e the exam. encourage the infant to suck on a pacifier during the abdominal exam. ask the parent to briefly leave the room when assessing the infant’s vital signs. A patient’s laboratory data reveal an elevated thyroxine level. The nurse would proceed with an examination of the: Question 2 options: thyroid gland. parotid gland. adrenal gland. thyroxine gland. The nurse practitioner is doing an oral assessment on a 40-year-old black patient and notes the presence of a 1-cm, nontender, grayish-white lesion on the left buccal mucosa. Which of the following is true concerning this lesion? Question 3 options: This lesion is leukoedema and is common in blacks. This is the result of hyperpigmentation and is normal. This is torus palatinus and would normally only be found in smokers. This type of lesion is indicative of cancer and should be tested immediately. During an examination, the nurse knows that Paget’s disease would be indicated by which of the following findings? Question 4 options: Positive Macewen’s sign Premature closure of the sagittal suture Headache, vertigo, tinnitus, and deafness Elongated head with heavy eyebrow ridge A 30-year-old woman with a history of mitral valve problems states that she has been “very tired.” She has started waking up at night and feels like her “heart is pounding.” During the assessment, the nurse practitioner palpates a thrill and lift at the fifth left intercostal space midclavicular line. In the same area the nurse practitioner also auscultates a blowing, swishing sound right after S1. These findings would be most consistent with: Question 5 options: heart failure. aortic stenosis. pulmonary edema. mitral regurgitation. The nurse practitioner notices that a patient’s submental lymph nodes are enlarged. In an effort to identify the cause of the node enlargement, the nurse would assess the: Question 6 options: infraclavicular area. supraclavicular area. area distal to the enlarged node. area proximal to the enlarged node. During an assessment of a newborn infant, the nurse practitioner recalls that pyloric stenosis would be manifested by: Question 7 options: projectile vomiting. hypoactive bowel activity. palpable olive-sized mass in right lower quadrant. pronounced peristaltic waves crossing from right to left. A patient has been shown to have a sensorineural hearing loss. During the assessment, it would be important for the nurse to: Question 8 options: speak loudly so he can hear the questions. assess for middle ear infection as a possible cause. ask the patient what medications he is currently taking. look for the source of the obstruction in the external ear. The most important reason to share information and offer brief teaching while performing the physical examination is to help: Question 9 options: the examiner feel more comfortable and gain control of the situation. build rapport and increase the patient’s confidence in the examiner. the patient understand his or her disease process and treatment modalities. the patient identify questions about his or her disease and potential areas of patient education. A patient’s thyroid is enlarged, and the nurse practitioner is preparing to auscultate the thyroid for the presence of a bruit. A bruit is a: Question 10 options: low gurgling sound best heard with the diaphragm of the stethoscope. loud, whooshing, blowing sound best heard with the bell of the stethoscope. soft, whooshing, pulsatile sound best heard with the bell of the stethoscope. high-pitched tinkling sound best heard with the diaphragm of the stethoscope. During a cardiac assessment on an adult patient in the hospital for “chest pain,” the nurse practitioner finds the following: jugular vein pulsations 4 cm above sternal angle when he is elevated at 45 degrees, BP 98/60, HR 130; ankle edema; difficulty in breathing when supine; and an S3 on auscultation. Which of the following best explains the cause of these findings? Question 11 options: Fluid overload Atrial septal defect Myocardial infarction Heart failure When examining an infant, the nurse practitioner should examine which area first? Question 12 options: Ear Nose Throat Abdomen