NURS6512 Walden University Clinical Analysis Midterm Exam Week 6 With Answers (200 Solved Questions)

Name: NURS6512 Walden University Clinical Analysis Midterm Exam Week 6 With Answers (200 Solved Questions)
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NURS 6512, Week 6 Midterm Exam
This exam is a test of your knowledge in preparation for your certification exam. No outside
resources including books, notes, websites, or any other type of resource are to be used to
complete this exam. You are expected to comply with Walden University’s Code of Conduct.
This exam will be on topics covered in weeks 1, 2, 3, 4, 5, and 6. Prior to starting the exam, you
should review all of your materials. This exam is timed with a limit of two hours for completion.
When time is up, your exam will automatically submit.
Submission and Grading Information
Submit Your Midterm Exam by Day 7
QUESTIONS
1. Before performing an abdominal examination, the examiner should:
Have the patient empty their bladder
2. During an interview, tears appear in the patient’s eyes and his voice becomes shaky. Initially, you
should:
Keep the interview moving to distract the patient
3. Which of the following is the most accurate reflection of an individual’s food intake?
Food Diary
4. Percussing at the right midclavicular line, below the umbilicus, and continuing upward is the correct
technique for locating the:
Lower liver border
5. A fixed image of any group that rejects its potential for originality or individuality is known as a:
Stereotype
6. Peritonitis produces bowel sounds that are
Decreased/Hypoactive
7. Brittle nails are typical findings in:
Older adults
8. Which of the following is an expected change in the assessment of the thyroid during pregnancy?
A Bruit is auscultated d/t increased vascularity
9. You are planning to palpate the abdomen of your patient. Which part of the examiner's hand is best for
palpating vibration?
Ulnar Surface

10. A 5-year-old child presents with nasal congestion and a headache to assess for sinus tenderness you
should palpate over the:
Maxillary sinuses only
11. During physical examination of a 30-year-old Chinese man you notice a slight asymmetry of his face.
the cranial nerve examination is normal. Your best action is to
Ask the patient if this characteristic runs in his family
12. Unusual white areas on the skin may be due to
Vitiligo
13. You are using an ophthalmoscope to examine a patient’s inner eye. You rotate the lens selector
clockwise, then counterclockwise to compensate for:
Myopia
14. Mrs. Webb is a 38-year old patient who has been changing her lifestyle to eat in a healthy way and
lose weight: during your health promotion education regarding her nutritional status, you explain the
function of dietary protein as:
Building and maintaining tissues
15. Mr. Akins is a 78-y/o patient who presents to the clinic with complaints of hearing loss. Which of the
following are changes in hearing that occur in the elderly? Select all that apply.
c. Loss of high frequency
e. Sounds may be garbled, difficult to localize
f. Unable to hear in a crowded room
16. The most superior part of the stomach is the
Fundus
17. Mrs. Grace is a 58-year-old patient who has a diagnosis of pernicious anemia. Which B vitamin is
deficient in patients with pernicious anemia?
B12
18. A 51-y/o woman calls with complaints of weight loss and constipation. She reports enlarged
hemorrhoids and rectal bleeding. You advise her to:
Come to the laboratory for a stool guaiac test.
19. Placing the base of a vibrating tuning fork on the midline vertex of the patient’s head is a test for:
Lateralization of Sound
20. Which technique is most likely to result in the patients understanding of questions?
Use the patient's own terms if possible.
21. Mr. Williams, age 25, has recovered recently from an upper and lower respiratory infection. He
describes a long-standing nasal dripping. He is seeking treatment for a mild hearing loss that has not gone
away. Information concerning his chronic postnasal drip should be documented within which section of
the history?
Past medical data
22. Nasal symptoms that imply an allergic response include:

Bluish gray turbinates. ("Turbinates that appear bluish gray or pale pink with a swollen, boggy
consistency may indicate allergies"-Seidel p.243)
23. Mr. Franklin is speaking with you the health care provider, about his respiratory problem. Mr.
Franklin says, “I’ve had this cough for 3 days and it’s getting worse.” You reply, “Tell me more about
your cough.” Mr. Franklin states, “I wish I could tell you more, that’s why I am here! You tell me what’s
wrong.” Which caregiver response would be the most appropriate for enhancing communication?
After 3 days, you're tired of coughing. Have you had a fever?"
24. When taking a history, you should:
Use a chronologic and sequential framework.
25. Which of the following formats would be used for visits that address problems not yet identified in the
problem-oriented medical record (POMR)?
Brief SOAP note
26. Mr. and Mrs. Johnson have presented to the office with their infant son with complaints of ear
drainage. When examining an infant’s middle ear, the nurse should use one hand to stabilize the otoscope
against the head while using the other hand to:
Pull the auricle down and back in an effort to straighten the upward curvature of the canal
27. Which question would be considered a leading question?
You don't get headaches often, do you?"
28. Mr. Black is a 44y/o patient who presents to the clinic with complaints of neck pain that he thinks is
from his job involving computer data entry. As the examiner, you are checking the range of motion in his
neck and note the greatest degree of cervical mobility is at?
C 4 to C 5: C4 and C5 or C5 and C 6 provide the greatest horizontal mobility in adults
29. The term denoting the caregiver’s need to do no harm to the patient is:
Deontologic imperatives.
30. A tool used to screen adolescents for alcoholism is the:
CRAFFT
31. Under normal circumstances, how much water is lost daily by the body?
Under normal circumstances, approximately 2 to 2.5 liters of water is lost daily
32. You have just completed a skin assessment on Mr. Baker. During your assessment, you have
transilluminated a skin lesion. During the physical examination, you know that skin lesions are
transilluminated to distinguish:
Transillumination is used to determine the presence of fluid in cysts and masses. Fluid-filled lesions will
transilluminate with a red glow, and solid masses will not transilluminate.
33. Mr. Mills is a 55/y/o patient who presents to the office for an initial visit for health promotion. A
survey of mobility and activities of activities of daily living is part of a(n):
Functional assessment.
34. Sweat glands, hair, and nails are all formed from?
Invagination of epidermis into dermis

35. A brief statement of the reason the patient is seeking health care is called the?
Chief concern
36. Which part of the information contained in the patient’s record may be used in court?
Anything that is entered into a patient’s record in paper or electronic form, is a legal document and
can be used
37. Which cranial nerves innervate the face?
5 and 7
38. In counseling a client regarding nutrition education, you explain that linoleic acid, a major fatty acid,
is thought to be essential for?
Linoleic acid, found abundantly in milk and dairy fat, is required for normal growth and
development, it has been suggested that it can reduce body fat in overweight patient
39. When are open-ended questions generally most useful?
During the initial part of the interview
40. Knowledge of the culture or cultures represented by the patient should be used to?
Help make interview questions more pertinent
41. Mrs. Berger is a 39-year-old woman who presents with a complaint of epigastric abdominal pain. You
have completed the inspection of the abdomen. What is your next step in the assessment process?
Auscultation
42. A guideline for history taking is for caregivers to?
Make notes sparingly so that patients can be observed during the history taking
43. Which type of speculum should be used to examine a patient’s tympanic membrane?
The largest speculum that will fit comfortably in ear
44. You are palpating a patient’s thyroid and find that its broadest dimension measures 4cm. the right lobe
is 25% larger than the left. These data would indicate?
The description is most likely a normal finding
45. Mr. L. presents to the clinic with severe groin pain and a history of kidney stones. Mr. L.’s son tells
you that, for religious reasons, his father wishes to keep any stone that is passed into the urine filter that
he has been using. What is your most appropriate response?
Healthcare provider should be willing to modify delivery and respectful of wishes/culture
background
46. Before performing an abdominal examination, the examiner should?
Have the patient empty his or her bladder
47. You are examining a pregnant patient and have noted a vascular lesion. When you Blanche over the
vascular lesion, the site blanches and refills evenly from the center outward. The nurse documents this
lesion as a?
Telangiectasia
48. As you explain your patient’s condition to her husband, you notice that he is leaning toward you and
pointedly blinking his eyes. Knowing that he is from England, your most appropriate response to this
behavior is to?

The English worry about being overheard and tend to speak in a modulated voice, so when they
lean toward you, they probably have a question
49. When palpating the abdomen, you should note whether the liver is enlarged in the?
The liver is located in the right upper quadrant of the abdomen
50. Expected normal percussion tones include?
Normal lings produce renaissance percussion tones
51. Mr. Abdul is a 40-year-old Middle Eastern man who presents to the office for a first visit with the
complaint of new abdominal pain. You ate concerned about violating a cultural prohibition when you
prepare to do his rectal examination. The best tactic would be to?
Inform the patient of the reason for the exam and ask if it is acceptable to him
52. Fluorescing lesions are best distinguished using a(n)?
Wood’s lamp
53. Mrs. Hartzell is a 34-year-old patient who has presented for nutritional counseling because she is a
vegetarian. Deficiency of which of the following is a concern in the vegetarian diet?
Proteins, calcium, iron, B12, and vitamin D
54. Underestimation of blood pressure will occur if the blood pressure cuff’s width covers?
Cuff that are too wide will underestimate blood pressure, which would happen with a cuff that is
more than one third of the upper arm
55. Mrs. Britton is a 34-year-old patient who presents to the office with complaints of skin rashes. You
have noted a 4’3cm, rough, elevated area of psoriasis. This is an example of a?
Plaque
56. Penicillin is considered a?
Miracle drug for all the reasons except. It was not the first antibiotic.
57. Small, minute bruises are called?
Petechiae
58. After thorough inspection of the abdomen, the next assessment step is?
Auscultation
59. When you are questioning a patient regarding alcohol intake, she tells you that she is only a social
drinker. Which initial response is appropriate?
What amount and what kind of alcohol do you drink in a week?
60. Regardless of the origin, discharge is described by noting?
Color and consistency
61. Recommended carbohydrate content of total dietary intake (% total calories) is?
50%
62. Tuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure?
Hearing range of normal speech

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63. Auscultation should be carried out last, except when examining the?
The abdomen
64. Mr. Kevin Marks is a new health care provider. What is the best method to develop cultural
competence?
Realize the cultural values are difficult to change and must be respected
65. Which of the following is an “ABCD” characteristic of malignant melanoma?
Asymmetric borders
66. Tracheal tug suggests the presence of a(n)?
Aortic aneurysm
67. Your patient presents with symptoms that lead you to suspect acute appendicitis. Which assessment
finding is least likely to be associated with this condition early in its course?
Consistent right lower quadrant pain
68. The review of systems is a component of the:
Personal and social history
69. Cherry angiomas are a common finding in:
Adults older than 30 years
70. Mr. Donalds is a 45-year-old roofer. Your inspection to determine color variations of the skin is best
conducted:
with illumination provided by daylight.
71. To correctly document absent bowel sounds, one must listen continuously for:
5 minutes
72. The adult recommended dietary fat intake should be ____g/day.
20 to 35
73. Mr. Jones is a 45-year-old patient who presents for a physical examination. On examination, you note
costochondral beading, enlarged skull, and bowed legs and diagnose him with rickets. A deficiency of
which fat-soluble micronutrient can result in rickets?
Vitamin D
74. A flat, non-palpable lesion is described as a macule if the diameter is:
Less than 1 cm
75. Mrs. Raymonds is a 24-year-old patient who has presented for a routine concern over her current
weight. In your patient teaching with her, you explain the importance of macronutrients. Which of the
following is a macronutrient?
Fat
76. Which of the following organs is part of the alimentary tract?
continuous tract from the mouth to the esophagus, stomach, small intestine, large intestine, and
anus

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77. Mr. Sanchez is a 45-year-old gentleman who has presented to the office for a physical examination to
establish a new primary care health care provider. Which of the following describes a physical, not a
cultural, differentiator?
Race
78. To approximate vocal frequencies, which tuning fork should be used to assess hearing?
500 to 1000 Hz
79. During percussion, a dull tone is expected to be heard over:
The liver
80. The attitudes of the health care professional:
Culturally derived/are largely irrelevant to the success of relationships with the patient
81. When recording physical findings, which data are recorded first for all systems?
Inspection
82. Spasmodic muscular contractions of the head, face, or neck are called:
tics
83. Which of the following occurs when firm pressure is used to apply the stethoscope’s bell end-piece to
the skin?
It functionally converts to a diaphragm end-piece.
84. Differential diagnoses belong in the:
Assessment
85. Pigmented, raised, warty lesions over the face and trunk should be assessed by an experienced
practitioner who can distinguish:
seborrheic keratoses from actinic keratoses.
86. Mr. Walter’s, a 32-year-old patient, tells you that his ears are “stopped up.” An objective assessment
of this complaint is achieved by using the:
tympanometer
87. Mrs. Leonard brings her newborn infant into the pediatrician’s office for a first well-baby visit. As the
health care provider, you teach her that newborns are more vulnerable to hypothermia due to:
a poorly developed subcutaneous fat layer.
88. Tympanic thermometers measure body temperature when a probe is placed:
Eardrum (in the ear)
89. A serous membrane that lines the abdominal cavity and forms a protective cover for many abdominal
structures is the:
peritoneum
90. White, rounded, or oval ulcerations surrounded by a red halo and found on the oral mucosa are:
aphthous ulcers (canker sores)
91. When assessing abdominal pain in a college-age woman, one must include:
the first day of the last menstrual period.

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92. Your patient is complaining of acute, intense sharp epigastric pain that radiates to the back and left
scapula with nausea and vomiting. Based on this history, your prioritized physical examination should be
to:
inspect for ecchymosis of the flank.
93. The infant should be placed in which position to have his or her height or length measured?
Supine on a measuring board
94. Mr. Marks is a 66-year-old patient who presents for a physical examination to the clinic. Which
question has the most potential for exploring a patient’s cultural beliefs related to a health problem?
"Why do you think you are having these symptoms?"
95. Which of the following is the most vital nutrient?
water
96. What finding is unique to the documentation of a physical examination of an infant?
Fontanel size
97. Mrs. G. reports an increase in her alcohol intake over the past 5 years. To screen her for problem
drinking, you would use the:
CAGE questionnaire
98. Mr. D. complains of a headache. During the history he mentions his use of alcohol and illicit drugs.
This information would most likely belong in the:
personal and social history
99. You are completing a general physical examination on Mr. Rock, a 39-year-old man with complaints
of constipation. When examining a patient with tense abdominal musculature, a helpful technique is to
have the patient:
flex his or her knees
100. When communicating with older children and teenagers, you should be sensitive to their:
typical reluctance to talk
101. Periods of silence during the interview can serve important purposes, such as: Providing time for
reflection.
 Question 1
1 out of 1 points
Mr. Franklin is speaking with you, the health care provider, about his respiratory problem.
Mr. Franklin says, "I've had this cough for 3 days, and it's getting worse." You reply, "Tell
me more about your cough." Mr. Franklin states, "I wish I could tell you more. That's why
I'm here. You tell me what's wrong!" Which caregiver response would be most appropriate
for enhancing communication?
 Question 2
1 out of 1 points
Before performing an abdominal examination, the examiner should:

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 Question 3
1 out of 1 points
Periods of silence during the interview can serve important purposes, such as:
 Question 4
1 out of 1 points
Your patient presents with symptoms that lead you to suspect acute appendicitis. Which
assessment finding is least likely to be associated with this condition early in its course?
 Question 5
1 out of 1 points
To perform the Rinne test, place the tuning fork on the:
 Question 6
1 out of 1 points
As part of your health promotion education for a new patient, you explain that the risk
factors for skin cancer include:
 Question 7
1 out of 1 points
A brief statement of the reason the patient is seeking health care is called the:
 Question 8
1 out of 1 points
When assessing abdominal pain in a college-age woman, one must
include:
 Question 9
1 out of 1 points
Peritonitis produces bowel sounds that are:
 Question 10
1 out of 1 points
The most superior part of the stomach is the:
 Question 11
1 out of 1 points
To approximate vocal frequencies, which tuning fork should be used to assess hearing?

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 Question 12
1 out of 1 points
Which of the following is the most vital nutrient?
 Question 13
1 out of 1 points
Which of the following is an expected change in the assessment of the thyroid during
pregnancy?
 Question 14
1 out of 1 points
Mr. Donalds is a 45-year-old roofer. Your inspection to determine color variations of the
skin is best conducted:
 Question 15
1 out of 1 points
Peritonitis produces bowel sounds that are:
 Question 16
1 out of 1 points
Macronutrients are so named because they:
 Question 17
1 out of 1 points
In examining the neck of a 34-year-old female patient, you note that the uppermost ridge
of the tracheal cartilage is at the:
 Question 18
1 out of 1 points
Which of the following occurs when firm pressure is used to apply the stethoscope's bell
end-piece to the skin?
 Question 19
1 out of 1 points
You have just completed a skin assessment on Mr. Baker. During your assessment, you
have transilluminated a skin lesion. During the physical examination, you know that skin
lesions are transilluminated to distinguish:

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 Question 20
1 out of 1 points
The position on a clock, topographic notations, and anatomic landmarks:
 Question 21
1 out of 1 points
Mrs. Kinder is a 39-year-old patient who presents to the office with
complaints of an earache. In explaining to the patient about the function
of her ears, which ear structure would you tell her is responsible for
equalizing atmospheric pressure when swallowing, sneezing, or yawning?
 Question 22
1 out of 1 points
Ms. Jones is a 31-year-old female patient who presents for a routine
physical examination. Which examination technique will be used first?
 Question 23
1 out of 1 points
When recording physical findings, which data are recorded first for all systems?
 Question 24
1 out of 1 points
Percussing at the right midclavicular line, below the umbilicus, and
continuing upward is the correct technique for locating the:
 Question 25
1 out of 1 points
Ms. G. is being seen for her routine physical examination. She is a college graduate and
president of a research firm. Although her exact salary is unknown, she has adequate
health insurance. Most of the above information is part of Ms. G.'s _____ history.
 Question 26
1 out of 1 points
You are planning to palpate the abdomen of your patient. Which part of
the examiner's hand is best for palpating vibration?
 Question 27
1 out of 1 points
Which of the following is an "ABCD" characteristic of malignant melanoma?

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 Question 28
1 out of 1 points
Mrs. Webb is a 38-year-old patient who has been changing her lifestyle to
eat in a healthy way and lose weight. During your health promotion
education regarding her nutritional status, you explain the function of
dietary protein as:
 Question 29
0 out of 1 points
George Michaels, a 22-year-old patient, tells the nurse that he is here
today to "check his allergies." He has been having "green nasal discharge"
for the last 72 hours. How would the nurse document his reason for
seeking care?
 Question 30
1 out of 1 points
Sweat glands, hair, and nails are all formed from:
 Question 31
0 out of 1 points
Your patient returns for a blood pressure check 2 weeks after a visit during which you
performed a complete history and physical. This visit would be documented by creating
a(n):
 Question 32
1 out of 1 points
Your patient is complaining of acute, intense sharp epigastric pain that
radiates to the back and left scapula with nausea and vomiting. Based on
this history, your prioritized physical examination should be to:
 Question 33
1 out of 1 points
Expected normal percussion tones include:
 Question 34
0 out of 1 points
Recommended carbohydrate content of total dietary intake (% total calories) is ____
%.
 Question 35

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1 out of 1 points
Underestimation of blood pressure will occur if the blood pressure cuff's width covers:
 Question 36
1 out of 1 points
Which technique is most likely to result in the patient's understanding of questions?
 Question 37
1 out of 1 points
Which question would be considered a leading question?
 Question 38
1 out of 1 points
Spasmodic muscular contractions of the head, face, or neck are called:
 Question 39
1 out of 1 points
Tangential lighting is best used for inspecting skin:
 Question 40
1 out of 1 points
Small, minute bruises are called:
 Question 41
1 out of 1 points
When examining the skull of a 4-month-old baby, you should normally find:
 Question 42
1 out of 1 points
Mr. L. presents to the clinic with severe groin pain and a history of kidney stones. Mr. L.'s
son tells you that, for religious reasons, his father wishes to keep any stone that is passed
into the urine filter that he has been using. What is your most appropriate response?
 Question 43
1 out of 1 points
What finding is unique to the documentation of a physical examination of an infant?

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 Question 44
0 out of 1 points
The recommended minimum daily protein requirement for the normal adult is
______.
 Question 45
1 out of 1 points
Ms. Davis is a 27-year-old patient with a BMI of 33. Based on her BMI, your
diagnosis would be:
 Question 46
1 out of 1 points
As you explain your patient's condition to her husband, you notice that he is leaning
toward you and pointedly blinking his eyes. Knowing that he is from England, your most
appropriate response to this behavior is to:
 Question 47
1 out of 1 points
Which of the following organs is part of the alimentary tract?
 Question 48
1 out of 1 points
Mr. Abdul is a 40-year-old Middle Eastern man who presents to the office
for a first visit with the complaint of new abdominal pain. You are
concerned about violating a cultural prohibition when you prepare to do
his rectal examination. The best tactic would be to:
 Question 49
1 out of 1 points
Tuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure:
 Question 50
1 out of 1 points
During an interview, tears appear in the patient's eyes and his voice becomes shaky.
Initially, you should:
 Question 51
1 out of 1 points
Tympanic thermometers measure body temperature when a probe is
placed:

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 Question 52
1 out of 1 points
Under normal circumstances, how much water is lost daily by the body?
 Question 53
1 out of 1 points
After thorough inspection of the abdomen, the next assessment step is:
 Question 54
1 out of 1 points
Mrs. Britton is a 34-year-old patient who presents to the office with complaints of skin
rashes. You have noted a 4' 3-cm, rough, elevated area of psoriasis. This is an example of
a:
 Question 55
1 out of 1 points
Which cranial nerves innervate the face?
 Question 56
1 out of 1 points
Which technique is most likely to result in the patient's understanding of questions?
 Question 57
1 out of 1 points
Which of the following is the most accurate reflection of an individual's food intake?
 Question 58
1 out of 1 points
When assessing abdominal pain in a college-age woman, one must
include:
 Question 59
1 out of 1 points
The infant should be placed in which position to have his or her height or length
measured?
 Question 60

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NURS6512 Walden University Clinical Analysis Midterm Exam Week 6 With Answers (200 Solved Questions)

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