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NR 304 2025 ACTUAL MIDTERM EXAM COMPLETE
200+ STRUCTURED QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+
palpation of radial pulse - CORRECT ANSWER >>> Palpate both pulses noting the rate,
rhythm, elasticity of vessel wall and equal force
grading pulse - CORRECT ANSWER >>> 3+ full bounding
2+ normal 1+ weak 0 absent
brachial pulse - CORRECT ANSWER >>> palpate this pulse if you suspect arterial
insufficiency
modified Allen's test - CORRECT ANSWER >>> tests for ulnar arterial insufficiency by
occluding both the radial and ulnar artery normal results: normal color of hand should reappear approximately 2-5 seconds abnormal results: pallor persists or a sluggish return to color suggest occlusion of the collateral arterial flow
temporal artery - CORRECT ANSWER >>> palpated in front of the ear
carotid artery - CORRECT ANSWER >>> palpated in the groove b/t the sternomastoid
muscle and the trachea
brachial artery - CORRECT ANSWER >>> major artery supplying the arm
radial artery - CORRECT ANSWER >>> lies medial to the radius and wrist supplies blood to
the hand
ulnar artery - CORRECT ANSWER >>> lies lateral to the ulna. Deeper and often difficult to
feel. Supplies blood to the hand
femoral artery - CORRECT ANSWER >>> major artery in the leg. Palpated in the inguinal
area
popliteal artery - CORRECT ANSWER >>> artery in the knee. Located posterior to the
patella. Divides into the anterior and posterial tibial artery
anterior tibial - CORRECT ANSWER >>> travels down the front of the leg on to the dorsal
of the foot becomes the dorsalis pedis. carries blood to the anterior compartment of the leg and dorsal surface of the foot
PVD - CORRECT ANSWER >>> circulation disorder in which narrowed blood vessels reduce
blood flow to the limbs. Caused by arteriosclerosis (hardening of arteries caused by plaque build up) Inspect skin for ulcers, temperature and color
lymphedema - CORRECT ANSWER >>> swelling in the arms or legs caused by a blockage
of the lymphatic system , causes a build up of lymph fluid in tissues
intermittent claudication - CORRECT ANSWER >>> a condition in which cramping pain in
the leg is induced by exercise, typically caused by obstruction of the arteries
5 P's - CORRECT ANSWER >>> Pain
Pulselessness Pallor Parasthesia (can't feel) Paralysis (can't move)
Grading Edema - CORRECT ANSWER >>> +1 mild pitting, no swelling
+2 moderate pulling, indentation goes away quickly +3 deep pitting, swollen +4 very deep pitting, indentation stays, very swollen
Arterial Occlusion - CORRECT ANSWER >>> - 5 P's
- decrease capillary refill
- cold temperature
arterial insufficiency - CORRECT ANSWER >>> - skin is cool
- skin is thin and shiny
- no edema
- no hair growth
- decreased pulses
- yellow toenails
- dependent rubor (ruddy red/blue)
- elevated pallor
venous insufficiency - CORRECT ANSWER >>> - normal temperature
- normal pulse
- flaky, dry, thick skin
- skin tears easily- friable
- edema
- brawny color
arterial ulcers - CORRECT ANSWER >>> - intermittent claudication pain
- no edema
- no pulse or weak pulse
- no drainage
correlation w/ the carotid artery, signified that systole is starting
S2 - CORRECT ANSWER >>> Dub. Heard at the base of the heart. closure of the semilunar
valves. Indicates that diastole is starting and systole is ending
AV valves - CORRECT ANSWER >>> tricuspid and mitral valves. Close during systole to
prevent regurgitation of blood back up into the atria. Filling phase during diastole Semilunar
valves - CORRECT ANSWER >>> pulmonic and aortic valve. Opens during systole to allow
blood to be ejected from the heart
systole - CORRECT ANSWER >>> S1 close of AV valves
S2 openof the semilunar valves
base - CORRECT ANSWER >>> top of the heart
apex - CORRECT ANSWER >>> bottom of the heart
S3 - CORRECT ANSWER >>> Lub-dupPA heart murmur, occurs when the ventricles are
resistant to filling during the early rapid filling phase. occurs after S2 during rapid filling phase when the AV valves open and atrial blood first pours into the ventricle (heard at the apex, low pitch, heart failure, heart overload)
S4 - CORRECT ANSWER >>> fourth heart sound. DaLub-dup. occurs at the end of diastole
at pre-systole (before S1) when the ventricle is resistant to filling A stiff wall (outflow stenosis, HTN, stiff ventricle)
murmurs - CORRECT ANSWER >>> turbulent blood flow/ collision current caused by
increased blood velocity, decreased blood viscosity and structural defect
varicosities - CORRECT ANSWER >>> enlarged, incompentent valves (varicose veins)
reflex grading - CORRECT ANSWER >>> 0 absent
1 hyporeflexive, diminished 2 normal 3 hyper-reflexive, may indicate disease 4 abnormally reflexive, indicates disease
level of consciousness - CORRECT ANSWER >>> a change in the level of consciousness.
note person, place time
spinothalamic tract - CORRECT ANSWER >>> originates in the spinal cord, transmits
impulses from the spine to the thalamus on pain, temperature, itch, vibration and crude touch sensory
lateral spinothalamic tract - CORRECT ANSWER >>> pain, temperature
tonic neck reflex - CORRECT ANSWER >>> when you turn the baby head to the side and
the arms and legs will extend and the opposite will flex. Appears at 2-3 months and disappears at 4-6 months abnormal- indicates brain damage
Babinski reflex - CORRECT ANSWER >>> take the baby foot and make a upside down
J,baby toes should go in a fanning motion (+ test in infants) present at birth and disappears by 24 months abnormal- present at 2 years occurs w/ pyramidal tract disease (motor) , in adults
spinothalamic test - CORRECT ANSWER >>> pain
light touch vibration position
(kinesthesia) tactile discrimination (fine touch) stereognosis graphesthesia two point discrimination extinction point location
conscious - CORRECT ANSWER >>> promptly and spontaneously to state their name,
location, date , time are said to be oriented to self, place and time ability to interact appropriately w/ in the context of the immediate environment
CN III, IV, VI - CORRECT ANSWER >>> EOM
- oculomotor (superior rectus, inferior rectus and oblique, medial rectus)
- Trochlear (superior oblique)
- Abducens (lateral rectus)
CN VII - CORRECT ANSWER >>> facial, sensory and motor
motor: smile, tightly close eyes, lift eyebrows, puff out cheeks, frown sensory: taste buds
CN VIII - CORRECT ANSWER >>> acoustic, sensory
whisper test, rinne test, weber test, equilibrium (romberg) corneal light reflec
CN IX - CORRECT ANSWER >>> glossopharyngeal, sensory and motor motor: soft
palate and uvual rise in midline, and phonation, swallowing sensory: gag reflex
CN X - CORRECT ANSWER >>> vagus, sensory and motor
motor: phonoation, swallowing, gag reflex sensory: sensation from the carotid body (lowers heart rate, pharynx, GI secretions)
CN XI - CORRECT ANSWER >>> spinal accessory, motor
turn head against resistance, shrug shoulders against resistance
CN XII - CORRECT ANSWER >>> hypoglossal (motor)
tongue protrusion, tongue retraction, lingual speech (light, tight, dynamite)
CN V - CORRECT ANSWER >>> trigeminal , sensory and motor
sensory: facial sensations, corneal reflex motor: blinking, clenching teeth, movement of jaw
cerebellar tests - CORRECT ANSWER >>> Romberg
Pain - CORRECT ANSWER >>> spinothalamic test, sharp and dull
hypoalgesia - CORRECT ANSWER >>> decreased pain sensation
analgesia - CORRECT ANSWER >>> absent pain sensation
hyperalgesia - CORRECT ANSWER >>> increased pain sensation
light touch test - CORRECT ANSWER >>> spinothalamic test, apply a wisp of cotton to the
skin ask person to say yes when the touch is felt. CN V, VII (if on face, corneal reflex)
hypoesthesia - CORRECT ANSWER >>> decreased touch sensation
graphesthesia - CORRECT ANSWER >>> the ability to "read" a number by having it traced
on the skin. A good measure of sensory loss if the person cannot make the hand movements needed for sterognosis
two point discrimination - CORRECT ANSWER >>> tests the persons ability to distinguish
the separation of two simultaneous pin point on the skin. Apply two point of an opened paper clip to the skin note the distance which the person no longer perceives two separate points
mental status exam - CORRECT ANSWER >>> measures appearance, behavior, thought
process and cognition
parathesia - CORRECT ANSWER >>> numbness, losing ability to feel
cerebellar test - CORRECT ANSWER >>> - rapid alternating movements (RAM)
- finger to finger test
- finger to nose test
- heel to shin test
- gait
- Romberg test
- heel to toe (tandem walking)
rapid alternating test - CORRECT ANSWER >>> cerebellar test, ask the person to pat the
knees w/ both hand and turn over and pat knees. should be done with equal turning and a quick, rhythmic pace abnormal- lack of coordination, slow, clumsy and sloppy response finger
to finger - CORRECT ANSWER >>> w/ persons eyes open, ask the he or she use the index
finger to touch your finger and this their own finger should be smooth and accurate abnormal- lack of coordination, dysmetria, past pointing
dysmetria - CORRECT ANSWER >>> clumsy movement w/ overshooting the mark and
ccurs w/ cerebellar disorders or acute alcoholism
past pointing - CORRECT ANSWER >>> a constant deviation to one side
papilledema - CORRECT ANSWER >>> abnormal CN II inspection increased intracranial
pressure
Babinski adults - CORRECT ANSWER >>> abnormal plantar reflex test. Dorsiflexion of the
big toe and fanning of the toes
cerebrovascular accident (CVA) - CORRECT ANSWER >>> stroke, occurs when the blood
flow is interrupted to a part of the brain
ischemic stroke - CORRECT ANSWER >>> most common, occurring when a blood clot
blocks a blood vessel in the brain
- tremors
- bradykinesia
- rigidity
- impaired balance
- small handwriting
Bell's palsy - CORRECT ANSWER >>> unilateral paralysis or weakness of the muscles on
one side of your face
symptoms of Bell palsy - CORRECT ANSWER >>> - facial droop on one side of the face -
numbness
- difficulty blinking eye on affected side
apical pulse - CORRECT ANSWER >>> site where you hear the combination of both the S
and S2 heart sounds at the 5th ICS
hypoactive bowel sounds - CORRECT ANSWER >>> absent bowel sounds caused by
constipation, ileum, abdominal surgery, inflammation of the peritoneum
hyperactive bowel sounds - CORRECT ANSWER >>> borborygmus, loud, high-pitched,
rushing tinkling sounds that signal increased motility causes: diarrhea, hunger, smokers, GI distress, caffeine, laxatives
ileus - CORRECT ANSWER >>> minimal or no bowel motility
absent or hypoactive bowel sounds (can't chart until after 5 mins)
percussion of the abdomen - CORRECT ANSWER >>> tympani and dullness sounds. Move
clockwise Dullness over distended bladder, adipose tissue. fluid or mass hyper- resonance is present w/ gaseous distension tympany- drum sound, hollow
Liver span - CORRECT ANSWER >>> Normal liver is 5-10 cm located in the RUQ
splenic dullness - CORRECT ANSWER >>> in the mid-axillary line 6-10th ICS normal is
<7cm.
CVA tenderness - CORRECT ANSWER >>> fist percussion. Causes the tissue to vibrate
instead of producing sound used to assess the kidney. located on the 12th ICS on the back pt should feel a thud but no pain abnormal- inflammation of the kidney or
paranephric area light palpation of the abdomen - CORRECT ANSWER >>> 1 - 2 cm.
to feel for superficial organs and tumors. abnormal- muscle guarding, large masses, tenderness
deep palpation of abdomen - CORRECT ANSWER >>> 5 - 8 cm Feeling for deep organs
