SET A

ARELLANO UNIVERSITY Jose Abad Santos Campus, Pasay City College of Nursing MIDTERM EXAMINATION HEALTHCARE I SKILLS NAME_____________________________________ COURSE / YEAR & SEC____________________
GENERAL INSTRUCTION:

DATE_______________ SCORE__________

MULTIPLE CHOICE. Choose the best answer from among the options provided. Shade

the circle that corresponds to your answer on a separate answer sheet.

:A

MR. CHRISTOPHER L. CALNEA, 45 years old, married, was admitted to the hospital due to fever, productive cough and rapid, labored breathing. His wife who went with him said that 2 weeks ago, he had colds and frequent, dry cough which resulted to shortness of breath on exertion. Yesterday, one day after admission, the health care provider reported that Mr. Calnea had high fever (38 degrees Celcius) and had began to experience pain in his chest during inspiration. But, his temperature dropped to 36 degrees Celcius 3 hours after he took 500 mgs of PARACETAMOL that was administered by the health care provider. 1. The underlined data in the paragraph above comprise what component of Health History? a. Social Data c. Biographic Data b. Lifestyle d. Past History 2. Which of the following data is/are also included in the category mentioned in number 1? a. Ethnic Affiliation c. Personal Habits b. Occupation d. a & c 3. In the paragraph, the phrases in bold letters is/are the a. Chief Complaints c. History of Present Illness b. Past History d. a & c 4. The answer/s in number 3 is/are a. signs c. components of Health History b. symptoms d. b & c 5. Which of the following statements about the paragraph above is/are true? a. It contains information on History of Present Illness b. There are Psychologic Data c. There is information on Patterns of Health Care d. a & c 6. The fact that Mr. Calnea has taken PARACETAMOL for his fever form part of the data on his a. History of Present Illness c. Past History b. Patterns of Health Care d. all of the above 7. The PARACETAMOL given to Mr. Calnea by the health care provider is a form of a. relief from discomfort c. cure b. ease from discomfort d. a & c 8. Other data included in the answer/s in number 6 is/are except: a. allergies b. hospitalization for serious illness c. factors that worsen his health problem d. childhood illnesses 9. The health care provider should assess the intensity of the pain that Mr. Calnea experiences in the chest during respiration because it is included in what sub-component of Health History? a. Psychologic Data b. History of Present Ilness c. Past History d. Chief Complaint

10. The Components of Health History is a tool which can ensure that a. the health problem of a client/patient is accurately defined & effectively resolved b. the health care provider will not have a difficult time taking care of the client/patient c. health care provider will not earn the anger of a client/patient and his significant others d. b & c S I T U A T I O N :B The health care provider decides to do further Interview and conduct a thorough Physical Health Assessment of Mr. Calnea. 11. The health care provider should start the physical assessment by a. preparing the client physically and psychologically for the procedure b. preparing all the equipment and materials needed c. ensuring that the environment is well-lit, quiet, private, well-ventilated d. all of the above 12. Physical Health Assessment in this situation is done to a. obtain a baseline data about Mr. Calneas functional abilities b. to establish rapport with the client c. to evaluate the progress of the clients health problem d. a & c 13. In general, the other purpose/s of the said assessment include/s a. to supplement and confirm data found in the clients Health History b. to evaluate the physiologic outcomes of health care the client receives c. to identify areas for health promotion and disease prevention d. all of the above 14. The health care provider remembers that preliminary examination requires General Survey. This survey includes all of the following except: a. taking Mr. Calneas vital signs b. taking his height and weight c. describing his general appearance and behavior d. none of the above 15. Mr. Calneas physical health assessment will begin a. at the skull b. at the posterior thorax c. at the upper extremities d. anterior thorax 16. The health care provider understands that the best position for the clients assessment is the a. sims position b. sitting position c. dorsal recumbent d. prone position 17. The answer in number 16 is properly done when a. client is made to lie on his abdomen with head turned to the side; with or without a small pillow b. client is made to lie on her back with legs extended; with or without a pillow under the head c. client is made to sit, back unsupported and legs hanging freely d. client is made to sit, back and legs supported 18. The client requested that Mrs. Calnea stay with him in the room during the Physical Assessment. The health care provider should a. not grant this request and explain that he (the health care provider) cant concentrate if Mrs. Calnea was inside the examination room b. allow Mrs. Calnea to stay while the assessment is done c. not allow Mrs. Calnea to stay and explain that the client needs utmost privacy d. ignore the request as the health care provider knows what is best for the client 19. If Mr. Calneas chest shape and size is considered normal, a. its anteroposterior diameter is half its transverse diameter b. its transverse diameter is half its anteroposterior diameter c. the thorax is oval d. a & c 20. Mr. Calneas posterior chest is palpated for respiratory excursion (thoracic expansion). When the client took a deep breath, the health care providers thumbs separated 2 inches and at the same time. The result of the test is a. full and asymmetric expansion of the lungs

b. decreased and asymmetric expansion of the lungs c. full and symmetric expansion of the thorax d. decreased and symmetric expansion of the thorax 21. Palpation of vocal (tactile) fremitus is done. The health care provider, discovered bilateral symmetry of vocal fremitus immediately. He says to himself that it is so much easier to do so in men than women because a. women have more adipose tissues underneath their skins b. males have low-pitched voices c. males usually have larger body surfaces d. b & c 22. The health care provider auscultates Mr. Calneas posterior thorax. Proper use of this technique requires listening to a total of how many areas/sites with a stethoscope? a. 13 b. 15 c. 10 d. 7 S I T U A T I O N :C Having examined the part of Mr. Calneas anatomy which the health care provider decided had to come ahead because of the presenting complaints, he continues to assess the other parts. 23. Palpation of the skull should result to findings about a. proportionality to the size of the body b. presence of prominences c. symmetry in of its planes d. all of the above 24. The health care provider wishes to describe the hair distribution, thickness, and lubrication. He has to use what technique? a. palpation b. inspection c. auscultation d. a & b 25. The health care provider is wrong if he classifies the hair on Mr. Calneas scalp as a. vellus hair b. terminal hair c. a combination of vellus and terminal hairs d. a & c 26. But, he is correct if he classifies the hair on Mr. Calneas armpit as a. vellus hair b. terminal hair c. a combination of vellus and terminal hair d. a & c 27. The care provider examines Mr. Calneas eyes. He should be finished with inspection of the general appearance of this part if he has observed for a. placement, symmetry, protrusion, clarity, b. placement, symmetry, protrusion, clarity, lacrimation c. placement, symmetry, protrusion, clarity, movement d. placement, symmetry, protrusion, clarity, movement, visual field 28. Mr. Calneas pupils were normally reactive to light. This means that a. they constricted when light was flashed; dilated when light was removed b. they dilated when light was flashed; constricted when light was removed c. they constricted when eyes were focused on objects near; dilated when focused on objects far d. a & c 29. Mr. Calnea cannot read. What would the health care provider use to test his visual acuity? a. eye chart b. Snellen Standard chart c. Snellen E chart d. Progress chart 30. The visual acuity of Mr. Calneas left eye is 20/40. This means that his left eye a. is able to see at 40 feet what an individual with normal vision can see at 20 feet. b. has good visual acuity c. is able to read at 20 feet what an individual with normal vision can see at 40 feet d. a & b 31. The health care provider plans to refer Mr. Calnea to an optalmologist after the assessment.

This intervention is a. correct b. not correct as the visual acuity of his left eye is expected of people who are 45 years old and above c. not correct as giving opinions is not therapeutic d. b & c 32. Mr. Calnea was made to cover his right eye and to look directly at the health care providers nose. The care giver covered his left eye and looked directly to the clients nose, extended his arm and moved into the visual field from various points in the periphery. The test done is meant to a. assess peripheral vision b. assess visual fields c. determine astigmatism d. determine presbyopia (loss of elasticity of the lens of the eyes) which normally starts at 45 years old
33. The result for the test done in number 46 will be accurate if client sat directly in front of care giver at a distance of 4 feet

a. when the arm of the care giver was moved 60 degrees superiorly, 90 degrees temporally, 70 degrees inferiorly b. when then care givers arm was moved 70 degrees superiorly, 90 degrees temporally, 60 degrees inferiorly c. a & b 34. Mr. Calneas ear canal was inspected. The canal should be straightened if the care giver will a. pull the pinna down and back b. pull the pinna up and back c. requests the client to open his mouth d. b & c 35. Care giver declared that Mr. Calneas gums are retracted. This means that a. his gums are pulling away from the teeth b. his gums are covering the teeth c. his gums have swelling d. b & c 36. Mr. Calnea shrugged his shoulders against the resistance of the care givers hand. This procedure a. determined the strength of the sternocleidomastoid muscles b. determined the strength of the trapezius muscles c. determined the presence of reflexes d. a & c 37. Physical Examination is done when? a. client is admitted to the hospital or long term care facility b. routine screening to promote preventive health care c. determination of eligibility for health insurance d. a and b 38. During assessment of the eyes the equipments needed are the following except? a. penlight c. tongue depressor b. Snellens chart d. ophthalmoscope 39. The general appearance of a client would include all of the following except: a. signs of distress c. posture and gait b. thought process d. type of clothing 40. The correct sequence of examining the head should be: a. scalp, face , eyes, ears c. scalp , hair, face , eyes b. skull, hair , scalp, eyes d. eyes, ears, nose, face 41. It refers to a persons feeling as they appear to others: a. mood c. emotion b. affect d. posture and gait 42. In inspecting the eye, you should observe for the following except: a. placement c. symmetry b. formation d. acuity 43. To test the pupils for accommodation, you would need to: a. use snellens chart b. use a penlight and shine light directly to the clients pupils c. use a penlight and move it in an H formation d. use your finger and position it 4-6 inches from the clients nose, then move the

finger away 44. The normal vision is a. 10 / 10 b. 20/20 c. 30 / 30 d. 40 / 40

46. The numerator in the visual acuity measure refers to: a. distance that the normal person can read the line b. distance from the chart c. age at which the client can read the line d. none of the above 47. Descriptor for a percussion sound that is moderate in intensity, moderate in duration, of high pitch, thudlike and normally located over organs. a. deep palpation c. duration b. dullness d. intensity 48. The description for a percussion sound that is loud in intensity, long in duration, of high pitch, drumlike and normally located over a gastric bubble is: a. flatness c. palpation b. hyperresonance d. tympany 49. The use of ones own sense to consciously observe the patient in the physical assessment of vision, hearing, smell and touch refers to: a. direct auscultation c. inspection b. direct percussion d. none of these 50. Using the plexor to strike the pleximeter in order to elicit sound refers to a. direct fist percussion c. palpation b. direct percussion d. indirect percussion 51. Touching the patient in a diagnostic manner to elicit specific information refers to: a. duration c. auscultation b. palpation d. indirect percussion 52. It is an assessment by active listening to body sounds via amplification or mechanical device such as stethoscope or Doppler ultrasound: a. Auscultation c. plexor b. direct percussion d. pleximeter 53. Percussion sound that is loud in intensity, moderate to long in duration, low in pitch, hollow and normally located in healthy lungs is classifieds as: a. duration c. resonance b. hyperresonance d. dullness 54. A time or period over which sound is heard a. duration b. intensity c. quality d. pitch

55. A stationary finger of the non-dominant hand used in indirect percussion is known as: a. plexor c. pleximeter b. fremitus d. plexus 56. A percussion sound that is soft in intensity, short in duration, and of high pitch and is normally located over a muscle or bone: a. flat c. resonance b. dullness d. tympany 57. The healthcare worker documents that there is a hyperresonance upon percussion of the clients lungs. A hyper-resonant is described as: a. A musical or drumlike sound produced in an air-filled organ. b. An extremely dull sound produced by a very dense tissue. c. Described as a booming and can be heard over an abnormal lung d. A thudlike sound produced by a very dense tissue 58. To palpate for tactile fremitus, the healthcare provider should: a. ask the patient to cough while palpating b. do a deep palpation for any abnormal lung movement c. palpate the anterior and posterior chest while asking the client to take a deep breath d. Ask the client to repeat words such as ninety nine or tres- tres while palpating the posterior thorax. 59. In what sites should the healthcare provider auscultate the heart? a. apical, sternal , costal, mitral b. aortic , pulmonic, tricuspid, mitral

c. lateral, anterior, posterior, apical d. carotid,aortic,jugular, coronary 60. In inspection, the following principles shall be observed except: a. provide for adequate lighting b. exposed all the body parts whether it is going to be assessed or not c. use additional light to expose the body cavities d. inspect each area for size, shape, symmetry, color , position and abnormalities 61. The pal mar surface of the hand is best used to assess the following, except: a. texture c. vibration b. pulsation d. temperature 62. The part of the stethoscope used for assessing bowel sound is: a. bell c. Y pipes b. diaphragm d. earpiece 63. In assessing the abdomen the client is placed in a dorsal recumbent position, This position is best described as: a. sitting b. lying flat on bed c. lying with a small pillow d. lying with small pillow and knees flexed 64. The diaphragm of the stethoscope is best used for assessing a. heart sound c. lung sound b. bowel sound d. both a and c

65. In the examination of the normal skull, prominences should be noted in the following areas: a. frontal and parietal b. parietal and occipital c. temporal and occipital d. frontal and occipital 66. During the inspection of the scalp, the healthcare worker should note for the following except: a. lice c. dandruff b. nits d. areas of tenderness 67. Examination of the eyes includes the following except: a. eye movement c. vision quest b. visual acuity d. field of vision 68. When inspecting the ear canal of an adult client, the examiner should pull the ear: a. downward and forward c. upward and forward b. downward and backward d. upward and backward 69. PERRLA stands for a. Pupils equal remain reactive to light and accommodation b. Pupils equilateral round reactive to light and accommodation c. Pupils equal ,round ,reactive to light and accommodation d. Pupils equal round reactive to light and alteration 70. Visual acuity is tested by a. Determining the smallest line of print from which the client is able to correctly identify all figures. b. determining the smallest line of print from which the client is able to correctly identify more than half of the figures c. determining the largest line of print from which the client is able to correctly identify more than half of the figures d. determining the largest line of print from which the client is able to correctly identify all figures 71. Accommodation is best described as: a. the ability of the eye to identify the figures from a distance b. the ability of the eye to adjust to objects at varying distances c. the ability of the eye to react to light and darkness d. the ability of the eye to blink 72. In inspecting the iris, the examiner should note for the following, except: a. texture c. symmetry b. color d. shape 73. In examining the client for eye movement, the client should be instructed to:

a. b. c. d.

face the direction opposite the object look straight ahead not to move the head turn the head to the direction of the object

74. When eliciting for tactile fremitus, the normal findings should be: a. vibrations should be bilaterally symmetrical b. vibrations are most intense at the 5th ICS at the sternal border c. vibrations are equal at the upper and lower portion of the thorax d. none of the above 75. Palpation a. b. c. d. of the breast is best done during what time? during menstruation a week before menstruation a week after menstruation during ovulation

76. Before concluding that the bowel sound is absent, the examiner should listen for at least a. 1 minute c. 1 minute b. 3 minutes d. 7 minutes 77. All of the following are normal sounds produced through percussion except: a. flat c. tympanic b. dull d. bruits 78. Vesicular sounds are heard over: a. peripheral lungs b. 2nd left ICS along the sternal borders c. abdomen d. temporal area

79. Abnormal lung sounds produced by rubbing together of inflamed and roughened pleural spaces are known as: a. ronchi c. rales b. wheezes d. friction rub 80. When palpating the breast you should move your fingers along concentric circles following a: a. Counter clockwise direction c. segmental direction b. clockwise direction d. both a and b

GOODLUCK AND GOD BLESS!