ATI RN
Physical Assessment Nursing Practice Questions Questions
Question 1 of 5
A 25-year-old accountant presents to your clinic, complaining of intermittent lower right- sided chest pain for several days. He describes it as knifelike and states it only lasts for 3 to 5 seconds, taking his breath away. He states he feels like he has to breathe shallowly to keep it from recurring. The only thing that makes it better is lying quietly on his right side. It is much worse when he takes a deep breath. He has taken some Tylenol and put a heating pad on his side but neither has helped. He remembers that 2 weeks ago he had an upper respiratory infection with a severe hacking cough. He denies any recent trauma. His past medical history is unremarkable. His parents and siblings are in good health. He has recently married, and his wife has a baby due in 2 months. He denies any smoking or illegal drug use. He drinks two to three beers once a month. He states that he eats a healthy diet and runs regularly, but not since his recent illness. He denies any cardiac, gastrointestinal, or musculoskeletal symptoms. On examination he is lying on his right side but appears quite comfortable. His temperature, blood pressure, pulse, and respirations are unremarkable. His chest has normal breath sounds on auscultation. Percussion of the chest is unremarkable. During palpation the ribs are nontender. What disorder of the chest best describes his symptoms?
Correct Answer: C
Rationale: The patient's symptoms of intermittent, sharp chest pain with breathing that worsens with deep breaths and is relieved by lying on the right side are suggestive of pleural pain. Pleuritic chest pain is often described as sharp or stabbing and occurs when the parietal pleura, the outer lining of the lungs, becomes inflamed or irritated. In this case, the patient's history of an upper respiratory infection with a severe hacking cough two weeks ago suggests that the pleural pain may be related to pleurisy or pleuritis, which can occur as a complication of respiratory infections.
Question 2 of 5
You are beginning the examination of a patient. All of the following areas are important to observe as part of the General Survey except:
Correct Answer: D
Rationale: Blood pressure is not typically included in the initial assessment during the General Survey. The General Survey primarily focuses on obtaining an overall impression of the patient's health status and any noticeable cues such as level of consciousness, signs of distress, and appearance including dress, grooming, and personal hygiene. While blood pressure is an important vital sign to assess during a comprehensive examination, it is usually measured later in the assessment process and not part of the initial general observation.
Question 3 of 5
You arrive at the bedside of an elderly woman who has had a stroke, affecting her entire right side. She cannot speak (aphasia). You are supposed to examine her. You notice that the last examiner left her socks at the bottom of the bed, and although sensitive areas are covered by a sheet, the blanket is heaped by her feet at the bottom of the bed. What would you do next?
Correct Answer: C
Rationale: The best course of action would be to put her socks back on and cover her completely before beginning the evaluation. It is important to prioritize the patient's dignity and comfort by ensuring they are appropriately covered. This also helps in maintaining the patient's sense of privacy during the examination, especially considering the sensitive nature of the situation with the elderly woman having a stroke and aphasia. By taking the time to properly dress and cover the patient before conducting the examination, you are showing respect and compassion for the patient's well-being.
Question 4 of 5
Francis is a middle-aged man who noted right-sided lower abdominal pain after straining with yard work. Which of the following would make a hernia more likely?
Correct Answer: D
Rationale: Inguinal hernias are common types of hernias that occur in the groin area. When a person strains, the hernia may become more noticeable as the abdominal contents push through a weak spot in the abdominal wall. The absence of symmetry of the inguinal areas with straining indicates that there is a hernia present, as the bulge or protrusion in the groin area becomes more prominent with straining. This makes a hernia more likely in this case.
Therefore, option D is the correct choice in this scenario. The other options do not directly point to the presence of a hernia.
Question 5 of 5
Alexandra is a 28-year-old editor who presents to the clinic with abdominal pain. The pain is a dull ache, located in the right upper quadrant, that she rates as a 3 at the least and an 8 at the worst. The pain started a few weeks ago, it lasts for 2 to 3 hours at a time, it comes and goes, and it seems to be worse a couple of hours after eating. She has noticed that it starts after eating greasy foods, so she has cut down on these as much as she can. Initially it occurred once a week, but now it is occurring every other day. Nothing makes it better. From this description, which of the seven attributes of a symptom has been omitted?
Correct Answer: B
Rationale: The description provided by Alexandra includes information about the location (right upper quadrant), intensity (3 to 8 on a scale), duration (2 to 3 hours), periodicity (coming and going, worse after eating), exacerbating factors (greasy foods), frequency (initially once a week, now every other day), and aggravating factors (nothing makes it better). However, there is no mention of any associated manifestations such as nausea, vomiting, fever, or other symptoms that may be occurring alongside the abdominal pain. Associated manifestations are important for a comprehensive assessment and differential diagnosis of the symptom.