Vitamin D deficiency
Mr.Williams, a 62-year-old patient, presents for a physical examination. You suspect a vitamin D deficiency. Which of the following assessment findings might lead the examiner to suspect vitamin D deficiency?
a. Spinal curvature and bowed legs
b. Night blindness and dry eyes
c. Neuropathy and seizures
d. Nausea and insomnia
A college student comes to the student health center complaining of difficulty in concentrating during class and while studying. The diet that would contribute to this problem is one that contains mostly:
a.fruit and vegetables.
b.lean meat and fish.
c.sandwiches and diet drinks.
d.pasta and chicken.
e.cereal and breads.
In counseling a client regarding nutrition education, you explain that linoleic acid, a major fatty acid, is thought to be essential for:
a. glycogen storage in the liver.
b. normal growth and development.
c. myocardial cell function.
d. building and maintaining tissues.
Monitoring a patient’s waist-to-hip ratio provides data concerning:
a. daily caloric requirements.
b. lung capacity.
c. stomach cancer risk.
d. cardiovascular disease risk.
Mr.Jones is a 45-year-old patient who presents for a physical examination. On examination, you note costochondral beading, an enlarged skull, and bowed legs and diagnose him with rickets. A deficiency of which fat-soluble micronutrient can result in rickets?
a. Vitamin A
b. Vitamin E
c. Vitamin D
d. Vitamin K
A 17-year-old girl presents to the clinic for a sports physical. Physical examination findings reveal bradycardia, multiple erosions of tooth enamel, and scars on her knuckles. She appears healthy otherwise. You should ask her if she:
a. binges and vomits.
b. has regular menstrual periods.
c. has constipation frequently.
d. is cold intolerant.
d. All provide the same number of calories per gram.
Macronutrients are so named because they:
a. have high molecular weights.
b. form long chemical chains.
c. tend to increase waist measurements.
d. are required in large amounts.
Bulging of an amber tympanic membrane without mobility is usually associated with:
a. middle ear effusion.
b. healed tympanic membrane perforation.
c. impacted cerumen in the canal.
d. repeated and prolonged crying cycles.
An infant’s auditory canal, compared with an adult’s, is:
a. short, narrow, and straight.
b. short and curved upward.
c. long, narrow, and curved forward.
d. short and curved downward.
An ear auricle with a low-set or unusual angle may indicate chromosomal aberration or:
a. digestive disorders.
b. skeletal anomalies.
c. renal disorders.
d. heart defects.
A 6-month-old who can hear well can be expected to:
a. exhibit the Moro reflex.
b. stop breathing in response to sudden noise.
c. turn his or her head toward the source of sound.
d. imitate simple words.
A hairy tongue with yellowish brown to black elongated papillae on the dorsum:
a. is indicative of oral cancer.
b. is sometimes seen following antibiotic therapy.
c. usually indicates vitamin deficiency.
d. usually indicates anemia.
A 5-year-old child presents with nasal congestion and a headache. To assess for sinus tenderness, you should palpate over the:
a. sphenoid and frontal sinuses.
b. maxillary and frontal sinuses.
c. maxillary sinuses only.
d. sphenoid sinuses only.
A smooth red tongue with a slick appearance may indicate:
a. niacin or vitamin B12 deficiency.
b. oral cancer.
c. recent use of antibiotics.
d. fungal infection.
A newborn whose serum bilirubin level is greater than 20 mg/100 mL has a risk of later:
a. hearing loss.
c. tooth decay.
A clinical syndrome of failing memory and impairment of other intellectual functions, usually related to obvious structural diseases of the brain, describes:
Flight of ideas or loosening of associations is associated with:
c. multiple sclerosis.
d. psychiatric disorders.
An older adult is administered the Set Test and scores a 14. The nurse interprets this score as indicative of:
b. cognitive impairment.
Assessing orientation to person, place, and time helps determine:
a. ability to understand analogies.
b. abstract reasoning.
c. attention span.
d. state of consciousness.
Appropriateness of logic, sequence, cohesion, and relevance to topics are markers for the assessment of:
a. mood and feelings.
b. attention span.
c. thought process and content.
d. abstract reasoning.
A 69-year-old truck driver presents with a sudden loss of the ability to understand spoken language. This indicates a lesion in the:
a. temporal lobe.
b. Broca area.
c. frontal cortex.
An aversion to touch or being held, along with delayed or absent language development, is characteristic of:
a. attention-deficit/hyperactivity disorder.
d. mental retardation.
Facial muscle or tongue weakness may result in:
b. impaired comprehension.
Adolescents most likely to smoke, abuse substances, perform poorly in school, and be depressed are those who are:
a. from dual-income families.
b. from families that emphasize strong reli-gious beliefs.
c. from deprived socioeconomic groups.
d. unsupervised after school.
An aspect of traditional Western medicine that may be troublesome to many Hispanics, Native Americans, Asians, and Arabs is Western medicine’s attempts to:
a. use a holistic approach that views a par-ticular medical problem as part of a bigger picture.
b. determine a specific cause for every prob-lem in a precise way.
c. establish harmony between a person and the entire cosmos.
d. restore balance in an individual’s life.
An image of any group that rejects its potential for originality or individuality is known as a(n):
A 22-year-old female nurse is interviewing an 86-year-old male patient. The patient avoids eye contact and answers questions only by saying, “Yeah,” “No,”or “I guess so.” Which of the following is appropriate for the interviewer to say or ask?
a.“Why are you so depressed?”
b.“It’s hard for me to gather useful information because your answers are so short.”
c.“Are you uncomfortable talking with me?”
d.“Does your religion make it hard for you to answer my questions?”
An example of a cold food is:
b. hard liquor.
e. a dairy product
An example of a cold condition would be:
a. a fever.
b. a rash.
d. an ulcer.
As the health care provider, you are informing a patient that he or she has a terminal illness. This discussion is most likely to be discouraged in which cultural group?
a. Navajo Native Americans
b. Dominant Americans
c. First-generation African descendants
d. First-generation European descendants
A flat, nonpalpable lesion is described as a macule if the diameter is:
a. larger than 1 cm.
b. smaller than 1 cm.
c. 3 cm exactly.
d. too irregular to measure.
A 17-year-old student complains of a “rash for 3 days.” You note pale, erythematous oval plaques over the trunk. They have fine scales and are arranged in a fernlike pattern, with parallel alignment. What is the nurse’s next action?
a. Teach infectious control measures.
b. Inquire about another recent skin lesion.
c. Inspect the palms and the soles.
d. Inform the patient that this will resolve within a week.
A 5-year-old child presents with discrete vesicles on an erythematous base (dew drops on a rose petal appearance) that began near her scalp and are spreading to the trunk. The child has a low-grade fever and feels tired. What is the nurse’s next action?
a. Teach infectious control measures.
b. Inquire about other patterns of physical abuse.
c. Inspect the buccal mucosa for Koplik spots.
d. Inform the parent that this will resolve within a couple of days.
Age spots are also called:
a. seborrheic keratoses.
b. solar lentigines.
c. cutaneous horns.
A single transverse line seen in the palm of a small child may imply:
a. Down syndrome.
b. Turner syndrome.
c. systemic sclerosis.
d. profound dehydration.
a. Whether she had unprotected sex
b. Whether she has a history of diabetes mellitus
c. Whether she had unusual bleeding prob-lems
d. Whether she eats a lot of yellow and orange vegetables
A slightly elevated brownish papule with indistinct borders is a typical characteristic of a(n) _____ nevus.
A Dennie-Morgan fold is probably caused by:
a. birth trauma.
b. high fever.
c. excess adipose tissue.
d. chronic rubbing.
A cause for alarm during chest assessment of a newborn is:
c. gurgles from the gastrointestinal tract.
A pregnant woman is expected to develop:
a. tachypnea and decreased tidal volume.
b. deep breathing but not more frequent breathing.
c. dyspnea and increased functional residual capacity.
d. bradypnea and increased tidal volume.
A musical squeaking noise heard on auscultation of the lungs is called:
a. a friction rub.
A 44-year-old male patient who complains of a cough has presented to the emergency department. He admits to smoking one pack per day. During your inspection of his chest, the most appropriate lighting source to highlight chest movement is:
a. bright tangential lighting.
b. daylight from a window.
c. flashlight in a dark room.
d. fluorescent ceiling lights
a. Right lower
b. Right upper
c. Left upper
d. Left lower
Bone spicule pigmentation is a hallmark of:
a. chorioretinal pigmentosa.
b. cytomegalovirus infection.
c. lipemia retinalis.
d. retinitis pigmentosa.
A pterygium is more common in people heavily exposed to:
a. high altitudes.
c. ultraviolet light.
d. cigarette smoke.
A condition that typically develops by the age of 45 years is:
An increased level of lysozyme in the tears will occur normally during which life stage?
Ask the patient to look directly at the light of the ophthalmoscope when you are ready to examine the:
b. optic disc.
c. retinal vessels.
Changes seen in proliferative diabetic retinopathy are the result of:
a. anoxic stimulation.
b. macular damage.
d. minute hemorrhages.
A condition in which the eyelids do not completely meet to cover the globe is called:
An abnormal growth of conjunctiva extending over the cornea from the limbus is known as:
a. a cataract.
d. a pterygium.
a. continue to collect information regarding the chief complaint in an unhurried man-ner.
b. finish the interview as rapidly as possible.
c. ask the patient to take a deep breath and calm down.
d. ask the patient if she wants to wait until another day to talk to you.
Constitutional symptoms in the ROS refer to:
a. height, weight, and body mass index.
b. fever, chills, fatigue, and malaise.
c. hearing loss, tinnitus, and diplopia.
d. rashes, skin turgor, and temperature.
A tool used to screen adolescents for alcoholism is the:
A guideline for history taking is for caregivers to:
a. ask direct questions before open-ended questions so that data move from simple to complex.
b. ask for a complete history at once so that data are not forgotten between meetings.
c. make notes sparingly so that the patient can be observed during the history taking.
d. write detailed information as stated by patients so that their priorities are reflect-ed.
A pedigree diagram is drafted for the purpose of obtaining:
a. sexual orientation and history.
b. growth and developmental status.
c. genetic and familial health problems.
d. ethnic and cultural backgrounds.
A brief statement of the reason the patient is seeking health care is called the:
a. medical history.
b. chief complaint.
Behaviors that diffuse anxiety during the interview include:
a. avoiding wearing uniforms or laboratory coats.
b. providing forthright answers to questions.
c. providing all necessary information before the patient has to ask for it.
d. completing the interview as quickly as possible.
After you ask a patient about her family history, she says, “Tell me about your family now.” Which response is generally most appropriate?
a. Ignore the patient’s comment and contin-ue with the interview.
b. Give a brief, undetailed answer.
c. Ask the patient why she needs to know.
d. Tell the patient that you do not discuss your family with patients.
If only two blood pressure values are recorded, they are the _______________ sounds. blank(s) with correct word
first systolic and second diastolic
A normal adult’s pulse pressure should range from _____ to _____ mm Hg. Fill in the blank(s) with correct word
Body language that leads you to suspect that a person is in pain is:
a. talkative, verbose speech.
b. fretful hand movements.
c. focused, fixed eye stares.
d. marked salivation.
During respiration, the internal intercostals:
a. increase the force of muscular contraction.
b. decrease the lateral diameter during expi-ration.
c. decrease the intrathoracic space.
d. increase elastic recoil during expiration.
Hypertension in the adult is generally defined as pressure in excess of:
a. 120 mm Hg plus the patient’s age.
b. 140 mm Hg.
c. 160 mm Hg.
d. 200 mm Hg.
If a sufficiently large cuff is unavailable to fit an obese arm, which technique may be used to assess blood pressure?
a. Wrap a standard cuff around the deltoid area and place the stethoscope over the radial artery.
b. Wrap a standard cuff around the forearm and place the stethoscope over the radial artery.
c. Wrap a standard cuff around the thigh and place the stethoscope on the dorsalis pedis.
d. Wrap a pediatric cuff around the ankle and place the stethoscope on the popliteal artery.
In a syndrome in which regional pain extends beyond this specific peripheral nerve injury, you would notice which of the following: (Select all that apply.)
b. Sleep disturbance
c. Blood flow changes
A blood pressure cuff bladder should be long enough to:
a. cover 20% to 25% of the arm circumfe-rence.
b. cover 45% to 50% of the arm circumfe-rence.
c. cover 75% to 80% of the arm circumfe-rence.
d. completely encircle the arm.
A variant of the percussion hammer is the neurologic hammer, which is equipped with which of the following?
a. Brush and needle
b. Tuning fork and cotton swab
c. Penlight and goniometer
d. Ruler and bell
Auscultation should be carried out last, except when examining the:
a. neck area.
A rubber or plastic ring should be around the bell endpiece of a stethoscope to:
a. prevent the transmission of static electric-ity.
b. prevent cold metal from touching the pa-tient.
c. prevent the sharp edge of the stethoscope from damaging the patient’s skin.
d. ensure secure contact with the body sur-face.
During percussion, a dull tone is expected to be heard over:
a. healthy lung tissue.
b. emphysemic lungs.
c. the liver.
d. most of the abdomen.
According to the guidelines for Standard Precautions, the caregiver’s hands should be washed:
a. only after touching body fluids with un-gloved hands and between patient con-tacts.
b. only after touching blood products with ungloved hands and after caring for infec-tious patients.
c. only after working with patients who are thought to be infectious.
d. after touching any body fluids or conta-minated items, regardless of whether gloves are worn.
During auscultation, you can limit your perceptual field best by:
a. asking patients to describe their symp-toms.
b. closing your eyes.
c. performing auscultation before percussion.
d. using an aneroid manometer.
A patient in the emergency department has a concussion. You suspect the patient may also have a retinal hemorrhage. You are using the ophthalmoscope to examine the retina of this patient. Which aperture of the ophthalmoscope is most appropriate for this patient?
b. Red-free filter
c. Slit lamp
d. Small aperture
A scale used to assess patients’ weight should be calibrated:
a. only by the manufacturer.
b. by a qualified technician at regularly scheduled intervals.
c. each time it is used.
d. when necessary, with the patient standing on the scale.
At what age does peak height growth velocity occur in boys?
a. 10 years
b. 12 years
An 11-year-old boy is brought in for an annual physical examination by his mother.You suspect _______________ when you measure his arm span at 65 inches and his height at 60 inches. Fill in the blank(s) with correct word
A pregnant woman of normal prepregnancy weight should be expected to gain how much weight per week during the second and third trimesters of pregnancy?
a. 1 pound
c. 2 pounds
A prominent forehead, large nose, large jaw, and elongation of the facial bones and extremities are signs of:
a. infantile hydrocephalus.
c. Cushing syndrome.
A marker for nutritional status is the:
a. head circumference.
b. waist-to-hip ratio.
c. standing height.
d. triceps skinfold thickness.
A woman with a normal prepregnancy body mass index (BMI) should gain approximately _____ pounds during pregnancy. Fill in the blank(s) with correct word
After 50 years of age, stature:
a. becomes fixed.
b. begins a barely perceptible secondary in-crease.
c. increases at a rate of 0.5 cm/ year.
A Mexican American mother brings her 12-year-old daughter to the clinic because this child is not maturing as quickly as her classmates. You examine the daughter and determine that her growth and physical findings are within normal limits. You should explain to the family that:
a. Mexican Americans may develop more slowly than other ethnic groups.
b. more tests should be conducted because the family appears so worried.
c. the daughter should drink more juices and eat more fruit.
d. there is a serious problem with the daugh-ter’s development.
A 29-year-old woman presents to the urgent care center with a history of a severe headache of 2 hours’ duration. She describes it as bandlike and constricting.In interviewing the woman about her complaint, you would ask:
a. whether she has experienced increased tearfulness.
b. the date of her last menstrual period.
c. whether these headaches started in child-hood.
d. whether she is particularly stressed or overworked.
An inconsequential finding on the head of an adult is a palpable:
a. embryonic remnant.
b. posterior fontanel.
c. sagittal suture ridge.
d. skull indentation.
Closure of the anterior skull fontanel should occur by ______________. Fill in the blank(s) with correct word
24 months of age
During a head and neck assessment of a neonate, it is important to screen for:
a. the presence of torticollis.
b. signs and symptoms of cerebral palsy.
c. uneven movement of the eyes.
d. unilateral movement of the tongue.
A stethoscope is used in a head and neck examination to assess:
a. intracranial fluid.
b. pulsating fontanels.
c. skull bone development.
d. thyroid vascular sounds.
a. ask the patient if this characteristic runs in his family.
b. perform monofilament testing on the face.
c. consult with the physician regarding the laboratory tests needed.
d. record the finding in the patient’s chart.
A bruit, or blowing sound, over the skull or temporal region of an adult indicates a:
a. degenerative change.
b. hyperthyroid storm.
c. skull fracture.
d. vascular anomaly.
Coarse, dry, and brittle hair is associated with which metabolic disorder?
b. Diabetes mellitus
c. Addison disease
d. Cushing syndrome
A red streak that follows the course of the lymphatic collecting duct is a finding associated with:
a. Hodgkin disease.
As adults age, their ability to resist infection is reduced because of the lymphatic nodes becoming more:
Equipment for examining the lymphatic system includes a:
b. centimeter ruler.
d. syringe and needle.
Cells that line the lymph node sinuses perform the specific function of:
a. fat absorption.
b. fetal immunization.
An organ that is essential to the development of protective immune function in the infant but has little or no demonstrated function in the adult is the:
A congenital defect in the immune system of a 2-week-old infant may be suspected if:
a. there are small femoral nodes palpable.
b. the umbilical cord has not yet dropped off.
c. the tonsils are visible.
d. the thymus is visible on a chest radio-graph.
Hodgkin disease is most common in ______________________. Fill in the blank(s) with correct word
late adolescence and young adulthood
Enlarged inguinal nodes are likely to be associated with:
a. genital herpes.
b. pelvic inflammatory disease.
c. uterine cancer.
d. testicular cancer.
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