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NURS 190- Physical Assessment MIDTERM Exam, Kim Hein.West Coast University/ Graded A+
Question : The nurse is performing a comprehensive skin
assessment. Which of the following pieces of equipment is appropriate to use during the skin assessment?Doppler Woods lamp Reflex hammer Goniometer
CORRECT ANSWER : Wood's lamp
Question : Which of the following is an expected finding in a
healthy client on assessment of Stensen's ducts?red glow is present midline and symmetric saliva is present redness is present
CORRECT ANSWER : saliva is present
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Question : Which of the following signs or symptoms does the
nurse recognize in a client with hypothyroidism? (select all that apply) Fatigue intolerance to cold increased cardiac output constipation
CORRECT ANSWER : Fatigue
intolerance to cold constipation
Question : The client has a new diagnosis of right sided heart
failure. The nurse understands a client with right sided heart failure may have edema and jugular vein distension.True False
CORRECT ANSWER : True
Question : The nurse performs the Romberg test to assess for: balance hearing
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vision loss cranial nerve 6 dysfunction 6
CORRECT ANSWER : balance
Question : Which of the following techniques will the nurse
perform to assess for signs of breast abnormalities?inspection, palpation, and auscultation inspection and palpation inspection, palpation, and percussion palpation and auscultation
CORRECT ANSWER : inspection and palpation
Question : The nurse is caring for a client with obesity. The
nurse places the client in which of the following positions to best hear heart sounds?supine prone sitting upright left lateral
CORRECT ANSWER : left lateral
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Question : State at which location(s) the S1 sound (lub) is heard
loudest on cardiac auscultation. State why the S1 isloudest at these locations. (Write 1-2 sentences).
CORRECT ANSWER :
Question : The nurse palpates an enlarged lymph node at the
back of the ear, over the mastoid bone. The nurse documents
this location as:
posterior auricular submental posterior occularoccipital
CORRECT ANSWER : posterior auricular
Question : The older adult client is admitted with new onset pain
and pressure to their eyes. On inspection, thesclera is red and the pupil is an irregular shape to the left eye. The nurse should
further assess for:
macular degeneration cataracts presbyopia