Exam 2 Review Questions

Question 1

When taking the health history, the patient complains of pruritus. What is a common cause of this symptom?

1. Excessive bruising
2. Hyperpigmentation
3. Melasma
4. . Drug reactions

Answer 1

4. Drug reactions

Common causes of pruritus include dry skin, aging, drug reactions, allergy, obstructive jaundice, uremia, and lice.

• Excessive bruising is not a common cause of pruritus.
• Hyperpigmentation is not a common cause of pruritus.
• Melasma is not a common cause of pruritus

Question 2

A flat macular hemorrhage is called a(n):

1. purpura
2. ecchyomosis
3. petechiae
4. hemangioma

Answer 2

1. purpura

Purpura is a flat, macular, red to purple hemorrhage that is a confluent and extensive patch of petechiae and ecchymoses greater than 3 mm.

An ecchymosis is petechiae that are greater than 3 mm.

Petechiae are tiny punctuate hemorrhages that are 1 to 3 mm, round and discrete, and dark red, purple, or brown caused by bleeding from superficial capillaries.

Hemangiomas are vascular lesions caused by a benign proliferation of blood vessels in the dermis.

Question 3

A student nurse has been assigned to teach fourth graders about hygiene. While preparing, the student nurse adds information about the sweat glands. Which of the following should be included while discussing this topic?

1. There are two types of sweat glands: the eccrine and the sebaceous.
2. The evaporation of sweat, a dilute saline solution, increases body temperature.
3. Eccrine glands produce sweat and are mainly located in the axillae, anogenital area, and navel.
4. Newborn infants do not sweat and use compensatory mechanisms to control body temperature.

Answer 3

4. Newborn infants do not sweat and use compensatory mechanisms to control body temperature.

Newborn infants’ eccrine glands do not secrete sweat in response to heat until the first few months of life; newborn temperature regulation is ineffective.

There are two types of sweat glands: the eccrine glands and the apocrine glands.

The evaporation of sweat reduces body temperature.

The apocrine glands produce a thick, milky secretion and open into the hair follicles; they are located mainly in the axillae, anogenital area, nipples, and navel.

Question 4

Functions of the skin include:

1. production of vitamin C.
2. temperature regulation.
3. the production of new cells by melanocytes.
4. the secretion of a drying substance called sebum.

Answer 4

temperature regulation

Functions of the skin include protection, prevention of penetration, perception (of touch, pain, temperature, and pressure), temperature regulation, identification, communication, wound repair, absorption and excretion, and production of vitamin D.

The skin produces vitamin D, not vitamin C.

The basal cell layer of the epidermis forms new skin cells. Melanocytes produce melanin, which gives brown tones to the skin and hair.

Sebum is produced by the sebaceous glands to lubricate the skin and hair.

Question 5

Risk factors that may lead to skin disease and breakdown include:

1. loss of protective cushioning of the dermal skin layer.
2. decreased vascular fragility.
3. a lifetime of environmental trauma.
4. increased thickness of the skin.

Answer 5

a lifetime of environmental trauma.

An accumulation of factors placing the aging person at risk for skin disease and breakdown include the thinning of the skin, the decrease in vascularity and nutrients, the loss of protective cushioning of the subcutaneous layer, a lifetime of environmental trauma to skin, the social changes of aging, the increasingly sedentary lifestyle, and the chance of immobility.

Aging results in the loss of protective cushioning of the subcutaneous layer of the skin.

Aging results in decreased vascularity of the skin.

Aging results in thinning of the skin.

Question 6

What term refers to a linear skin lesion that runs along a nerve route?

1. Zosteriform
2. Annular
3. Dermatome
4. Shingles

Answer 6

Zosteriform

Zosteriform describes a lesion that has a linear arrangement along a nerve root.

Annular describes a lesion that is circular and begins in the center and spreads to the periphery.

A dermatome is an area of skin that is mainly supplied by a single spinal nerve.

Shingles (herpes zoster) are small grouped vesicles that emerge along the route of a cutaneous sensory nerve, then pustules, then crusts; shingles is caused by the herpes zoster virus.

Question 7

The components of a nail examination include:

1. contour, consistency, and color.
2. shape, surface, and circulation.
3. clubbing, pitting, and grooving.
4. texture, toughness, and translucency.

Answer 7

contour, consistency, and color.

The nails should be assessed for shape and contour, consistency, and color.

Question 8

To determine if a dark skinned patient is pale, the nurse should assess the color of the:

1. conjunctivae
2. ear lobes.
3. palms of the hands.
4. skin in the antecubital space.

Answer 8

conjunctivae

To detect pallor in a dark skinned individual, the nurse should assess an area with the least pigmentation, such as the conjunctivae or mucous membranes.

Question 9

An example of a primary lesion is a(n):

1. erosion
2. ulcer
3. urticaria
4. port-wine stain.

Answer 9

urticaria

Urticaria is a primary lesion; a primary lesion is a lesion that develops on previously unaltered skin.

Erosions are secondary lesions; a secondary lesion is a lesion that changes over time or changes because of a factor such as scratching or infection.

Ulcers are secondary lesions; a secondary lesion is a lesion that changes over time or changes because of a factor such as scratching or infection.

A port-wine stain is a vascular lesion.

Question 10

A scooped out, shallow depression in the skin is called a/an:

1. ulcer
2. excoriation
3. fissure
4. erosion

Answer 10

erosion

An erosion is a scooped out, shallow depression in the skin.

Question 11

Bleeding into the periosteum during birth is known as:

1. caput succedaneum.
2. craniosynostosis
3. molding
4. cephalhematoma

Answer 11

cephalhematoma

A cephalhematoma is a subperiosteal hemorrhage resulting from birth trauma.

A caput succedaneum is edematous swelling and ecchymosis of the presenting part of the head caused by birth trauma.

Craniosynostosis is marked asymmetry caused by a severe deformity caused by premature closure of the sutures resulted in a long, narrow head.

Molding of the cranial bones during passage through the birth canal makes the head asymmetric and ridges more prominent.

Question 12

Craniosynostosis is a severe deformity caused by:

1. premature closure of the sutures.
2. increased intracranial pressure.
3. a localized bone disease that softens, thickens, and deforms bone.
4. excess growth hormone or a deficit in thyroid hormone.

Answer 12

premature closure of the sutures

Craniosynostosis is marked asymmetry caused by a severe deformity caused by premature closure of the sutures resulting in a long, narrow head.

Hydrocephalus (obstruction of drainage of cerebrospinal fluid) results in excessive accumulation of cerebrospinal fluid, increasing intracranial pressure, and enlargement of the head.

Paget disease (osteitis deformans) is a localized bone disease of unknown etiology that softens, thickens, and deforms bone.

Acromegaly results from excessive secretion of growth hormone from the pituitary after puberty. Congenital hypothyroidism and myxedema are caused by thyroid hormone deficiency.

Question 13

Narrow palpebral fissures, epicanthal folds, and midfacial hypoplasia are characteristic of:

1. Down syndrome.
2. fetal alcohol syndrome.
3. chronic childhood allergies.
4. congenital hypothyroidism.

Answer 13

fetal alcohol syndrome.

Facial characteristics of fetal alcohol syndrome include narrow palpebral fissures, epicanthal folds, and midfacial hypoplasia.

Facial characteristics of Down syndrome include upslanting eyes with inner epicanthal folds, flat nasal bridge, small broad flat nose, protruding thick tongue, and ear dysplasia.

Facial characteristics of chronic allergies include exhausted face, blue shadows below the eyes, double or single crease on the lower eyelids, central facial pallor, open mouth breathing (malocclusion of the teeth and malformed jaw), and a transverse line on the nose.

Facial characteristics of congenital hypothyroidism include low hairline, hirsute forehead, swollen eyelids, narrow palpebral fissures, widely spaced eyes, depressed nasal bridge, puffy face, thick tongue protruding through an open mouth, and a dull expression.

Question 14

Kyphosis of the spine is common with aging. To compensate, older adults will:

1. increase their center of gravity.
2. extend their heads and jaws forward.
3. stiffen their gait.
4. shuffle

Answer 14

The older adult may show an increased anterior cervical (concave or inward) curve when the head and jaw are extended forward to compensate for kyphosis of the spine.

Question 15

Which statement is accurate related to aggravating symptoms or triggers of headaches?

1. Alcohol consumption may precipitate the onset of cluster or migraine headaches.
2. Certain foods such as chocolate or cheese may precipitate the onset of tension headaches.
3. Premenstrual hormonal fluctuations may precipitate the onset of cluster headaches.
4. Poor posture may trigger a migraine headache.

Answer 15

Alcohol consumption may precipitate the onset of cluster or migraine headaches

Aggravating symptoms or triggers for cluster headaches include alcohol consumption, stress, or wind or heat exposure. Aggravating symptoms or triggers for migraines include hormonal fluctuations, certain foods, letdown after stress, changes in sleep pattern, sensory stimuli, and changes in weather or physical activity.

Aggravating symptoms or triggers for tension headaches include stress anxiety, depression, poor posture.

Question 16

Most facial bones articulate at a suture. Which facial bone articulates at a joint?

1. Nasal bone
2. Mandible
3. Zygomatic bone
4. Maxilla

Answer 16

Mandible

The facial bones articulate at sutures (nasal bone, zygomatic bone, and maxilla), except for the mandible. The mandible articulates at the temporomandibular joint.f

Question 17

Select the best description of the secretion of the eccrine glands:

1. thick, milky
2. dilute saline solution
3. protective lipid substance
4. keratin

Answer 17

2. diltute saline solution

Question 18

Which of the following statements describing a headache would warrant an immediate referral?

1. “This is the worst migraine of my life.”
2. “This is the worst headache I’ve had since puberty.”
3. “I have never had a headache like this before; it is so bad I can’t function.”
4. “I have had daily headaches for years.”

Answer 18

“I have never had a headache like this before; it is so bad I can’t function.”

A sudden severe headache in an adult or child who has never had it before warrants an immediate referral. A sudden severe headache could indicate a subarachnoid hemorrhage.

Question 19

What disease is characterized by a flat, expressionless, or mask-like face, a staring gaze, oily skin, and elevated eyebrows?’

1. Acromegaly
2. Scleroderma
3. Cushing syndrome
4. Parkinson disease

Answer 19

Parkinson disease

Facial characteristics of Parkinson disease include a flat and expressionless face that is “mask-like” with elevated eyebrows, a staring gaze, oily skin, and drooling.

Facial characteristics of acromegaly include an elongated head, a massive face, a prominent nose and lower jaw, a heavy eyebrow ridge, and coarse facial features.

Facial characteristics of scleroderma include hard, shiny skin on forehead and cheeks; thin, pursed lips with radial furrowing; absent skinfolds; muscle atrophy on face and neck; and absence of expression.

Facial characteristics of Cushing syndrome include a plethoric, rounded, “moonlike” face, prominent jowls, red cheeks, and hirsutism on the upper lip, lower cheeks, and chin.

Question 20

A patient is admitted to the emergency room after a motor vehicle accident. The trachea is deviated to the left side. This finding is characteristic of:

1. right pneumothorax.
2. aortic arch aneurysm.
3. right pleural adhesion.
4. right sided atelectasis.

Answer 20

right pneumothorax.

The trachea is normally midline; the trachea will deviated to the unaffected side (left) with a right pneumothorax.

The trachea will be pulled downward with systole of an aortic arch aneurysm occurs.

The trachea will be deviated to the affected side (right) with a large right sided pleural adhesion.

The trachea will be deviated to the affected side (right) with a large right sided atelectasis.

Question 21

The extraocular muscles consist of four straight or ________ muscles and two slanting or ______ muscles.

1. palpebral; conjugate
2. superior; inferior
3. rectus; oblique
4. rectilinear; diagonal

Answer 21

rectus; oblique

The four straight, or rectus, muscles are the superior, inferior, lateral, and medial rectus muscles. The two slanting, or oblique, muscles are the superior and inferior muscles.

Question 22

Nevus is the medical term for:

1. a freckle
2. a birthmark
3. an infected hair follicle
4. a mole

Answer 22

4. a mole

Question 23

The location in the brain where optic nerve fibers from the temporal fields of vision cross over is identified as the:

1. optic chiasm.
2. fovea centralis.
3. optic disc.
4. choroid.

Answer 23

optic chiasm.

At the optic chiasm, nasal fibers (from both temporal visual fields) cross over.

The fovea centralis is the area of the retina that has the sharpest and keenest vision.

The optic disc is the area in which fibers from the retina converge to form the optic nerve.

The choroid is the middle vascular layer of the eye; the choroid has dark pigmentation to prevent light from reflecting internally and is heavily vascularized to deliver blood to the retina.

Question 24

Which of the following groups of individuals need to be tested for the presence of color blindness (deficiency)?

1. Black males between the ages of 10 and 15 years
2. White males between the ages of 4 and 8 years
3. Asian females between the ages of 3 and 6 years
4. White females between the ages of 4 and 8 years

Answer 24

White males between the ages of 4 and 8 years

Color blindness is an inherited recessive X-linked trait affecting about 8% of white males and 4% of black males. Test only boys for color vision, once between the ages of 4 and 8 years.

Question 25

Which of the following statements is true in regard to the results obtained from use of the Snellen chart?

1. The smaller the denominator, the poorer the vision.
2. The larger the denominator, the poorer the vision.
3. The larger the numerator, the better the vision.
4. The smaller the numerator, the poorer the vision.

Answer 25

The larger the denominator, the poorer the vision.

Using the Snellen chart, the larger the denominator, the poorer the vision.

Question 26

The lens of the eye functions as a:

1. refracting medium
2. . mediator of light.
3. sensory facilitator.
4. controller of intraocular pressure.

Answer 26

refracting medium.

The lens serves as a refracting medium, keeping a viewed object in continual focus on the retina.

The muscle fibers of the iris function as the mediator of light.

The cornea is very sensitive to touch.

The intraocular pressure is determined by a balance between the amount of aqueous produced and resistance to its outflow at the angle of the anterior chamber.

Question 27

When inspecting the eyeballs of an African American individual, which of the following might the examiner expect to observe?

1. A slight misalignment of the eyeballs
2. A slight yellow discoloration of the sclera
3. Small brown macules on the sclera
4. A slight amount of drainage around the lacrimal apparatus

Answer 27

Small brown macules on the sclera

Dark-skinned people may normally have small brown macules on the sclera.

Question 28

The normal color of the optic disc is:

1. red.
2. creamy pink.
3. creamy yellow-orange to pink.
4. creamy red to yellow-orange.

Answer 28

creamy yellow-orange to pink.

The color of a normal optic disc will range from creamy yellow-orange to pink.

Question 29

To assess for early jaundice, you will assess:

1. slera and hard palate
2. nail beds
3. lips
4. all visible skin surfaces

Answer 29

1. sclera and hard palate

Question 30

Which of the following findings is associated with Horner syndrome?

1. Bilateral miosis
2. Bilateral mydriasis
3. A unilateral small regular pupil that reacts to light and accommodation
4. A unilateral dilated pupil with no reaction to light or accommodation

Answer 30

A unilateral small regular pupil that reacts to light and accommodation

Horner syndrome is caused by a lesion of the sympathetic nerve. An individual with Horner syndrome will have a unilateral, small, regular pupil that does react to light and accommodation. There will be unilateral ptosis and absence of sweat on the same side.

Question 31

Decreased vision in the elderly may be due to which of the following conditions?

1. Macular degeneration
2. Retinoblastoma
3. Fixation
4. Presbyopia

Answer 31

Macular degeneration

Decreased vision in the elderly is most commonly caused by cataracts, glaucoma, or macular degeneration.

Retinoblastoma is a malignant tumor of the retina that usually affects children under the age of 6 years.

Fixation is a reflex direction of the eye toward an object attracting a person’s attention; fixation is impaired by drugs, alcohol, fatigue, and inattention.

The lens in an older adult loses elasticity and becomes hard and glasslike; this decreases the lens’s ability to change shape to accommodate for near vision called presbyopia.

Question 32

A slight protrusion of the eyeballs may be noticed when examining individuals who come from which ethnic/cultural group?’

1. Asian
2. African American
3. Hispanic
4. American Indian

Answer 32

African American

African Americans normally may have a slight protrusion of the eyeball beyond the supraorbital ridge.

Question 33

Which of the following is an expected response on the cover test?

1. The covered eye moves into a relaxed position.
2. The covered eye maintains its position when uncovered.
3. The uncovered eye is unable to maintain its gaze on a fixed object.
4. The covered eye jumps to reestablish fixation when it is uncovered.

Answer 33

The covered eye maintains its position when uncovered.

A normal response to the cover test is a steady fixed gaze.

If muscle weakness is present the covered eye will drift into a relaxed position.If when the eye is uncovered, it jumps to reestablish fixation, then eye muscle weakness exists.

Question 34

Skin turgor is assessed by picking up a large fold of skin on the anterior chest under the clavicle. This is done to determine the presence of:

1. edema
2. dehydreation
3. vitiligo
4. scleroderma

Answer 34

2. dehydration

Question 35

You note a lesion during an examination. Select teh descrioption that is most complete.

1. raised, irregular lesion the sized of a quarter, located on dorsum of left hand
2. open lesion with no drainage or odor, approximately 1/4 inch in diameter
3. pedunculated lesion below left scapula with consistent red color, no drainage or odor
4. dark brown, raised lesion, with irregular border, on dorsum of right foot, 3 cm in size with no drainage

Answer 35

4. dark brown, raised lesion, with irregular border, on dorsum of right foot, 3 cm in size with no drainage

Question 36

Binaural interaction at the level of the brain stem permits:

1. interpretation of sound.
2. identification and location of the direction of the sound.
3. amplification of sound.
4. direction of sound toward the appropriate conduction pathway.

Answer 36

identification and location of the direction of the sound.

The function at the brainstem level is binaural interaction which permits locating the direction of a sound in space as well as identifying the sound.

Question 37

You examine nail beds for clubbing. The normal angle between the nail base and the nails is:

1. 60 degrees
2. 100 degrees
3. 160 degrees
4. 180 degrees

Answer 37

3. 160 degrees

Question 38

The capillary beds should refill after being depressed in:

1. < 1 second
2. > 2 seconds
3. 1 - 2 seconds
4. time is not significant as long as color returns

Answer 38

1 - 2 seconds

Question 39

Which of the following behaviors demonstrated by an individual may be indicative of
hearing loss?

1. Not looking at the examiner when being questioned
2. Frequently asking for the question to be repeated
3. Talking in a high-pitched voice
4. Speaking slowly with well-articulated consonants

Answer 39

Frequently asking for the question to be repeated

’

Hearing loss is indicated when a person frequently asks to have statements repeated.

Question 40

During a routine visit, M.B., age 78, asks about small, round, flat, brown macules on the hands. Your best response after examining the areas is:

1. “These are the result of sun exposure and do not require treatment.”
2. “These are related to sun exposure. They may become cancerous.”
3. “These are the skin tags that occur with aging. No treatment is required.”
4. “I’m glad you brought this to my attention. I will arrange for a biopsy.”

Answer 40

“These are the result of sun exposure and do not require treatment.”

Question 41

An area of thin, shiny skin with decreased visibility of normal skin markings is called:

1. lichenification
2. plaque
3. atrophy
4. keloid

Answer 41

atrophy

Question 42

Which of the following children is at risk of recurrent otitis media?

1. An 18-month-old infant who lives with a smoker.
2. A 2-year-old child who has had two ear infections in the past 6 months.
3. A 6-month-old infant who has a sibling who had tubes inserted at 3 years of age.
4. An 18-month-old infant who has had three episodes of ear infections in a 5-month period.

Answer 42

An 18-month-old infant who has had three episodes of ear infections in a 5-month period.

A first episode of otitis media (OM) that occurs within 3 months of life increases risk of recurrent OM. Recurrent OM is 3 episodes in past 3 months or 4 episodes within the past year.

Question 43

The external structure of the ear is identified as the:

1. auricle
2. atrium
3. aureole
4. auriga

Answer 43

auricle

The auricle or pinna is the external structure of the ear.

Question 44

When an otoscope examination is performed on an older adult client, the tympanic membrane may be:

1. pinker than that of a younger adult.
2. thinner than that of a younger adult.
3. whiter than that of a younger adult.
4. more mobile than that of a younger adult.

Answer 44

whiter than that of a younger adult.

During otoscopy the tympanic membrane of an older adult may be whiter in color than that of a younger adult. The tympanic membrane may also appear more opaque and dull.

An older adult’s tympanic membrane may be thicker compared to that of a younger adult. A yellow-amber drum color occurs with otitis media with effusion. A red color occurs with acute otitis media.

Question 45

Which of the following tests provides a precise quantitative measure of hearing?

1. Tuning fork tests
2. Romberg test
3. Audiometer test
4. Whispered voice test

Answer 45

Audiometer test

An audiometer gives a precise quantitative measure of hearing by assessing the person’s ability to hear sounds of varying frequency.

The tuning fork tests (Weber and Rinne) are inaccurate and should not be used for general screening. The Romberg test assesses the ability of the vestibular apparatus in the inner ear to help maintain standing balance . The whispered voice test is nonquantitative; this test documents the presence of hearing loss but does not measure the degree of loss.

Question 46

The labyrinth of the inner ear is responsible for maintaining the body’s:

1. binaural interaction.
2. air conduction
3. equilibrium
4. pressure equalization

Answer 46

equilibrium

The labyrinth maintains the body’s equilibrium.

Binaural interaction is controlled by the brainstem and permits locating the direction of a sound. The normal pathway of hearing is by air conduction. The eustachian tube allows equalization of air pressure on each side of the tympanic membrane.

Question 47

The position of the tympanic membrane in the neonate is more ________________, making it more difficult to visualize with the otoscope.

1. horizontal
2. vertical
3. perpendicular
4. oblique

Answer 47

horizontal

The position of the eardrum is more horizontal in the neonate, making it more difficult to see completely and harder to differentiate from the canal wall.

Question 48

The tympanic membrane of a child with acute otitis media would be:

1. flat and slightly pulled in at the center.
2. mobile and would flutter with the Valsalva maneuver.
3. bulging with a distinct red color.
4. shiny and translucent, with a pearly gray color.

Answer 48

bulging with a distinct red color.

The tympanic membrane would be bulging and red with acute otitis media.

A normal tympanic membrane is flat and slightly pulled in at the center.

A normal tympanic membrane is mobile and will flutter with the Valsalva maneuver.

A normal tympanic membrane is shiny and translucent, with a pearly gray color.

Question 49

If the tympanic membrane has white dense areas, the examiner suspects:

1. perforation from a ruptured membrane.
2. scarring from recurrent ear infections.
3. serous fluid from serous otitis media.
4. a fungal infection.

Answer 49

scarring from recurrent ear infections.

White dense areas indicate scarring on the tympanic membrane from recurrent ear infections.

Dark oval areas indicate perforation from a ruptured tympanic membrane.

Air or fluid levels or air bubbles indicate serous fluid from serous otitis media.

Question 50

Flattening of the angle between the nail and its base is:

1. found in subacute bacterial enocarditis
2. a description of spoon-shaped nails
3. related to calcium deficiency
4. described as clubbing

Answer 50

described as clubbing

Question 51

The configuration for individual lesions arranged in circles or arcs, as occurs with ringworms, is called:

1. linear
2. clustered
3. annular
4. gyrate

Answer 51

annular

Question 52

The “A” in the ABCDE rule stands for:

1. accuracy
2. appearance
3. asymmetry
4. attenuated

Answer 52

asymmetry

Question 53

A risk factor for melanoma is:

1. brown eyes
2. darkly pigmented skin
3. skin that freckles or burns before tanning
4. use of sunscreen products

Answer 53

skin that freckles or burns before tanning

Question 54

Lyme disease is more prevalant:

1. from May through September
2. along the West Coast
3. in children younger than 3 years
4. in those participatin in water sports

Answer 54

from May through September

Question 55

The nasal mucosa of an individual with rhinitis would be:

1. moist and pink.
2. swollen, boggy, and gray.
3. bright red and swollen.
4. pale with bright red bleeding.

Answer 55

bright red and swollen.

The nasal mucosa is bright red and swollen with rhinitis.

Normally, the nasal mucosa is red with a smooth and moist surface. The nasal mucosa is swollen, boggy, pale, and gray with chronic allergies. Bright red bleeding occurs with epistaxis (bleeding from the nose).

Question 56

The examiner notices a fine tremor when the patient sticks out his or her tongue. What disorder is consistent with this finding?

1. Hyperthyroidism
2. Diabetic ketoacidosis
3. Halitosis
4. Alcoholism

Answer 56

Hyperthyroidism

A fine tremor of the tongue occurs with hyperthyroidism.

A patient in diabetic ketoacidosis will have a sweet, fruity breath odor. Halitosis is a term used to describe any breath odor. A coarse tremor occurs with alcoholism.

Question 57

Which of the following questions would the examiner ask to determine whether an individual has epistaxis?

1. “Do you have any difficulty with swallowing?”
2. “Have you ever noticed any unusual lesions on the inside of your mouth?”
3. “Do you experience nose bleeds?”
4. “Do you experience a runny nose frequently?”

Answer 57

“Do you experience nose bleeds?”

Epistaxis is the medical term for a nose bleed.

Dysphagia is the medical term for difficulty swallowing. Rhinorrhea is the medical term for a runny nose.

Question 58

Herpes zoster (shingles):

1. caused by bacteria
2. lesion on only one side of body; does not cross midline
3. has absence of pain or edema
4. forms pustular, umbilicated lesions

Answer 58

lesion on only one side of body; does not cross midline

Question 59

On examination of an American Indian’s mouth, the examiner notices the presence of a bifid uvula. How should this finding be interpreted?

1. This is an expected variation associated with this individual.
2. This condition is frequently associated with cleft palate.
3. This may indicate the presence of oral cancer.
4. This is rare and indicates other congenital anomalies may be present.

Answer 59

This is an expected variation associated with this individual.

Bifid uvula is a condition in which the uvula is split either completely or partially. This condition occurs in 18% of some American Indian groups.

Bifid uvula may indicate a submucous cleft palate. Bifid uvula is not associated with oral cancer. The incidence of bifid uvula is common in American Indians.

Question 60

An enlarged tongue (macroglossia) may accompany:

1. cleft palate.
2. hairy tongue.
3. Down syndrome.
4. fissured tongue.

Answer 60

Down syndrome.

Macroglossia occurs with Down syndrome; it also occurs with cretinism, myxedema, and acromegaly. A transient swelling also occurs with local infections.

Question 61

In addition to initiating digestion of food, saliva also:

1. augments taste sensation.
2. protects the mucosa from caustic substances.
3. inhibits overgrowth of bacteria in the mouth.
4. cleans and protects the mucosa.

Answer 61

cleans and protects the mucosa.

Saliva moistens and lubricates the food bolus, starts digestion, and cleans and protects the mucosa.

Question 62

One of the purposes of the paranasal sinuses is to:

1. lighten the weight of the skull bones.
2. warm and moisten the inspired air.
3. amplify sound.
4. augment the sensory sensation of smell.

Answer 62

lighten the weight of the skull bones.

The paranasal sinuses lighten the weight of the skull bones.

Nasal mucosa and nasal turbinates warm, humidify, and filter the inhaled air.. The paranasal sinuses serve as resonators for sound production. Olfactory receptors (responsible for the sensation of smell) are located in the nasal cavity and septum and merge into the olfactory nerve.

Question 63

The parotid gland’s duct that opens into the mouth opposite the second molar is:

1. the Wharton duct.
2. the salivary duct.
3. Stensen duct.
4. the sublingual duct.

Answer 63

Stensen duct.

The parotid gland’s duct is the Stensen duct; it runs forward to open on the buccal mucosa opposite the second molar.

The Wharton duct (for the submandibular gland) runs up and forward to the floor of the mouth and opens at either side of the frenulum.

The mouth contains three pairs of salivary glands, which are the parotid gland, the submandibular gland, and the sublingual gland.

The sublingual gland lies within the floor of the mouth under the tongue.

Question 64

Clubbing can be assessed by:

1. observing for transverse ridges in the nails
2. the presence of pits in the neails
3. noting a change in the angle of the nail base
4. palpating a rigid nail base

Answer 64

noting a change in the angle of the nail base

Question 65

.Which of the following pairs of sinuses is absent at birth, is fairly well developed between 7 and 8 years of age, and is fully developed after puberty?

1. Maxillary
2. Frontal
3. Sphenoid
4. Ethmoid

Answer 65

Frontal

The frontal sinuses are absent at birth, are fairly well developed between 7 and 8 years of age, and reach full size after puberty.

The maxillary sinuses are present at birth and reach full size after all permanent teeth have erupted.

The sphenoid sinuses are minute at birth and develop after puberty.

The ethmoid sinuses are present at birth and grow rapidly between 6 and 8 years of age and after puberty.

Question 66

What is the major cause of decreased saliva production in the older adult?

1. Use of anticholinergic medications
2. Normal aging process
3. Decreased fluid intake
4. A diminished sense of taste and smell

Answer 66

Use of anticholinergic medications

The major cause of decreased saliva flow is the use of medications that have anticholinergic effects.

Normal aging is a secondary cause of decreased saliva flow.

Decreased fluid intake is not the major cause of decreased saliva production in the older adult.

Question 67

Milia occur because:

1. sebum occludes skin follicles
2. of a vascular occlusion in the skin
3. excess carotene is ingested
4. of a genetic variation in skin tone

Answer 67

sebum occludes skin follicles

Question 68

____ is an intense redness of the skin due to excess blood in the dilated superficial capillaries

Answer 68

erythema

Question 69

____ is a bluish mottled color that signifies decreased perfusion

Answer 69

cyanosis

Question 70

Increased tactile fremitus would be evident in an individual who has which of the following conditions?

1. Emphysema
2. Pneumonia
3. Crepitus
4. Pneumothorax

Answer 70

Pneumonia

Fremitus is a palpable vibration. Increased fremitus occurs with compression or consolidation of lung tissue (e.g., lobar pneumonia).

Decreased fremitus occurs when anything obstructs transmission of vibrations (e.g., obstructed bronchus, pleural effusion or thickening, pneumothorax, or emphysema).

Crepitus is a coarse crackling sensation palpable over the skin surface. It occurs in subcutaneous emphysema when air escapes from the lung and enters the subcutaneous tissue.

Question 71

____ is an absence of red-pink tones from the oxygenated hemoglobin in blood

Answer 71

pallor

Question 72

A clinical manifestation common in an individual with chronic obstructive pulmonary disease (COPD) is:

1. periodic breathing patterns.
2. pursed-lip breathing.
3. unequal chest expansion.
4. hyperventilation.

Answer 72

pursed-lip breathing.

An individual with COPD may purse the lips in a whistling position. By exhaling slowly and against a narrow opening, the pressure in the bronchial tree remains positive, and fewer airways collapse.

Periodic breathing patterns are Cheyne-Stokes or Biot respirations. Cheyne-Stokes respirations occur in heart failure, renal failure, meningitis, drug overdose, and increased intracranial pressure; this type also normally occurs in infants and aging persons during sleep. Biot respirations occur with head trauma, brain abscess, heat stroke, spinal meningitis, and encephalitis.

Unequal chest expansion occurs when part of the lung is obstructed or collapsed, as with pneumonia, or when guarding to avoid postoperative incisional pain or pleurisy pain.

Hyperventilation is a normal response to fever, fear, or exercise; respiration rate also increases with respiratory insufficiency, pneumonia, alkalosis, pleurisy, and lesions in the pons.

Question 73

The thoracic cage is defined by all of the following except the:

1. sternum.
2. ribs.
3. costochondral junction.
4. diaphragm.

Answer 73

costochondral junction.

The thoracic cage is defined by the sternum, ribs, vertebrae, and diaphragm.

Question 74

Inspiration is primarily facilitated by which of the following muscles?

1. Diaphragm and abdominus rectus
2. Trapezia and sternomastoids
3. Internal intercostals and abdominal
4. Diaphragm and intercostals

Answer 74

Diaphragm and intercostals

The major muscle responsible for inspiration is the diaphragm. Intercostal muscles lift the sternum and elevate the ribs, making them more horizontal; this increases the anteroposterior diameter.

Question 75

Which of the following voice sounds would be a normal finding?

1. The voice transmission is distinct and sounds close to the ear.
2. The “eeeee” sound is clear and sounds like “eeeee”.
3. The whispered sound is transmitted clearly.
4. Whispered “1-2-3” is audible and distinct.

Answer 75

The “eeeee” sound is clear and sounds like “eeeee”.

A normal finding from voice sounds is egophony; “eeeee” heard through the stethoscope clearly.

A normal finding from voice sounds is bronchophony; normal voice transmission is soft, muffled, and indistinct. A normal finding from voice sounds is whispered pectoriloquy: whispered sound is faint, muffled, and almost inaudible.

Question 76

_____ is an increase in bilirubin in the blood causing a yellow color in the skin

Answer 76

jaundice

Question 77

The gradual loss of intraalveolar septa and a decreased number of alveoli in the lungs of the elderly cause:

1. hyperventilation.
2. spontaneous atelectasis.
3. decreased surface area for gas exchange.
4. decreased dead space.

Answer 77

decreased surface area for gas exchange.

The histologic changes result in less surface area for gas exchange.

Question 78

The function of the trachea and bronchi is to:

1. transport gases between the environment and the lung parenchyma.
2. condense inspired air for better gas exchange.
3. moisturize air for optimum respiration.
4. increase air turbulence and velocity for maximum gas transport.

Answer 78

transport gases between the environment and the lung parenchyma.

The trachea and bronchi transport gases between the environment and the lung parenchyma.

Question 79

____ tiny, punctate red macules and papules ion the cheeks, trunk, chest, back, and buttocks

Answer 79

erythema toxicum

Question 80

Stridor is a high-pitched, inspiratory crowing sound commonly associated with:

1. upper airway obstruction.
2. atelectasis.
3. congestive heart failure.
4. pneumothorax.

Answer 80

upper airway obstruction.

Stridor is associated with upper airway obstruction from swollen, inflamed tissues or a lodged foreign body.

Question 81

Percussion of the chest is:

1. a useful technique for identifying small lesions in lung tissue.
2. helpful only in identifying surface alterations of lung tissue.
3. is not influenced by the overlying chest muscle and fat tissue.
4. normal if a dull note is elicited.

Answer 81

helpful only in identifying surface alterations of lung tissue.

Percussion detects only the outer 5 to 7 cm of tissue; it will not penetrate to reveal any change in density deeper than that.

An abnormal finding must be 2 to 3 cm wide to yield an abnormal percussion note. Percussion findings (resonant notes) may be modified by a muscular chest wall of an athlete or subcutaneous tissue of the obese person. Resonance is a low-pitched, clear, hollow sound that predominates with percussion of healthy lung tissue.

Question 82

Which of the following correctly expresses the relationship to the lobes of the lungs and their anatomic position?

1. Upper lobes—lateral chest
2. Upper lobes—posterior chest
3. Lower lobes—posterior chest
4. Lower lobes—anterior chest

Answer 82

Lower lobes—posterior chest

The posterior chest is almost all lower lobe. The anterior chest contains mostly upper and middle lobe with very little lower lobe.

Question 83

An increase in the transverse diameter of the chest cage in a pregnant female is due to a(n):

1. compensatory increase in respiratory parenchyma.
2. increase in estrogen.
3. increase in surfactant.
4. increase in tidal volume.

Answer 83

increase in estrogen.

The increase in estrogen level during pregnancy relaxes the chest cage ligaments. This allows an increase in the transverse diameter of the chest cage by 2 cm, and the costal angle widens.

Question 84

____ lower half of body turns red, upper half blanches

Answer 84

harlequin

Question 85

_____ transient mottling on trunk and extremities

Answer 85

cutis marmorata

Question 86

_____ bluish color around the lips, hands, fingernails, feet, and toenails

Answer 86

acrocyanosis

Question 87

_____ large round or oval patch of light

brown usually present at birth

Answer 87

cafe au lait

Question 88

_____ yellowing of skin, sclera, and mucous membranes due to increase numbers of red blood cells hemolyzed following birth

Answer 88

physiologic jaundice

Question 89

The first heart sound is produced by the:

1. closure of the semilunar valves.
2. closure of the AV valves.
3. opening of the semilunar valves.
4. opening of the AV valves.

Answer 89

closure of the AV valves.

The first heart sound (S1) occurs with closure of the AV valves.

The second heart sound (S2) occurs with closure of the semilunar valves. Normally opening of the semilunar valves is silent, but in aortic or pulmonic stenosis, an ejection click may be heard. An ejection click occurs early in systole at the start of ejection because it results from opening of the semilunar valves. A third heart sound (S3) can be heard when the ventricles are resistant to filling during the early rapid filling phase. S3 is heard when the AV valves open and atrial blood first pours into the ventricles.

Question 90

Which of the following guidelines may be used to identify which heart sound is S1?

1. S1 is louder than S2 at the base of the heart.
2. S1 coincides with the A wave of the jugular venous pulse wave.
3. S1 coincides with the carotid artery pulse.
4. S1 coincides with the Q wave of the QRS electrocardiogram complex.

Answer 90

S1 coincides with the carotid artery pulse.

S1 is loudest at the apex of the heart. S1 coincides with the C wave of the jugular venous pulse wave. S1 coincides with the R wave (the upstroke of the QRS complex).

Question 91

Which of the following cardiac alterations occurs during pregnancy?

1. An increase in cardiac output and blood pressure
2. An increase in cardiac volume and a decrease in blood pressure
3. An increased heart rate and increased blood pressure
4. An increased stroke volume with decreased cardiac output

Answer 91

An increase in cardiac volume and a decrease in blood pressure

During pregnancy the blood volume increases by 30% to 40%; this creates an increase in stroke volume and cardiac output and an increased pulse rate of 10 to 15 beats per minute. The arterial blood pressure decreases in pregnancy as a result of peripheral vasodilation.

Question 92

Which of the following is an appropriate position to have the patient assume when auscultating for extra heart sounds or murmurs?

1. Roll toward the left side
2. Roll toward the right side
3. Trendelenburg position
4. Recumbent position

Answer 92

Roll toward the left side

After auscultation in the supine position, the nurse should have the patient roll onto the left side; the examiner should listen at the apex with the bell for the presence of any diastolic filling sounds (i.e., S3 or S4) or murmurs that may be heard only in this position. The examiner should have the patient sit up and lean forward; the examiner should auscultate at the base with the diaphragm for a soft, high-pitched, early diastolic murmur of aortic or pulmonic regurgitation.

Question 93

The leaflets of the tricuspid and mitral valves are anchored by __________________ to the _________________, which are embedded in the ventricular floor.

1. endocardial ligaments; mediastinal muscles
2. atrioventricular tendons; pericardial bundles
3. chordae tendineae; papillary muscles
4. pericardial cords; ventricular sheaths

Answer 93

chordae tendineae; papillary muscles

The valves are anchored by collagenous fibers (chordae tendineae) to the papillary muscles, which are embedded in the ventricle floor.

Question 94

The ability of the heart to contract independently of any signals or stimulation is due to:

1. depolarization.
2. automaticity.
3. conduction.
4. repolarization.

Answer 94

automaticity

The heart can contract by itself, independent of any signals or stimulation from the body; this property is termed automaticity. Depolarization is the reversal of the resting potential in excitable cardiac muscle cell membranes when stimulated. Conduction is the process by which an electrical impulse is transmitted through the heart. Repolarization is the process by which the membrane potential of a cardiac muscle cell is restored to the cell’s resting potential.

Question 95

_____ yellow-orange color in light-skinned persons from large amounts of foods containing carotene

Answer 95

carotenemia

Question 96

When auscultating the heart of a newborn within 24 hours after birth, the examiner hears a continuous sound that mimics the sound of a machine. This finding most likely indicates:

1. the presence of congenital heart disease.
2. a normal sound because of the thinner chest wall of the newborn.
3. an expected sound caused by nonclosure of the ductus arteriosus.
4. pathology only when accompanied by an increased heart rate.

Answer 96

an expected sound caused by nonclosure of the ductus arteriosus.

The murmur of a patent ductus arteriosus is a continuous machinery murmur, which disappears by 2 to 3 days.

Question 97

A bruit heard while auscultating the carotid artery of a 65-year-old patient is caused by:

1. decreased velocity of blood flow through the carotid artery.
2. turbulent blood flow through the carotid artery.
3. rapid blood flow through the carotid artery.
4. increased viscosity of blood.

Answer 97

turbulent blood flow through the carotid artery.

A carotid bruit is a blowing, swishing sound indicating blood flow turbulence. A bruit indicates atherosclerotic narrowing of the vessel.

Question 98

The jugular venous pressure is an indirect reflection of the:

1. heart’s efficiency as a pump.
2. cardiac cycle.
3. conduction effectiveness.
4. synchronization of mechanical activity.

Answer 98

heart’s efficiency as a pump.

Jugular venous pressure is a reflection of the heart’s ability to pump blood. If the pressure is elevated, heart failure is suspected.

Question 99

Identify the facial bone that articulates at a joint instead of a suture:

1. zygomatic
2. maxilla
3. nasal
4. mandible

Answer 99

mandible

Question 100

The semilunar valves separate the:

1. atria from the ventricles.
2. right atria from the left atria.
3. ventricles from the arteries.
4. atria from the veins.

Answer 100

ventricles from the arteries.

The semilunar valves separate the ventricles from the arteries. The atrioventricular valves separate the atria and ventricles. The septum separates the right atria from the left atria. The vena cava are not separated by a valve from the right atrium; the pulmonary veins are not separated by a valve from the left atrium.

Question 101

Identify the blood vessel that rund diagonally across the sternomastoid muscle:

1. temporal artery
2. carotic artery
3. external jugular vein
4. internal jugular vein

Answer 101

external jugular vein

Question 102

One of the leg’s deep veins is the:

1. great saphenous.
2. small saphenous.
3. tibial.
4. popliteal.

Answer 102

popliteal

The femoral and popliteal veins are the deep veins in the leg.

The superficial veins are the great and small saphenous veins. The anterior tibial veins extend downward from the popliteal veins.

Question 103

Arteriosclerosis refers to:

1. a variation from the heart’s normal rhythm.
2. a sac formed by dilation in the arterial wall.
3. thickening and loss of elasticity of the arterial walls.
4. deposition of fatty plaques along the intima of the arteries.

Answer 103

thickening and loss of elasticity of the arterial walls.

Arteriosclerosis is the thickening and loss of elasticity of the arterial walls.

A dysrhythmia is a variation from the heart’s normal rhythm. An aneurysm is a sac formed by dilation in the artery wall. Atherosclerosis is the deposition of fatty plaques on the intima of the arteries.

Question 104

Palpable inguinal lymph nodes are:

1. normal if small (less than 1 cm), movable, and nontender.
2. abnormal in adults but common in children and infants.
3. normal if fixed and tender.
4. abnormal and indicate the presence of malignant disease.

Answer 104

normal if small (less than 1 cm), movable, and nontender.

Inguinal lymph nodes may be palpable. This is a normal finding if the nodes are small (1 cm or less), movable, and nontender.

Lymph nodes may be relatively large in children, and the superficial ones often are palpable even when the child is healthy. Enlarged, tender, or fixed inguinal lymph nodes are an abnormal finding.

Question 105

In pulsus paradoxus:

1. the rhythm is irregular; every other beat is premature.
2. there is a deficiency of arterial blood to a body part.
3. the rhythm is regular, but the force of the pulse varies with alternating beats.
4. beats have weaker amplitude with respiratory inspiration and stronger amplitude with expiration.

Answer 105

beats have weaker amplitude with respiratory inspiration and stronger amplitude with expiration.

In pulsus paradoxus beats have weaker amplitude with inspiration and stronger amplitude with expiration.

In pulsus bigeminus the rhythm is irregular and coupled, every other beat comes early or premature. A weak, thready pulse may result in a deficiency of arterial blood to a body part. In pulsus alternans the rhythm is regular, but the force varies with alternating beats of large and small amplitude.

Question 106

Select the statement that is true regarding cluster headaches.

1. may be precipitated by alcohol and daytime napping
2. usual occurrence is two per month, each lasting 1 to 3 days
3. characterized as throbbing
4. tend to be supraorbital, retro-orbital, or frontotemporal

Answer 106

may be precipitated by alcohol and daytime napping

Question 107

Lymphedema is:

1. the indentation left after the examiner depresses the skin over swollen edematous tissue.
2. a thickening and loss of elasticity of the arterial walls.
3. an inflammation of the vein associated with thrombus formation.
4. the swelling of an extremity caused by an obstructed lymph channel.

Answer 107

the swelling of an extremity caused by an obstructed lymph channel.

Lymphedema is swelling of the limb caused by surgical removal of lymph nodes or damage to lymph nodes and vessels.

Pretibial edema (pitting) occurs if an indentation is left after the examiner depresses skin over the tibia or the medial malleolus for 5 seconds. Arteriosclerosis is the thickening and loss of elasticity of the arterial walls. In deep vein thrombosis a deep vein is occluded by a thrombus, causing inflammation, blocked venous return, cyanosis, and edema.

Question 108

.A water-hammer “Corrigan” pulse is associated with:

1. hyperkinetic states.
2. decreased cardiac output.
3. aortic valve regurgitation.
4. conduction disturbance.

Answer 108

aortic valve regurgitation

A water-hammer (Corrigan) pulse occurs in aortic valve regurgitation.

A full, bounding pulse is associated with hyperkinetic states (exercise, anxiety, fever). A weak, thready pulse occurs with decreased cardiac output. Pulsus bigeminus occurs with conduction disturbances.

Question 109

The cervical nodes drain the:

1. upper arm and breast.
2. hand and lower arm
3. . external genitalia.
4. head and neck.

Answer 109

head and neck.

The cervical nodes drain the head and neck.
Axillary nodes drain the breast and upper arm. The epitrochlear node drains the hand and lower arm. Inguinal nodes drain most of the lymph from the lower extremity, the external genitalia, and the anterior abdominal wall.

Question 110

In young children, the thymus gland:

1. produces T lymphocytes.
2. is small and begins to atrophy.
3. is not important in immune function.
4. produces B lymphocytes.

Answer 110

produces T lymphocytes.

In young children, the thymus gland is important in developing the T lymphocytes of the immune system. The thymus is large in the fetus and young children and atrophies after puberty. The thymus has no function in adults. The thymus gland does not produce B lymphocytes.

Question 111

Claudication is caused by:

1. venous insufficiency.
2. arterial insufficiency.
3. varicose veins.
4. stasis ulcerations.

Answer 111

arterial insufficiency.

Claudication is caused by arterial insufficiency.

Question 112

The patient has severe bilateral lower extremity edema. The most likely cause is:

1. an infection of the right great toe.
2. Raynaud phenomenon.
3. heart failure.
4. an aortic aneurysm.

Answer 112

heart failure.

Bilateral lower extremity edema is a result of a generalized disorder such as heart failure.

An infection of only one extremity would lead to unilateral edema. Raynaud phenomenon does not result in bilateral lower extremity edema. Aneurysms do not cause bilateral lower extremity edema.

Question 113

Select the symptom that is least likely to inidicate a pssible malignancy.

1. history of radiation therapy to head, neck, or upper chest
2. history of using chewing tobacco
3. history of large alcohol consumption
4. tenderess

Answer 113

tenderness

Question 114

Providing resistance while the patient shrugs the shoulders is a test of the status of cranial nerve:

1. II
2. V
3. IX
4. XI

Answer 114

eleven

Question 115

Upon examination, the fontanels should feel:

1. tense or bulging
2. depressed or sunken
3. firm, slightly concave, and well defined
4. pulsating

Answer 115

firm, slightly concave, and well defined

Question 116

The palpebral fissues is:

1. the border between the cornea and sclera
2. the open sapce between the eyelids
3. the angle where the eyelicds meet
4. visibile on the upper and lower lids at the inner canthus

Answer 116

the open sapce between the eyelids

Question 117

If the tryroid glandd is enlarged bilaterally, which of the following maneuvers is appropriate?

1. Check for deviation of the trachea
2. Listen for a bruit over the carotid arteries
3. Listen for a murmur over the aortic area
4. Listen for a bruit over the thyroid lobes

Answer 117

Listen for a bruit over the thyroid lobes

Question 118

It is normal to palpate a few lymph nodes in the neck of a healthy person. What are the characteristics of these nodes?

1. mobile, soft, nontender
2. large, clumped, tender
3. matted, fixed, tender, hard
4. matted, fixed, nontender

Answer 118

mobile, soft, nontender

Question 119

Cephalhematoma is associated with:

1. subperiosteal hemorrhage
2. increase intracranial pressure
3. Down syndrome
4. mental retardation

Answer 119

subperiosteal hemorrhage

Question 120

Normal cervical lymph nodess are:

1. smaller than 1 cm
2. warm to palpation
3. fixed
4. firm

Answer 120

smaller than 1 cm

Question 121

A throbbing, unilateral pain associated with nausea, vomiting, and photophobia is characteristic of:

1. cluster headache
2. subarachnoid hemorrhage
3. migraine headache
4. tension headache

Answer 121

migraine headache

Question 122

Bell’s palsy is characterized by:

1. unilateral paralysis of half of the face
2. bulging eyeballs
3. a face that appears masklike
4. a puffy, edematous face

Answer 122

unilateral paralysis of half of the face

Question 123

The examiner suspects an infants’s head is of abnrmal size and can use which procedure to verify these findings?

1. palpation
2. measuring tape
3. observing for symmetry of facial features
4. noting absence of the tonic neck reflex

Answer 123

measuring tape

Question 124

the corneal reflex is mediated by cranial nerves

1. II and III
2. II and VI
3. V and VII
4. VI and IV

Answer 124

V and VII

Question 125

The retinal structures viewed through the opthalmoscope are

1. the optic disc, the retinal vessels, the general background, and the macula
2. the cornea, the lens, the choroid, and the ciliary body
3. the optic papilla, the sclera, the retina, and the iris
4. the pupil, the sclera, the ciliary body, and the macula

Answer 125

the optic disc, the retinal vessels, the general background, and the macula

Question 126

Using the otoscope, the tympanic membrane is visualized. the color of a normal membrane is:

1. deep pink
2. creamy white
3. pearly gray
4. dependent upon the ethniciy of the individual

Answer 126

pearly white

Question 127

The examiner records “positive consensual light reflex” This is

1. The convergence of the axes of the eyeballs
2. the simultaneous constriction of the other pupil when one eyes is exposed to bright light
3. a reflex direction of the eye toward an object attracting a person’s attention
4. the adaptation of the eye for near vision

Answer 127

the simultaneous constriction of the other pupil when one eyes is exposed to bright light

Question 128

Several changes occur in the eye with the aging process. The thickening and yellowing of the lens is referred to as:

1. presbyopia
2. floaters
3. macular degeneration
4. senile cataract

Answer 128

senile cataract

Question 129

Sensorineural hearing loss may be rlated to:

1. a gradual nerve degeneration
2. foreign bodies
3. impacted cerumen
4. perforated tympanic membrane

Answer 129

a gradual nerve degeneration

Question 130

Be alert to symptoms that may constitute an eye emergency. Identify the symptom(s) that should be referred immediately

1. floaters
2. epiphora
3. sudden onset of vision change
4. photophobia

Answer 130

sudden onset of vision change

Question 131

Visual acuity is assess with

1. the Snellen eye chart
2. an opthalmoscope
3. the Hirschberg test
4. the confrontation test

Answer 131

the Snellen eye chart

Question 132

Before examining the ear with the otoscope, the _____ should be palpated for tenderness.

1. helix, external auditory meatus, and lobule
2. mastoid process, tympanic membrane, and malleus
3. pinna, pars flaccida, and antitragus
4. pinna, tragus, and mastoid process

Answer 132

pinna, tragus, and mastoid process

Question 133

The cover test is used to assess for:

1. nystagmus
2. peripheral vision
3. muscle weakness
4. visual acuity

Answer 133

muscle weakness

Question 134

When using the opthalmoscope, you would:

1. remove your own glasses and apprach the patient’s left your with your left eye
2. leave light on in the examining room and remove glasses from the patient
3. remove the glasses and set the diopter setting at 0
4. use the smaller white light and instruct the patient to focus on the opthalmoscope

Answer 134

remove your own glasses and apprach the patient’s left your with your left eye

Question 135

The six muscles that control eye movement are innervated by cranial nerves

1. II, II, V
2. IV, VI, VII
3. III, IV, VI
4. II, III, VI

Answer 135

III, IV, VI

Question 136

During the otoscope examination of a child younger than 3 years, the examiner:

1. pulls the pinna up and back
2. pulls the pinna down
3. holds the pinna gently but firmly in its normal position
4. tilts the head slighlty toward the examiner

Answer 136

pulls the pinna down

Question 137

Conjunctivitis is always associated with

1. absent red reflex
2. reddened conjunctiva
3. impairment of vision
4. fever

Answer 137

reddened conjunctiva

Question 138

A patient has blurred peripheral vision. You suspect glaucoma and test the visual fields. A person with normal vision would see your moving finger temporally at:

1. 50 degrees
2. 60 degrees
3. 90 degrees
4. 180 degrees

Answer 138

90 degrees

Question 139

While viewing with the otoscope, the examiner instructs the person to hold the nose and swallow. During this maneuver, the eardrum should:

1. flutter
2. retract
3. buldge
4. remain immobile

Answer 139

flutter

Question 140

A person is known to be blind in the left eye. What happens to the pupil when the right eye is illuminated by a penlight beam?

1. No response in both
2. Both pupils constrict
3. Right pupil constricts, left has no response
4. Left pupil constrictison, right has no response

Answer 140

Both pupils constrict

Question 141

in examining the ear of an adult, the canal is straightened by pulling the auricle:

1. down and foward
2. down and back
3. up and back
4. up and forward

Answer 141

down and back

Question 142

Use of the opthalmoscope: an interruption of the red reflex occurs when:

1. there is an opacity in the cornea or lens
2. the patient has pathology of the optic tract
3. the blood vessels are tortuous
4. the pupils are constricted

Answer 142

there is an opacity in the cornea or lens

Question 143

Darwin’s tubercle is:

1. an overgrowth ofscar tissue
2. a blocked sebaceous gland
3. a sign of gout called tophi
4. a congenital, painless nodule at the helix

Answer 143

a congenital, painless nodule at the helix

Question 144

One of the cause of visual impairement in aging adults is:

1. strabismus
2. glaucoma
3. amblyopia
4. retinoblastoma

Answer 144

glaucoma

Question 145

Briefly describe the mthod of assessing the six cardinal fields of vision:

Answer 145

Instruct the pt to hold the head steady and follow the examiner’s finger. The examiner holds the finger 12 inches from the indivual and moves it clockwise to the 2, 3, 4, 8, 8, and 10 o’clock positions and back to the center each time. A normal response is parallel tracking of the object with both eyes

Question 146

When the ear is being examined with an otoscope, the patient’s head should be:

1. tilted toward the examiner
2. tilted away from the examiner
3. as vertical as possible
4. tilted down

Answer 146

tilted away from the examiner

Question 147

What is PERRLA?

Answer 147

P - pupils

E - equal

R - round

R - react (to)

L - light (and)

A - accomodation

Question 148

The hearing receptors are located in the:

1. vestibule
2. emicircular canals
3. middle ear
4. cochlea

Answer 148

cochlea

Question 149

What is the cause of the red reflex?

1. petechial hemorrhages in the sclera
2. diabetic retinopathy
3. light reflecting from the retina
4. blood in the vitreous

Answer 149

light reflecting from the retina

Question 150

The most common site of nosebleeds is:

1. the tubinates
2. the columellae
3. Kiesselbach plexus
4. the meatus

Answer 150

Kiesselbach plexus

Question 151

The sensation of vertigo is the result of:

1. otitis media
2. pathology in the semicircular canals
3. pathology in the cochlea
4. 4th cranial nerve damage

Answer 151

pathology in the semicircular canals

Question 152

The sinuses that are accessible to examination the:

1. ethmoid and sphenoid
2. frontal and ethmoid
3. maxillary and sphenoid
4. frontal and maxillary

Answer 152

frontal and maxillary

Question 153

The frenulum is:

1. the midline fold of tissue that connects the tongue to the floor of the mouth
2. the anterior border of the oral cavity
3. the arching roof of the mouth
4. the free projection hanging down from the middle of the soft palate

Answer 153

the midline fold of tissue that connects the tongue to the floor of the mouth

Question 154

A common cause of a conductive hearing loss is:

1. impacted cerumen
2. acute rheumatic fever
3. a CVA
4. otitis externa

Answer 154

impacted cerumen

Question 155

The largest salivary gland:

1. within the cheeks in front of the ear
2. beneath the mandible at the angle of jaw
3. within the floor of the mouth under the tongue
4. at the base of the tongue

Answer 155

within the cheeks in front of the ear

Question 156

A 70-year-old woman complains of dry mouth. The most frequent cause of this problem is:

1. the aging process
2. related to medications she may be taking
3. the use dentures
4. related to a diminsihed sense of smell

Answer 156

related to medications she may be taking

Question 157

Upon examination of the tympanic membrane, visualization of which of the following finding indicates the infection of acute purulent otitis media?

1. absent light reflex, bluish drum, oval dark areas
2. absent light reflex, reddened drum, bulging drum
3. oval dark areas on drum
4. absent light reflex, air-fluid level, or bubbles behind drum
5. retracted drum, very prominent landmarks

Answer 157

absent light reflex, reddened drum, bulging drum

Question 158

During an inspection of the nares, a deviated septum is noted. The best actions to:

1. request a consultation with an ear, nose, and throat specialist
2. document the deviation in the medical record in case the person needs to be suctioned
3. teach the person what to do if a nosebleed should occur
4. explore further because polyps frequently accompany a devaited septum

Answer 158

document the deviation in the medical record in case the person needs to be suctioned

Question 159

Oral malignancies are most likely to develop:

1. on the soft palate
2. on the tongue
3. in the buccal cheek mucosa
4. in the mucsal “gutter” under the tongue

Answer 159

in the mucsal “gutter” under the tongue

Question 160

In a medical record, the tonsils are graded as 3+. The tonsils would be:

1. visible
2. halfway between the tonsillar pillars and uvula
3. touching the uvula
4. touching each other

Answer 160

touching the uvula

Question 161

In examining a young adult woman, you observe her tympanic membrane to be yellow in color. You suspect she has:

1. serum in the middle ear
2. blood in the middle ear
3. infection of the drumhead
4. jaundice

Answer 161

serum in the middle ear

Question 162

The function of the nasal tubinates is to:

1. warm the inhaled air
2. detect odors
3. stimulate tear formation
4. lighten the weight of the skull bones

Answer 162

warm the inhaled air

Question 163

Risk reduction for acute otitis media includes:

1. use of pacifiers
2. increasing group daycare
3. avoiding breastfeeding
4. eliminated smoking in the house and car

Answer 163

eliminated smoking in the house and car

Question 164

The opening of an adult’s parotid gland (Stensen’s duct) is opposite the:

1. lower 2nd molar
2. lower incisors
3. upper incisors
4. upper 2nd molar

Answer 164

upper 2nd molar

Question 165

When assessing hearing acuity in a 6 month old child, the examiner should:

1. use an audiometer
2. observe for shyness and withdrawal
3. watch for head turning when sayning the child’s name
4. test the startle (Moro) reflex

Answer 165

watch for head turning when sayning the child’s name

Question 166

A nasal polyp may be distinuisghed from the nasal tubinates for the 3 of the following reasons. Which reason is FALSE?

1. The polyp is highly vascular
2. The polyp is movable
3. The polyp is pale gray in color
4. The polyp is nontender

Answer 166

The polyp is highly vascular

Question 167

The examiner notes small, round, white, shiny papules on the hard palate and gums of a 2-month-old. What is the significance of this finding?

1. These are aphthous areas or ulcers that are the result of sucking
2. Teeth buds are beginning to appear
3. This is a normal finding called Epstein pearls
4. It inidcates the presence of a monilial

Answer 167

This is a normal finding called Epstein pearls

Question 168

A patient with a head injury has clear, watery drainage from the ear; the examiner should:

1. place a cotton ball loosely at the entrance to the ear canal
2. assess for the presence of glucose in the drainage
3. perform pneumatic otoscopy to assess for drum hypomobility
4. assess for the presence of a tympanostomy tube in the ear

Answer 168

assess for the presence of glucose in the drainage

Question 169

When assessing the tongue, the examiner should:

1. palpate the U-shaped area under the tongue
2. check tongue color for cyanosis
3. use a tongue blade to elevate the tongue while placing your finger under the jaw
4. ask the person to say “ahh” and note a rise in the midline

Answer 169

palpate the U-shaped area under the tongue

Question 170

The manubriosternal angle is:

1. The articulation of the manubrium and the body of the sternum
2. a hollow, U-shaped depression just above the sternum
3. also known as the breastbone
4. a term synonymous with costochondral junction

Answer 170

The articulation of the manubrium and the body of the sternum

Question 171

The precordium is:

1. a synonym for the mediastinum
2. the area on the chest where the apical impulse is felt
3. the area on the anterior chest overlying the heart and great vessels
4. a synonym for the area where the superior and inferior venae cavae return

Answer 171

the area on the anterior chest overlying the heart and great vessels

Question 172

Select the correct description of the left lung

1. narrower than the right lung with three lobes
2. narrower than the right lung with two lobes
3. wider than the right lung with two lobes
4. shorter than the right lung with three lobes

Answer 172

narrower than the right lung with two lobes

Question 173

Some conditions have a cough with characteristic timing. The cough associated with chronic bronchitis is best describes as:

1. continuous throughout the day
2. productive cough for at least 3 months of the year for 2 years in a row
3. occuring in the afternoon/evening because of exposure to irritants at work
4. occuring in the early morning

Answer 173

productive cough for at least 3 months of the year for 2 years in a row

Question 174

Symmetric chest expansion is best confirmed by:

1. placing hands on the posterolateral chest wall with thumbs at the level of T9 and T10 and then sliding the hands up to pinch up a small fold of skin between the thumbs
2. Inspection of the shape and configuration of the chest wall
3. placing the palmar surface of the fingers of one hand against he chest and having the person repeat the words “ninety-nine”
4. Percussion of the posterior chest

Answer 174

placing hands on the posterolateral chest wall with thumbs at the level of T9 and T10 and then sliding the hands up to pinch up a small fold of skin between the thumbs

Question 175

The function of the pulmonic valve is to:

1. divide the left atrium and left ventricl
2. guard the oopening betwen the right atrium and the right ventricle
3. protect the orifice between the right ventricle and the pulmonary artery
4. fuard the entrance to he aorta from the left ventricle

Answer 175

protect the orifice between the right ventricle and the pulmonary artery

Question 176

Absence of diapharmagmatic excursion occurs with:

1. asthma
2. an unusually thick chest wall
3. pleural effusion or atelectasis of the lower lobes
4. age-related changes in the chest wall

Answer 176

pleural effusion or atelectasis of the lower lobes

Question 177

Atrial systole occurs:

1. during ventricular systole
2. during ventricular diastole
3. concurrently with ventricular systole
4. independently of ventricular function

Answer 177

during ventricular diastole

Question 178

Auscultation of breath sounds is an important component of respiratory assessment. Select the most accurate description of this part of the examination.

1. Hold the bell of the stethoscope against the chest wall; listen to the entire right field and then the entire left field
2. Hold the diaphargm of the sthethoscope against the chest wall; listen to one full respiration in each location, being sure to do side-to-side comparisons
3. Listen from the apices to the bases of each lung field using the bell of the stethoscope
4. Select the bell or diaphargm depending upon the quality of sounds heard; listen for one respiration in each location, moving from side to side

Answer 178

Hold the diaphargm of the sthethoscope against the chest wall; listen to one full respiration in each location, being sure to do side-to-side comparisons

Question 179

The second heart sound is the result of :

1. opening of the mitral and tricuspid valves
2. closing of the mitral and tricuspid valves
3. opening of the aortic and pulmonic valves
4. closing of the aortic and pulmonic valves

Answer 179

closing of the aortic and pulmonic valves

Question 180

Select the best description of bronchovesicular breath sounds

1. high pitched, of longer duration on inspiration than expiration
2. moderate pitched, inspiration equal to expiration
3. low pitched, inspiration greater than expiration
4. rustling sound, like the wind in the trees

Answer 180

moderate pitched, inspiration equal to expiration

Question 181

After examining a patient, you make the following notation: increased respiratory rate, chest expansion decreased on left side, dull to percussion over left lower lobe, breath sounds louder with fine crackles over left lower lobe. These findings are consistent with a diagnosis of:

1. bronchitis
2. asthma
3. pleural effusion
4. lobar pneumonia

Answer 181

lobar pneumonia

Question 182

Upon examining a patient’s nails, you note that the angle of the nail base is >160 degrees and that the nail base feels spongy to palpation. These findings are consistent with:

1. adult respiratory distress syndrome
2. normal findings for the nails
3. chronic congenital heart disease and COPD
4. atelectasis

Answer 182

chronic congenital heart disease and COPD

Question 183

The examiner is palpating the apical impulse. The normal size of this impulse:

1. is less than 1 cm
2. is about 2 cm
3. is 3 cm
4. varies depending on the size of the person

Answer 183

is about 2 cm

Question 184

Upon examination of patient , you note a coarse, low-pitched sound during both inspiration and expiration. This patient complains of pain with breathing. These findings are consistent with:

1. fine cracles
2. wheezes
3. atelectatic crackles
4. pleural friction rub

Answer 184

pleural friction rub

Question 185

The examiner wishes to listen in the pulmonic valve area. To do this, the stethoscope would be placed at the:

1. second right interspace
2. second left interspace
3. left lower sternal border
4. fifth interspace, left midclavicular line

Answer 185

second left interspace

Question 186

In order to use the technique of egophony, ask the patient to:

1. take several deep breaths and then hold for 5 seconds
2. say “eeee” each time the stethoscope is moved
3. repeat the phrase “99” each time this stethoscope is moved
4. whisper a phrase as auscultation is performed

Answer 186

say “eeee” each time the stethoscope is moved

Question 187

Select the statement that best differentiates a split S2 from S3.

1. S3 is lower pitched and is heard at the apex
2. S2 is heard at the left lower sternal border
3. the timing of S2 varies with respirations
4. S3 is heard at the base; timing varies with respirations

Answer 187

S3 is lower pitched and is heard at the apex

Question 188

When examining for tactile frewmitus, it is important to

1. have the pt breathe quickly
2. ask the pt to cough
3. palpate the chest symmetrically
4. use the bell of the stethoscope

Answer 188

palpate the chest symmetrically

Question 189

The examiner wishes to listen for a pericardial friction rub. Select the best method of listening.

1. with the diaphragmn, patient sitting up and leaning forward, breath held in expiration
2. using the bell with the patient leaning for forward
3. at the base during normal respiration
4. with the diaphragm, patient turned to the left side

Answer 189

with the diaphragmn, patient sitting up and leaning forward, breath held in expiration

Question 190

The pulse oximeter measures

1. arterial oxygen saturation
2. venous oxygen saturation
3. combined saturation of arterial and venous blood
4. carboxyhemoglobin levels

Answer 190

arterial oxygen saturation

Question 191

A pleural friction rub is best detected by:

1. observation
2. palpation
3. auscultation
4. percussion

Answer 191

auscultation

Question 192

A barrel-shaped chest is characterized by:

1. equal anteroposteror-to-transverse diameter and ribs being horizontal
2. anteroposterior-to-transverse diameter of 1:2 and an ellipitical shape
3. anteroposterior-to-transverse diameter of 2:1 and ribs being elevated
4. anteroposterior-to-transverse diameter of 3:7 and ribs sloping back

Answer 192

equal anteroposteror-to-transverse diameter and ribs being horizontal

Question 193

When auscultating the heart, your first step is to;

1. identify S1 and S2
2. listen for S3 and S4
3. listen for murmurs
4. identity all four sounds on the first round

Answer 193

identify S1 and S2

Question 194

Lung borders:

____ apex

1. rests on the diaphargm
2. C7
3. sixth rib, midclavicular line
4. 5th intercostal
5. 3-4 cm above the inner third of the clavicles

Answer 194

3-4 cm above the inner 3rd of the clavicles

Question 195

You will hear a split S2 most clearly in what area?

1. apical
2. pulmonic
3. tricuspid
4. aortic

Answer 195

pulmonic

Question 196

Lung borders:

____ base

1. rests on the diaphargm
2. C7
3. sixth rib, midclavicular line
4. 5th intercostal
5. 3-4 cm above the inner third of the clavicles

Answer 196

rests on the diaphargm

Question 197

The stethoscope bell should be pressed lightly against the skin so that:

1. chest hair doesn’t simulate crackles
2. high-pitched sounds can be heard better
3. it does not act as a diaphragm
4. it does not interfere with amplification

Answer 197

it does not act as a diaphragm

Question 198

A murmur heard after S1 and before S2 is classified as:

1. diastolic (possibly benign)
2. diastolic (always pathologic)
3. systolic (possibly benign)
4. systolic (possibly pathologic)

Answer 198

systolic (possibly benign)

Question 199

Lung borders:

____ lateral left

1. rests on the diaphargm
2. C7
3. sixth rib, midclavicular line
4. 5th intercostal
5. 3-4 cm above the inner third of the clavicles

Answer 199

sixth rib, midclavicular line

Question 200

Lung border:

_____ lateral right

1. rests on the diaphargm
2. C7
3. sixth rib, midclavicular line
4. 5th intercostal
5. 3-4 cm above the inner third of the clavicles

Answer 200

5th intercostal

Question 201

Lung borders

____ posterior apex

1. rests on the diaphargm
2. C7
3. sixth rib, midclavicular line
4. 5th intercostal
5. 3-4 cm above the inner third of the clavicles

Answer 201

C7

Question 202

When assessing the carotid artery, the examiner should palpate:

1. bilaterally at the same time, while standing behind the patient
2. medial to the sternomastoid muscle, one side at a time
3. for a bruit while asking the patient to hold his or her breath briefly
4. for unilateral deistention while turning the patient’s head to one side

Answer 202

medial to the sternomastoid muscle, one side at a time

Question 203

Configurations of the thorax:

___normal chest

1. anteriorposterior = transverse diameter
2. exaggerated posterior curvature of thoracic spine
3. lateral S-shaped curvature of the thoracic and lumbar spine
4. sunken sternum and adjacent cartilages
5. ellipitacal shape with an anteroposterior:transverse diameter in the ratio of 1:2
6. forward protrusion of the sternum with ribs sloping back at either side

Answer 203

ellipitcal shape with an anteroposterior:transverse diameter in the ratio of 1:2

Question 204

Configurations of the thorax:

____ barrel chest

1. anteriorposterior = transverse diameter
2. exaggerated posterior curvature of thoracic spine
3. lateral S-shaped curvature of the thoracic and lumbar spine
4. sunken sternum and adjacent cartilages
5. ellipitacal shape with an anteroposterior:transverse diameter in the ratio of 1:2
6. forward protrusion of the sternum with ribs sloping back at either side

Answer 204

anteriorposterior = transverse diameter

Question 205

List the major risk factors for heart disease and stroke identified in the text.

Answer 205

The major risk factors for heart disease and stroke are hypertension, smoking, high cholesterol levels, obesity, and diabetes. Physical inactivity, family history of heart disease, and age are other risk factors.

Question 206

Configuations of the thorax:

_____ pectus excavatum

1. anteriorposterior = transverse diameter
2. exaggerated posterior curvature of thoracic spine
3. lateral S-shaped curvature of the thoracic and lumbar spine
4. sunken sternum and adjacent cartilages
5. ellipitacal shape with an anteroposterior:transverse diameter in the ratio of 1:2
6. forward protrusion of the sternum with ribs sloping back at either side

Answer 206

sunken sternum and adjacent cartilages

Question 207

Configuations of the thorax:

____ pectus carinatum

1. anteriorposterior = transverse diameter
2. exaggerated posterior curvature of thoracic spine
3. lateral S-shaped curvature of the thoracic and lumbar spine
4. sunken sternum and adjacent cartilages
5. ellipitacal shape with an anteroposterior:transverse diameter in the ratio of 1:2
6. forward protrusion of the sternum with ribs sloping back at either side

Answer 207

forward protrusion of the sternum with ribs sloping back at either side

Question 208

Configuation of the thorax:

____ scoliosis

anteriorposterior = transverse diameter

exaggerated posterior curvature of thoracic spine

lateral S-shaped curvature of the thoracic and lumbar spine

sunken sternum and adjacent cartilages

ellipitacal shape with an anteroposterior:transverse diameter in the ratio of 1:2

forward protrusion of the sternum with ribs sloping back at either side

Answer 208

lateral S-shaped curvature of the thoracic and lumbar spine

Question 209

Configuation of the thorax:

____ kyphosis

anteriorposterior = transverse diameter

exaggerated posterior curvature of thoracic spine

lateral S-shaped curvature of the thoracic and lumbar spine

sunken sternum and adjacent cartilages

ellipitacal shape with an anteroposterior:transverse diameter in the ratio of 1:2

forward protrusion of the sternum with ribs sloping back at either side

Answer 209

exaggerated posterior curvature of thoracic spine

Question 210

The organs that aid the lymphatic system are:

1. liver, lymph nodes, and stomach
2. pancreas, small intestine, and thymus
3. spleen, tonsils, and thymus
4. pancreas, spleen, and tonsils

Answer 210

spleen, tonsils, and thymus

Question 211

Ms. T. has come for a prenatal visit. She complains of dependent edema, varicosities in the legs, and hemorrhoids. The best response is:

1. “If these symptoms persist, we will perfrom an amniocentesis.”
2. “If these symptoms persist, we will discuss having you hospitalized.”
3. “The symptoms are caused by the pressure of the growing uterus on the veins. They are usual condition of pregnancy.”
4. “At this time, the symptoms are a minor inconvenience. You should learn to accept them.”

Answer 211

“The symptoms are caused by the pressure of the growing uterus on the veins. They are usual condition of pregnancy.”

Question 212

A pulse with an amplitude of 3+ would be considered:

1. irregular, with 3 premature beats
2. increased, full
3. normal
4. weak

Answer 212

increased, full

Question 213

Inspection of a person’s right hand reveals a red, swollen area. To further assess for infection, you would palpate the:

1. cervial node
2. axillary node
3. epitrochlear node
4. inguinal node

Answer 213

epitrochlear node

Question 214

To screen for deep vein thrombosis, you would:

1. measure the circumference of the ankel
2. check the temperature with the palm of the hand
3. compress the dorsalis pedis pulse , looking for blood return
4. measure the widest point with a tape measure

Answer 214

measure the widest point with a tape measure

Question 215

During the examination of the lower extremities, you are unable to palpate the popliteal pulse. You should:

1. proceed with the examination. It is often impossible to palpate this pulse
2. refer the patient tot a vascular surgeon for further evaluation
3. schedule the patient for a venogram
4. schedule the patient for an arteriogram

Answer 215

proceed with the examination. It is often impossible to palpate this pulse

Question 216

While reviewing a medical record, a notation of 4+ edema of the right leg is noted. The best description of this type of edema is:

1. mild pitting, no perceptible swelling of the leg
2. moderate pitting, indentation subsides rapidly
3. deep pitting, leg looks swollen
4. very deep pitting, indentation lasts a long time

Answer 216

very deep pitting, indentation lasts a long time

Question 217

The examiner wishes to assess for arterial deficit in the lower extremities. After raising the legs 12 inches off the table and then having the person sit up and dangle the leg, the color should return in:

1. 5 seconds or less
2. 10 seconds or less
3. 15 seconds
4. 30 seconds

Answer 217

10 seconds or less

Question 218

A 54 year old woman with five children has varicose veins of the lower extremities. Her most characteristics sign is:

1. reduced arterial circulation
2. blanching, deathlike appearance of the extremities on elevation
3. loss of hair on feet and toes
4. dilated, tortuous superficial bluish vessels

Answer 218

dilated, tortuous superficial bluish vessels

Question 219

Atrophic skin changes that occur with peripheral arterial insufficiency include:

1. thin, shiny skin with loss of hair
2. brown discoloration
3. thick, leathery skin
4. slow-healing blisters on the skin

Answer 219

thin, shiny skin with loss of hair