Nurse Practitioner Clinical Assessment
Exam Materials
Course Introduction
Nurse Practitioner Clinical Assessment is a comprehensive course that equips advanced nursing students with the essential knowledge and hands-on skills necessary to conduct thorough, evidence-based health assessments across the lifespan. Emphasizing a holistic and patient-centered approach, the course covers advanced techniques in history taking, physical examination, and diagnostic reasoning. Students will learn to integrate findings from physical, psychological, and social assessments to formulate differential diagnoses and develop appropriate care plans. Through a combination of lectures, case studies, and practical simulations, students gain the competence required to provide high-quality care in diverse clinical settings.
Recommended Textbook
Seidels Guide to Physical Examination 9th Edition by Jane W. Ball
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26 Chapters
648 Verified Questions
648 Flashcards
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Chapter 1: The History and Interviewing Process
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22 Verified Questions
22 Flashcards
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Sample Questions
Q1) 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:
A) chief complaint.
B) past medical history.
C) personal and social history.
D) review of systems.
Answer: C
Q2) JM has been seen in your clinic for 5 years. She presents today with signs and symptoms of acute sinusitis. The type of history that is warranted is a(n) _________ history.
A) complete
B) inventory
C) problem or focused
D) interim
Answer: C
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Chapter 2: Cultural Competency
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18 Verified Questions
18 Flashcards
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Sample Questions
Q1) Campinha-Bacote's Process of Cultural Competence Model includes which cultural constructs? (Select all that apply.)
A) Desire
B) Awareness
C) Thought processes
D) Skill
E) Language
Answer: A, B, D
Q2) The definition of ill or sick is based on a:
A) stereotype.
B) cultural behavior.
C) belief system.
D) cultural attitude.
Answer: C
Q3) The attitudes of the healthcare professional:
A) are largely irrelevant to the success of relationships with the patient.
B) do not influence patient behavior.
C) are difficult for the patient to sense.
D) are culturally derived.
Answer: D
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Chapter 3: Examination Techniques and Equipment
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29 Verified Questions
29 Flashcards
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Sample Questions
Q1) Expected normal percussion tones include:
A) dullness over the lungs.
B) hyperresonance over the lungs.
C) tympany over an empty stomach.
D) flatness over an empty stomach.
Answer: C
Q2) 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?
A) Light palpation
B) Deep palpation
C) Percussion
D) Auscultation
Answer: D
Q3) During percussion, a dull tone is expected to be heard over:
A) healthy lung tissue.
B) emphysemic lungs.
C) the liver.
D) most of the abdomen.
Answer: C
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Chapter 4: Clinical Reasoning
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15 Flashcards
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Sample Questions
Q1) Which of the following is not a component of a management plan?
A) Presumptive diagnosis
B) Patient education
C) Diet modification
D) Physical therapy
Q2) After the subjective and objective data have been prioritized, the next step is to:
A) order laboratory tests.
B) formulate a problem list.
C) initiate appropriate referrals.
D) initiate therapy.
Q3) Positive outcomes depend on the:
A) number of laboratory tests ordered.
B) quality of decisions made.
C) use of pharmacologic modalities.
D) time saved by the use of ancillary personnel.
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6
Chapter 5: Documentation
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23 Flashcards
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Sample Questions
Q1) The patient's perceived disabilities and functional limitations are recorded in the:
A) problem list.
B) general patient information.
C) social history.
D) history of present illness.
Q2) Regardless of the origin, discharge is described by noting:
A) a grading scale of 0 to 4.
B) color and consistency.
C) demographic data and risk factors.
D) associated symptoms in alphabetic order.
Q3) The position on a clock, topographic notations, and anatomic landmarks:
A) are methods for recording locations of findings.
B) are used for noting disease progression.
C) are ways for recording laboratory study results.
D) should not be used in the legal record.
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Chapter 6: Vital Signs and Pain Assessment
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11 Verified Questions
11 Flashcards
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Sample Questions
Q1) Infants delivered by Cesarean section demonstrate which respiratory characteristic in comparison to infants delivered vaginally?
A) Slower respiratory rate
B) Faster respiratory rate
C) Shallower respirations
D) Deeper respirations
Q2) Underestimation of blood pressure will occur if the cuff's width covers:
A) less than half of the upper arm.
B) less than 5 inches of the lower arm.
C) more than two-thirds of the upper arm.
D) more than 4 inches of the lower arm.
Q3) In a syndrome in which regional pain extends beyond this specific peripheral nerve injury, you would notice which of the following? (Select all that apply.)
A) Allodynia
B) Sleep disturbance
C) Blood flow changes
D) Numbness
E) Edema
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8
Chapter 7: Mental Status
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27 Verified Questions
27 Flashcards
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Sample Questions
Q1) The ability for abstract thinking normally develops during:
A) infancy.
B) early childhood.
C) adolescence.
D) adulthood.
Q2) The Mini-Mental State Examination (MMSE) should be administered for the patient who:
A) gets lost in her neighborhood.
B) sleeps an excessive amount of time.
C) has repetitive ritualistic behaviors.
D) uses illegal hallucinogenic drugs.
Q3) The examiner should be concerned about neurologic competence if a social smile cannot be elicited by the time a child is _________ old.
Q4) When is the mental status portion of the neurologic system examination performed?
A) During the history-taking process
B) During assessment of cranial nerves and deep tendon reflexes
C) During the time when questions related to memory are asked
D) Continually, throughout the entire interaction with a patient
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9
Chapter 8: Growth, Measurement, and Nutrition
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39 Verified Questions
39 Flashcards
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Sample Questions
Q1) By 10 to 12 years of age, lymphatic tissues are about:
A) 25% of adult size.
B) 50% of adult size.
C) the same as adult size.
D) twice the size of those in the adult.
Q2) What is the youngest age at which pubic hair growth in the male may be considered normal?
A) 7 years
B) 8 years
C) 9 years
D) 10 years
Q3) During a preventive healthcare visit, Ms. G, an older patient, states that she is getting shorter. She says that her son mentioned that her change in stature became noticeable to him during his last visit with her. Her posture appears straight and aligned. When addressing Ms. G.'s present concerns, it is most important to inquire about:
A) the number of pregnancies.
B) her parents' heights.
C) a history of scoliosis.
D) her usual height and weight.
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Page 10
Chapter 9: Skin, Hair, and Nails
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49 Verified Questions
49 Flashcards
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Sample Questions
Q1) Expected hair distribution changes in older adults include:
A) increased terminal hair follicles on the scalp.
B) more prominent axillary and pubic hair production.
C) increased terminal hair follicles to the tragus of men's ears.
D) more prominent peripheral extremity hair production.
Q2) The adipose tissue in the hypodermis serves to:
A) provide sensory input.
B) generate heat and insulate.
C) create tensile strength.
D) secrete collagen.
Q3) You are examining a pregnant patient and have noted a vascular lesion. When you blanch over the vascular lesion, the site blanches and refills evenly from the center outward. The nurse documents this lesion as a:
A) telangiectasia.
B) spider angioma.
C) petechiae.
D) purpura.
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11
Chapter 10: Lymphatic System
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22 Flashcards
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Sample Questions
Q1) The harder and more discrete a node, the more likely that there is a(n):
A) innocent cause.
B) infection.
C) malignancy.
D) metabolic disease.
Q2) Mrs. Sing is a 44-year-old patient who presents to the office with a complaint of enlarged lymph nodes. When enlarged, which lymph nodes are most likely to be a sign of pathology (e.g., malignancy)?
A) Occipital
B) Anterior cervical
C) Supraclavicular
D) Femoral
Q3) Mr. Shea is a 45-year-old patient who presents to the office for multiple complaints. The examination of the upper left quadrant of the abdominal cavity is essential to the evaluation of the immune system because of the location of which organ?
A) Spleen
B) Liver
C) Stomach
D) Pancreas
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Page 12
Chapter 11: Head and Neck
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19 Verified Questions
19 Flashcards
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Sample Questions
Q1) Which cranial nerves innervate the face?
A) II and V
B) III and VI
C) V and VII
D) VIII and IX
Q2) During a head and neck assessment of a neonate, it is important to screen for:
A) the presence of torticollis.
B) signs and symptoms of cerebral palsy.
C) uneven movement of the eyes.
D) unilateral movement of the tongue.
Q3) Mr. Mathews is a 47-year-old patient who presents for a routine physical examination. On examination, you noted a bruit heard over the thyroid. This is suggestive of:
A) hypothyroidism.
B) hyperthyroidism.
C) thyroid cancer.
D) thyroid cyst.
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Chapter 12: Eyes
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28 Verified Questions
28 Flashcards
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Sample Questions
Q1) Cotton wool spots are most closely associated with:
A) glaucoma.
B) normal aging processes.
C) hypertension.
D) eye trauma.
Q2) Ask the patient to look directly at the light of the ophthalmoscope when you are ready to examine the:
A) retina.
B) optic disc.
C) retinal vessels.
D) macula.
Q3) When testing corneal sensitivity controlled by cranial nerve V, you should expect the patient to respond with:
A) brisk blinking.
B) copious tearing.
C) pupil dilation.
D) reflex smiling.
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14
Chapter 13: Ears, Nose, and Throat
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21 Verified Questions
21 Flashcards
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Sample Questions
Q1) To inspect the lateral borders of the tongue, you should:
A) ask the patient to extend the tongue outward.
B) insert the tongue blade obliquely against the tongue.
C) lift the tongue upward with gloved fingers.
D) pull the gauze-wrapped tongue to each side.
Q2) A hairy tongue with yellowish brown to black elongated papillae on the dorsum:
A) is indicative of oral cancer.
B) is sometimes seen following antibiotic therapy.
C) usually indicates vitamin deficiency.
D) usually indicates anemia.
Q3) Speech with a monotonous tone and erratic volume may indicate:
A) otitis externa.
B) hearing loss.
C) serous otitis media.
D) sinusitis.
Q4) When conducting an adult otoscopic examination, you should:
A) position the patient's head leaning toward you.
B) grasp the handle of the otoscope as you would a baseball bat.
C) select the largest speculum that will fit in the canal.
D) ask the patient to keep his or her eyes closed.
Page 15
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Chapter 14: Chest and Lungs
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) An Apgar score of __________ is given to the infant who demonstrates irregular respiratory effort.
Q2) A 44-year-old male patient who complains of a cough has presented to the emergency department. He admits to smoking one pack per day. During your inspection of his chest, the most appropriate lighting source to highlight chest movement is:
A) bright tangential lighting.
B) daylight from a window.
C) flashlight in a dark room.
D) fluorescent ceiling lights.
Q3) You would expect to document the presence of a pleural friction rub for a patient being treated for:
A) pneumonia.
B) atelectasis.
C) pleurisy.
D) emphysema.
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Chapter 15: Heart
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17 Verified Questions
17 Flashcards
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Sample Questions
Q1) Your patient has been diagnosed with pericarditis. Which are signs and symptoms, or a precipitating factor? (Select all that apply.)
A) Sharp pain
B) Pain relieved by sitting up
C) Pain relieved by resting
D) Friction rub heard to right of sternum
E) History of kidney failure
F) Result of viral infection
G) Result of medications such as procainamide
Q2) An apical PMI palpated beyond the fifth intercostal space may indicate:
A) decreased cardiac output.
B) obesity.
C) left ventricular hypertrophy.
D) hyperventilation.
Q3) Chest pain with an organic cause in a child is most likely the result of:
A) cardiac disease.
B) asthma.
C) esophageal reflux.
D) arthritis.
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Page 17
Chapter 16: Blood Vessels
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19 Verified Questions
19 Flashcards
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Sample Questions
Q1) You are palpating bilateral pedal pulses and cannot feel one of the pulses. The feet are equally warm. You find that both great toes are pink, with a capillary refill within 2 seconds. Which of the following statements is correct?
A) Immediate emergency surgery is indicated.
B) Pedal pulses are not always palpable.
C) Unilateral pulses are never normal.
D) Venogram studies will be needed.
Q2) Induration, edema, and hyperpigmentation are common associated findings with which of the following?
A) Peripheral arterial disease
B) Venous ulcer
C) Arterial embolic disease
D) Venous thrombus
Q3) A venous hum heard over the internal jugular vein of a child:
A) usually signifies untreatable illness.
B) usually has no pathologic significance.
C) usually requires surgical intervention.
D) must be monitored until the child is grown.
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Chapter 17: Breasts and Axillae
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Sample Questions
Q1) When conducting a clinical breast examination, the examiner should:
A) forgo the examination if the patient has had a recent mammogram.
B) keep the patient's breasts completely covered to respect modesty.
C) dim the lights to minimize anxiety.
D) inspect both breasts simultaneously.
Q2) You are conducting a clinical breast examination for your 30-year-old patient. Her breasts are symmetric, with bilateral, multiple tender masses that are freely movable and with well-defined borders. You recognize that these symptoms and assessment findings are consistent with:
A) fibroadenoma.
B) Paget disease.
C) cancer.
D) fibrocystic changes.
Q3) Most women with breast cancer:
A) possess the BRCA1 or BRCA2 gene.
B) risk increases with aging.
C) have a mother who had breast cancer.
D) continue to menstruate after age 52.
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19
Chapter 18: Abdomen
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Sample Questions
Q1) 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:
A) percuss for ascites.
B) assess for rebound tenderness.
C) inspect for ecchymosis of the flank.
D) auscultate for abdominal bruits.
Q2) An umbilical assessment in the newborn that is of concern is:
A) a thick cord.
B) umbilical hernia.
C) one umbilical artery and two veins.
D) pulsations superior to the umbilicus.
Q3) When assessing abdominal pain in a college-age woman, one must include:
A) history of interstate travel.
B) food likes and dislikes.
C) age at completion of toilet training.
D) the first day of the last menstrual period.
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Page 20
Chapter 19: Female Genitalia
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29 Flashcards
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Sample Questions
Q1) Which systemic feature is related to the effects of menopause?
A) Increased abdominal fat distribution
B) Decreased LDL levels
C) Cold intolerance
D) Decreased cholesterol levels
Q2) The vaginal mucosa of a woman of childbearing years should appear:
A) smooth and pink.
B) moist and excoriated.
C) dry and papular.
D) transversely rugated.
Q3) Pregnancy-related cervical changes include:
A) flattening and lengthening.
B) thinning and reddening.
C) hardening and pallor.
D) softening and bluish coloring.
Q4) Which risk factor is associated with cervical cancer?
A) Endometriosis
B) Low parity
C) Multiple sex partners
D) Obesity
Page 21
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Chapter 20: Male Genitalia
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Sample Questions
Q1) Which genital virus infection is known to have a latent phase followed by the production of viral DNA capsids and particles?
A) Condyloma acuminatum
B) Molluscum contagiosum
C) Herpetic lesions
D) Lymphogranuloma venereum
Q2) Inspection of the scrotum should reveal:
A) lightly pigmented skin.
B) two testes per sac.
C) smooth scrotal sacs.
D) the left scrotal sac lower than the right.
Q3) Inspection of the male urethral orifice requires the examiner to:
A) ask the patient to bear down.
B) insert a small urethral speculum.
C) press the glans between the thumb and forefinger.
D) transilluminate the penile shaft.
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22
Chapter 21: Anus, Rectum, and Prostate
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Sample Questions
Q1) Which finding in an infant may indicate lower spinal deformities?
A) Perirectal redness
B) Shrunken buttocks
C) Rectal prolapse
D) Dimpling in the pilonidal area
Q2) Mr. Dunn is a 62-year-old man who has presented for a routine annual examination. On examination of the prostate you note a hard, irregular, painless nodule and obliteration of the median sulcus. These are signs of:
A) benign prostatic hypertrophy.
B) cancer of the prostate.
C) long-standing prostatitis.
D) swelling as a result of aging.
Q3) A lower spinal cord lesion may be indicated by which finding?
A) Lack of an anal wink
B) Rectal prolapse
C) Anal fistula
D) Small flaps of anal skin
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23
Chapter 22: Musculoskeletal System
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Sample Questions
Q1) Long bones in children have growth plates known as:
A) epiphyses.
B) epicondyles.
C) synovium.
D) fossae.
Q2) The elasticity of pelvic ligaments and softening of cartilage in a pregnant woman are the result of:
A) decreased mineral deposition.
B) increased hormone secretion.
C) uterine enlargement.
D) gait changes.
Q3) Expected normal findings during the inspection of spinal alignment include:
A) asymmetric skin folds at the neck.
B) slight right-sided scapular elevation.
C) concave lumbar curve.
D) the head positioned superiorly to the gluteal cleft.
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24
Chapter 23: Neurologic System
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Sample Questions
Q1) The major function of the sympathetic nervous system is to:
A) orchestrate the stress response.
B) coordinate fine motor movement.
C) determine proprioception.
D) perceive stereognosis.
Q2) Normal changes of the aging brain include:
A) increased velocity of nerve conduction.
B) diminished perception of touch.
C) increased total number of neurons.
D) diminished intelligence quotient.
Q3) You are most concerned for the infant who has a:
A) weak palmar grasp at 3 months.
B) strong stepping reflex at 2 months.
C) weak plantar reflex at 9 months.
D) strong tonic neck at 6 months.
Q4) Which condition is consistent with Brown-Séquard syndrome?
A) Central sensory loss that is generalized
B) Motor paralysis on the lesion side of the body
C) Multiple peripheral neuropathy of the joints
D) Spinal root paralysis below the umbilicus
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Chapter 24: Sports Participation Evaluation
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Sample Questions
Q1) You are conducting a preparticipation physical examination for a 10-year-old girl with Down syndrome who will be playing basketball. She has slight torticollis and mild ankle clonus. Which additional diagnostic test would be required for her?
A) Cervical spine radiography
B) Visual acuity
C) Mini-Mental State Examination
D) Nerve conduction studies
Q2) A child has a poorly controlled seizure disorder. He has restricted sports participation but would be able to engage in:
A) archery.
B) swimming.
C) weight lifting.
D) badminton.
Q3) The checkout station for preparticipation physical evaluation is critical because at this point:
A) all completed forms are distributed.
B) parental signatures are obtained.
C) the relevant history is obtained.
D) the coordination of follow-ups is reviewed.
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Page 26
Chapter 25: Putting it All Together
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Sample Questions
Q1) Palpation of the epitrochlear nodes is part of the:
A) examination of the upper extremities.
B) assessment of the chest and thorax.
C) palpation of the abdomen.
D) examination of the head and neck.
Q2) Which is true regarding the relationship between the examiner and patient?
A) It is the examiner's responsibility to help the patient understand that he or she is qualified to make decisions regarding health care.
B) The patient must trust the examiner completely.
C) The examiner-patient relationship is enhanced by ignoring cultural issues.
D) The patient is a full partner with the examiner.
Q3) Which cannot be assessed in the crying infant?
A) Tactile fremitus
B) Respiratory rate
C) Lung excursion
D) Facial symmetry
Q4) Mrs. Jones is a 44-year-old patient who presents for a routine physical examination. The patient is unable to shrug her shoulders against the examiner's hands during the examination. The cranial nerve involved with successful shoulder shrugging is CN ____.
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Chapter 26: Emergency or Life-Threatening Situations
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Sample Questions
Q1) Which injury is the most common precipitator of blunt trauma?
A) Age-related falls
B) Motor vehicle accidents
C) Work-related injuries
D) Childhood play injuries
Q2) The term status epilepticus is defined as:
A) convulsive activity uncontrolled by medication.
B) nonconvulsive brain wave disturbance, with psychomotor dysfunction.
C) prolonged seizures that occur without recovery of consciousness.
D) seizures that result in hypotension, pallor, and prolonged diaphoresis.
Q3) Clear or amber drainage from the nose or ears of a blunt trauma patient may indicate:
A) epiglottitis.
B) a retropharyngeal abscess.
C) a basilar skull fracture.
D) a perforated tympanic membrane.
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