NUR 634 MIDTERM EXAM NEWEST 2024-

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NUR 634 MIDTERM EXAM NEWEST 2024-

2025 ACTUAL EXAM COMPLE TE ALL 100

QUESTIONS AND CORRECT DE TAILED

ANSWERS (VERIFIED ANSWERS )

|ALREADY GRADED A+

NUR 634 MIDTERM EXAM

If a patient has splenomegaly, what sound would be heard when percussing the left side of the abdomen?

• Dullness
• Tympany
• Fremitus

D. Hyperactive bowel sounds - ANSWER- ANS: A

Which of the following percussion notes would you obtain over the gastric bubble?

• Resonance
• Tympany
• Hyperresonance 1 / 4

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D. Flatness - ANSWER- ANS: B

Rationale; : The gastric bubble produces one of the longest

percussion notes. A patient with COPD may have hyperresonance over his chest, while a normal person would have resonance. Dullness is heard over a normal liver, and flatness is heard if one percusses a large muscle

Where is the point of maximal impulse (PMI) normally located?

• In the left 5th intercostal space, 7 to 9 cm lateral to the

sternum

• In the left 5th intercostal space, 10 to 12 cm lateral to the

sternum

• In the left 5th intercostal space, in the anterior axillary line
• In the left 5th intercostal space, in the midaxillary line -

ANSWER- ANS: A

Rationale; The PMI is usually located in the left 5th intercostal space, 7 to 9 centimeters lateral to the sternal border. If it is located more laterally, it usually represents cardiac enlargement. Its size should not be greater than the size of a US quarter, or about an inch. Left ventricular enlargement should be suspected if it is larger. The PMI is often the best place to listen for mitral valve murmurs as 2 / 4

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well as S3 and S4. The PMI is often difficult to feel in normal patients.

A 62-year-old smoker complains of "coughing up small amounts of blood," so you consider hemoptysis. Which of the following should you also consider?

• Intestinal bleeding
• Hematoma of the nasal septum
• Epistaxis

D. Bruising of the tongue - ANSWER- ANS: C

A patient complaining of hemoptysis what may warrant consideration?

• Upper GI Beed
• Oral Bruising
• Hematoma of nasal septum

D. Periungual infection - ANSWER- ANS: A

A 46-year-old executive who is obese and otherwise healthy presents to a family medicine clinic with a 3-month course of recurrent severe abdominal pain that usually resolves on its own after a few hours. Her last episode was prolonged lasting 6 3 / 4

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hours, and she is frustrated that she has had to leave or miss work on three separate occasions. She would like a diagnosis and the problem fixed. Which symptoms or signs would be most suggestive of a diagnosis of biliary colic?

• Vomiting of bile
• Poorly localized periumbilical pain
• Associated right shoulder pain
• Positive McBurney point tenderness
• Exacerbating factor includes alcohol intake - ANSWER-

ANS: C

Rationale; Pain with biliary colic can produce referred pain to the right shoulder or scapula due to irritation of the right hemidiaphragm. Alcohol is not an exacerbating factor for biliary colic. Positive McBurney point tenderness is associated with acute appendicitis. The Murphy sign is associated with acute cholecystitis. Vomiting bile is associated with small bowel obstruction

A 37-year-old nurse comes for evaluation of colicky right upper quadrant abdominal pain. The pain is associated with nausea and vomiting and occurs 1 to 2 hours after eating greasy foods.Which one of the following physical examination descriptions would be most consistent with the diagnosis of cholecystitis?

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