recognizes that the patient may have which condition?
a. Intra-abdominal bleeding
b. Constipation
c. Umbilical hernia
d. Abdominal tumor
Q:
During reporting, the student nurse hears that a patient has hepatomegaly and recognizes that this term refers to:
a. Enlarged liver.
b. Enlarged spleen.
c. Distended bowel.
d. Excessive diarrhea.
Q:
The nurse is assessing a patient for possible peptic ulcer disease. Which condition or history often causes this problem?
a. Hypertension
b. Streptococcal infections
c. Recurrent constipation with frequent laxative use
d. Frequent use of nonsteroidal antiinflammatory drugs
Q:
The nurse is reviewing statistics for lactose intolerance. In the United States, the incidence of lactose intolerance is higher in adults of which ethnic group?
a. Blacks
b. Hispanics
c. Whites
d. Asians
Q:
When palpating the abdomen of a 20-year-old patient, the nurse notices the presence of tenderness in the left upper quadrant with deep palpation. Which of these structures is most likely to be involved?
a. Spleen
b. Sigmoid colon
c. Appendix
d. Gallbladder
Q:
A 45-year-old man is in the clinic for a physical examination. During the abdominal assessment, the nurse percusses the abdomen and notices an area of dullness above the right costal margin of approximately 11 cm. The nurse should:
a. Document the presence of hepatomegaly.
b. Ask additional health history questions regarding his alcohol intake.
c. Describe this dullness as indicative of an enlarged liver, and refer him to a physician.
d. Consider this finding as normal, and proceed with the examination.
Q:
A 40-year-old man states that his physician told him that he has a hernia. He asks the nurse to explain what a hernia is. Which response by the nurse is appropriate?
a. "No need to worry. Most men your age develop hernias."
b. "A hernia is a loop of bowel protruding through a weak spot in the abdominal muscles."
c. "A hernia is the result of prenatal growth abnormalities that are just now causing problems."
d. "I"ll have to have your physician explain this to you."
Q:
Which of these percussion findings would the nurse expect to find in a patient with a large amount of ascites?
a. Dullness across the abdomen
b. Flatness in the right upper quadrant
c. Hyperresonance in the left upper quadrant
d. Tympany in the right and left lower quadrants
Q:
Just before going home, a new mother asks the nurse about the infant's umbilical cord. Which of these statements is correct?
a. "It should fall off in 10 to 14 days."
b. "It will soften before it falls off."
c. "It contains two veins and one artery."
d. "Skin will cover the area within 1 week."
Q:
A patient is suspected of having inflammation of the gallbladder, or cholecystitis. The nurse should conduct which of these techniques to assess for this condition?
a. Obturator test
b. Test for Murphy sign
c. Assess for rebound tenderness
d. Iliopsoas muscle test
Q:
During an abdominal assessment, the nurse is unable to hear bowel sounds in a patient's abdomen. Before reporting this finding as silent bowel sounds, the nurse should listen for at least:
a. 1 minute.
b. 5 minutes.
c. 10 minutes.
d. 2 minutes in each quadrant.
Q:
The nurse is reviewing the assessment of an aortic aneurysm. Which of these statements is true regarding an aortic aneurysm?
a. A bruit is absent.
b. Femoral pulses are increased.
c. A pulsating mass is usually present.
d. Most are located below the umbilicus.
Q:
During an assessment of a newborn infant, the nurse recalls that pyloric stenosis would be exhibited by:
a. Projectile vomiting.
b. Hypoactive bowel activity.
c. Palpable olive-sized mass in the right lower quadrant.
d. Pronounced peristaltic waves crossing from right to left.
Q:
The nurse is assessing the abdomen of an older adult. Which statement regarding the older adult and abdominal assessment is true?
a. Abdominal tone is increased.
b. Abdominal musculature is thinner.
c. Abdominal rigidity with an acute abdominal condition is more common.
d. The older adult with an acute abdominal condition complains more about pain than the younger person.
Q:
During an abdominal assessment, the nurse elicits tenderness on light palpation in the right lower quadrant. The nurse interprets that this finding could indicate a disorder of which of these structures?
a. Spleen
b. Sigmoid
c. Appendix
d. Gallbladder
Q:
The nurse notices that a patient has had a black, tarry stool and recalls that a possible cause would be:
a. Gallbladder disease.
b. Overuse of laxatives.
c. Gastrointestinal bleeding.
d. Localized bleeding around the anus.
Q:
The nurse knows that during an abdominal assessment, deep palpation is used to determine:
a. Bowel motility.
b. Enlarged organs.
c. Superficial tenderness.
d. Overall impression of skin surface and superficial musculature.
Q:
A nurse notices that a patient has ascites, which indicates the presence of:
a. Fluid.
b. Feces.
c. Flatus.
d. Fibroid tumors.
Q:
A patient is complaining of a sharp pain along the costovertebral angles. The nurse is aware that this symptom is most often indicative of:
a. Ovary infection.
b. Liver enlargement.
c. Kidney inflammation.
d. Spleen enlargement.
Q:
An older patient has been diagnosed with pernicious anemia. The nurse knows that this condition could be related to:
a. Increased gastric acid secretion.
b. Decreased gastric acid secretion.
c. Delayed gastrointestinal emptying time.
d. Increased gastrointestinal emptying time.
Q:
The nurse is performing percussion during an abdominal assessment. Percussion notes heard during the abdominal assessment may include:
a. Flatness, resonance, and dullness.
b. Resonance, dullness, and tympany.
c. Tympany, hyperresonance, and dullness.
d. Resonance, hyperresonance, and flatness.
Q:
The nurse is assessing the abdomen of a pregnant woman who is complaining of having "acid indigestion" all the time. The nurse knows that esophageal reflux during pregnancy can cause:
a. Diarrhea.
b. Pyrosis.
c. Dysphagia.
d. Constipation.
Q:
During an abdominal assessment, the nurse would consider which of these findings as normal?
a. Presence of a bruit in the femoral area
b. Tympanic percussion note in the umbilical region
c. Palpable spleen between the ninth and eleventh ribs in the left midaxillary line
d. Dull percussion note in the left upper quadrant at the midclavicular line
Q:
The physician comments that a patient has abdominalborborygmi. The nurse knows that this term refers to:
a. Loud continual hum.
b. Peritoneal friction rub.
c. Hypoactive bowel sounds.
d. Hyperactive bowel sounds.
Q:
The nurse is listening to bowel sounds. Which of these statements is true of bowel sounds? Bowel sounds:
a. Are usually loud, high-pitched, rushing, and tinkling sounds.
b. Are usually high-pitched, gurgling, and irregular sounds.
c. Sound like two pieces of leather being rubbed together.
d. Originate from the movement of air and fluid through the large intestine.
Q:
The nurse is watching a new graduate nurse perform auscultation of a patient's abdomen. Which statement by the new graduate shows a correct understanding of the reason auscultation precedes percussion and palpation of the abdomen?
a. "We need to determine the areas of tenderness before using percussion and palpation."
b. "Auscultation prevents distortion of bowel sounds that might occur after percussion and palpation."
c. "Auscultation allows the patient more time to relax and therefore be more comfortable with the physical examination."
d. "Auscultation prevents distortion of vascular sounds, such as bruits and hums, that might occur after percussion and palpation."
Q:
A patient has hypoactive bowel sounds. The nurse knows that a potential cause of hypoactive bowel sounds is:
a. Diarrhea.
b. Peritonitis.
c. Laxative use.
d. Gastroenteritis.