6621 Module 1 Mystery Breakout

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NURS 6621 Advanced Physical Assessment

Module 1 Mystery Breakout

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You have entered a dark and unknown world from which you have to get out before it's too late and you will be locked in forever.

Intro

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Mission 1

A 24-year-old man presents to a sexually transmitted infections clinic with concern regarding possible exposures to such diseases. During the course of the interview, the patient becomes somewhat uncomfortable with detailed questions about his exposures, including history of intravenous drug use and anal receptive sexual intercourse, all of which he denies vehemently. He questions the need for such interrogation and answers some inquiries with a shrug and a glare. Ultimately, he demands to know the purpose of this process. In answer to his question, the ultimate role of the medical history is to obtain which of the following?

Assist with generation and testing of hypotheses about the patient's diagnosis

Document the patient's narrative for billing and reimbursement reasons

Document the patient's narrative for medico-legal preotection of the clinician

Answer the question and you will find out the address of the following scenario

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Mission 2

Drag and discover

A 38-year-old schoolteacher presents with a large, palpable breast lump, significant weight loss, and fatigue. Her mother died of breast cancer at the age of 51, which the patient states is “why I’m so afraid to get a mammogram.” Which of the following should the nurse practitioner (NP), avoid sharing with the patient?

His suspicion that the patient has breast cancer

A mammogram can be arranged, if desired

The lump is palpable

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Completed

Mission 3

"A mass roughly the size of a golf ball"

A 35-year-old woman comes to the physician due to pelvic pain and bloating. These symptoms have been present for most of the past six weeks. On pelvic examination, the clinician detects a retrouterine mass approximately the diameter of a golf ball, which is itself roughly 4 cm in diameter. How should the size of this mass be recorded?

"A 4 cm mass"

"A 30 mm mass"

A 24-year-old man presents to his primary care clinic and relates the following information: “I have been having this pain in my abdomen for the past week. I tried taking antacids but it didn’t seem to help. The pain stayed the same. But when I bend over the pain gets worse and sort of moves to my back. It feels like a sharp burning pain. Sometimes it seems to go away when I sit down but in an hour or so it returns. I think it is getting worse.” Which of the following clarifying questions would best complete the history of her presenting symptom?

Where on your abdomen is the pain?

How would you rate the pain on a scale of 1-10?

Does the pain radiate anywhere?

A 45-year-old man is brought to the emergency department (ED) after a serious car accident. The ED resident suspects subarachnoid hemorrhage (SAH). In researching the likelihood of SAH in motor vehicle accidents, he finds that the likelihood ratio of SAH is 10 in the presence of neck stiffness and 0.4 in the absence of neck stiffness. The patient’s neck is not stiff. Which of the following is correct?

The patient is unlikley to have SAH

The presence of SAH is unrelated to neck stiffness

The patient is fairly likely to have SAH

Remember the code

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216

Completed

Completed

Mission 4

Completed

A 59-year-old man complains of frequent pain “in my stomach,” and when questioned in detail, points to his substernal area. He says that the pain feels like a dull ache. He also reports dry mouth, itching between his toes, and a feeling that his vision is “just isn’t as sharp as it used to be.” Which of the following actions would help the clinician narrow down the patient’s problem to the cardiovascular system?

Identifying the conditions that precipitate the pain

Identifying other problems the patient has not yet mentioned

Asking the patient to rate his pain severity on a 10 point scale

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