Advanced Health Assessment Exam
A 10-year-old is at the health facility for "a sore throat lasting 6 days." The nurse is aware that
which of those findings would be steady with an acute infection?
A) Tonsils three+/1-four+ with large white spots
B) Tonsils 1+/1-four+ with faded coloring
C) Tonsils 1+/1-4+ and red, same color as oral mucosa
D) Tonsils 2+/1-four+ and crimson with white particles interior deep crypts - ANS-A) Tonsils
3+/1-4+ with massive white spots
With an acute infection, tonsils are brilliant purple and swollen and might have exudate or large
white spots. Tonsils are enlarged to 2+, three+, or four+ with an acute infection.
A 15 month old is brought to you for a fever of one zero one F and fussiness. The ear
examination is as follows: outside ear - everyday appearance and no tenderness with
manipulation; canal - ordinary diameter with out proof of infection; tympanic membrane -
bulging, erythematous, and the light reflex is dull. Insufflation is deferred because of pain. What
is your diagnosis?
A) ruptured tympanic membrane
B) cholesteatoma
C) otitis media
D) otitis externa - ANS-C) otitis media
Acute otitis media in a symptomatic toddler typically has a crimson, bulging tympanic
membrane, with a dull or absent mild reflex.
A 15-year-old excessive faculty sophomore provides to the emergency room together with his
mom for assessment of an area of blood within the left eye. He denies trauma or injury but has
been coughing forcefully with a current bloodless. He denies visual disturbances, eye pain, or
discharge from the eye. On physical examination, the students are equal, round, and reactive to
light, with a visible acuity of 20/20 in every eye and 20/20 bilaterally. There is a homogeneous,
sharply demarcated vicinity on the lateral thing of the base of the left eye. The cornea is
obvious. Based in this description, what is the maximum in all likelihood diagnosis?
A) Conjunctivitis
B) Acute iritis
C) Corneal abrasion
D) Subconjunctival hemorrhage - ANS-D) Subconjunctival hemorrhage
Leakage of blood out of doors of the vessels, generating a homogenous, sharply demarcated,
pink location. The student isn't affected, vision isn't always affected and the cornea is obvious.
May result from trauma, bleeding disorders, or surprising growth in venous pressure, as from a
cough.
,A 27 yr antique woman affected person has 3 furuncles connected around a hair follicle. You
use the following term to your charting:
A) nodules
B) carbuncle
C) macules
D) bulla - ANS-B) carbuncle
Multiple furuncles around a hair follicle form a carbuncle.
A 29-year-old bodily therapist provides for evaluation of an eyelid hassle. On remark, the right
eyeball appears to be sticking out forward. Based on this description, what's the maximum
probable analysis?
A) Epicanthus
B) Ptosis
C) Exophthalmos
D) Ectropion - ANS-C) Exophthalmos
Eye protrusion (proptosis or exophthalmos)
A 29-12 months-vintage female tells the nurse that she has "excruciating pain" in her again.
Which of the subsequent would be the ideal reaction by using the nurse to her assertion?
A) "How does your family react for your pain?"
B) "That must be horrible. You possibly pinched a nerve."
C) "I've had back ache myself and it can be excruciating."
D) "How could you assert the ache influences your ability to do your each day sports?" - ANS-D)
"How would you say the ache affects your capability to do your daily activities?"
Inquire about the outcomes of ache on the affected person's day by day sports, temper, sleep,
work, and sexual pastime.
A forty five-yr-vintage man is inside the health facility for a routine bodily. During history the
affected person states he has been having issue dozing. "I'll be snoozing incredible and then I
wake up and feel like I cannot seize my breath." His signs suggests sleep associated signs and
symptoms of a sure kind of disease, so which query could the NP need to ask?
A) Have you had a current sinus infection or URI?
B) Do you've got any history of issues together with your heart?
C) Do you observed it's miles because it's been so hot at night?
D) When changed into your ultimate electroencephalogram? - ANS-B) Do you've got any history
of problems with your heart?
Paroxysmal nocturnal dyspnea happens with heart failure. Lying down will increase extent of
intrathoracic blood, and the weakened heart can not accommodate the increased load.
Classically, the character awakens after 2 hours of sleep, arises, and flings open a window with
the belief of desiring clean air. (Bates, p357)
A 46 12 months antique female patient is inside the health facility with a main criticism of chest
pain. You are trying to best recognize the affected person's belief of the chest ache. Which fo
the following questions could you ask first?
, A) How do you charge your ache on a scale of zero-10?
B) Is the pain related to exertion?
C) Tell me about your chest pain.
D) Are you taking all your medications? - ANS-C) Tell me approximately your chest pain.
Move from open ended to targeted questions to permit for the flow of thoughts and mind from
the patient.
A 53-12 months-antique obese man comes in for an examination. When he starts offevolved to
sit up straight, you notice a ridge/bulge vertically just under the sternum that resolves as soon
as he sits up. This is most likely:
A) lipoma
B) diastasis recti
C) an immediate hernia
D) an oblique hernia - ANS-B) diastasis recti
A diastasis recti is the separation of the two rectus abdominus muscular tissues that happens
whilst the pinnacle and shoulders are raised in some patients, especially obese, chronic lung
disorder, or after repeated pregnancies (Bates, p499).
A 59 yr vintage patients tells the nurse practitioner that he thinks he must have ulcerative colitis.
He has been having "black stools" for the ultimate 24 hours. How might the nurse practitioner
satisfactory file THE FACTS for his cause for in search of care?
A) JM is a 59 year vintage male right here for having "black stools" for the beyond 24 hours.
B) JM came into the health center complaining of black stools for the beyond 24 hours.
C) JM is a 59 yr antique male right here for "ulcerative colitis."
D) JM, a 59 yr vintage male, states he has ulcerative colitis and wishes it checked. - ANS-A) JM
is a 59 year old male here for having "black stools" for the past 24 hours.
Chief Complaint(s) The one or more signs and symptoms or issues causing the affected person
to searching for care. Make each attempt to cite the affected person's own words.
A 72-12 months-antique teacher comes to a professional nursing facility for rehabilitation after
being inside the sanatorium for six weeks. She turned into treated for sepsis and breathing
failure and had to be on a ventilator for 3 weeks. The nurse is completing an preliminary
evaluation and comparing the customer's pores and skin condition. On her sacrum there's
full-thickness skin loss that is 5 cm in diameter with damage to the subcutaneous tissue. The
underlying muscle is not affected. What is the degree of this strain ulcer?
A) Stage 1
B) Stage 2
C) Stage three
D) Stage four - ANS-C) Stage 3
A crater seems within the skin, with full-thickness skin loss and harm to or necrosis of
subcutaneous tissue that can make bigger to, but now not via underlying muscle.
A patient has are available in for an exam and states, "I even have this spot in the front of my
ear lobe here on my cheek that seems to be getting larger and is soft. What do you watched it's
