Physical Assessment NCLEX Practice Questions -Nurselytic

Question 1 of 5

A 68-year-old retired truck driver comes to your office for evaluation of swelling in his legs. He is a smoker and has been taking medications to control his hypertension for the past 25 years. You are concerned about his risk for peripheral vascular disease. Which of the following tests are appropriate to order to initially evaluate for this condition?

A. Venogram B. CT scan of the lower legs C. Ankle-brachial index (ABI) D. PET scan

Correct Answer: C

Rationale: The ankle-brachial index (ABI) is the appropriate test to initially evaluate for peripheral vascular disease in this case. ABI is a simple, non-invasive test that compares the blood pressure in the arms to the blood pressure in the legs. A lower ABI value indicates a higher likelihood of peripheral arterial disease (PA
D). Given the patient's presentation of leg swelling and risk factors like smoking and hypertension, ABI can help determine the presence and severity of PAD, guiding further management and treatment decisions.

Question 2 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?

A. Anal fissure B. External hemorrhoids C. Internal hemorrhoids D. Anorectal fistula

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 3 of 5

Is the following information subjective or objective? Mr. M. has shortness of breath that has persisted for the past 10 days; it is worse with activity and relieved by rest.

A. Subjective B. Objective C. None of the Above D. both

Correct Answer: B

Rationale: The information provided about Mr. M's shortness of breath being present for the past 10 days, worsening with activity, and relieved by rest are all objective findings. These are measurable and observable facts that can be documented by healthcare professionals through physical examination, assessment, and potentially diagnostic tests. Subjective information would involve Mr. M's personal feelings or descriptions of his symptoms, which are not included in the given information.

Question 4 of 5

A patient is describing a very personal part of her history very quickly and in great detail. How should you react to this?

A. Write down as much as you can, as quickly as possible. B. Ask her to repeat key phrases or to pause at regular intervals, so you can get almost every word. C. Tell her that she can go over the notes later to make sure they are accurate. D. Push away from the keyboard or put down your pen and listen.

Correct Answer: D

Rationale: In this situation, it is important to prioritize active listening over taking detailed notes. By pushing away from the keyboard or putting down your pen, you are signaling to the patient that you are fully present and engaged in listening to their story. This will help foster trust and encourage the patient to continue sharing their personal history. Taking notes can be done later, but the immediate focus should be on providing a supportive and attentive environment for the patient to share their experiences.

Question 5 of 5

Which of the following synovial joints would be an example of a condylar joint?

A. Hip B. Interphalangeal joints of the hand C. Temporomandibular joint D. Intervertebral joint

Correct Answer: B

Rationale: A condylar joint is a type of synovial joint that allows movement in two planes, typically flexion/extension and abduction/adduction. The interphalangeal joints of the hand, which are the joints between the phalanges (finger bones), exhibit this type of movement, making them an example of a condylar joint. The hip joint (choice
A) is a ball-and-socket joint, the temporomandibular joint (choice
C) is a hinge joint, and the intervertebral joint (choice
D) is a cartilaginous joint, none of which are examples of condylar joints.