Question 11 ptsThe nurse is performing a general survey. Which action is a component of the general survey?Group of answer choicesObserving the patient’s body stature and nutritional statusInterpreting the subjective information the patient has reportedMeasuring the patient’s temperature, pulse, respirations, and blood pressureObserving specific body systems while performing the physical assessmentFlag question: Question 2Question 21 ptsThe nurse is assessing an 80-year-old male patient. Which assessment findings would be considered normal?Group of answer choicesIncrease in body weight from his younger yearsAdditional deposits of fat in the cheeks and forearmsPresence of kyphosis and flexion in bilateral knees and hipsChange in overall body proportion, including a longer trunk and shorter extremitiesFlag question: Question 3Question 31 ptsIn a patient with acromegaly, which assessment finding will the nurse expect to find?Group of answer choicesSternal deformity and hyperextensible jointsGrowth retardation and a delayed onset of pubertyOvergrowth of bone in the face, head, hands, and feetIncreased height and weight and delayed sexual developmentFlag question: Question 4Question 41 ptsDuring an examination, the nurse notices that a female patient has a round “moon” face, central trunk obesity, and a cervical hump. Her skin is fragile with bruises. The nurse determines that the patient likely has which condition?Group of answer choicesGigantismAcromegalyCushing syndromeMarfan syndromeFlag question: Question 5Question 51 ptsThe nurse is preparing to measure the length, weight, chest, and head circumference of a 6-month-old infant. Which measurement technique is correct?Group of answer choicesMeasuring the infant’s length by using a tape measureWeighing the infant by placing him or her on an electronic standing scaleMeasuring the chest circumference at the nipple line with a tape measureMeasuring the head circumference by wrapping the tape measure over the nose and cheekbonesFlag question: Question 6Question 61 ptsA 60-year-old male patient has been treated for pneumonia for the past 6 weeks. He is seen today in the clinic for an “unexplained” weight loss of 10 pounds over the last 6 weeks. Which is an appropriate rationale for this patient’s weight loss?Group of answer choicesChronic diseases such as hypertension cause weight loss.Weight loss is probably the result of unhealthy eating habits.Unexplained weight loss often accompanies short-term illnesses.Weight loss is probably the result of a mental health dysfunction.Flag question: Question 7Question 71 ptsWhich of these specific measurements is the best index of a child’s general health?Group of answer choicesBody mass indexHeight and weightHead circumferenceChest circumferenceFlag question: Question 8Question 81 ptsWhen assessing a 75-year-old patient who has asthma, the nurse notes that he assumes a tripod position, leaning forward with arms braced on the chair. How should the nurse interpret these findings?Group of answer choicesAssume that the patient is eager and interested in participating in the interview.Evaluate the patient for abdominal pain, which may be exacerbated in the sitting position.Assume that the patient is having difficulty breathing and assist him to a supine position.Recognize that a tripod position is often used when a patient is having respiratory difficulties.Flag question: Question 9Question 91 ptsThe nurse is assessing an 8-year-old child whose growth rate measures below the third percentile for a child his age. He appears significantly younger than his stated age and is chubby with infantile facial features. Which condition does this child likely have?Group of answer choicesAcromegalyMarfan syndromeHypopituitary dwarfismAchondroplastic dwarfismFlag question: Question 10Question 101 ptsWhich of these guidelines should a nurse follow when measuring a patient’s weight?Group of answer choicesThe patient is always weighed wearing only his or her undergarments.The type of scale does not matter, as long as the weights are similar from day to day.The patient may leave on his or her jacket and shoes as long as these are documented next to the weight.Attempts should be made to weigh the patient at approximately the same time of day, if a sequence of weights is necessary.
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