ATI RN
Physical Assessment NCLEX Practice Questions Questions
Question 1 of 5
A 49-year-old administrative assistant comes to your office for evaluation of dizziness. You elicit the information that the dizziness is a spinning sensation of sudden onset, worse with head position changes. The episodes last a few seconds and then go away, and they are accompanied by intense nausea. She has vomited one time. She denies tinnitus. You perform a physical examination of the head and neck and note that the patient's hearing is intact to Weber and Rinne and that there is nystagmus. Her gait is normal. Based on this description, what is the most likely diagnosis?
Correct Answer: A
Rationale: The patient's presentation of sudden-onset spinning sensation triggered by head position changes, accompanied by nausea and vomiting without tinnitus, is characteristic of benign positional vertigo (BPV). BPV is caused by displaced otoconia (calcium crystals) within the semicircular canals of the inner ear. These crystals disrupt the normal flow of fluid in the inner ear, leading to false signals being sent to the brain about head movement. This results in brief episodes of vertigo triggered by specific head positions.
Question 2 of 5
Her right carotid pulse is bounding but the left carotid pulse is weak. She is afebrile but her respirations are 24 times a minute. On auscultation her lungs are clear and her cardiac examination is unremarkable. You call EMS and have her taken to the hospital's ER for further evaluation. What disorder of the chest best describes her symptoms?
Correct Answer: C
Rationale: A dissecting aortic aneurysm is the most likely disorder that best describes the symptoms presented. In this condition, the inner layer of the aorta tears and blood can flow between the layers of the aortic wall, causing a number of potential symptoms. A patient with a dissecting aortic aneurysm may present with a difference in pulses between the right and left sides due to decreased blood flow to one side. The bounding pulse on one side and weak pulse on the other are indicative of uneven blood flow distribution. Additionally, a dissecting aortic aneurysm can lead to respiratory symptoms such as increased respiratory rate if there is associated pain or discomfort, although clear lung sounds would not typically be expected with this condition. The condition is a life-threatening emergency that requires immediate evaluation and treatment.
Question 3 of 5
Her abdominal examination reveals a gravid uterus but is otherwise unremarkable. On visualization of the anus there is a slight red, moist- appearing protrusion from the anus. As you have her bear down, the protrusion grows larger. On digital rectal examination you can feel an enlarged tender area on the posterior side. There is some blood on the glove after the examination. What disorder of the anus or rectum best fits this presentation?
Correct Answer: C
Rationale: The described clinical presentation is consistent with internal hemorrhoids. The typical symptoms of internal hemorrhoids include painless rectal bleeding, protrusion from the anus during straining, and a feeling of incomplete evacuation. In this case, the protrusion is observed to be red, moist, and enlarges with bearing down, all indicative of internal hemorrhoids. The enlarged tender area felt on digital rectal examination supports the diagnosis. Additionally, the presence of blood on the glove after the examination is also suggestive of internal hemorrhoids causing bleeding. Anal fissures typically present with sharp pain during defecation and may have visible tears in the anal mucosa. External hemorrhoids are usually more painful and can be felt as a lump around the anus. Anorectal fistulas have different signs and symptoms, including discharge of pus and recurrent infections.
Question 4 of 5
A young man is concerned about a hard mass he has just noticed in the midline of his palate. On examination, it is indeed hard and in the midline. There are no mucosal abnormalities associated with this lesion. He is experiencing no other symptoms. What will you tell him is the most likely diagnosis?
Correct Answer: B
Rationale: A hard mass in the midline of the palate with no associated mucosal abnormalities is most likely a torus palatinus.
Torus palatinus is a benign bony growth that often occurs in the midline of the hard palate. It is typically asymptomatic and does not require treatment unless it causes issues with function or hygiene. Leukoplakia is a clinical term used to describe a white patch in the mouth that cannot be scrapped off and is associated with a risk of cancer. Thrush (candidiasis) presents as white, creamy patches in the mouth that can be scrapped off and is caused by a yeast infection. Kaposi's sarcoma presents as red or purple patches or nodules in the mouth and is associated with immunocompromised individuals, like those with HIV/AIDS.
Question 5 of 5
You are examining a newborn and note that the right testicle is not in the scrotum. What should you do next?
Correct Answer: A
Rationale: When examining a newborn and noting that the right testicle is not in the scrotum, it is important to refer the newborn to a pediatric urologist for further evaluation and management. This condition could be a case of undescended testis (cryptorchidism), where the testicle fails to descend into the scrotum. Early intervention is crucial as the undescended testis may lead to complications such as infertility, testicular cancer, and inguinal hernia. Urology specialists can determine the best course of action to bring down the testis and ensure proper testicular development. Waiting or attempting manual descent without expertise could lead to complications, so it is best to involve a urologist for proper assessment and management.