ATI RN
Test Bank Physical Examination and Health Assessment Questions
Question 1 of 5
A 20-year-old part-time college student comes to your clinic, complaining of growths on his penile shaft. They have been there for about 6 weeks and haven't gone away. In fact, he thinks there may be more now. He denies any pain with intercourse or urination. He has had three former partners and has been with his current girlfriend for 6 months. He says that because she is on the pill they don't use condoms. He denies any fever, weight loss, or night sweats. His past medical history is unremarkable. In addition to college, he works part-time for his father in construction. He is engaged to be married and has no children. His father is healthy, and his mother has hypothyroidism. On examination the young man appears healthy. His vital signs are unremarkable. On visualization of his penis you see several moist papules along all sides of his penile shaft and even two on the corona. He has been circumcised. On palpation of his inguinal region there is no inguinal lymphadenopathy. Which abnormality of the penis does this patient most likely have?
Correct Answer: A
Rationale: The patient in the case presented has multiple moist papules on the penile shaft and corona, which are classic features of condylomata acuminata, also known as genital warts. Condylomata acuminata are caused by the human papillomavirus (HPV) and are typically painless, unlike other conditions such as genital herpes or syphilitic chancre which may be associated with pain or tender sores. Given the patient's history of multiple sexual partners and lack of condom use with his current girlfriend, there is a higher likelihood of exposure to HPV. Condylomata acuminata can be treated with various options including topical agents, cryotherapy, or surgical removal, and it is important to address the potential risk of HPV transmission to sexual partners.
Question 2 of 5
He is afebrile and his cardiac, lung, and abdominal examinations are normal. On visualization of the anus you see no inflammation, masses, or fissures. Digital rectal examination reveals a smooth, enlarged prostate. No discrete masses are felt. There is no blood on the glove or on guaiac testing. An analysis of the urine shows no red blood cells, white blood cells, or bacteria. What disorder of the anus, rectum, or prostate is this most likely to be?
Correct Answer: A
Rationale: The clinical presentation described in the scenario is consistent with benign prostatic hyperplasia (BPH). BPH is a non-cancerous enlargement of the prostate gland, typically seen in older males. The findings of a smooth, enlarged prostate on digital rectal examination without discrete masses, along with the absence of other alarming signs such as blood in the urine or on examination, make BPH the most likely diagnosis in this case.
Question 3 of 5
Where is the point of maximal impulse (PMI) normally located?
Correct Answer: A
Rationale: The point of maximal impulse (PMI), also known as the apical impulse, is the point where the left ventricle is closest to the chest wall. Normally, the PMI is located in the left 5th intercostal space, around 7 to 9 cm lateral to the sternum. This area corresponds to the apex of the heart. By palpating the PMI, healthcare providers can assess the size, strength, and regularity of the heart's contractions, which can provide important diagnostic information about cardiac health. Locating the PMI accurately is essential for physical examination and diagnosis of cardiac conditions.
Question 4 of 5
Which of the following occurs in respiratory distress?
Correct Answer: B
Rationale: In respiratory distress, the skin between the ribs moves inward with inspiration, a phenomenon known as retractions. This is a sign of increased work of breathing as the body tries to pull in more air due to difficulty in breathing. The inward movement of the skin between the ribs indicates that the individual is not able to generate enough negative pressure in the chest cavity to inhale properly. This can be seen in conditions such as asthma, pneumonia, or other respiratory issues. Skin retractions are a concerning sign and may indicate a severe respiratory compromise that requires immediate medical attention. The other options listed do not specifically describe a characteristic of respiratory distress.
Question 5 of 5
Linda is a 29-year-old who had excruciating pain which started under her lower ribs on the right side. The pain eventually moved to her lateral abdomen and then into her right lower quadrant. Which is most likely, given this presentation?
Correct Answer: A
Rationale: The progression of excruciating pain starting under the lower ribs on the right side, then moving to the lateral abdomen, and finally settling in the right lower quadrant is classic for appendicitis. Appendicitis is an inflammation of the appendix, a small tube-like structure attached to the cecum (beginning of the large intestine). The pain typically starts around the umbilicus and then migrates to the right lower quadrant, where the appendix is located. Other symptoms that may accompany appendicitis include fever, nausea, vomiting, loss of appetite, and tenderness at McBurney's point (a specific area in the abdomen). It is a medical emergency that requires immediate attention to avoid complications such as perforation and peritonitis.