Question1

Marks: 1

There are several types of reflexes present, some of which include deep tendon reflexes and superficial reflexes. Which is NOT a deep tendon reflex? Choose one answer. a. Patellar b. Biceps c. Cremasteric Patellar, biceps and brachioradialis are all deep tendon reflexes which are commonly elicited by striking with a reflex hammer. The cremasteric reflex is a superficial reflex observed in human males. This reflex is elicited by lightly stroking the superior and medial (inner) part of the thigh.[1] The normal response is a contraction of the cremaster muscle that pulls up the scrotum and testis on the side stroked. (Jarvis, 1993).

d.Brachioradialis Correct
Marks for this submission: 1/1.

Question2
Marks: 1

Which is not a normal finding when assessing the female external genitalia? Choose one answer. a. Inguinal lymph nodes are not enlarged. b.Bartholins glands are soft, nontender with clear, nonpurulent discharge. Inguinal lymphnodes should not be enlarged or swollen. Enalrged inguinal nodes may indicate a vaginal infection or may be the result of irritation from shaving pubic hairs. Labia majora are equal in size and free of lesions, swlling and excoriation. Lesions may result from infection or disease. Excoriations and swelling may be from scratching or selftreatment of lesions. Urethral meatus is small and slitlike. Excoriation may result from client scratching herself. Bartholins glands are usually soft, nontender and drainage free. Swelling, pain, discharge may result from abscess and infection. If you detect a discharge, obtain a specimen and sent to lab for culture. (Weber and Kelley, 2007)

c. Urethral meatus is small and slitlike. d. Labia majora are equal in size. Correct
Marks for this submission: 1/1.

Question3
Marks: 1

You are performing examination of the scrotum on a 7-year-old patient. However, upon palpation, you notice that the testes appears absent. What condition could the patient be currently experiencing? Choose one answer. a. Orchitis b.Cryptorchidism Scrotal edema is manifested by tenderness, an enlarged scrotum with reddening (local irritation) and is taut with pitting. It accompanies marked edem in the lower half of the body due to CHF or other conditions as well as local inflammation. Scrotal Hernia is manifested by an enlarged scrotum which does not transilluminate. There is a soft mushy mass that palpating fingers cannot get above mass. Mass is distinct from testicle that is normal. Orchitis is an acute or moderate pain of sudden onset manifested by a swollen testes. Cryptochordism is in which the testes has never descended. Incidence at birth is 3-4%, one half of these descend in the first month. Incidence with premature infants is 30%, the adult 0.7-0.8%. True undescended testes have a histologic change by 6 years, causing decreased spermatogenesis and infertility. It is manifested by an empty scrotal half. Atrophic

scrotum is on the affected side and no testis can be palpated. (Jarvis, 1993). c. Scrotal Edema d. Scrotal Hernia Correct
Marks for this submission: 1/1.

Question4
Marks: 1

You are performing a physical assessment of an adolescent. You note that there are changes in the normal development of the genitals. Which of the following is NOT a normal change in adolescents? Choose one answer. a. Scrotal sac becomes pendulous with less Normal changes associated with rugae adolescence include enlargement of testes and scrotum, pubic hair growth, darkening of scrotal color, roughening of scrotal skin, increase in penis length and width, and axillary hair growth. IN the older male, there is thinner, graying pubic hair and decreased size of the penis. Size of testes may be decreased and feel less firm. The scrotal sac is pendulous with less rugae. The scrotal skin may become excoriated if the man continually sits on it. (Jarvis, 1993).

b.Roughening of scrotal skin c.Enlargement of testes and scrotum d.Darkening of scrotal color Correct
Marks for this submission: 1/1.

Question5
Marks: 1

Which test is performed to assess for presence of kidney inflammation or other nephritic problems? Choose one answer. a. Indirect fist percussion Fluid Wave and Shifting Dullness are special tests done to assess or when ascites is suspected. A positive fluid test occurs with large amounts of ascetic fluid. Shifting dullness is the use of shifting positions and the percussion and the sounds elicted from it. The obturator test is performed when appendicitis is suspected - the right leg is lifted and flexed if there is pain, appendicitis is most probable. Indirect fist percussion at the costoverterbral angle is also called the Kidney Punch. To assess the kidney, place one hand over the 12th rib at the costovertebral angle on the back. Thump that hand with the ulnar edge of the other fist. The person normally feels a thud but no pain. Sharp pain occurs with inflammation of the kidney or

paranephric area. (Jarvis, 1993). b. Shifting Dullness c.Obturator Test d. Fluid Wave Correct
Marks for this submission: 1/1.

Question6
Marks: 1

You are conducting your initial interview with your client. You asked about her last menstrual period. Which of the following statements warrants further investigation? Choose one answer. a. "The length of my menstrual blood flow is around 3 days. b. I havent had my period in 3 months. A normal menstrual cycle usually occurs approximately every 18-45 days. The average length of menstrual blood flow is 3 to 7 days. Headache, weight gain, mood swings, abdominal cramping and bloating are common complaints before or during the menstrual period. The absence of menstruation excessive bleeding or a marked change in menstrual pattern indicates a need to collect more information. (Weber and Kelley, 2007)

c. My normal menstrual cycle is around 19-25 days. d. "I experience headache and abdominal cramping before I get my period. Correct
Marks for this submission: 1/1.

Question7
Marks: 1

You are inspecting your patients anal region and you observed a longitudinal tear in the superficial mucosa of the anal margin. Patient reports that it is painful as well. You know that this is also called as: Choose one answer. a.Hemorrhoids b. Fissure Rectal polyp is a protruding growth from the rectal mucous membrane that is fairly common. An abscess is a localized cavity of pus from infection in a pararectal space. Hemorrhoids are painless flabby papules due to varicose vein of the hemorrhoidal plexus.

c. Rectal Polyp d. Abscess Correct

Marks for this submission: 1/1.

Question8
Marks: 1

One of the internal structures that must be assessed in the female is the uterus. During palpation of the uterus, which of the following reflects an abnormal finding? Choose one answer. a. The uterus is fixed. The fundus, is the large end of the uterus, normally round, firm and smooth. IN most women, it is at the level of the pubis; cervix is aimed posteriorly. An enlarged uterus above the level of the pubis is abnormal, an irregularly shaped uterus suggests abnormalities such as myomas or endometriosis. THe normal uterus moves freely and is non tender. A fixed or tender uterus may indicate fibroids, infection, masses. (Weber and Kelley, 2007) b. The uterus is nontender. c. The fundus is round, firm and smooth. d. The uterus is at the level of the pubis Correct
Marks for this submission: 1/1.

Question9
Marks: 1

In doing a complete neurological examination, the nurse also assesses the patients muscle and motor capabilities. The nurse performs a motor exam on a 21-year-old male patient and gives the patient a score of 3/5, based on the motor grading scale. What does this score imply?

Choose one answer. a. Moves with gravity b.Overcomes gravity, offers no resistance 5/5 implies that the patient is strong against resistance. 4/5 means the patient is weak against resistance but can overcome gravity. 3/5 overcomes gravity but offers no resistance, 2/5 cannot overcome gravity, and/or moves with gravity eliminated. 1/5 contracts muscle to stimulus. 0/5 means there is no observed muscle movement (Jarvis, 1993).

c.Contracts muscle to Stimulus d. Strong against resistance Correct

Marks for this submission: 1/1.

Question10
Marks: 1

Assessment of the Cranial Nerves is an important part of the neurological examination. A nurse ask the patient to turn head against her palm (resistance). Which cranial nerve is being tested? Choose one answer. a.Cranial Nerve VI b.Cranial Nerve VIII

c.Cranial Nerve XI

Cranial Nerve V is also called the Trigeminal Nerve. It receives sensation from the face and innervates the muscles of mastication. Cranial Nerve VI is also called the Abducens Nerve it controls an extraoculomotor muscle, the lateral rectus which abducts the eye. Cranial Nerve VIII is also called the Vestibulocochlear Nerve which is responsible for sensation of sound, rotation and gravity (balance and movement). Cranial Nerve XI is also called the Spinal Accessory of the Accessory Nerve. It controls sternocleidomastoid and trapezius muscles. To test CN XI, you ask the patient to shrug his shoulders (Trapezius) and to turn his head against a resistance (Sternocleidomastoid). (Jarvis, 1993).

d.Cranial Nerve V Correct

Marks for this submission: 1/1.

Question11
Marks: 1

The nurse is currently performing assessment of the male genitalia. She notices that the foreskin is advanced and fixed and that it is impossible to retract over the glans penis. What is this condition called? Choose one answer. a. Phimosis Paraphimosis is a condition wherein the foreskin is retracted and fixed. Once retracted behind the glans, a tight or inflamed foreskin cannot return to the original position. Hypospadias is a condition wherein the meatus opens of

the ventral side of the glans or at the penoscrotal junction, it is a congenital defect. A urethral stricture is a pinpoint, constricted opening at meatus or inside along the urethra. Phimosis is a condition whereun te foreskin is advanced and fixed, so tight it is impossible to retract over the glans. It may be congenital or acquired from adhesions secondary to infection. Poor hygiene leads to retained dirt and smegma, which increases risk of inflammation or calculus formation. (Jarvis, 1993) b.Hypospadias c. Urethral Stricture d.Paraphimosis Correct
Marks for this submission: 1/1.

Question12
Marks: 1

The Glasgow Coma Scale is used to grade or score a patients level of consciousness. A nurse assesses a patient using the three indicators for GCS Eye, Verbal and Motor response. She gives him a score of E2 V2 M4. What does this score imply? Choose one answer.

a. Eyes open to pain, incomprehensible sounds, withdraws from pain.

Eye response is graded as follows: 4 Spontaneous eye opening ,3 - Eyes open to speech , 2 - Eyes open to pain , 1 - No eye opening. Verbal response is graded as follows: 5 - Alert and Oriented , 4 - Confused, yet coherent, speech , 3 - Inappropriate words and jumbled phrases consisting of words , 2 Incomprehensible sounds , 1 - No sounds. Motor Response is graded as follows.: 6 Obeys commands fully , 5 - Localizes to noxious stimuli , 4 - Withdraws from noxious stimuli , 3 - Abnormal flexion, i.e. decorticate posturing , 2 - Extensor response, i.e. decerebrate posturing , 1 - No response.

b. Eyes open to speech, Confused coherent speech and localizes pain c. Eyes open to pain, inappropriate words and phrases, and abnormal flexion d. Eyes open to speech, incomprehensible sounds, abnormal extension Correct
Marks for this submission: 1/1.

Question13
Marks: 1

A patient is due for his digital rectal exam. How do you best position your patient for a digital rectal exam?

Choose one answer. a. Prone b. Left Sims position Left Sims Position allows the examiner to follow the natural contour of the anatomic structures. (Jarvis, 1993),

c. All of the Choices d. Right side lying Correct

Marks for this submission: 1/1.

Question14
Marks: 1

One of the first things that a nurse assesses in a patient is his level of consciousness (LOC). Nurse Amy is assessing a 24-year-old patient brought to the ER. She notices that patient is oriented to time, place, person but has slow sluggish speech and response. Response however is appropriate. What is the proper term to describe the patients LOC? Choose one answer. a.Lethargic Confused patients are disoriented to time place and person and have short attention span, poor memory and are easily bewildered. Obtunded patients have decreased LOC and arouses only to stimulation, they respond with 1-2 words and follow 1-step commands to stimulation. Stuporous patients lie quietly with minimal movement and responds only to vigorous and repeated stimulation. They open

their eyes and responds to pain appropriately and makes incomprehensible sounds. Lethargic patients are oriented to three spheres, but however had slow, sluggish speech and mental processes. They are able to respond appropriately (Jarvis, 1993). b.Stuporous c.Obtunded d.Confused Correct
Marks for this submission: 1/1.

Question15
Marks: 1

You are conducting a physical assessment of a 14-year-old male when suddenly, in the middle of assessment, he gets an erection. What is the appropriate nursing action? Choose one answer. a. Stop the examination and leave the room to give patient privacy. b. Proceed with the examination c. Proceed with the examination and reassure patient that this is a physiologic response. In palpating male genitalia, use a firm deliberate touch, not a soft stroking one. If an erection does occur, do not stop the examination or leave the room. This only focuses more attention on the erection and increases embarrassment.

Reassure the male that this is only a normal physiologic response to touch, just as when the knee jerks when tapped with the reflex hammer or when the pupil constricts in response to bright light. Proceed with the rest of the examination. (Jarvis, 1993). d. Stop the examination. Correct
Marks for this submission: 1/1.

Question16
Marks: 1

You are conducting an interview with a female patient. Which of the following statements indicates a higher risk for cervical cancer: i. Patient is a chain smoker for 5 years, smoking about 2 packs a day ii. Patient has been using oral contraceptives for 6 years iii. Patient has regular Pap smear tests iv. Patient is married and says she is monogamous Choose one answer. a. i, ii, iii b. i only c. i, ii, iii, iv d.i,ii Risk factors that increase patients risk for cervical cancer include, HPV infection (most important risk factor), females of late teens to mid thirties, multiple sexual partners, failure to

have regular Pap tests, cigarette smoking, diet low in fruit and vegetables, low socioeconomic status associated with low level of preventive care, African American or Hispanic heritage, multiple pregnancies, family history, overweight, history of Chlamydia infection, HIV infection, daughter of mother who took DES in early pregnancy to prevent miscarriage, possible use of contraceptives for 5 or more years. (Weber and Kelley, 2007) Correct
Marks for this submission: 1/1.

Question17
Marks: 1

A nurse is conducting a full neurological assessment of a 45-year-old patient. She is about to test his deep tendon reflexes. Which of the following principles should she keep in mind? Choose one answer. a. All of the Choices b. The muscle group to be tested must be in a neutral position. c. If she is having problems locating a tendon, she should ask the patient to relax the muscle to which it is attached. d. Strike the tendon with several brisk strokes. The muscle group to be tested must be in It should not elicit pain. a neural position extremity should be positioned such that the tendon can be easily struck with the reflex hammer. If

you are having difficulty locating the tendon, ask the patient to contract the muscle to which it is attached. When the muscle shortens, you should be able to both see and feel the cord like tendon, confirming it precise location. You strike the tendon with a single, brisk stroke. It should be done firmly and should not elicit pain. (Jarvis, 1993). Correct
Marks for this submission: 1/1.

Question18
Marks: 1

You are performing DRE on a 56-year-old male. In the middle of the assessment, he complains of being lightheaded and nauseous. What is the appropriate nursing action? Choose one answer. a. Ask patient to take deep, slow breaths and slow down DRE. b. Slow down in performing DRE. c. Stop assessment immediately and document right away. d. Stop assessment immediately and monitor VS. When a patient complains of being dizzy, lightheaded, nauseous and may even vomit, patient may have been vagally stimulated. In such cases, do NOT proceed with the DRE.

Instead, stop right away and monitor vital signs. Monitor and document accordingly. (Jarvis, 1993). Correct
Marks for this submission: 1/1.

Question19
Marks: 1

Complete assessment of the female genitalia includes the palpation of the cervix. When assessing the cervix, you palpate for the following except: Choose one answer. a.Consistency b.Discharge You inspect for cervical color, size, position, appearance of the os, discharge and lesions. When palpating for the cervix, you advance the fingers until they touch the cervix and you run your fingers around the circumference. You palpate for contour, mobility, tenderness and consistency. (Weber and Kelley, 2007)

c. Contour d. Mobility Correct

Marks for this submission: 1/1.

Question20

Marks: 1

Which of the following reflexes is NOT abnormal when found in a 22-year-old male patient? Choose one answer. a.Abdominal The abdominal reflex is a normal superficial reflex. The abdominal reflex includes contraction of abdominal muscles in the quadrant of the abdomen that is stimulated by scraping the skin tangential to or toward the umbilicus. This contraction can often be seen as a brisk motion of the umbilicus toward the quadrant that is stimulated.The Babinski, Dolls Eyes and Grasp Reflex are not normal in adult patients. A presend Babinski reflex may indicate brain or spinal cord damage from many causes. A grasp reflex is an involuntary grasp in response to stimulation of palm. This is very much normal in infants, but abnormal in an adults. Dolls eyes: impairment of eye movement to opposite side when head is turned. This implies damage to brainstem. (Jarvis, 1993). b. Dolls eyes c.Babinski d. Grasp Correct

Marks for this submission: 1/1.

Question21
Marks: 1

You are ready to assess the anal region of your area. Before you proceed with palpation, you must keep in mind the following guidelines except: Choose one answer. a. Don clean gloves and lubricate your index finger. b. None of the choices. c. Place the pad of your index finger gently against the anal verge d. Approach the anus at right angles. Never approach the anus at right agnles with your index finger extended. Such a jabbing motion does not promote sphincter relaxation and is painful. (Jarvis, 1993).

Correct
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Question22
Marks: 1

Nurse Joy is currently performing assessment of the cranial nerves on her 26-year-old patient. When she wants to test the 4th cranial nerve, what must she tell the patient to do? Choose one answer. a. Elicit Gag Reflex

b. Ask patient to identify specific odors while eyes are closed c. None of the choices The Fourth cranial nerve is the Trochlear nerve and it innervates the superior oblique muscle, which depresses, rotates laterally (around the optic axis), and intorts the eyeball. To test this nerve, the nurse asks the patient to "Follow finger with eyes without moving head" and tests the 6 cardinal points in an H pattern. Eliciting the gag reflex tests the 9th (Glossopharyngeal) and 10th (Vagus) cranial nerve. While asking the patient to identify odors is a test for the 1st (Olfactory) cranial nerve. Asking the patient to stick out her tongue is a test for the 12th cranial nerve (Hypoglossal). (Jarvis, 1993)

d. Stick out her tongue Correct

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Question23
Marks: 1

You are currently performing a digital rectal exam when you patient tells you that he feels pain. You ask him to rate the pain and he gives it a score of 7/10. What is your appropriate nursing action? Choose one answer. a. Stop and use more lubricating jelly and continue with assessment. b. Let him rest for a few minutes and continue

assessment c. Stop DRE and chart findings DRE is not a painful procedure. You may tell the patient that the procedure is NOT painful but it may feel like needing to move the bowels. Should there be pain, stop the digital rectal exam and note the observation and patients reports. (Jarvis, 1993).

d. Stop and defer DRE. Correct

Marks for this submission: 1/1.

Question24
Marks: 1

A nurse uses the Glasgow Coma Scale to assess the LOC of a patient following acute trauma. Nurse AJ is an ICU nurse, and is currently assessing a 55-year-old stroke patients LOC. Patient opens eyes to voice, utters inappropriate words/responses and is able to localize painful stimuli. Given the data, what would the patients GCS score be? Choose one answer. a.11 When patient is able to open eyes to voice or verbal commands, this is given a score of 3. Patient utters inappropriate words or verbal responses is given a score of 3. When patient is able to localize painful stimuli, he is given a score of 5. 3 + 3 + 5 = 11. (Jarvis, 1993). b.12

c.10 d.9 Correct

Marks for this submission: 1/1.

Question25
Marks: 1

Along with assessing, nurses must also provide health education. The nurse instructs the male patient (adolescence onwards) how to examine his own testicles every month. Which statement is incorrect? Choose one answer. a. A good time to examine the testicles is during shower or bath. b. Gently feel each testicle using the palm A good time to examine the testicles is during of your hands. shower or bath when the hands and scrotum are warm. Cold hands stimulate cremasteric reflex, which may retract scrotal contents. The procedure is simple. Tell the patient to hold the scrotum in the palm of each hand and gently feel each testicle using the thumb and first two fingers (not using the palm). If it hurts, the patient may be using too much pressure. The testicle is egg shaped and movable. It feels rubbery with a smooth surface. The epididymis is on top and behind the testicle, and will feel a bit softer. If patient notices a firm painless lump, hard area or an overall enlarged testicle, advise

him to call his physician for further investigation. (Jarvis, 1993). c. If you should notice a firm, painless lump, you should notify your doctor. d. Cold hands would stimulate muscle reflex, and may retract scrotal contents. Correct
Marks for this submission: 1/1.

Question26
Marks: 1

A nurse is about to perform a digital rectal examination. Which of the following materials is not necessarily needed? Choose one answer. a. Sterile gloves Digital rectal exam is a clean procedure, not sterile procedure.Clean gloves would be okay. A penlight is needed to illuminate parts during inspection. The lubricating jelly is used to minimize discomfort and risk for tissue trauma. (Jarvis, 1993) b.Lubricating jelly c. Penlight d. Clean gloves Correct
Marks for this submission: 1/1.

Question27
Marks: 1

A nurse is conducting a physical assessment of a 33 year old male. Upon inspection of his penis, she notes soft, pointed, moist, wartlike papules in his penis. What condition could the patient be experiencing? Choose one answer. a.Condylomata Acuminata Priapism is the prolonged painful erection of penis without sexual desire. Urethritis is infection of the urethra and is characterized by urethral discharge and dysuria. Carcinoma begins as a red, raised growth or as an ulcer with watery discharge. It grows and may necrose and slough, but is usually painless. Condylomata acuminate is also called as venereal warts. It is characterized by soft, pointed, moist, wartlike papules which may be single or multiple in a cauliflower-like patch. It occurs on the shaft of penis or behind corona or around anus. It is an STD. (Jarvis, 1993). b. Priapism c. Urethritis d.Carcinoma Correct
Marks for this submission: 1/1.

Question28
Marks: 1

You are going to conduct a physical examination of the genitalia. Which of the following is NOT appropriate? Choose one answer. a. Be sure to explain in detail what you will be doing throughout the examination b. Be sure to explain in detail what you will be doing throughout the examination c. Discourage patient to ask questions during the procedure Physical examination of the genitalia may create client anxiety. Client may be embarrassed about exposing her genitalia and nervous that an infection or disorder may be discovered. Be sure to explain in detail what you will be doing throughout the examination and to explain the significance of each portion of the examination. Encourage the patient to ask questions to help educate and alleviate her anxiety. Provide for privacy. (Weber and Kelley, 2007)

d. Drape the patient and expose only parts to be visualized when needed Correct
Marks for this submission: 1/1.

Question29

Marks: 1

The nurse is currently inspecting a 26-year-olds penis. Which of the following observations reflects an abnormal finding? Choose one answer. a. Cheesy smegma may collect under foreskin. b. At the base of the penis, pubic hair distribution is consistent with age. c. Urethral meatus is found on the dorsal side of the glans. The skin normally looks wrinkled, hairless and without lesions. The dorsal vein may be apparent. The glans looks smooth and without lesions. Ask the uncircumcised male to retract the foreskin, or you retract it. It should move easily. Some cheesy smegma may have collected under the foreskin. After inspection, slide the foreskin back to the original position. The urethral meatus is position about centrally. If the urethral meatus is located at the dorsal location of the meatus, this is abnormal and is called Epispadias. (Jarvis, 1993).

d. Skin of the penis is wrinkled, hairless and without lesions. Correct

Marks for this submission: 1/1.

Question30
Marks: 1

The nurse is inspecting a 65-year-old patients external genitalia. Which of the following findings warrants further investigation? Choose one answer. a. There is gray, thinning pubic hair. b. Patient has a healed episiotomy scar. c. Perineum is smooth. d. The labia minora is asymmetric. A healed tear or episiotomy scar may be visible on the perineum if patient has history of childbirth. The perineum should be smooth. Pubic hair is distributed in an inverted triangular pattern and there are no infestations. Older clients may have gray and thinning pubic hair. Labia minora should appear symmetric, dark pink and moist. Asymmetric labia may indicate abscess. (Weber and Kelly,2007).

Correct
Marks for this submission: 1/1.

Question31
Marks: 1

A nurse is assessing the deep tendon reflexes of her patient. She is currently testing the Achilles Reflex. Which statement is NOT true about this reflex and testing it? Choose one answer. a. Patient can be positioned seating (feet

dangling over edge of table) or supine with one leg crossed. b. You can strike the tendon directly. c. The Achilles tendon is a taut, discrete, cord-like structure running from the heel to the muscles of the calf. d. The normal response is plantar extension. Patient is best positioned in a sitting position with feet dangling over the edge of the table but patient can also be positioned supine, so as long as the leg that is to be tested is freely dangling (hence, crossing of legs in a figure 4 or a frog-type position). The Achilles tendon is a taut, discrete, cord-like structure running from the heel to the muscles of the calf. If you are unsure, ask the patient to plantar flex (i.e. step on the gas). You strike the tendon DIRECTLY. The normal response is plantar flexion or a contraction of the Gastrocnemius. (Jarvis, 1993).

Correct
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Question32
Marks: 1

A nurse is assessing a nulliparous woman. Then nurse visualizes the patients cervix. Which of the following is not a normal finding? Choose one answer.

a. None of the choices b. Cervical os appears as a small, round opening c. Cervical os appears slit-like. In a nulliparous woman, the cervical os appears round and is small. It appears slitlike in parous women. (Weber and Kelley, 2007)

d. Cervical secretions are clear without unpleasant odor. Correct

Marks for this submission: 1/1.

Question33
Marks: 1

Complete assessment involves conducting the health interview. You are asking your 33-year-old patient about his urinary habits. He says that he drinks about 2 liters of fluids a day, and voids about 5-6 times a day. However, he reports that he feels a burning sensation during urination. What is the term that refers to this condition? Choose one answer. a.Oliguria b.Nocturia c.Polyuria d.Dysuria Nocturia is the phenomenon wherein the client has to awaken at night due to a need to

urinate. Polyuria refers to excessive urination, whereas dysuria refers to diminished quantity (<400mL/24 hours). Dysuria refers to the burning or painful sensation associated with urination. It is common in infections, acute cystitis, prostatits and urethritis. (Jarvis, 1993). Correct
Marks for this submission: 1/1.

Question34
Marks: 1

A nurse is assessing a 23-year-old males scrotum. Which of the following statements should the nurse remember during assessment of the scrotum? Choose one answer. a. An abnormal finding includes sebaceous cysts which are small, yellowish nodules chart these accordingly. b. Testes are freely movable and are tender to moderate pressure. c. Asymmetry is not normal and should be noted. d. Scrotal size varies with ambient room temperature. Asymmetry is normal, the left scrotal half lower than the right. Normally, there are no scrotal lesions except for commonly found sebaceous cysts. These are yellowish, 1-cm nodules and are firm nontender and often multiple. Scrotal

contents should slide easily. They are oval, firm and rubbery, smooth and equal bilaterally. They are freely movable and only slightly tender to moderate pressure. Each epididymis normally feels discrete, softer than the testis, smooth and nontender. Scrotal size varies with ambient room temperature. (Jarvis, 1993) Correct
Marks for this submission: 1/1.

Question35
Marks: 1

You are preparing a female patient for physical assessment of the genitalia. Which of the following should the nurse do? Choose one answer. a. Ask patient to put her hands over her head to help relax abdominal muscles. b. Ask patient to assume a dorsal recumbent position in preparation for examination c. Nurse can offer a mirror so the patient can view the examination. Physical examination of the genitalia may create client anxiety. Client may be embarrassed about exposing her genitalia and nervous that an infection or disorder may be discovered. Be sure to explain in detail what you will be doing throughout the examination and to explain the significance

of each portion of the examination. Encourage the patient to ask questions to help educate and alleviate her anxiety. Provide for privacy. (Weber and Kelley, 2007) d. Ask the patient to void and douche herself prior to examination. Correct
Marks for this submission: 1/1.

Question36
Marks: 1

The nurse is examining the cranial nerves of a 23 year-old-patient. She asks the patient to smile, then frown and puff her cheeks out. Which cranial nerve is the nurse testing? Choose one answer. a.VII Cranial nerve VII is the Facial Nerve. Testingt he motor function of the nerve incolves noting mobility and facial symmetry as the person responds to requests such as smile, frown, close eyes lightly, lift eyebrows, show teeth and puff cheeks. (Jarvis, 1993) b.V c.VI d.VIII Correct

Marks for this submission: 1/1.

Question37
Marks: 1

You are interviewing the parent of a 4 year old child. The parent reports that the child has intense perianal itching during the night. Upon assessment, you see that the skin around the anus is red, raised and excoriated. What is this condition called? Choose one answer. a. Pruritus ani Pruritus ani is manifested by intense perinanal itching which may cause red, raised, thickened and excoriated skin around the anus. Common causes are pinworms in children and fungal infections in adults. The area is swollen and moist and with a fungal infection, it appears dull-grayish pink. The skin is dry and brittle with psychosomatic itching. (Jarvis, 1993) b.Carcinoma c. Fecal Impaction d. Hernia Correct
Marks for this submission: 1/1.

Question38
Marks: 1

You are currently inspecting the genitalia of a 6-year-old boy. Upon inspection of the inguinal area, you do not see any bulges but his parents give a positive history of one. Which of the following is not an appropriate nursing action?

Choose one answer. a. Palpate the inguinal area using the little finger to reach the external inguinal ring b. Try to elicit the bulge by increasing intrabdominal pressure by having him blow up a balloon. c. Note the finding and proceed to assessing When the parents give a positive history of a the other aspects of the genitalia. bulge or any abnormal finding for that matter, TRY to elicit the said finding. In the case of suspected hernia, try to elicit the bulge by increasing intrabdominal pressure by asking the boy to hold his breath and strain down or having him blow up a balloon. You may also palpate the inguinal area using the little finger to reach the external inguinal ring. Do not just chart or disregard the findings. (Jarvis, 1993). d. Ask the boy to hold his breath and strain down Correct
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Question39
Marks: 1

The Glasgow Coma scale is the most widely used scoring system used in quantifying level of consciousness following a traumatic brain injury. Which of the following statements is not true about the Glasgow Coma Scale (GCS)? Choose one answer.

a. It is not possible to get a score of zero in the GCS. b. None of the choices c. The highest possible score in the GCS is 15. d. The GCS measures three responses namely: Eye, Verbal and Sensory Responses. It is not possible to get a score of ZERO in the GCS. The lowest possible score is 3, indicating deep unconsciousness, while the highest score is 15 (fully alert). The three responses being tested and measured are Eye, Verbal and Motor responses. (Jarvis, 1993).

Correct
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Question40
Marks: 1

There are several ways to test the VIII cranial nerve. Which is NOT one of them? Choose one answer. a. Have patient listen to the ticking of a wrist watch. b. Have patient stand erect with his feet close together and eyes closed. c. None of the choices Cranial Nerve VIII is also called the Acoustic or Vestibulocochlear nerve. This nerve has one modality;

Special Sensory. It has two branches; the Cochlear which transmits sound messages to the brain; and Vestibular which controls balance or equilibrium. To Test this nerve have the patient occlude one ear with a finger. Stand about 1 to 2 feet away (30-60 cm) and softly whisper a word with two distinct syllables such as football, baseball, or doorbell. Make sure the patient can't read your lips. Repeat with the other ear and a different word. Repeat the word slightly louder if necessary and observe for difficulties distinguishing words. Equilibrium can be tested using the Romberg test: Have the patient stand erect with his feet close together and his eyes closed. He might sway slightly, but should not fall. (Stay close to the patient in case he does begin to fall.) (Jarvis, 1993). d. Stand about 1 to 2 feet away (30-60 cm) and softly whisper a word. Correct
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