APEA Clinical Assessment Skills Questions and Answers Flashcards

The NP notes dullness to percussion in the right lower lung field with decreased breath sounds and tactile fremitus. Which diagnosis is most likely?

Answer: Pleural effusion

Pleural effusion causes dullness to percussion and decreased transmission of voice sounds due to fluid accumulation in the pleural space.

A patient presents with facial drooping, arm weakness, and slurred speech for the past 45 minutes. The NP's priority assessment is to determine onset time because the thrombolytic window is:

Answer: 4.5 hours from symptom onset

IV tPA must be administered within 4.5 hours of ischemic stroke symptom onset to be safe and effective per current guidelines.

During an abdominal exam, the NP notices the umbilicus deviated to the right. Which condition could cause this finding?

Answer: Large right-sided abdominal mass

A large mass on the right side of the abdomen can displace the umbilicus toward the affected side due to fascial tension.

Which assessment technique is most reliable for detecting an abdominal aortic aneurysm during physical exam?

Answer: Palpation of a pulsatile abdominal mass

Palpation of a pulsatile expansile abdominal mass is the primary physical exam finding for AAA, though ultrasound is needed for definitive assessment.

A 70-year-old patient demonstrates a positive Romberg test. Which area of the nervous system is implicated?

Answer: Proprioception/posterior columns

The Romberg test assesses proprioceptive input; increased sway or fall with eyes closed indicates dysfunction of dorsal column sensory pathways.

When performing a rectal exam, the NP palpates the prostate and notes a hard, irregular nodule. The most appropriate next step is:

Answer: Refer for PSA and urology evaluation

A hard, irregular prostate nodule raises concern for prostate cancer and requires PSA testing and urology referral for further workup.