ATI RN
Physical Examination and Health Assessment 9th Edition Test Bank Questions
Question 1 of 5
A 28-year-old musician comes to your clinic, complaining of a "spot" on his penis. He states his partner noticed it 2 days ago and it hasn't gone away. He says it doesn't hurt. He has had no burning with urination and no pain during intercourse. He has had several partners in the last year and uses condoms occasionally. His past medical history consists of nongonococcal urethritis from Chlamydia and prostatitis. He denies any surgeries. He smokes two packs of cigarettes a day, drinks a case of beer a week, and smokes marijuana and occasionally crack. He has injected IV drugs before but not in the last few years. He is single and currently unemployed. His mother has rheumatoid arthritis and he doesn't know anything about his father. On examination you see a young man appearing deconditioned but pleasant. His vital signs are unremarkable. On visualization of his penis there is a 6-mm red, oval ulcer with an indurated base just proximal to the corona. There is no prepuce because of neonatal circumcision. On palpation the ulcer is nontender. In the inguinal region there is nontender lymphadenopathy. What disorder of the penis is most likely the diagnosis?
Correct Answer: C
Rationale: The presentation described in the scenario is consistent with a syphilitic chancre, which is the primary lesion of syphilis. Syphilitic chancres are painless, indurated ulcers that occur at the site of initial infection with Treponema pallidum. These chancres are typically 0.5-2 cm in size, have a clean base, and are often accompanied by regional lymphadenopathy. The red oval ulcer with an indurated base in this patient, along with the absence of pain and presence of lymphadenopathy, is consistent with a syphilitic chancre.
Question 2 of 5
A 68-year-old retired farmer comes to your office for evaluation of a skin lesion. On the right temporal area of the forehead, you see a flattened papule the same color as his skin, covered by a dry scale that is round and feels hard. He has several more of these scattered on the forehead, arms, and legs. Based on this description, what is your most likely diagnosis?
Correct Answer: B
Rationale: Based on the description provided, the skin lesions are most consistent with seborrheic keratosis. Seborrheic keratoses are common non-cancerous (benign) growths of the skin that often appear as brown, black, or light tan growths with a waxy, stuck-on appearance. They can vary in color and may be round or oval, with a well-defined border. Seborrheic keratoses are typically asymptomatic and can be found on various parts of the body including the face, arms, and legs. The dry, hard scale covering the lesion is typical for seborrheic keratoses.
Question 3 of 5
What is responsible for the inspiratory splitting of S ?
Correct Answer: A
Rationale: Inspiratory splitting of S occurs due to the normal physiological delay in the closure of the aortic and pulmonic valves during inspiration. During inspiration, the negative intrathoracic pressure leads to increased venous return to the right side of the heart, causing a slight delay in the closure of the pulmonic valve. This results in the aortic valve closing first, followed by the closure of the pulmonic valve, leading to the splitting of S during inspiration.
Question 4 of 5
A daycare worker presents to your office with jaundice. She denies IV drug use, blood transfusion, and travel and has not been sexually active for the past 10 months. Which type of hepatitis is most likely?
Correct Answer: B
Rationale: Among the options presented, Hepatitis B (HBV) is most likely in this scenario. HBV can be transmitted through mucous membrane exposure to infectious blood or body fluids, including sexual contact. The daycare worker's history of not being sexually active for the past 10 months would not completely rule out the possibility of acquiring HBV through a past sexual encounter. Also, HBV can persist in the blood for prolonged periods, making it a likely cause of jaundice in this case. The other types of hepatitis (A, C,
D) are less likely based on the information provided concerning the daycare worker's history and risk factors.
Question 5 of 5
Which of the following conditions involves a tight prepuce which, once retracted, cannot be returned?
Correct Answer: B
Rationale: Paraphimosis is a condition where the foreskin is retracted behind the glans penis and cannot be returned to its original position. This can lead to swelling and constriction of the penis, causing pain and potential damage to the tissue due to decreased blood flow. Phimosis (
Choice
A) refers to a tight prepuce that cannot be retracted over the glans penis. Balanitis (
Choice
C) is inflammation of the glans penis, often associated with poor hygiene or infections. Balanoposthitis (
Choice
D) refers to inflammation of both the glans penis and the foreskin.