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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Do you know how doctors check if you're healthy? Take our Physical Assessment Quiz and see if you've 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'll 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're curious about healthcare or just want Read moreto test your knowledge, this quiz will give you a clearer picture of the medical procedures that keep us healthy.
Physical Assessment Questions and Answers
1.
The consumption of alcohol, tobacco, caffeine, or herbal products is vital in health history and is part of what?
A.
Illegal activity
B.
Habits and lifestyle patterns
C.
Fun and pleasure
D.
Rest and recreation
Correct Answer
B. Habits and lifestyle patterns
Explanation The consumption of alcohol, tobacco, caffeine, or herbal products is a crucial part of an individual's health history and is categorized under habits and lifestyle patterns. Documenting these habits helps healthcare providers understand potential risk factors and influences on health conditions. These substances can impact various bodily systems and are associated with numerous health outcomes. Therefore, accurate recording of these habits is essential for diagnosing, preventing, and treating health issues, as well as for making informed decisions about patient care and lifestyle recommendations.
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2.
Which of the following are true regarding cultural sensitivity?
A.
All members of one cultural group behave in exactly the same manner.
B.
As a nurse, it is important to identify and examine our own cultural and ethnic beliefs.
C.
Cultural and ethnic diversity have no impact in health care.
D.
Patient's response to signs and symptoms are independent of their cultural values.
Correct Answer
B. As a nurse, it is important to identify and examine our own cultural and ethnic beliefs.
Explanation Cultural sensitivity in healthcare involves acknowledging and respecting the diverse backgrounds of patients, including their cultural, ethnic, and religious beliefs. For nurses and healthcare professionals, it's essential to recognize their own cultural biases and beliefs to provide unbiased and effective care. Understanding one’s own cultural perspective helps in delivering culturally competent care, which improves patient communication, trust, and treatment outcomes. This awareness is crucial for minimizing misunderstandings and enhancing the therapeutic relationship between healthcare providers and patients.
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3.
We know that the nurse knows the right time to do a physical assessment when she says:
A.
"I will do it as soon as possible."
B.
"I think the next shift will have to do it."
C.
"After I give the medication"
D.
"Maybe later, when I am done with others."
Correct Answer
A. "I will do it as soon as possible."
Explanation When a nurse responds with "I will do it as soon as possible," it suggests a recognition of the urgency in conducting a physical assessment without unnecessary delay. This proactive approach ensures timely evaluation and appropriate intervention, promoting patient well-being and efficient healthcare delivery.
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4.
The difference between a "head to toe" assessment and a "focused assessment"
A.
Head to toe is systemic while focused concentrates on regional parts
B.
Head to toe is completed when the patient is admitted; focused concentrates on a particular part of a body
C.
Head to toe is done on every shift while focused is done when the person is admitted
D.
Both RN's and LPN's should do head to toe assessments as well as focused assessments
Correct Answer
A. Head to toe is systemic while focused concentrates on regional parts
Explanation A "head to toe" assessment is a comprehensive evaluation where the nurse examines the entire body systematically, from the head and neurological systems down to the toes, including all major body systems. This type of assessment is typically performed to obtain a complete health picture of the patient. On the other hand, a "focused assessment" is targeted and concentrates on a specific area or system based on the patient’s current health issues or complaints. This method allows for detailed attention to particular concerns or symptoms the patient may be experiencing.
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5.
The nurse tells a 75-year-old patient that she will have to do a "head to toe" assessment on him. The patient asks, "what is that"? Her best answer would be?
A.
I will need to determine the etiology of any pathologic symptoms you might have.
B.
Oh nothing, it is just something that we do.
C.
It is a way for us to know how we are going to take care of you later.
D.
Maybe you can tell me how you got here.
Correct Answer
C. It is a way for us to know how we are going to take care of you later.
Explanation When explaining a "head to toe" assessment to a patient, especially an older adult, it's important to communicate clearly and reassuringly. The best response, "It is a way for us to know how we are going to take care of you later," succinctly describes the purpose of the assessment in a way that is easy to understand. This explanation implies that the comprehensive evaluation will help the healthcare team determine the best care plan, ensuring the patient feels informed and involved in their own care process without overwhelming them with technical details or medical jargon.
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6.
A person who is just being admitted complains of pain in his right foot. What is the proper way to provide this patient with an accurate physical assessment?
A.
Do a focused assessment on foot first and do the complete physical examination later.
B.
If a complete physical assessment is necessary, it is best to assess any painful areas last.
C.
Focus on the pain and provide comfort before anything else.
D.
Since the patient is a new admit, concentrate on the general physical assessment only.
Correct Answer
A. Do a focused assessment on foot first and do the complete pHysical examination later.
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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7.
In the interview portion of the physical assessment, there is no need to wash our hands since we are not touching the patient.
A.
True
B.
False
Correct Answer
B. False
Explanation Hand hygiene is a fundamental practice in all aspects of healthcare, including during the interview portion of a physical assessment. Washing hands before and after interacting with each patient is crucial, regardless of whether direct physical contact occurs. This practice helps prevent the transmission of infectious agents and ensures the safety of both the patient and the healthcare provider. It also sets a standard of cleanliness and professionalism, demonstrating a commitment to patient care and infection control. Thus, hand washing is necessary at all times in the clinical setting.
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8.
Before the beginning of a physical examination, to make the patient more comfortable, what should be done first
A.
Give patient a warm blanket
B.
Ask if patient wants a glass of water
C.
Offer patient to empty his/her bladder
D.
Provide a small
Correct Answer
C. 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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9.
When performing a head-to-toe assessment, we usually begin with a neurologic evaluation. What is the next?
A.
Skin, hair, head, and neck, including eyes, ear, nose, and mouth
B.
Chest, back, arm, abdomen
C.
Perineal area, legs, and feet
D.
Eyes and ears alone
Correct Answer
A. Skin, hair, head, and neck, including eyes, ear, nose, and mouth
Explanation After beginning a head-to-toe assessment with a neurologic evaluation, the next logical step is to assess the skin, hair, head, and neck, including the eyes, ears, nose, and mouth. This systematic progression allows for a thorough examination of areas that can provide vital clues about a patient’s overall health and detect any abnormalities early. Evaluating the skin can reveal conditions such as dehydration, jaundice, or other dermatological issues, while examining the head and neck areas, including the sensory organs, provides insights into potential infections, neurological issues, or signs of other systemic diseases.
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10.
Which of the following are included in the neurologic assessment?
A.
Motor function
B.
Range of motion
C.
Level of consciousness
D.
Pupillary response
Correct Answer(s)
A. Motor function C. Level of consciousness D. 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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11.
PERRLA refers to:
A.
Motor function
B.
Order of assessment
C.
Level of consciousness
D.
Pupillary response
Correct Answer
D. 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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12.
A neurologic examination about the sensations of body movements and awareness of posture and cerebellar function.
A.
Deep tendon reflexes
B.
Coordination and Sensory Examination
C.
Cranial nerve assessment
D.
Pupillary reflex
Correct Answer
B. Coordination and Sensory Examination
Explanation A neurologic examination that focuses on the sensations of body movements, awareness of posture, and cerebellar function is specifically referred to as a Coordination and Sensory Examination. This type of assessment tests a patient’s ability to perform coordinated movements smoothly and accurately, which is critical for diagnosing conditions that affect the cerebellum and other related nervous system structures. It also includes testing sensory responses to determine how well the patient perceives touch, pain, temperature, and proprioception (sense of body position), which are integral to understanding neurological health and function.
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13.
Vital signs are reliable even when there is a central nervous system deficit.
A.
True
B.
False
Correct Answer
B. False
Explanation Vital signs may not always be reliable indicators of overall health when there is a central nervous system (CNS) deficit. Conditions affecting the CNS, such as severe brain injuries, strokes, or infections like meningitis, can impair the body's ability to regulate vital functions. For example, CNS deficits can influence the brain’s control over the cardiovascular system, potentially leading to abnormal blood pressure readings or altered heart rates. Similarly, respiratory control can be compromised, affecting breathing patterns and oxygen saturation levels. Therefore, in cases of CNS deficits, additional diagnostic tools and assessments are often necessary to accurately evaluate a patient’s condition.
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14.
What do the signs and symptoms of Cushing's triad include? They are typical of someone who had a traumatic brain injury.
A.
Increase in systolic blood pressure
B.
Bradycardia
C.
Irregular breathing pattern
D.
Widening pulse pressure
Correct Answer(s)
A. Increase in systolic blood pressure B. Bradycardia C. Irregular breathing pattern
Explanation Cushing's triad is a set of three primary signs that indicate increased intracranial pressure, often associated with traumatic brain injury or other conditions that affect the brain. The signs include an increase in systolic blood pressure (leading to a widening pulse pressure, but the key feature is the increased systolic), bradycardia (a slower than normal heart rate), and an irregular breathing pattern. These symptoms occur as a result of the body's attempt to maintain adequate cerebral perfusion in the face of rising pressure within the skull. Cushing's triad is a critical medical finding, as it suggests a severe and potentially life-threatening condition that requires immediate intervention.
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15.
Standardized objective measurement of the level of consciousness is do through:
A.
Glasgow Coma Scale
B.
PERRLA
C.
Rhomberg Test
D.
Motor function assessment
Correct Answer
A. Glasgow Coma Scale
Explanation The Glasgow Coma Scale (GCS) is a standardized tool used to objectively measure a person's level of consciousness. This scale assesses a patient based on verbal response, motor response, and eye opening to various stimuli. The GCS provides a score ranging from 3 (indicating deep unconsciousness) to 15 (fully alert and oriented), which helps medical professionals evaluate the severity of brain injury and guide treatment decisions. This scale is widely used in medical settings, particularly in emergency medicine and for patients with acute brain injury, making it an essential tool for assessing consciousness.
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16.
A patient has just been admitted. During physical assessment, it was observed that patient had decreased skin turgor and dried outer lips. What would be the most appropriate thing to offer this patient while the physical assessment is going on?
A.
A chair to sit on
B.
Medication
C.
Water
D.
Some snacks
Correct Answer
C. Water
Explanation Observing decreased skin turgor and dry lips during a physical assessment are signs that typically indicate dehydration. Offering water to the patient is the most appropriate and immediate action to help address these symptoms. Hydration can improve skin turgor and alleviate dryness of the lips, which not only enhances patient comfort but also helps in ensuring more accurate ongoing assessments. Providing water is a simple yet effective intervention to begin addressing potential dehydration while further medical evaluation and treatment are considered.
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17.
A patient with increased turgor in his lower extremities manifested by smooth, taut, shiny skin that cannot be grasped or raised is most likely to have:
A.
Enema
B.
Decubitus
C.
Edema
D.
Infection
Correct Answer
C. Edema
Explanation Increased turgor in the lower extremities, characterized by smooth, taut, and shiny skin that cannot be easily grasped or raised, typically indicates edema. Edema is the accumulation of fluid in the tissues, leading to swelling. This condition can be caused by a variety of factors, including heart failure, kidney disease, liver problems, or certain medications. It is important to identify the underlying cause of edema to address it effectively. The description of skin that is taut and shiny particularly points towards fluid retention, rather than other options like infection or pressure ulcers (decubitus).
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18.
Abnormal swishing sounds are heard over organs, glands, and arteries and result from an abnormality in an artery resulting from narrow or partially occluded arteries such as atherosclerosis.
A.
Thrill
B.
Crackles
C.
Bruits
D.
Wheezes
Correct Answer
C. 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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19.
A vibrating sensation perceived when an artery is palpated and is not expected when examining a carotid pulse.
A.
Bruit
B.
Thrill
C.
Crackles
D.
Rhonci
Correct Answer
B. 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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20.
An abnormal respiration cycle begins with slow, shallow respiration that becomes rapid, then becomes slower, followed by periods of apnea (20 seconds)—usually caused by heart failure, opioid overdose, renal failure, meningitis, and severe headache.
A.
Kussmaul
B.
Cheyne-stokes
C.
Botte's
D.
Whooping sneeze
Correct Answer
B. 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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21.
What is indicative of acute or chronic respiratory distress?
A.
Height
B.
Posture
C.
Weight
D.
Hair loss
Correct Answer
B. 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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22.
Teaching patients to perform breast self-exams is only directly related to females.
A.
True
B.
False
Correct Answer
B. 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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23.
When auscultating for lung sounds, which part of the stethoscope is designed to transmit the higher pitch of abnormal sounds?
A.
Ear piece
B.
Bell
C.
Diaphragm
D.
Tubes
Correct Answer
C. 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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24.
When doing a respiratory assessment to a patient, which of the following is the most appropriate technique?
A.
Use a stethoscope over the clothing of a patient who feels cold
B.
Instruct patient to breathe through his or her mouth quietly and more deeply and slowly than in a usual respiration
C.
Allow a patient with a slight lower back pain to lie supine on bed
D.
Listen to the heart sound at the same time that your are listening to the lung sounds
Correct Answer
B. 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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25.
When auscultating for lung sounds, place the stethoscope firmly and tightly on the skin, and listen for one full inspiratory-expiratory cycle at each point.
A.
True
B.
False
Correct Answer
B. 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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26.
Rubbing, grating or squeaky sound upon auscultation; as if two pieces of leather are being rubbed together is called:
A.
Pulmonary friction
B.
Pleural friction rub
C.
Pulmonary bruising
D.
Whooping cough
Correct Answer
B. 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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27.
Exaggeration of the posterior curvature of the thoracic spine is called:
A.
Spina Bifida
B.
Kyphosis
C.
Lordosis
D.
Scoliosis
Correct Answer
B. 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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28.
A swayback, an increased lumbar curvature is called:
A.
Spina Bifida
B.
Kyphosis
C.
Lordosis
D.
Scoliosis
Correct Answer
C. Lordosis
Explanation Lordosis refers to an increased inward curvature of the lumbar spine, commonly known as swayback. This condition results in a pronounced arch in the lower back and can be caused by a variety of factors including obesity, pregnancy, and poor posture, as well as developmental issues affecting spinal alignment. Lordosis can lead to discomfort and pain due to the abnormal strain it places on the muscles and spinal discs. It is important to distinguish lordosis from other spinal conditions such as kyphosis, which affects the upper back, and scoliosis, which involves a lateral curvature of the spine. Treatment typically involves physical therapy, weight management, and in some cases, surgery to correct the curvature and relieve symptoms.
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29.
Lateral spinal curvature is called:
A.
Spina Bifida
B.
Kyphosis
C.
Lordosis
D.
Scoliosis
Correct Answer
D. Scoliosis
Explanation Scoliosis is the medical term for a lateral, or sideways, curvature of the spine. This condition typically appears during the growth spurt just before puberty, although it can also occur due to conditions like muscular dystrophy and cerebral palsy, or can be idiopathic with no identifiable cause. Scoliosis can range from mild to severe, and in more pronounced cases, it can impair breathing and cause physical deformity. Diagnosis often involves observing the back in standing positions and may require X-rays to assess the severity of the curve. Treatment depends on the degree of curvature and the age of the patient, ranging from observation to bracing and surgery.
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30.
Lubb-dubb is caused by:
A.
Closure of the atrioventricular and semilunar valves respectively
B.
Closure of the semilunar and atrioventricular valves respectively
C.
Closure of the atrioventricular and semilunar valves simultaneously
D.
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 characteristic heart sounds, known as "lubb-dubb," are caused by the closure of the heart's valves in sequence during the cardiac cycle. The "lubb" sound is the first heart sound (S1) and is produced by the closure of the atrioventricular valves (the mitral and tricuspid valves) at the beginning of ventricular systole when the ventricles start to contract. The "dubb" sound is the second heart sound (S2) and results from the closure of the semilunar valves (the aortic and pulmonary valves) at the end of ventricular systole as the ventricles begin to relax. This sequential closing of the valves is crucial for the efficient flow of blood through the heart and into the major arteries.
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31.
The first normal heart sound S1 occurs when?
A.
Closure of the AV valves and signals the start of systole
B.
Closure of the AV valves and signals the end of systole
C.
Opening of the AV valves and signals the start of systole
D.
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.
Where is S1 auscultated most clearly?
A.
Apex of the heart
B.
Base of heart
C.
Around the heart
D.
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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33.
When does normal heart sound S2 occur?
A.
With the closure of the AV valve and signals the end of systole
B.
With the opening of the AV valve and signals opening of systole
C.
With the opening of the semilunar valves and signals the beginning of systole.
D.
With the closure of the semilunar valves and signals the end of systole
Correct Answer
D. 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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34.
Heard in patients with coronary artery disease after MI (myocardial infarction), heard late in diastole when the atria contracts.
A.
S1
B.
S2
C.
S3
D.
S4
Correct Answer
D. 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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35.
Which of the following is not a peripheral pulse?
A.
Ulnar
B.
Femoral
C.
Brachial
D.
Humoral
Correct Answer
D. 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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36.
This happens when there is a decreased supply of oxygenated blood to the tissues often caused by a narrowing of an artery.
A.
Ischemia
B.
Claudication
C.
Hypoventilation
D.
Atelactesis
Correct Answer
A. Ischemia
Explanation Ischemia occurs when there is a decreased supply of oxygenated blood to the tissues, often caused by a narrowing or blockage of arteries. This condition can lead to various symptoms and complications depending on the area of the body affected. For example, coronary artery ischemia can result in chest pain or a heart attack, while cerebral ischemia can lead to stroke-like symptoms. Ischemia is primarily due to atherosclerosis or other conditions that obstruct blood flow, critically reducing the oxygen and nutrient supply needed for tissue function and health.
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37.
Cramp-like pain in the lower extremities usually after walking is called:
A.
Ischemia
B.
Claudication
C.
Hypoventilation
D.
Atelactesis
Correct Answer
B. Claudication
Explanation Claudication refers to cramp-like pain that occurs in the lower extremities, typically triggered by walking or other forms of exercise. This pain is caused by inadequate blood flow to the muscles, often due to peripheral artery disease (PAD), where arteries become narrowed by atherosclerotic plaque. The pain usually subsides with rest as it is directly related to the increased demand for oxygen by muscles during physical activity, which cannot be met due to the restricted blood flow. Claudication is a critical symptom for diagnosing PAD and assessing the severity of arterial insufficiency.
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38.
In person with good cardiac function and distal perfusion, how long should a capillary refill take place?
A.
Less than 3 seconds
B.
More than 3 seconds
C.
More than 5 seconds
D.
Around 5 seconds
Correct Answer
A. Less than 3 seconds
Explanation Capillary refill time is a quick test to assess circulatory status, especially peripheral perfusion. In a person with good cardiac function and distal perfusion, capillary refill time should typically be less than 3 seconds. This measurement is obtained by pressing on a fingernail or skin until it turns white and then observing how long it takes for color to return once pressure is released. A prompt return of color indicates effective blood circulation, suggesting that the heart is efficiently pumping blood and the blood vessels are adequately delivering blood to peripheral tissues.
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39.
Which of the following is not a symptom?
A.
Soreness
B.
Pruritus
C.
Flatus
D.
Pain
Correct Answer
C. Flatus
Explanation Flatus, or the passing of gas, is not considered a symptom but rather a normal physiological process of the digestive system. It involves the expulsion of gas that is produced or introduced into the gastrointestinal tract. While excessive flatus can sometimes indicate digestive issues and may accompany symptoms like bloating or discomfort, flatus in itself is a normal bodily function and not inherently symptomatic of disease. In contrast, soreness, pruritus (itching), and pain are all considered symptoms as they indicate an abnormal condition or the presence of an underlying health issue.
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40.
Two significant alterations in bowel sounds:
A.
Hyperactive and hypoactive bowel sounds
B.
Loud and quiet bowel sounds
C.
Fetid and scentless bowel sounds
D.
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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41.
Which of the following is a priority when assessing a patient with a suspected stroke?
A.
Check their shoe size
B.
Assess their cognitive function
C.
Ask about their dietary preferences
D.
Evaluate their fashion sense
Correct Answer
B. 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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42.
What is the first step in conducting a physical assessment of the cardiovascular system?
A.
Listen to the patient's family history
B.
Measure the blood pressure
C.
Check the patient's email for recent health updates
D.
Review the patient's latest tweets
Correct Answer
B. 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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43.
How should a nurse proceed when a patient expresses pain during a musculoskeletal assessment?
A.
Continue the assessment as usual
B.
Stop the assessment immediately
C.
Modify the assessment to avoid causing further pain
D.
Record the patient's pain as irrelevant
Correct Answer
C. Modify the assessment to avoid causing further pain
Explanation When a patient experiences pain during a musculoskeletal assessment, it's essential to adjust the examination techniques to prevent further discomfort. This can involve using passive movements, supporting painful joints, or temporarily halting actions that exacerbate the pain, thereby respecting the patient's comfort while still gathering necessary diagnostic information.
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44.
Which technique is used to assess the liver size during a physical examination?
A.
Percussion
B.
Auscultation
C.
Visualization
D.
Speculation
Correct Answer
A. Percussion
Explanation Percussion is the recommended technique for assessing liver size. This method involves tapping on the abdominal surface to elicit sound waves that bounce off the liver, creating audible feedback that correlates with liver size and consistency. It's an effective diagnostic tool for detecting liver enlargement or abnormalities in its texture and form.
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45.
A patient reports feeling dizzy when standing up. What should be assessed first?
A.
Color of their clothing
B.
Orthostatic blood pressure
C.
Their preference for room decorations
D.
Latest social media updates
Correct Answer
B. Orthostatic blood pressure
Explanation Orthostatic blood pressure measurement is vital when a patient reports dizziness upon standing. This test involves taking blood pressure readings in different positions—lying, sitting, and standing—to identify significant drops in blood pressure that occur with position changes. Such changes can indicate orthostatic hypotension, a condition that needs further investigation and management.
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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.
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