Unit 1 Introduction and health history taking

Unit 1 Test

1、Which of the following is the symptom but not sign of the patient?
    A、Enlarged spleen
    B、Abdominal tenderness
    C、Systolic murmur
    D、Palpitation
    E、Enlarged liver

2、When the nurse is collecting the health history data and doing physical examination in the ward, the correct standing position is standing at the
    A、left side of the patient
    B、right side of the patient
    C、head of the bed
    D、foot of the bed
    E、There is no specific requirement

3、The health history interview should be cut off if the patient
    A、develops a high fever
    B、has a jaundice
    C、suffers from a chest pain attack
    D、has edema
    E、coughs a blood-streaked sputum

4、The best way for the nurse to communicate with the patient is
    A、taking notes while listening to the patient
    B、taking a phone call while listening to the patient
    C、facing the patient and maintain eye contact
    D、keeping within a distance of 250cm from the patient
    E、asking the patient’s family to answer questions

5、The main part of patients’ medical history is
    A、chief complaint
    B、history of present illness
    C、condition of daily life
    D、past medical history
    E、personal history

6、The depth of deep palpation usually is
    A、above lcm
    B、above 1.5cm
    C、above 2cm
    D、above 2.5cm
    E、above 3cm

7、The best way to encourage the patient to talk about his/her condition is
    A、to ask the patient to fill out a questionnaire
    B、to nod while he/she is speaking to show approval or understanding
    C、to ask the roomates to encourage the patient
    D、to ask questions constantly
    E、to ask the patient’s family to help

8、The best way to acquire accurate medical history during an interview is
    A、by listening attentively
    B、by guiding the patient
    C、by questioning continuously
    D、by health promotion
    E、by using medical terminology

9、A male patient who is 56 years old is admitted to the hospital with diarrhea. The most appropriate question for the nurse to start with is
    A、Do you have pain in your abdomen?
    B、What brings you here today?
    C、Have you suffered from diarrhea?
    D、Did you do stool analysis?
    E、When did the diarrhea start?

10、Which of the following palpation techniques helps to detect abdominal resistance?
    A、Light palpation
    B、Deep slipping palpation
    C、Ballottement
    D、Deep press palpation
    E、Bimanual palpation

11、Which of the following is commonly used for detecting abdominal tender points?
    A、Light palpation
    B、Deep slipping palpation
    C、Ballottement
    D、Deep press palpation
    E、Bimanual palpation

12、The sound of percussion of a parenchymal organ covered by tissue with gas should be
    A、dullness
    B、flatness
    C、resonance
    D、hyperresonance
    E、tympany

13、Which kind of percussion note occurs on the patient with emphysema?
    A、Dullness
    B、Flatness
    C、Resonance
    D、Hyperresonance
    E、Tympany

14、A 36-year-old man comes to the ward with the complaint of upper abdominal distention and discomfort. The two symptoms can be relieved after excessive vomiting. The vomitus is fermented and sour-smelling, containing food eaten many hours ago. Which is the most likely diagnosis?
    A、Pyloric obstruction
    B、Functional dyspepsia
    C、Intestinal obstruction
    D、Gastric perforation
    E、Acute gastritis

15、In order to detect deep-seated abdominal masses and gastrointestinal lesions, which of the palpation method should be used?
    A、Deep slipping palpation
    B、Deep press palpation
    C、Bimanual palpation
    D、Light palpation
    E、Ballottement

16、The patients’ history of present illness includes
    A、onset and duration of chief symptom or signs
    B、causes of illness and inducements/precipitating factors
    C、features of chief symptom
    D、associated symptoms and significant negative symptoms
    E、previous studies and treatment

17、Which of the following belongs to precipitating factors?
    A、Injury
    B、Poisoning
    C、Infection
    D、Climate changing
    E、Depression

18、Under normal conditions, tympany can be heard on examination of
    A、lungs
    B、heart
    C、liver
    D、abdomen
    E、stomach bubble

19、Under normal conditions, flatness can be heard on examination of
    A、lungs
    B、heart
    C、abdomen
    D、liver
    E、stomach bubble

20、Which of the following is true regarding indirect percussion?
    A、Strike 6 or 7 times consecutively when percussing on the same place
    B、Strike lightly to identify the relative cardiac dullness
    C、The nurse uses the middle finger of left hand to strike the proximal or distal interphalangeal joint of the pleximeter finger of the right hand.
    D、The motion of percussion should be oriented by the movement of the wrist and metacarpophalangeal joint, and not the elbow or shoulder joint.
    E、Strike hard to identify the upper border of liver.

Unit 1 Assignment

1、Dear students, The assignment for this unit is to draw a mind mapping based on the case of the following: A male patient aged 58 presents with progressive exertional dyspnea for 3 months. His dyspnea is not accompanied with chest pain or wheezes. He has cough associated with smoking for several years. He has experienced weight loss of 5kg in recent three months. He also complains of hoarseness for nearly six weeks. His dyspnea has been gradually worsened, and he can barely climb one stair to the clinic. Blood was found in his sputum. He did not have fever. Please review the percussion of the lungs, and draw a mind mapping on the percussion of this patient to find the abnormalities. Try to do like the following chart.

Unit 2 General Assessment

Unit 2 test

1、Which of the following group of lymph nodes is not located in head and neck areas?
    A、Preauricular lymph nodes
    B、Postauricular lymph nodes
    C、Occipital lymph nodes
    D、Inguinal lymph nodes
    E、Submental lymph nodes

2、What kind of facies usually poses in patients with lobar pneumonia?
    A、Masked facies
    B、Full moon facies
    C、Acute facies
    D、Chronic facies

3、What gait could be seen in patients with rickets?
    A、Waddling gait
    B、Ataxic gait
    C、Festinating gait
    D、Steppage gait
    E、Scissors gait

4、Cyanosis is due to the change of hemoglobin which is
    A、Increase of reductive hemoglobin
    B、Increase of oxidized hemoglobin
    C、Decrease of reductive hemoglobin
    D、Decrease of oxidized hemoglobin

5、Which of the following statements does not conform to metastatic lymphadenopathy?
    A、Hard texture
    B、Easy adhesion
    C、Not easy to push
    D、Tenderness
    E、May spread to other areas

6、Please refer to the descriptions of a patient below and choose the name of the gait that best fits his conditions: The patient is diagnosed with cerebral palsy,when he walks,his gait is characterized by excessive adduction of lower limbs,his legs are crossed when moving.
    A、Scissors gait
    B、Intermittent claudication gait
    C、Ataxic gait
    D、Dring man gait
    E、Waddling gait

7、This is a patient with Parkinson disease.When the patient begins to walk,his gait is characterized by small steps at slightly fast rate,stooped posture and difficulty in stopping after starting to walk. How would you describe this kind of gait?
    A、Festinating gait
    B、Ataxic gait
    C、Waddling gait
    D、Intermittent claudication gait

8、A patient visits you with a tired looking,with pallor and pale lips and tongue,the patient tells you that he feels exhausted after walking fast or climbing the stairs. What kind of appearance will you describe him?
    A、Anemic facies
    B、Nephrotic facies
    C、Myxedema facies
    D、Hepatic facies
    E、Mitral facies

9、Today entering the ward a patient with meningitis,when you are communicating with him,he seems indifferent and slow in understanding your questions.How would you describe his appearance?
    A、Typhoid facies(Masked face)
    B、Anemic facies
    C、Nephrotic facies
    D、Hepatic facies
    E、Acute facies

10、A child patient with facial edema,with pale tongue with identation on the lingual margin.What kind of facies will you describe him?
    A、Nephrotic facies
    B、Hepatic facies
    C、Myxedema facies
    D、Mitral facies

11、Why does rickets could cause development problems among children?
    A、Calcium absorption problem
    B、Bone destruction
    C、Less secretion of growth hormones
    D、Muscle development problem
    E、Immunological dysfunction

12、Of those descriptions about sthenic type habitus,which of the following options is INCORRECT?
    A、Drooping shoulder
    B、Short and thick limbs
    C、Broad shoulder
    D、Epigastric angle larger than ninety
    E、Epigastric angle less than ninety

13、This morning in the out-patient center comes a patient with mild ascites,his face is gloomy with brown pigmentation,with one spider angioma by the cheek.What kind of facies will you use to describe him?
    A、Hepatic facies
    B、Mitral facies
    C、Nephrotic facies
    D、Anemic facies
    E、Hyperthyreosis facies

14、Which of the following option is NOT included in the general examination?
    A、Sight test
    B、Lymph nodes examination
    C、Hair examination
    D、Weight assessment
    E、Nutritional assessment

15、Systematic enlargement of lymph nodes can be seen in those diseases EXCEPT
    A、Tonsil inflammation
    B、Leukemia
    C、Infectious monocytosis
    D、Lymphoma

16、Which of the following options could be the appropriate sites to help estimate the state of nutrition?
    A、Flexual area of forearm or the inferior one-third of the dorsal upper arm
    B、Dorsum of hands or the interior upper arm
    C、Upper abdomen
    D、Dorsum of hands or the superior one-third of the dorsal upper arm
    E、Calf muscle

17、Cretinism mainly occurred before maturation and often caused by
    A、Hyperthyroidism
    B、Hypothyroidism
    C、Hyperhypophysism
    D、Hypopituitarism
    E、Abnormal secretion of certain hormones

18、Passive position is seen in patients with
    A、Extreme weakness and unconsciousness
    B、Acute peritonitis
    C、Massive pleural effusion
    D、Unconscious patients
    E、Spine disease

19、A 42-old woman comes into your office with dim eyes,worried expression,darkish complexion,purplish-red cheeks and slightly cyanosis lips.What kind of facies can we adopt to describe her appearance?(Multiple choices)
    A、Mitral facies
    B、Chronic facies
    C、Anemic facies
    D、Hepatic facies
    E、Nephrotic facies

20、A 33-year old lady with a complaint of cough,chest distress and shortness of breath for 3 months is diagnosed with massive pleural effusion of the right chest,Which position will this patient most likely to choose when lying?
    A、Compulsive position
    B、Lateral position on the right
    C、Lateral position on the left
    D、Supine position

Unit 2 Assignment

1、The assignment of this unit is to submit a reflective diary of superficial palpation of lymph nodes, and then to evaluate the work of other students, and finally conduct self-evaluation.You should try hands-on practice and reflecting on the following aspects: 1. Operation process; 2. Operation technique 3. Difficulties encountered and how to solve.

Unit 3 Head & Neck Assessment

Unit 3 test

1、In patient with trachoma,which part of the eye is mainly involved?
    A、Conjunctiva
    B、Lacrimal sac
    C、Conea
    D、Pupil

2、When a patient is poisoned by organophosphorus,what will happen with his eyes?
    A、To reduce in diameter of pupils
    B、To expand in diameter of pupils
    C、Direct reflection of light will disappear
    D、Indirect reflection of light will disappear
    E、None of the others is correct

3、In the inspection of oral cavity,the palatine tonsils protrude beyond the palatopharyngeal arch but do not reach the midline.Which of the following degree of tonsillar enlargment should be classified?
    A、II
    B、I
    C、III
    D、Could not determine based on the information given

4、In which of the following conditions can bilateral ptosis be detected?
    A、Myasthenia gravis
    B、Cerebral abscess
    C、Myelitis
    D、Intercranial hypertension
    E、Spinal tuberculosis

5、What is the border between the anterior and posterior triangle of the neck?
    A、The sternocleidomastoid
    B、The jugular notch
    C、The inferior border of the mandible
    D、The clavicle

6、Which of the following disease could jugular vein distension suggest?
    A、Constrictive pericarditis
    B、Peritonitis
    C、Acute left heart failure
    D、Early stage of hepatitis

7、About the descriptions of carotid pulsation and jugular pulsation,which one is NOT correct?
    A、Carotid pulsation is more dispersed
    B、Jugular pulsation is softer
    C、Carotid pulsation can be detected in patient with hyperthyroidism
    D、Jugular pulsation usually is not palpable

8、About the assessment of thyroid,which one of the following descriptions is correct?
    A、Normal thyroid is not visible.
    B、We could ask the patient to take a deep breath for better feeling for the movement of the thyroid gland
    C、It not necessary to auscultate the thyroid gland
    D、Usually in patient with hyperthyroidism,the thyroid is usually very hard in texture

9、What is NOT correct about the palpation of the thyroid?
    A、It needs two examiner's cooperation to palpate the thyroid
    B、The examiner could use one hand or both hands to palpate
    C、The examiner could examine standing opposite the patient
    D、The examiner could examine standing behind the patient

10、When we are trying to determine the enlargement of the thyroid,Degree II and Degree III are different because
    A、Whether the pain the patient feels during palpation
    B、Whether the enlargement exceeds sternocleidomastoid or not
    C、Whether the enlargement is attached to the trachea
    D、Whether the texture of the enlargment is hard or soft
    E、It depends on further examinations like B ultrasound,or CT

11、The swelling of parotid gland could happen when the patient is having those following diseases EXCEPT
    A、Oral infection
    B、Epidemic mumps
    C、Suppurative mumps
    D、Tumor of parotid gland
    E、Carcinoma of parotid gland

12、Bleeding of the gum could be caused by the following conditions EXCEPT
    A、Deficiency of riboflavin
    B、Deficienty of Vitamin C
    C、Liver disease
    D、Dental tartar

13、Herpes on lip could be a sign of
    A、Viral infection
    B、Fungal infection
    C、The increase of reduced hemoglobin in the blood
    D、Cyanosis

14、A 70-year old female presented with clustered semitransparent vesicles on the vermilion border of the lip with an initial itching and tingling sensation.Vesiculation progressed to crusting in about one week before,the patient later recovered without any scar.Which of the following is the most likely to be the cause of the changes above?
    A、Infection of herpes simplex virus
    B、Vitamin D deficiency
    C、Angioedema
    D、Fungal infection

15、A 2-year old boy presents with frontal bossing ,a flat square vertex and increased sweating.Which of the following is the most likely diagnosis?
    A、Rickets
    B、Tuberculosis
    C、Cretinism
    D、Down's syndrome

16、A 67-year old man presents with sudden dyspnea over the past 2 hours,the following considerations should be noted in the first place in his physical eamination EXCEPT
    A、Skinfold thickness measurement
    B、Vital signs
    C、The ascultation of the lungs
    D、Pulsation of the carotid artery
    E、Patient's history before the hospitalization

17、Fissured tongue is characterized by deep grooves in the tongue and could be cause by
    A、Down syndrome
    B、Lack of riboflavin intake
    C、Anemia
    D、Hyperthyroidism

18、Pupillary dilation can be seen in which of the following conditions?(Multiple choices)
    A、Drug reaction of atropine
    B、Injury
    C、Absolute glaucoma
    D、Organophosphorus poisoning

19、Which of the following descriptions about Koplik spot is correct
    A、White spots
    B、On the buccal mucosa lateral to the second molar teech
    C、Happens in the early stage of measles
    D、Could be seen in leukemia
    E、Could happen in patients with ulcerative colonitis

20、Which of the following is TRUE regarding the examination of the jugular vein?
    A、Jugular vein distention could be seen in right heart failure
    B、Jugular vein distention can be seen in pericardia effusions
    C、The external jugular vein are easily seen in normal persons in sitting or standing position.
    D、Jugular vein distention means venous pressure is elevated

Unit 3 Assignment

1、The assignment of this unit is to submit a reflective diary of palpation of throid gland, and then to evaluate the work of other students, and finally conduct self-evaluation. Specific requirements: Carrying out hands-on practice according to palpation requirements , and reflecting on the following aspects: 1. Which kind of technique will you choose? 2. Single handed or both handed? 3. From the patient’s back or front? 4. Operation technique 5. Difficulties encountered and how to solve

Unit 4 Chest wall, Thorax, Breast, and Lungs Assessment

Unit 4 Test

1、Which of the following is an important landmark to count ribs and intercostal spaces on the front chest?
    A、Xiphoid process
    B、Sternal angle
    C、Spinous process
    D、Suprasternal notch
    E、Body of sternum

2、In the standing position with upper limbs falling naturally, inferior angle of scapula reaches which of the following spaces?
    A、5th intercostal space
    B、6th intercostal space
    C、7th intercostal space
    D、8th intercostal space
    E、9th intercostal space

3、Which of the following is the Three Depression Sign?
    A、Suprasternal, infraclavicular, and intercostal fossae depression
    B、Infrasternal, supraclavicular, and intercostal fossae depression
    C、Suprasternal, infraclavicular, and intercostal protrusion
    D、Suprasternal, supraclavicular, and intercostal protrusion
    E、Suprasternal, supraclavicular, and intercostal fossae depression

4、Increased tactile fremitus is seen in patients with which of the following conditions?
    A、Increased gas volume in alveoli
    B、Bronchial obstruction
    C、Consolidation of lung tissue caused by alveolar inflammation
    D、Massive pleural effusion or pneumothorax
    E、Subcutaneous emphysema or edema of thoracic wall

5、Dullness is not likely to be detected in patients with which of the following conditions?
    A、Pulmonary tumor
    B、Emphysema
    C、Pleural effusion
    D、Pneumonia
    E、Pneumothorax

6、Which of the following is the percussion sound of normal lung field?
    A、Resonance
    B、Hyperresonance
    C、Tympany
    D、Dullness
    E、Flatness

7、Decreased chest breathing and increased abdominal breathing could be seen in :
    A、Peritonitis
    B、Pleurisy
    C、Abdominal tumor
    D、Abdominal effusion
    E、Being pregnant

8、Which of the following is the correct procedure of auscultation of lungs?
    A、From the top to the bottom and compare the anterior side with the posterior side
    B、From the top to the bottom and compare the left side with the right side but avoid heart area
    C、From the bottom to the top and compare the anterior side with the posterior side
    D、From left to right and compare the anterior side with the posterior side
    E、Random auscultation spots without comparison

9、In which of the following locations do coarse crackles mainly occur?
    A、Bronchiole
    B、Main bronchus
    C、Bronchia
    D、Alveoli
    E、Terminal bronchioles

10、In which of the following locations can pleural rubs be heard clearly?
    A、Lung apex
    B、Upper lateral sections of chest
    C、Interscapular area
    D、Lower anterior thoracic wall
    E、Upper anterior thoracic wall

11、A 20-year-old male felt a sudden pain in the right chest during exercise and has dyspnea for 2 hours. Which of the following should be examined more intensively?
    A、Pupils
    B、Heart and lungs
    C、The abdomen
    D、The nervous system
    E、Limbs

12、A 26-year-old young man has progressive dyspnea after a trauma. Physical examination reveals lateral displacement of the trachea, unilateral chest enlargement, broadened intercostal spaces, and tympany to percussion. Which of the following is the most likely diagnosis?
    A、Emphysema
    B、Plural effusion
    C、Pneumothorax
    D、Fracture of ribs
    E、Atelectasis

13、A 32-year-old female has fever, chill, productive cough, and chest pain for 3 days after being caught in the rain. Physical examination reveals decreased breathing motions of lower left lung, increased tactile fremitus. There is flatness to percussion and coarse crackles to auscultation. Which of the following is the most likely diagnosis?
    A、Plural effusion
    B、Pneumothorax
    C、Bronchial asthma
    D、Consolidation
    E、Emphysema

14、A 10-year-old boy presents with dyspnea, cyanosis and prolonged expiratory phase after breathing in to cold air. Wheezes are detected to auscultation throughout her lung fields. Which of the following is the most likely diagnosis?
    A、Bronchial asthma
    B、Inflammatory consolidation
    C、Plural effusion
    D、Pneumothorax
    E、Emphysema

15、A 27-year-old male, presents with a low-grade fever, and nonproductive cough after catching a cold 3 days ago. He also has pain in the left chest which can be worsened during deep breath. X-Ray reveals blunting of the left costophrenic angle. Which kind of sounds can be heard to auscultation?
    A、Velcro-like sound
    B、Coarse and medium crackles
    C、Wheezes
    D、Pleural rubs
    E、Sonorous rhonchi

16、A kind of repeated breathing pattern, which starts from several regular breaths, followed by a pause and starts again. Which of the following breathing is it?
    A、Cheyne-Stokes breathing
    B、Biots breathing
    C、Kussmaul breathing
    D、Sighing breathing
    E、Hurried and interrupted breathing

17、Ascending of the inferior boundary of lung can be detected in patients with which of the following conditions?
    A、Atelectasis
    B、Lung fibrosis
    C、Abdominal visceroptosis
    D、Atrophy of lung tissue
    E、Increased intra-abdominal pressure

18、Decrease or disappearance of respiratory movement could be seen in:
    A、Emphysema
    B、Pneumonia
    C、Pleural effusion
    D、Pneumothorax
    E、Compensatory emphysema

19、Thoracic local eminence could be seen in:
    A、Enlarged heart
    B、Hydropericardium
    C、Aortic aneurysm
    D、Costochondritis
    E、Rib fracture

20、A 65-year-old female has a 15-year history of chronic productive cough and a 10-year history of dyspnea, and her condition worsened 2 days ago. She is diagnosed with COPD in the acute exacerbation stage. Which of the following can be detected on physical examination?
    A、Barrel chest
    B、Decreased breathing sounds
    C、Sporadic crackles and rhonchi
    D、Deepened breathing
    E、Dullness to percussion

Unit 4 Assignment

1、Assignment for Unit 4 A 60-year-old man was discharged afer being hospitalized for 10 days with acute respiratory failure secondary to chronic obstructive pulmonary disease (COPD). His eyes sparkling, he tells you he is feeling great and that he was able to walk outside on his patio for a few minutes today without his oxygen. He uses oxygen at 2 L/min when he exercises and prn for shortness of breath. He reports a "chronic cough, as usual" but denies sputum production. He says he still has difficulty "getting off a good cough" because "I just don't have the energy anymore." Upon inspection and auscultation, what kind signs would you find? You might either describe or draw a mindmap.

Unit 5 Heart and Vascular Assessment

Unit 5 Test

1、The physical examination for Mr. Lin, a 58-year-old man, reveals the lateral and inferior displacement of the apical impulse. It suggests
    A、left ventricular enlargement
    B、right ventricular enlargement
    C、dextrocardia
    D、left pneumothorax
    E、left pleural effusion

2、A 36-year-old woman, who has a history of rheumatic arthritis, is admitted for palpitation, shortness of breath and unable to assume the supine position for 2 weeks. Physical examination reveals: faint S1 in apical area; holosystolic murmurs of grade 3 with radiation to the axilla; moderate crescendo diastolic rumbling murmurs with thrills. The diagnosis is
    A、mitral stenosis combined with mitral regurgitation
    B、mitral stenosis combined with aortic regurgitation
    C、mitral stenosis combined with aortic stenosis
    D、mitral regurgitation combined with tricuspid stenosis
    E、mitral stenosis combined with tricuspid regurgitation

3、The most clinically significant sign of aortic stenosis is
    A、the conspicuously shift of heart to the left and downward
    B、diastolic high-pitched decrescendo murmurs in the 3rd and 4th intercostal space closing to the left sternal border
    C、peripheral vessel signs
    D、austin flint murmurs
    E、ejection murmurs in aortic valve area with faint or absent S2

4、To distinguish hepatogenic ascites from cardiogenic ascites, the most reliable sign is
    A、change of heart border on percussion
    B、hepatomegaly
    C、lower extremity edema
    D、jugular venous distention
    E、splenomegaly

5、Which of the following can occur in pericardial effusion?
    A、Water-hammer pulse
    B、Dropped pulse
    C、Pulseless
    D、Pulsus alternans
    E、Paradoxical pulse

6、Which of the following can occur in hypertensive heart disease?
    A、Water-hammer pulse
    B、Dropped pulse
    C、Pulseless
    D、Pulsus alternans
    E、Paradoxical pulse

7、Austin Flint murmurs occur in
    A、moderate or severe aortic regurgitation
    B、rheumatic valvular heart disease-mitral stenosis
    C、ventricular septal defect
    D、mitral stenosis
    E、mitral regurgitation

8、Systolic murmurs in aortic valve area can occur in
    A、hyperthyroidism
    B、stenosis of the ascending aorta
    C、aortic regurgitation
    D、congenital atrial septal defect
    E、dilated cardiomyopathy

9、Organic systolic murmurs in apex can be heard in patients with
    A、anemia
    B、hyperthyroidism
    C、hypertensive heart disease
    D、mitral valve prolapse syndrome
    E、dilated cardiomyopathy

10、Which of the following murmurs will be more audible when the patient takes deep breath?
    A、Rumbling diastolic murmurs of mitral stenosis
    B、Murmurs of aortic regurgitation
    C、Murmurs of pulmonary valve stenosis or pulmonary valve regurgitation
    D、Murmurs of mitral regurgitation
    E、Murmurs of aortic stenosis

11、Which of the following murmurs will be more audible with the patient leaning forward?
    A、Rumbling diastolic murmurs of mitral stenosis
    B、Murmurs of mitral regurgitation
    C、Sighing murmurs of aortic regurgitation
    D、Murmurs of tricuspid regurgitation
    E、Murmurs of pulmonary valve stenosis

12、Besides mitral stenosis, in which of the following can abnormally louder S1 be detected?
    A、Mitral regurgitation
    B、Myocarditis
    C、Myocardial infarction
    D、Heart failure
    E、Anemia

13、The second aortic auscultation area is located
    A、at the apex
    B、next to the left sternal edge in the second intercostal space
    C、next to the right sternal edge in the second intercostal space
    D、next to the left sternal edge in the third intercostal space
    E、on the left or right border of the lower end of the sternum

14、In heart percussion, the cardiac dullness border extends bilaterally, and the left heart border extends laterally and inferiorly. It suggests
    A、left ventricular enlargement
    B、right ventricular enlargement
    C、left and right ventricular enlargement
    D、left atrial enlargement
    E、pericardial effusion

15、Murmurs of patients with patent ductus arteriosus are usually
    A、crescendo murmurs
    B、decrescendo murmurs
    C、crescendo-decrescendo murmurs
    D、continuous murmurs
    E、plateau murmurs

16、A 45-year-old woman comes to the clinic complaining of shortness of breath and palpitation on exertion for 3 years. Physical examination reveals that cardiac dullness border enlarges laterally and inferiorly, and cardiac dullness border is boot-shaped. The cause for her symptoms is most likely to be
    A、aortic regurgitation
    B、cor pulmonale
    C、dilated cardiomyopathy
    D、isolated mitral stenosis
    E、hypertensive heart disease

17、A 59-year-old woman has a history of hypertension for more than 10 years. She complains of palpitation, shortness of breath and marked limitation of physical activity for 10 days. Which of the following signs is most likely to be found in her physical examination?
    A、The apical impulse shifts to the left and slightly upward.
    B、The apical impulse shifts to the left and downward.
    C、Subxiphoid pulsation
    D、Cardiac dullness border enlarges to both the left and the right on percussion.
    E、Pear-shaped cardiac dullness border

18、Typical systolic murmurs of aortic stenosis are
    A、crescendo murmurs
    B、decrescendo murmurs
    C、organic murmurs
    D、continuous murmurs
    E、plateau murmurs

19、The increased intensity of A2 can NOT occur in
    A、aortic stenosis
    B、pulmonary valve stenosis
    C、hypotension
    D、hypertension
    E、pericardial effusion

20、Louder S1 in heart auscultation can NOT occur in
    A、mitral stenosis
    B、mitral regurgitation
    C、hypothyroidism
    D、myocardial infarction
    E、atrial fibrillation

21、The right percussion orders of cardiac dull resonance border are
    A、from bottom to up
    B、from left to right
    C、from outside to innerside
    D、from innerside to outside
    E、from right to left

22、Which of the following valve diseases can produce diastolic murmurs?
    A、Aortic stenosis
    B、Pulmonary stenosis
    C、Aortic insufficiency
    D、Mitral insufficiency
    E、Mitral stenosis

Unit 5 Assignment

1、A 35-year-old woman has chest distress and throbbing sensation in head and neck frequently. Physical examination: mitral face, pathological cardiac murmur, increased pulse pressure and capillary pulsation sign. Questions: 1.What kind of medical history helps to confirm diagnosis? 2.Considering peripheral vessel signs and mitral face, what diagnosis may be got? 3.If aortic regurgitation is suspected, what is the most characteristic sign for auscultation?

Unit 6 Abdomen Assessment

Unit 6 Test

1、The correct order of abdomen assessment should be
    A、inspection, palpation, percussion and auscultation
    B、inspection, auscultation, percussion and palpation
    C、auscultation, inspection, percussion and palpation
    D、inspection, palpation, auscultation and percussion
    E、inspection, auscultation, palpation and percussion

2、Liver span is the distance between upper and lower bounds of the liver in the right when you percuss along the midclavicular line, the normal range is
    A、5-7cm
    B、7-9cm
    C、9-11cm
    D、11-13cm
    E、13-15cm

3、The upper bound of liver dullness space disappears and is replaced by tympany. This can be found in
    A、liver cyst
    B、acute hepatitis
    C、flatulence
    D、acute gastrointestinal perforation
    E、liver cirrhosis

4、Shifting dullness in abdomen suggests
    A、abdominal mass
    B、ascites
    C、huge ovarian cyst
    D、acute gastric dilatation
    E、urinary retention

5、Which is the palpable organ in normal assessment?
    A、Spleen
    B、Gallbladder
    C、Bladder
    D、Lumbar cone
    E、Uterus

6、Rebound tenderness in abdomen indicates that
    A、organ inflammation has involved the visceral peritoneum.
    B、organ inflammation has involved the parietal peritoneum.
    C、organ inflammation has spread to the omentum.
    D、organ inflammation has spread to adjacent organs.
    E、organ inflammation has gone through abdominal wall.

7、Gallbladder enlargement and tenderness to palpation are found in abdominal assessment, which is the most likely diagnosis?
    A、Acute cholecystitis
    B、Gallbladder cancer
    C、Pancreatic head cancer
    D、Gallbladder polyps
    E、Gallstone

8、A 32-year-old man comes to the emergency room with acute abdomen pain. The diagnosis for him is acute appendicitis. What is the most significant sign?
    A、Abdominal muscle tension
    B、Fixed tenderness of McBurney point
    C、Rovsing’s test positive
    D、Obturator maneuver positive
    E、Iliopsoas test positive

9、When auscultate the abdomen of a young man, succession splash in abdominal assessment is heard. Which of the following is the most likely diagnosis?
    A、Pyloric obstruction or gastric dilatation
    B、Low small intestine obstruction
    C、High small intestine obstruction
    D、Obstruction of colon
    E、Obstruction of rectum

10、A 55-year-old woman complains of abdominal distention for more than 3 months. Her abdominal circumference progressively increases accompanied with pitting edema in lower extremities. Lab test indicates abnormal liver function. She has been diagnosed with Hepatitis B for more than 30 years. The possible diagnosis is
    A、peptic ulcer perforation
    B、pancreatic cancer with ascites
    C、nephrotic syndrome with ascites
    D、cirrhosis after hepatitis B infection with ascites
    E、acute pancreatitis with necrosis and hemorrhage

11、A 58-year-old woman complains of abdominal distention for more than 3 months. Her abdominal circumference progressively increases accompanied with pitting edema in lower extremities. Lab test indicates abnormal liver function. She has been diagnosed with Hepatitis B for more than 30 years. What is the positive sign for her?
    A、Positive in succession splash
    B、Positive in shifting dullness
    C、Obvious peristalsis in umbilicus region
    D、Murphy sign
    E、Positive in ruler pressure test

12、A 57-year-old woman complains of abdominal distention for more than 3 months. Her abdominal circumference progressively increases accompanied with pitting edema in lower extremities. She has been diagnosed with Hepatitis B for more than 25 years. She has varicose veins in abdomen. Which of the following is the direction of blood flow on her abdominal wall?
    A、Bottom-up above the umbilical horizontal line, top-down below the umbilical horizontal line
    B、Bottom-up above and below the umbilical horizontal line
    C、Top-down above and below the umbilical horizontal line
    D、Top-down above the umbilical horizontal line, bottom-up below the umbilical horizontal line
    E、The veins are umbilicus-centered and blood flows in all direction.

13、Put left hand behind the organ or mass palpating, and push the examination region to the right-hand direction. The right hand press on the right side of abdomen. The organ or mass could be made not only fixed but also closer to the surface to ease right hand palpation. What kind of palpation is this?
    A、Light palpation
    B、Deep sliding palpation
    C、Bimanual palpation
    D、Pressure deep palpation
    E、Ballottement

14、A 56-year-old man has a large amount of ascites. What kind of abdomen contour is it for him?
    A、Abdomen is frog-like with umbilicus depressed.
    B、Abdomen is frog-like with umbilicus exerted.
    C、Pointed abdomen
    D、Spherical abdomen
    E、Scaphoid abdomen

15、Abdominal breathing weakens or disappears in the following cases
    A、peritonitis
    B、ascites
    C、diaphragmatic paralysis
    D、pregnancy
    E、pleural effusion

16、In abdominal inspection, gastrointestinal pattern and peristalsis could be seen in
    A、the elderly with meager or loose abdominal wall
    B、patients with pyloric obstruction
    C、patients with intestinal obstruction
    D、patients with colonic obstruction
    E、patients with paralytic ileus

17、Epigastric pulsation could be found in
    A、lanky health adults
    B、abdominal aneurysm
    C、hemangiomas of liver
    D、gastric cancer
    E、mitral stenosis or increased right ventricular caused by tricuspid regurgitation

18、Which of the following can NOT be heard in normal abdominal auscultation?
    A、Arterial murmurs
    B、Friction rub
    C、Bowl sounds
    D、Succession splash
    E、Venous murmurs

19、Which of the following descriptions are right about auscultation of bowel sounds?
    A、Bowel sounds appear about 8-12 times per minute.
    B、Active bowel sounds can be heard in acute gastroenteritis, taking laxatives or gastrointestinal bleeding.
    C、Hyperactive bowel sounds can be heard in mechanical obstruction.
    D、Decreased bowel sounds can be heard in senile constipation.
    E、Bowel sounds disappearance can be heard in acute peritonitis or paralytic ileus.

20、Liver dullness area extension is likely to be found in
    A、HCC (Hepatocellular Carcinoma)
    B、liver abscess
    C、liver cirrhosis
    D、liver congestion
    E、polycystic liver disease

Unit 6 Assignment

1、Case Analysis A 48-year-old man complains of upper central abdominal pain for six hours after heavy drinking, which progressively worsens persistently. The pain is knife-like radiating to the lower back, which can slightly be relieved by bending forward. He also complains of nausea and vomiting and his vomitus is gastric contents, with no defecation or gas expelled. Questions: 1. What is the most likely diagnosis for him? 2. What is the most diagnostic value sign for him? 3. What is the best next step to confirm the likely diagnosis?

Unit 7 Spine, Extremities, Joints and Neurological Examination

Unit 7 Test

1、About the muscle strength (myodynamia)test ,how many degrees altogether are there in the evaluation system?
    A、6
    B、7
    C、10
    D、5
    E、4

2、Which of the following is scoliosis that can be corrected by changing posture?
    A、Organic scoliosis
    B、Scoliosis caused by injury
    C、Postural scoliosis
    D、Permanent scoliosis
    E、Congenital scoliosis

3、Spinal cord diseases often lead to which of the following signs or diseases?
    A、Hemiplegia
    B、Paraplegia
    C、Crossed paralysis
    D、Monoplegia
    E、Parkinson’s disease

4、Which of the following does not belong to the ataxia examination?
    A、Finger-to-nose test
    B、Heel-knee-shin test
    C、Action tremor
    D、Romberg test
    E、Rapid alternating test

5、Which of the following diseases is common in festination gait?
    A、Cerebellum diseases
    B、Injury of common peroneal nerve
    C、Spinal cord disease
    D、Parkinson's Disease
    E、Rickets

6、Which of the following is (are)not deep reflex(reflexes)?
    A、Biceps reflex
    B、Cremasteric reflex
    C、Triceps reflex
    D、Patellar tendon reflex
    E、Radioperiosteal reflex

7、Babinski sign is due to which of the following parts is damaged?
    A、Prefrontal lobe
    B、Pyramidal tract
    C、Cerebellum
    D、Brain stem
    E、Cerebral cortex

8、Which of the following is not a superficial reflex?
    A、Patellar tendon reflex
    B、Abdominal reflex
    C、Cremasteric reflex
    D、Corneal reflex
    E、Plantar reflex

9、Which of the following is not a deep reflex?
    A、Brachioradialis reflex
    B、Ankle reflex
    C、Abdominal reflex
    D、Patellar tendon reflex
    E、Biceps reflex

10、If a patient shows level 2 in the muscle strength assessment, then his/her performance meets which of the following?
    A、Limbs can move horizontally but cannot lift/ Full range of motion without gravity (passive motion)
    B、Only muscle contraction but no limb movement/ Palpable muscle contraction but no movement
    C、The patient can perform resistance action, but worse than normal/ Full range of motion against gravity with moderate resistance
    D、Limbs can be lifted off the bed, but they cannot resist resistance/ Full range of motion with gravity
    E、Normal muscle strength/ Full range of motion against gravity with full resistance

11、Which of the following is a typical manifestation of a positive Babinski sign?
    A、All joints of the lower extremities are rapidly retracted
    B、All five toes are dorsiflexed
    C、Plantar flexion of all five toes
    D、Hallux dorsiflexion, other toes fanned out
    E、Calf suddenly bent

12、If a patient shows level 4 in the muscle strength assessment, then his/her performance meets which of the following?
    A、Limbs can be lifted off the bed, but they cannot resist resistance/ Full range of motion with gravity
    B、Only muscle contraction but no limb movement/ Palpable muscle contraction but no movement
    C、Completely paralyzed/ No muscle contraction
    D、Can perform resistance action, but worse than normal/ Full range of motion against gravity with moderate resistance
    E、Limbs can move horizontally but cannot lift/ Full range of motion without gravity (passive motion)

13、Which of the following is not included in the exercise function test?
    A、Nerve reflex
    B、Muscle strength
    C、Muscular tension
    D、Involuntary exercise
    E、Coordinate movement

14、The patient exhibited diplopia, a drooping eyelid, restricted inward, upward, and downward movement of the eyeball, and dilated pupils, suggesting the problem of cranial nerves of
    A、Abduncens nerve
    B、Trochlear nerve
    C、Trigeminus nerve
    D、Oculomotor nerve
    E、Facial nerve

15、Which pair of cranial nerves innervates the facial expression muscles?
    A、Facial nerve
    B、Trigeminus nerve
    C、Oculomotor nerve
    D、Accessory nerve
    E、Trochlear nerve

16、About the physiological curvatures of the spine,which ones (different parts of the spine) are in the direction of backward?
    A、Thoracic vertebrae
    B、Sacral vertebrae
    C、Cervial vertebrae
    D、Lumber vertebrae

17、Regarding the physiological curvatures of the spine, which of the following is (are)forward?
    A、Cervical vertebra
    B、Thoracic vertebra
    C、Lumbar vertebra
    D、Sacral vertebra
    E、Coccygeal vertebra

18、Which of the following is a superficial reflex?
    A、Light reflex
    B、Abdominal reflex
    C、Corneal reflex
    D、Cremasteric reflex
    E、Plantar reflex

19、When checking muscle strength, which of the following descriptions about the patient is correct?
    A、Could cooperate with the nurse to check
    B、The patient has to be conscious
    C、The patient who has muscle paralysis is available to complete the exmination
    D、The patients who has muscle atrophy is available to complete the examination
    E、The patient who is in coma is available to complete the examination
    F、The patients who has a recent injury in the wrist joint is available to complete the examination with the injured hand

20、Which of the following is a meningeal irritation sign?
    A、Kernig sign
    B、Babinski sign
    C、Oppenheim sign
    D、Brudzinski sign
    E、Chaddock sign

Unit 7 Assignment

1、To submit a reflective diary of comparing the examinations of two similar signs. Kernig sign(one sign indicating meningeal irritation) and Lasegue sign(Straight leg rising test). You are also supposed to evaluate the work of other students, and finally conduct self-evaluation. Specific requirements: 1. Different purposes of those two signs? Different procedures of the two signs? 2. Anything related between the two signs?

Unit 8 Psycho-social Assessment, Symptom Assessment, and Nursing Diagnosis

Unit 8 Test

1、The locations of hypertension-induced headaches are characterized by
    A、pain in the whole head
    B、pain mainly in the occiput
    C、pain mainly in the neck
    D、pain mainly in the temporal part of face
    E、superficial pain in the whole head

2、In which of the following conditions can impulsive headache occur?
    A、Drug poisoning
    B、Heat stroke
    C、Vascular headache
    D、Uremia
    E、Hysterical headache

3、In which of the follow conditions can headache with violent vomiting occur?
    A、Cerebral hemorrhage
    B、Intracranial hypertension
    C、Heat stroke
    D、Migraine
    E、Uremia

4、Pain of angina can radiate to
    A、the left shoulder and the inner side of the left forearm.
    B、right shoulder.
    C、left lumbar back.
    D、right lumbar back.
    E、right leg.

5、Chest pain that happens behind the sternum or below the xiphoid, with a squeezing or compressing nature, indicates
    A、herpes zoster.
    B、spontaneous pneumothorax.
    C、angina.
    D、aortic dissection.
    E、pulmonary embolism.

6、Which of the following is a cause of chest pain, but not a disease of the chest wall?
    A、Intercostal neuritis.
    B、Mediastinal mass.
    C、Herpes zoster.
    D、Rib fracture.
    E、Non-suppurative costal chondritis.

7、A 64-year-old man has symmetric pitting edema in both legs for 3 weeks. The edema worsens over the day and relieves after night sleep. He has no limitation of motion, no eyelid edema, no fever and no pain. And he is able to lie down at night. History of past illnesses: hypertension for several years and it is under control by oral amlodipine and metoprolol. Bp: 120/70mmHg. Physical exam reveals no abnormalities in his heart and lungs but mild pitting edema in his legs. Which of the following is UNLIKELY to be the diagnosis?
    A、Age-related edema
    B、Inferior vena cava obstruction syndrome
    C、Angioneurotic edema
    D、Drug-induced edema
    E、Sedentary edema

8、A 4-year-old boy suddenly had dyspnea after laughing at a meal. He has cyanosis, positive three retraction signs, and high-pitch wheezing. Which of the following is the most likely diagnosis?
    A、Foreign body in the trachea
    B、Acute laryngitis
    C、Bronchial asthma
    D、Acute bronchitis
    E、Acute left-sided heart failure

9、A 59-year-old male patient has been unable to lie down for two days. He also complains of dyspnea, coughing up pink foamed sputum. Which of the following is the most likely diagnosis for him?
    A、Bronchial asthma
    B、Acute left heart failure
    C、Pneumothorax
    D、Lobar pneumonia
    E、COPD

10、A 16-year-old boy had a sudden chest pain with dyspnea after the collision with a player at a basketball game. Which is the most likely diagnosis for this patient?
    A、Acute myocardial infarction
    B、Lobar pneumonia
    C、Pulmonary infarction
    D、Bronchial asthma
    E、Pneumothorax

11、A 36-year-old female patient presents with recurrent upper abdominal pain for 3 years, which relieves after meals and aggravates at night. Her physical examination is unremarkable. Which of the following is the most likely diagnosis for her?
    A、Chronic gastritis
    B、Duodenal bulbar ulcer
    C、Gastric cancer
    D、Carcinoma of the gastric cardia
    E、Chronic pancreatitis

12、Which of the following disorders of consciousness is the least severe one?
    A、Lethargy
    B、Stupor
    C、Confusion
    D、Moderate coma
    E、Deep coma

13、A 71-year-old male patient presents with sudden severe headache and vomiting. Soon later, he presents impaired consciousness, and is unresponsive to sound and light stimuli, and shows unpleasant facial expression to pain stimulus. His light reflex and eye movement are present. Which of the following diagnoses is correct?
    A、Lethargy
    B、Stupor
    C、Mild coma
    D、Moderate coma
    E、Deep coma

14、A 42-year-old woman presents with depressive emotion, loss of interest and appetite, loss of energy, frequent feeling of fatigue, hypologia, insomnia, early wakening, and occasional intent for suicide for half a year. Which of the following is the most likely diagnosis?
    A、Neurasthenia
    B、Depression
    C、Depressive neurosis
    D、Reactive depression
    E、Insomnia

15、Which of the following belongs to the first role?
    A、Mother
    B、Nurse
    C、Teacher
    D、Member of Committee
    E、Doctor

16、The basic method for mental health assessment is
    A、observation
    B、psychometric
    C、medical test
    D、scale
    E、interview

17、Factors that affect the clients’ reaction include
    A、age
    B、willpower
    C、pain experience
    D、social-cultural background
    E、marital status

18、Which of the following statements regarding the mechanisms of edema and ascites caused by liver cirrhosis are correct?
    A、Obstruction of lymph drainage in the liver.
    B、Secondary aldosteronism.
    C、Portal hypertension.
    D、Hyponatremia.
    E、Hypoalbuminemia.

19、Which of the following are the mechanisms of edema?
    A、Capillary hydrostatic pressure increases.
    B、Plasma colloid osmotic pressure increases.
    C、Tissue colloid osmotic pressure increases.
    D、Interstitial fiuid pressure increases.
    E、Capillary permeability increases.

20、Which of the following conditions are edema?
    A、Edema in lower extrimities.
    B、Eyelid edema.
    C、Pulmonary edema.
    D、Pericardial effusion.
    E、Pleural effusion.

21、A 26-year-old female patient has a persistent chest pain on the right side for one week and dyspnea after activities. Chest X-ray shows meniscus sign on the right side. Which of the following are the most likely nursing diagnoses?
    A、Pain related to pleuritis
    B、Activity intolerance related to pleuritis
    C、Hyperthermia related to inflammation
    D、Anxiety related to dyspnea
    E、Risk for falls related to pain

22、A 25-year-old male patient comes to clinic for high fever after a cold. He also complains of cough with yellow sputum that not easy to be excreted and right chest pain. Which of the following are the most likely nursing diagnoses?
    A、Pain related to poneumonia
    B、Ineffective Airway Clearance related to poneumonia
    C、Hyperthermia related to inflammation
    D、Anxiety related to dyspnea
    E、Risk for falls related to pain

Unit 8 Assignment

1、Case analysis A 40-year-old male patient has a 10-year history of chronic nephritis. Half a year ago, the eyelid and face edema appeared in the morning. Recently, the edema developed to the whole body. The skin was tense and shiny. There were blisters. The urine volume decreased. It was 500-600ml / day. It was difficult to sleep. What are the most likely nursing diagnosis for him?

Unit 9 Electrocardiogram (ECG)

Unit 9 Test

1、Lead I is a standard lead, where should the electrodes be placed?
    A、Left wrist and left ankle
    B、Right and left ankle
    C、Right and left wrist
    D、Left ankle and right wrist
    E、Right ankle and left wrist

2、When the graph paper moves at a constant speed of 25mm/s, then one small box represents
    A、0.02s
    B、0.04s
    C、0.1s
    D、0.2s
    E、0.25s

3、A 59-year-old male patient presents with palpitation for 1 hour. The patient’s ECG is shown as follows. Which of the following is the most likely diagnosis for this patient?
    A、Supraventricular tachycardia
    B、Sinus tachycardia
    C、Atrial flutter
    D、Sinus tachycardia
    E、Non-paroxysmal junctional tachycardia

4、A 17-year-old male presents with the following ECG. Which of the following is the most likely diagnosis for this patient?
    A、Sinus arrest
    B、Second degree sinoatrial block (Type I)
    C、Second degree sinoatrial block (Type II)
    D、Sinus arrhythmia
    E、Atrial premature beats

5、A 42-year-old male presents with the following ECG. Which of the following is the most likely diagnosis for this patient?
    A、Left atrial hypertrophy
    B、Right atrial hypertrophy
    C、Left ventricular hypertrophy
    D、Right ventricular hypertrophy
    E、Both sides atrial hypertrophy

6、A 50-year-old female presents with the following ECG. Which of the following is the most likely diagnosis for this patient?
    A、Left atrial hypertrophy
    B、Right atrial hypertrophy
    C、Left ventricular hypertrophy
    D、Right ventricular hypertrophy
    E、Both sides atrial hypertrophy

7、A 50-year-old female presents with the following ECG. Which of the following is the most likely diagnosis for this patient?
    A、Left ventricular hypertrophy
    B、Right ventricular hypertrophy
    C、Left ventricular hypertrophy with heart strain
    D、Right ventricular hypertrophy with heart strain
    E、Both sides ventricular hypertrophy with heart strain

8、A 50-year-old male presents with the following ECG. Which of the following is the most likely diagnosis for this patient?
    A、Left ventricular hypertrophy
    B、Right ventricular hypertrophy
    C、Left ventricular hypertrophy with heart strain
    D、Right ventricular hypertrophy with heart strain
    E、Both sides ventricular hypertrophy with heart strain

9、A 50-year-old male presents with the following ECG. Which of the following is the most likely diagnosis for this patient?
    A、Left ventricular hypertrophy
    B、Right ventricular hypertrophy
    C、Left ventricular hypertrophy with heart strain
    D、Right ventricular hypertrophy with heart strain
    E、Both sides ventricular hypertrophy with heart strain

10、A 48-year-old male presents with the following ECG. Which of the following is the most likely diagnosis for this patient?
    A、Acute anterior septal myocardial infarction
    B、Acute anterior myocardial infarction
    C、Acute anterior wall myocardial infarction
    D、Acute inferior myocardial infarction
    E、Acute posterior myocardial infarction

11、A 48-year-old male presents with the following ECG. Which of the following is the most likely diagnosis for this patient?
    A、Atrial premature beats
    B、Junctional premature beats
    C、Ventricular premature beats
    D、Second degree atrioventricular block
    E、Third degree atrioventricular block

12、A 32-year-old male presents with the following ECG. Which of the following is the most likely diagnosis for this patient?
    A、Paroxysmal supraventricular tachycardia
    B、Paroxysmal ventricular tachycardia
    C、Atrial fbrillation
    D、Ventricular fibrillation
    E、Atrial flutter

13、A 67-year-old male presents with the following ECG. Which of the following is the most likely diagnosis for this patient?
    A、Atrial fibrillation
    B、Atrial flutter
    C、Ventricular fibrillation
    D、Ventricular flutter
    E、Ventricular tachycardia

14、A 46-year-old male presents with the following ECG. Which of the following is the most likely diagnosis for this patient?
    A、First degree AVB
    B、Second degree AVB (Type I)
    C、Second degree AVB (Type II)
    D、Third degree AVB
    E、High degree AVB

15、A 46-year-old male presents with the following ECG. Which of the following is the most likely diagnosis for this patient?
    A、First degree AVB
    B、Second degree AVB (Type I)
    C、Second degree AVB (Type II)
    D、Third degree AVB
    E、High degree AVB

16、A 52-year-old female presents with the following ECG. Which of the following is the most likely diagnosis for this patient?
    A、First degree AVB
    B、Second degree AVB (Type I)
    C、Second degree AVB (Type II)
    D、Third degree AVB
    E、High degree AVB

17、A 67-year-old female presents with the following ECG. Which of the following is the most likely diagnosis for this patient?
    A、First degree AVB
    B、Second degree AVB (Type I)
    C、Second degree AVB (Type II)
    D、Third degree AVB
    E、High degree AVB

18、Normal cardiac excitation generates from
    A、sinus node.
    B、atrioventricular node.
    C、internodal pathways.
    D、bundle of His.
    E、Pukinje fibers.

19、Which of the following are true concerning the waveforms of ECG?
    A、P-wave indicates atrial depolarization.
    B、QRS complex indicates ventricular depolarization.
    C、ST segment indicates slowly ventricular repolarization.
    D、QT interval indicates the duration of ventricular repolarization.
    E、T wave indicates fast ventricular repolarization.

20、Which of the following indicate ventricular repolarization?
    A、PR segment
    B、PR interval
    C、ST segment
    D、T wave
    E、QT interval

21、Standard leads include:
    A、Lead I
    B、Lead Ⅱ
    C、Lead Ⅲ
    D、Lead aVL
    E、Lead aVF

22、The augmented leads include:
    A、Lead I
    B、Lead Ⅱ
    C、Lead aVR
    D、Lead aVL
    E、Lead aVF

23、Potentially dangerous ventricular premature contractions include
    A、frequent ventricular premature contraction.
    B、multiple ventricular premature contraction.
    C、syncytial ventricular premature contraction.
    D、R on T ventricular premature contraction.
    E、sporadic ventricular premature contraction.

24、Premature beats could be seen in
    A、excitement.
    B、overeating, drinking, smoking.
    C、physical overwork.
    D、carditis.
    E、acute myocardiac infarction.

25、Complete compensatory pause could be seen in
    A、atrial premature beats.
    B、ventricular premature beats.
    C、junctional premature beats.
    D、bigeminy of ventricular premature contraction.
    E、sinus premature beats.

Unit 9 Assignment

1、1.What type of tachycardia for the following ECG is? 2. What type of tachycardia for the following ECG is?

Unit 10 Laboratory Examination

Unit 10 Test

1、Routine blood test does not include
    A、Red blood cell count
    B、Reticulocyte count
    C、Hemoglobin concentration
    D、White blood cell count
    E、Hematocrit determination

2、Which of the following description meets the characteristics of leakage ?
    A、Often caused by inflammation
    B、Presents with serous appearance
    C、Usually with specific gravity above 1.018
    D、Can self-coagulate
    E、Usually with lot of cells

3、Oliguria means that the urine volume within 24 hours is less than
    A、100ml
    B、400ml
    C、600ml
    D、1000ml
    E、17ml

4、Hyperkalemia means that the blood potassium concentration exceeds:
    A、3.5mmol / L
    B、4.5mmol / L
    C、5mmol / L
    D、5.5mmol / L
    E、6mmol / L

5、A 55-year-old male patient, 2 hours after eating and drinking, suffered persistent pain in the upper abdomen and radiated to his left shoulder, lower back, and nausea and vomiting. He was admitted to the emergency department 12 hours later. Currently, the most helpful diagnostic test is:
    A、Blood routine
    B、Abdominal puncture
    C、Blood and urine amylase
    D、Plain films of chest and abdomen
    E、Urine routine

6、In the blood test, the right shift of the nucleus of the peripheral blood neutrophils often indicates:
    A、Leukemia
    B、Allergic diseases
    C、Strong hematopoietic function
    D、Low bone marrow hematopoietic function
    E、Acute suppurative bacterial infection

7、Which of the following result of blood examinations is ABNORMAL?
    A、Red blood cell count 5 × 1012/L (adult female)
    B、Hemoglobin 130g / L (adult female)
    C、Neutrophil ratio 70% (adult female)
    D、Lymphocyte ratio 10% (adult female)
    E、Lymphocyte ratio 30% (adult female)

8、Which of the following statement indicates liver cells seriously damaged as well as a poor prognosis?
    A、Increased bilirubin
    B、Increased alanine aminotransferase
    C、Significantly and continuously reduced albumin
    D、Increased serum cholesterol
    E、Significantly increased albumin

9、Which of the following statements about collection procedure of stool is WRONG?
    A、Put in a water-absorbent container without a lid
    B、A little fresh stool
    C、Do not mix external impurities
    D、Take the part with pus and blood if they exist
    E、When there is no fecal discharge and must be checked, the specimen can be collected by digital rectal examination

10、Regarding the examination of red blood cells, which of the following statement is INCORRECT?
    A、Severe vomiting can cause a relative increase in red blood cells
    B、Polycythemia vera can cause an absolute increase in red blood cells
    C、Women may have erythrocyte reduction in late pregnancy
    D、Secondary erythrocytosis has nothing to do with EPO
    E、Reticulocyte count helps the differential diagnosis of anemia

11、The normal human albumin / globulin ratio (A / G) is:
    A、1-1.2 / 1
    B、1-1.5 / 1
    C、1.5-2.0 / 1
    D、1.5-2.5 / 1
    E、1.8-2.5 / 1

12、Which of the following condition will cause the increase the eosinophil count:
    A、Intestinal hookworm infection
    B、Cardiogenic asthma
    C、Late pregnancy
    D、Long term use of glucocorticoid
    E、Typhoid fever

13、In the urine microscopic examination, some white blood cell casts are found, most probably this may indicate:
    A、Acute glomerulonephritis
    B、Pyelonephritis
    C、Nephrotic syndrome
    D、Chronic renal failure
    E、Kidney congestion

14、Which of the following conditions will cause soy sauce urine?
    A、Prostatitis
    B、Urine concentration induced by high fever
    C、Cirrhosis
    D、Acute hepatitis
    E、Transfusion of blood incompatible

15、Which of the following conditions does not show a decrease in red blood cells and hemoglobin?
    A、End-stage renal failure
    B、Massive loss of body fluids
    C、Impaired bone marrow function
    D、Iron deficiency
    E、Anemia

16、Which of the following element could exist in the urine of a healthy person?
    A、Water
    B、Protein
    C、Urea
    D、Red blood cells
    E、Inorganic salt

17、Under which of the following condition will the patient be tested positive for serum AFP(alpha-fetoprotein)?
    A、Acute pancreatitis
    B、Cirrhosis
    C、Primary liver cancer
    D、Pregnancy
    E、Viral hepatitis

18、Which of the following indicators can be used to assess red blood cell morphology?
    A、Average red blood cell index
    B、Mean corpuscular hemoglobin
    C、Mean corpuscular hemoglobin concentration
    D、Mean corpuscular volume
    E、Hematocrit

19、Regarding the examination of stool, which of the following statements is correct?
    A、When small intestine is inflamed, it is easy for mucus to adhere to the surface of stool
    B、Purulent mucus could be found in the stool of patient with amoebic dysentery
    C、Black stools may appear in the upper gastrointestinal bleeding volume of 50 ml
    D、Bile duct obstruction could result in white clay-like stool
    E、Rectal cancer can result in bloody stools

20、Abnormal urine smell can be seen in which of the following conditions?
    A、Eating food with pungent smell
    B、Chronic cystitis
    C、Diabetic ketoacidosis
    D、Organophosphorus pesticide poisoning
    E、Phenylketonuria

Unit 10 Assignment

1、Please contemplate on the issues nurses have to communicate with the patient before those three most common examinations: blood routine; stool and urine routine examinations. You are also supposed to evaluate the work of other students, and finally conduct self-evaluation. Specific requirements: 1. List the points about specimen collecting patient has to be informed. 2. Things the patient should be reminded to AVOID before the collection of the specimens.

Final Exam!

Final Exam

1、Which of the following is most commonly used for detecting masses which are deep in abdomen and gastrointestinal lesions?
    A、Light palpation
    B、Bimanual palpation
    C、Deep slipping palpation
    D、Deep press palpation
    E、Ballottement

2、Which of the following is the normal sound of percussion of the lung fields?
    A、Hyperresonance
    B、Tympany
    C、Dullness
    D、Flatness
    E、Resonance

3、To ascertain the presence of tenderness, resistance, pulsation, masses and enlargement of organs, which of the following method should be taken?
    A、Deep press palpation
    B、Deep slipping palpation
    C、Bimanual palpation
    D、Light palpation
    E、Ballottement

4、The best way to deal with the patient who digresses from the topic during a health history interview is
    A、To stop the interview and continue another day
    B、To wait patiently for him/her to finish
    C、To tell the patient that he/she has digressed from the topic
    D、To politely lead the conversation back to the topic
    E、To stop the patient right away

5、Which of the following is the major anatomical mark in counting thoracic vertebra?
    A、Inferior angle of scapula
    B、Spinous process of C7
    C、Posterior axillary line
    D、Floating ribs
    E、Clavicle

6、Physical examination of a patient reveals a repeated breath pattern which is shallow and slow in the beginning, gradually turns deep and fast, and finally presents with a brief pause. Which of the following is the most likely diagnosis?
    A、Biot breathing
    B、Sighing breathing
    C、Cheyne-Stoke breathing
    D、Bradypnea
    E、Tachypnea

7、Which of the following describes a deepened respiration caused by severe acidosis?
    A、Cheyne-Stoke breathing
    B、Biot breathing
    C、Hurried and interrupted breathing
    D、Kussmaul breathing
    E、Sighing breathing.

8、If systolic thrills are palpable in the left second intercostal space, it suggests
    A、Aortic stenosis
    B、Pulmonary artery stenosis
    C、Ventricular septal defect
    D、Mitral stenosis
    E、Patent ductus arteriosus

9、The decreased intensity of S2 usually occurs in
    A、Hypertension
    B、Pulmonary valve stenosis
    C、Atherosclerosis
    D、Atrial septal defect
    E、Cor pulmonale

10、A 45-year-old woman has had chest pain and dyspnea on exertion for 3 years. The blood pressure is 150/30mmHg and his heart enlarges like a boot. Which of the following signs is most likely to be found on physical examination?
    A、Systolic thrills in the second intercostal space close to the right sternal border
    B、Holosystolic apical murmurs
    C、Apical rumbling diastolic murmurs
    D、Diastolic murmurs in the third intercostal space close to the left sternal border
    E、Systolic murmurs in the third intercostal space close to the left sternal border

11、For abdominal examination, which is the best way to distinguish between tenderness of lesions in the abdominal wall and the abdominal organs?
    A、Ups breath test
    B、Light abdominal palpation
    C、Abdominal deep slipping palpation
    D、Do deep abdominal palpation pressure
    E、Abdominal ballottement

12、Mild coma can present
    A、Asleep, unarousable
    B、Pharyngeal refex is absent
    C、Corneal reflex and eye movement is present
    D、Pupillary light reflex is absent
    E、No responsive movement to pain stimuli

13、Chest lead V5 should be placed in which of the following position?
    A、In the 5th intercostal space at left midaxillary line
    B、In the 4th intercostal space at right sternal border
    C、In the 4th intercostal space at left sternal border
    D、At the point intersection of left clavicular line and the 5th intercostal space
    E、V4 level at left anterior axillary line

14、A 66-year-old male patient presents to the emergency department with palpitation andsyncope. The patient’s ECG is shown in the following figure. Which of the following is the most likelydiagnosis for this patient?
    A、Ventricular tachycardia
    B、Atrial tachycardia with aberrant ventricular conduction
    C、Nonvparoxysmal supraventricular tachycardia
    D、Junctional tachycardia with aberrant ventricular conduction
    E、Supraventricular tachycardia conducted through the accessory pathway

15、A 61-year-old female patient was hospitalized with sudden onset of persistent chest pain. The patient’s ECG is shown in the following figure. Which of the following is the most likely diagnosis for this patient?
    A、Acute anterior myocardial infarction
    B、Cardiomyopathy
    C、Acute pericarditis
    D、Acute anterior septal myocardial infarction
    E、Acute inferior myocardial infarction

16、A female patient pays a visit to your office today. She presents with facial edema, thick wide face and dull eyes. During communication she looks a little unresponsive. Physical examination shows that her tongue is hypertrophic and with pale color. What problem may she suffer?
    A、Pneumonia
    B、Leukemia
    C、Anemia
    D、Tuberculosis
    E、Hypothyroidism

17、In the inspection of oral cavity, if the left tonsil exceeds the midline of the posterior pharyngeal wall, while the right tonsil protrudes beyond the palatopharyngeal arch but do not reach the midline. Which of the following degree of tonsillar enlargement should be classified?
    A、Left III; Right II
    B、Left I; Right II
    C、Left II; Right III
    D、Left III; Right I
    E、Could not determine based on the information given

18、About the assessment of thyroid, which one of the following descriptions is NOT correct?
    A、Located below the thyroid cartilage and anterior to the trachea.
    B、We could ask the patient to swallow a sip of water for better feeling for the movement of the thyroid gland.
    C、It is not necessary to auscultate the thyroid gland.
    D、Usually in patient with hyperthyroidism, the thyroid is soft in texture.
    E、Normal thyroid is not visible.

19、About corneal reflex, which of the following statement is NOT correct?
    A、Belongs to superficial reflex.
    B、If corneal reflex on both sides disappear, it could be caused by trigeminal neuropathy.
    C、If direct reflex disappears while indirect exists, it could be caused by paralysis of facial nerve.
    D、Both direct and indirect reflex should be examined.
    E、Deep coma could cause this reflex to disappear on one side.

20、If a patient shows level 2 in the muscle strength assessment, then his/her performance meets which of the following?
    A、Limbs can be lifted off the bed, but they cannot resist resistance/ Full range of motion with gravity.
    B、Only muscle contraction but no limb movement/ Palpable muscle contraction but no movement.
    C、Completely paralyzed/ No muscle contraction.
    D、Can perform resistance action, but worse than normal/ Full range of motion against gravity with moderate resistance.
    E、Limbs can move horizontally but cannot lift/ Full range of motion without gravity (passive motion).

21、Which of the following description does NOT meet the characteristics of exudate?
    A、Often caused by inflammation.
    B、Presents with serous appearance.
    C、Usually with specific gravity above 1.018.
    D、Can self-coagulate.
    E、Usually with lot of cells.

22、About the examination of the urine, which of the following statement is NOT correct?
    A、Anuria refers to less than 100ml of urine per day.
    B、Less than 400ml per day is defined as oliguria.
    C、Rotten apple smell could indicate diabetic ketoacidosis.
    D、Normal urine is weakly basic.
    E、Increase of urine pH can be seen in alkalosis.

23、Which of the following result of blood examinations is ABNORMAL?
    A、Fasting blood glucose 4.5mmol/L (adult female)
    B、Hemoglobin 130g / L (adult female)
    C、TG(Triglyceride) 1.02mmol/L (adult male).
    D、ESR 30mm/1h (adult female)
    E、Lymphocyte ratio 30% (adult female)

24、Which of the following statements regarding subcutaneous emphysema are correct?
    A、Gas mass is present in subcutaneous tissue of the chest.
    B、Crepitatus with palpation.
    C、It can spread to the neck and abdomen in severe cases.
    D、It can sometimes be detected in Clostridium Perfringens infection.
    E、It can only be detected in lung, trachea, or pleura damage.

25、Which of the following are right about liver palpation?
    A、Patients should be put into supine position with two knee flexed, and do deep abdominal breathing.
    B、Examiner should stand on the right side of the patients with one hand or bimanual palpation.
    C、The most sensitive parts of tactual sensation are index fingertips.
    D、Examiner should close four fingers together, extend metacarpophalangeal joints, and roughly put hands parallel to the lower border of liver in the right side of abdomen or below the area of liver dullness, move with the abdominal breathing to costal margin.
    E、Palpation of liver needs to closely coordinate breathing movements. Finger elevation must be behind the elevation of abdominal wall in inspiration and should press inward ahead of the anterior abdominal wall subsidence in expiration.

26、A 25-year-old male patient comes to clinic for high fever after a cold. He also complains of cough with yellow sputum that not easy to be excreted and right chest pain. Which of the following are the most likely nursing diagnoses?
    A、Pain related to poneumonia
    B、Ineffective Airway Clearance related to poneumonia
    C、Hyperthermia related to inflammation
    D、Anxiety related to dyspnea
    E、Risk for falls related to pain

27、Among the following descriptions about asthenic(leptosomic)type habitus, which is INCORRECT?
    A、Drooping shoulder
    B、Short and thick limbs
    C、Epigastric angle less than ninety
    D、Broad shoulder
    E、Epigastric angle larger than ninety

28、Local enlargement of lymph nodes can be seen in those diseases EXCEPT
    A、Tuberculosis
    B、Viral influenza
    C、Infectious monocytosis
    D、Lymphoma
    E、Gonorrhoea

29、Which of the following descriptions about Koplik spot is NOT correct?
    A、White spots.
    B、On the buccal mucosa lateral to the second molar teeth.
    C、Happens in the early stage of measles.
    D、Could be seen in lymphoma.
    E、Could happen in patients with systemic lupus erythematosus.

30、Which of the following do not belong to meningeal irritation sign?
    A、Kernig sign
    B、Neck stiffness
    C、Oppenheim sign
    D、Brudzinski sign
    E、Chaddock sign