NURS 612 Advanced Health Assessment Exam 2

NURS 612 Advanced Health Assessment Exam 2 Latest Update 2024 Version 240 Questions and Verified Correct Answers Guaranteed Success *If the patient has a history of asthma and is exposed to allergens, what s/s would you expect if the patient comes in with wheezing?*what would the dx be?

*dx for allergen exposure & fever? - CORRECT ANSWER: *SOB, coughing

*Acute asthma exacerbation *Pneumonia

• areas of auscultation - cardiac - CORRECT ANSWER: * Aortic valve should be heard

at the second right intercostal space at the right sternal border

*Pulmonic valve area: second left intercostal space at the left sternal border

* Second pulmonic area: third left intercostal space at the left sternal border

*Tricuspid area: fourth left intercostal space along the lower left sternal border

• Mitral (apical) area: at the apex of the heart in the fifth intercostal space at the

midclavicular line

10 types of heart murmurs - CORRECT ANSWER: 1. mitral stenosis

• aortic stenosis
• subaortic stenosis
• pulmonic stenosis
• tricuspid stenosis
• mitral regurgitation
• mitral valve prolapse
• aortic regurgitation
• pulmonic regurgitation
• tricuspid regurgitation

A 2-month-old infant is brought to the clinic for immunizations. The examiner palpates enlarged inguinal nodes. What additional findings might explain the enlarged nodes?

• The mother reports that the infant has colic
• The infant's length and weight are about the 85th percentile
• The infant has a severe diaper rash
• A port-wine stain is present on the infant's left thigh - CORRECT ANSWER: c. The

infant has a severe diaper rash

A 6-month-old infant is brought to the clinic for immunizations. While examining the baby, the examiner notes that the anterior fontanel has not closed. What is the significance of this finding?

• This indicates a slight developmental delay
• There may be a nutritional deficiency
• This finding is consistent with hydrocephaly
• This is a normal finding - CORRECT ANSWER: d. This is a normal finding 1 / 4

A 6-year-old girl has freckles over her nose and cheeks. Freckles are a type of

• Macule
• Papule
• Nodule

d. Petechiae - CORRECT ANSWER: a. Macule

A 16 y/o female comes in saying that her periods are irregular. What are you going to

do? - CORRECT ANSWER: Start by checking her thyroid levels (TSH)

A 19-year-old man has a severe infection involving the fifth digit of his right hand.Where should the examiner expect to palpate enlarged and tender lymph nodes?

• Radial aspect of the right wrist
• Palmar aspect of the right hand
• Lateral aspect of the right forearm
• Medial aspect of the right elbow - CORRECT ANSWER: d. Medial aspect of the right

elbow

A 26 y/o female presents with complaints of fatigue and hair falling out, You would check for what? - CORRECT ANSWER: Check TSH first and then if it is abnormal, then check a T3 and T4

A bounding pulse would be expected in an infant with what condition?

• Coarctation of the aorta
• Patent ductus arteriosus
• Venous hum

d. Right-sided heart failure - CORRECT ANSWER: b. Patent ductus arteriosus

A condition that results in progressive ischemia caused by insufficient perfusion is

• Raynaud phenomenon
• Peripheral atherosclerotic disease
• Venous thrombosis

d. Arterial aneurysm - CORRECT ANSWER: b. Peripheral atherosclerotic disease

A healthcare professional is examining the chest of a 22-year-old woman who is 8 months pregnant. The patient has a wide thoracic cage. Which of the following best explains this finding?

• She may have lung disease, such as emphysema
• She may be hypoxic and require oxygen supplementation
• She may be pregnant with twins, causing abdominal contents to be forced up and out
• This is considered a normal finding with advanced pregnancy - CORRECT ANSWER:
• This is considered a normal finding with advanced pregnancy

A mother tells the examiner that her 2-year-old child has a cough that "sounds just like a bark". Given this history, what other findings should the examiner anticipate during respiratory examination? 2 / 4

• Wheezing and coarse crackles bilaterally
• Labored breathing and inspiratory stridor
• Hyperresonance with percussion
• Productive, blood-tinged, or "rusty" sputum - CORRECT ANSWER: b. Labored

breathing and inspiratory stridor

A newborn infant has a small chest-to-head size ratio. This finding is usually associated with

• Maternal diabetes
• Cocaine use during pregnancy
• Intrauterine growth restriction

d. A normal variation of chest-to-head ratio - CORRECT ANSWER: c. Intrauterine

growth restriction

A patient demonstrates asymmetry of the mouth. The examiner suspects a problem with the

• Inferior facial nerve
• Thyroid gland
• Peripheral trigeminal nerve

d. Salivary duct - CORRECT ANSWER: c. Peripheral trigeminal nerve

A patient with diabetes presents to the clinic complaining of an infected foot. Upon removing the patient's sock, the examiner notes an odor that resembles rotting apples.This finding is consistent with what type of infection?

• Pseudomonas aeruginosa
• Proteus
• Viridans streptococci

d. Clostridium perfringens - CORRECT ANSWER: d. Clostridium perfringens

A thrill generally indicates which of the following?

• A disturbance in the electrical conductivity of the heart
• A fine, rushing vibration related to disruption of blood flow in the heart
• The presence of significant infection of the myocardium
• Forceful apical impulse felt below the left sternal border - CORRECT ANSWER: b. A

fine, rushing vibration related to disruption of blood flow in the heart

ABCDE of lesions - CORRECT ANSWER: A= asymmetry; one half is unlike the other

half B= border; an irregular, scalloped or poorly defined border C= color; is varied from one area to another; has shades of tan, brown, or black, or is sometimes white, red, or blue D= diameter; melanomas are usually greater than 6mm (size of a pencil eraser) when diagnosed, but they can be smaller E= evolving; a mole or skin lesion that looks different from the rest or is changing in size, shape or color

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An adolescent patient asks the examiner why teens have more problems with acne than children. Which of the following would be an appropriate response?

• Children have better hygiene habits than adolescents because of parental guidance
• Adolescents have reduced blood flow to the epidermal layer of the skin, making them

more susceptible to infections

• At puberty, adolescents begin to secrete more oil from their sebaceous glands
• Children have very little skin mass, which prevents development of acne - CORRECT

ANSWER: c. At puberty, adolescents begin to secrete more oil from their sebaceous glands

An infant with an alcoholic other is admitted to the hospital with fetal alcohol syndrome.What assessment finding is consistent with this syndrome?

• Ear dysplasia
• Moon face
• Torticollis

d. Thin upper lip - CORRECT ANSWER: d. Thin upper lip

An older patient asks the examiner, "Is this spot on my chin a cancer?" Which of the following would indicate a need for further medical investigation?

• Reddish-brown color of the lesion
• Presence on his chin for 20 years
• Bleeds easily when it is touched
• Slightly raised and circumscribed - CORRECT ANSWER: c. Bleeds easily when it is

touched

Aortic regurgitation - CORRECT ANSWER: *heard with diaphragm patient sitting and leaning forward; Austin-Flint murmur heard with bell; ejection click heard in second intercostal space

• Valve incompetence allows backflow from aorta to ventricle

*Caused by rheumatic heart disease, endocarditis, aortic diseases (like marfan syndrome, medial necrosis), syphilis, ankylosing spondylitis, dissection, cardiac trauma

Aortic regurgitation findings - CORRECT ANSWER: *Early diastolic, high pitch blowing, often with diamond-shaped mid-systolic murmur, sounds often not prominent *duration varies with blood pressure *Low-pitched, rumbling murmur at apex common (Austin-Flint) *Early ejection click is sometimes present *S1 soft

• S2 split may have drum-like quality

*Mitral (M1) and A2 often intensified, S3-4 gallop common

• In left ventricular hypertrophy, prominent prolonged apical impulse down and to left

*Pulse pressure wide *Water-hammer or Corrigan pulse common in carotid, brachial, and femoral arteries

Aortic Stenosis - CORRECT ANSWER: *heard over aortic area; ejection sound at 2nd RICB

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