Which of the following are Review of Systems (ROS) questions? SELECT ALL THAT APPLY.
No cough, wheezing, shortness of breath
Bilateral inspiratory wheeze with mild intercostal retractions
Reports increased inhaler use following exercise
No hemoptysis or change in sputum color or consistency
Chest radiograph findings show loculated pleural effusion
The Correct Answer is ["A","C","D"]
A. No cough, wheezing, shortness of breath is correct because it reflects subjective information provided by the patient regarding their respiratory system. In a ROS, the clinician systematically asks the patient about the presence or absence of specific symptoms across body systems. Stating “no cough, wheezing, shortness of breath” is a patient-reported history, which is exactly what ROS aims to capture.
B. Bilateral inspiratory wheeze with mild intercostal retractions is incorrect because this is an objective finding observed by the clinician during the physical examination, not a symptom reported by the patient. ROS focuses exclusively on subjective reports, not observable signs.
C. Reports increased inhaler use following exercise is correct because it is a patient-reported symptom indicating functional limitations or exacerbations of their respiratory condition. This type of information is included in the ROS because it comes directly from the patient’s experience, rather than the nurse’s observations or test results.
D. No hemoptysis or change in sputum color or consistency is correct because it documents the absence of patient-reported symptoms, which is a standard approach in ROS. ROS often captures both the presence and absence of symptoms, allowing clinicians to screen systematically for abnormalities.
E. Chest radiograph findings show loculated pleural effusion is incorrect because this represents an objective diagnostic result, not a patient-reported symptom. Imaging, lab tests, and other diagnostic data are part of the physical exam or diagnostic workup, not the ROS.Top of FormBottom of Form
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Related Questions
Correct Answer is B
Explanation
A. Bilateral tympanic membranes erythematous, flat, with good cone of light is incorrect because, although erythema is present, the TM is flat, landmarks are intact, and the cone of light is visible, which suggests no middle ear effusion and does not meet criteria for AOM. This may indicate mild irritation, viral upper respiratory infection, or early inflammation.
B. Left tympanic membrane erythematous, bulging and non-mobile, with loss of landmarks is correct because these findings reflect the classic presentation of acute otitis media. Bulging occurs due to pressure from pus or fluid in the middle ear, and non-mobility on pneumatic testing confirms the presence of middle ear effusion, which differentiates AOM from viral pharyngitis or external ear infections.
C. Bilateral tympanic membranes intact and mobile, with good cone of light is incorrect because these are normal otoscopic findings, indicating no acute infection, normal TM integrity, and proper mobility.
D. Right tympanic membrane erythematous and flat, with blood-tinged discharge is incorrect because the blood-tinged discharge suggests trauma, tympanic membrane perforation, or chronic otitis media with perforation, rather than typical AOM. While erythema is consistent with inflammation, the presence of discharge and flat TM points to a different pathology.
Correct Answer is C
Explanation
A. Suprapubic area is incorrect because this region is located just above the bladder. Tenderness here usually indicates bladder pathology, such as cystitis, bladder distention, or other lower urinary tract issues, rather than kidney problems. While suprapubic pain may coexist with kidney disease if infection spreads, it does not reliably indicate renal tenderness.
B. Periumbilical area is incorrect because this area surrounds the navel and is typically evaluated for abdominal and gastrointestinal conditions such as early appendicitis, bowel obstruction, or gastroenteritis. Kidney pain originates higher in the back, near the costovertebral angle, and periumbilical assessment does not provide information about renal involvement.
C. Costovertebral angle is correct because the costovertebral angle (CVA) is located at the junction of the 12th rib and the vertebral column on each side of the back. It is the standard anatomical landmark for assessing kidney tenderness. The APRN typically uses percussion (CVA punch) or gentle palpation to evaluate for pain. Tenderness in this area is associated with upper urinary tract conditions such as pyelonephritis, renal calculi, or hydronephrosis. CVA tenderness helps distinguish kidney pathology from lower urinary tract or abdominal causes.
D. Epigastric area is incorrect because this area is located just above the stomach and below the sternum, and it is assessed for gastric, pancreatic, cardiac, or hepatobiliary issues, not kidney disease. Tenderness in the epigastric region does not provide information about renal function or pathology.
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