NR 414 Exam 4 - Revised Curriculum M.B Regis University.
Access The Exact Questions for NR 414 Exam 4 - Revised Curriculum M.B Regis University.
💯 100% Pass Rate guaranteed
🗓️ Unlock for 1 Month
Rated 4.8/5 from over 1000+ reviews
- Unlimited Exact Practice Test Questions
- Trusted By 200 Million Students and Professors
What’s Included:
- Unlock Actual Exam Questions and Answers for NR 414 Exam 4 - Revised Curriculum M.B Regis University. on monthly basis
- Well-structured questions covering all topics, accompanied by organized images.
- Learn from mistakes with detailed answer explanations.
- Easy To understand explanations for all students.
Ace Your Test with NR 414 Exam 4 - Revised Curriculum M.B Regis University. Actual Questions and Solutions - Full Set
Free NR 414 Exam 4 - Revised Curriculum M.B Regis University. Questions
-
It is increased and leads to strokes.
-
It is decreased and results in a more vigorous deep tendon reflex.
-
It is the same as the younger adult and causes no significant problems.
-
It is decreased and may cause the patient to be dizzy and off-balance.
Explanation
Correct Answer: D. It is decreased and may cause the patient to be dizzy and off-balance.
In older adults, cerebral blood flow decreases due to age-related cardiovascular changes. During range of motion assessment, position changes can further reduce cerebral perfusion, causing dizziness, lightheadedness, and loss of balance. The nurse must perform ROM movements slowly and monitor the patient carefully to prevent falls.
Why Other Options are Incorrect:
A. Cerebral blood flow decreases, not increases, with aging. While decreased cerebral blood flow is a risk factor for stroke, it does not increase during ROM assessment.
B. Decreased cerebral blood flow does not cause more vigorous deep tendon reflexes; deep tendon reflexes actually tend to decrease with aging.
C. Cerebral blood flow is not the same in older adults as in younger adults; it measurably decreases with age due to vascular changes.
-
Perform a whispered voice test
-
Ask the patient to say "light, tight, dynamite" and note the lingual speech is clear and distinct
-
Perform Snellen visual acuity test
-
Ask the patient to say "sharp" or "dull," depending on the sensation felt when applying a sharp point or dull end to the patient's body
Explanation
Correct Answer: A. Perform a whispered voice test
Cranial nerve VIII (Vestibulocochlear/Acoustic nerve) is responsible for hearing and balance. The whispered voice test assesses hearing by having the examiner whisper words at a set distance and asking the patient to repeat them. This directly evaluates the auditory component of CN VIII function.
Why Other Options are Incorrect:
B. Asking the patient to say "light, tight, dynamite" tests the clarity of lingual speech, which assesses CN XII (Hypoglossal) function, not CN VIII.
C. The Snellen visual acuity test assesses visual sharpness and tests CN II (Optic nerve) function, not the acoustic nerve.
D. Asking the patient to identify sharp or dull sensations tests pain and touch sensation through sensory nerve pathways, not CN VIII function.
-
1+
-
4+
-
3+
-
2+
Explanation
Correct Answer Is:
D. 2+
On the standard deep tendon reflex grading scale, 2+ indicates a normal or average reflex response. The scale is as follows: 0 = absent, 1+ = diminished, 2+ = normal, 3+ = increased but not necessarily abnormal, 4+ = hyperactive with clonus, suggesting neurological pathology.
Why the other options are incorrect:
A. 1+ indicates a diminished or below-normal reflex response, suggesting possible nerve or muscle pathology.
B. 4+ indicates a hyperactive reflex with clonus, which is abnormal and associated with upper motor neuron lesions.
C. 3+ indicates an above-average but not necessarily pathological reflex response.
-
Demonstrates ability to hear normal conversation
-
Moves the head and shoulders against resistance with equal strength
-
Follows an object with eyes without nystagmus or strabismus
-
Sticks tongue out midline without tremors or deviation
Explanation
Correct Answer: B. Moves the head and shoulders against resistance with equal strength
Cranial nerve XI (Spinal Accessory) innervates the sternocleidomastoid and trapezius muscles, which control head rotation and shoulder elevation. Testing involves asking the patient to turn their head and shrug their shoulders against resistance. Equal bilateral strength indicates an intact spinal accessory nerve.
Why Other Options are Incorrect:
A. Hearing normal conversation tests cranial nerve VIII (Vestibulocochlear), which handles hearing and balance. C. Following an object with eyes without nystagmus tests cranial nerves III, IV, and VI (Oculomotor, Trochlear, and Abducens), which control eye movement. D. Sticking the tongue out midline without deviation tests cranial nerve XII (Hypoglossal), which controls tongue movement.
-
Contralateral central axillary
-
Ipsilateral central axillary
-
Ipsilateral inguinal
-
Contralateral inguinal
Explanation
Correct Answer Is:
B. Ipsilateral central axillary
The lymphatic drainage of the breast flows primarily to the axillary lymph nodes on the same side (ipsilateral) as the affected breast. The central axillary nodes are the main group receiving drainage from the breast. In the presence of infection, these nodes become enlarged as they filter pathogens and mount an immune response.
Why the other options are incorrect:
A. Contralateral axillary nodes are on the opposite side of the body from the infection and would not typically be the primary drainage site for a breast infection.
C. Ipsilateral inguinal nodes drain the lower extremities and perineal region, not the breast.
D. Contralateral inguinal nodes drain the opposite lower extremity and would have no connection to a breast infection.
-
Occult blood resulting from gastrointestinal bleeding
-
Increased iron intake resulting from a change in diet
-
Absent bile pigment from liver problems
-
Excessive fat caused by malabsorption
Explanation
Correct Answer: A. Occult blood resulting from gastrointestinal bleeding
Black, tarry, sticky stools (melena) are a classic sign of upper gastrointestinal bleeding. When blood from the upper GI tract is digested, it turns the stool dark black and gives it a sticky, tarlike consistency. Since the patient denies medication use or dietary changes, GI bleeding is the most likely cause and requires urgent evaluation.
Why Other Options are Incorrect:
B. Iron supplementation or dietary iron changes can cause dark stools, but the patient specifically denies any dietary changes or medication use. C. Absent bile pigment causes clay-colored or pale stools, not black tarry stools. D. Malabsorption of fat causes steatorrhea, which produces pale, greasy, foul-smelling stools that float, not black tarry stools.
-
Before testing, assess the patient's mental status and ability to follow directions at this time.
-
Do not perform this part of the examination because results would not be valid.
-
Proceed with the explanations of each test, making sure the spouse understands.
-
Perform the tests, knowing that mental status does not affect sensory ability.
Explanation
Correct Answer: A. Before testing, assess the patient's mental status and ability to follow directions at this time.
Sensory system testing requires the patient to accurately report what they feel, making it highly dependent on the patient's ability to understand and follow directions. Before proceeding, the nurse must first assess the patient's current mental status to determine whether the results of sensory testing will be reliable and valid at this time.
Why Other Options are Incorrect:
B. Skipping the sensory examination entirely is inappropriate. The nurse should first assess mental status and proceed if the patient is able to cooperate, rather than automatically omitting the assessment.
C. Explaining the tests to the spouse rather than the patient is not appropriate, as the patient is the one who must understand and respond during sensory testing. The focus should be on the patient's current ability to participate.
D. Mental status directly affects sensory testing reliability. A confused or disoriented patient cannot accurately report sensory stimuli, making this statement clinically incorrect.
-
"Oh, I had pain like that after my son was born; it turned out to be a blocked milk duct."
-
"I would like some more information about the pain in your left breast."
-
"Breast pain is almost always the result of benign breast disease."
-
"Don't worry about the pain; breast cancer is not painful."
Explanation
Correct Answer Is:
B. "I would like some more information about the pain in your left breast."
The most appropriate nursing response is to gather more information through therapeutic communication. Asking for more details about the pain allows the nurse to fully assess the symptom including its location, quality, duration, and associated factors before drawing any conclusions. This is the foundation of proper patient assessment.
Why the other options are incorrect:
A. Sharing a personal experience is unprofessional and shifts focus away from the patient's concern, which is not therapeutic.
C. Dismissing the symptom by stating it is almost always benign is inappropriate and could cause the patient to minimize a potentially serious finding.
D. Telling the patient not to worry and that breast cancer is not painful is clinically inaccurate, as some breast cancers can cause pain, and dismisses a legitimate health concern.
-
Sexual history because it will build rapport to discuss this first
-
Urinary system history because there may be problems in this area as well
-
Obstetric history because it is the most important information
-
Menstrual history because it is generally nonthreatening
Explanation
Correct Answer: D. Menstrual history because it is generally nonthreatening
Beginning a gynecologic interview with menstrual history is appropriate because it is a routine, nonthreatening topic that helps establish rapport and comfort before moving to more sensitive subjects such as sexual history. Starting with less sensitive questions allows the patient to feel at ease and more willing to share information openly.
Why Other Options are Incorrect:
A. Starting with sexual history may make the patient uncomfortable and defensive before rapport has been established, making it a poor choice to begin the interview. B. While urinary history is relevant, it is not the standard starting point for an annual gynecologic examination interview. C. Obstetric history, while important, is not necessarily the most important information, and menstrual history is a more natural and comfortable starting point.
-
Supine with arms relaxed at the sides
-
Sitting with arms relaxed at the sides
-
Sitting with arms flexed and fingertips touching shoulders
-
Supine with arms raised over her head
Explanation
Correct Answer: D. Supine with arms raised over her head
When a patient lies supine with arms raised over her head, the breast tissue flattens evenly across the chest wall, making the tissue thinner and more uniform. This position allows lumps and abnormalities to become more distinct and easier to palpate against the underlying chest wall.
Why Other Options are Incorrect:
A. Supine with arms relaxed at the sides does not fully flatten the breast tissue, making deeper lumps harder to detect. B. Sitting with arms relaxed causes breast tissue to hang, which can obscure lumps rather than make them more distinct. C. Sitting with arms flexed and fingertips touching shoulders is useful for inspecting the breast contour and detecting skin changes but is not optimal for palpating lumps.
How to Order
Select Your Exam
Click on your desired exam to open its dedicated page with resources like practice questions, flashcards, and study guides.Choose what to focus on, Your selected exam is saved for quick access Once you log in.
Subscribe
Hit the Subscribe button on the platform. With your subscription, you will enjoy unlimited access to all practice questions and resources for a full 1-month period. After the month has elapsed, you can choose to resubscribe to continue benefiting from our comprehensive exam preparation tools and resources.
Pay and unlock the practice Questions
Once your payment is processed, you’ll immediately unlock access to all practice questions tailored to your selected exam for 1 month .