ATI RN
Test Bank Physical Examination and Health Assessment Questions
Question 1 of 5
A 21-year-old receptionist comes to your clinic, complaining of frequent diarrhea. She states that the stools are very loose and there is some cramping beforehand. She states this has occurred on and off since she was in high school. She denies any nausea, vomiting, or blood in her stool. Occasionally she has periods of constipation, but that is rare. She thinks the diarrhea is much worse when she is nervous. Her past medical history is not significant. She is single and a junior in college majoring in accounting. She smokes when she drinks alcohol but denies using any illegal drugs. Both of her parents are healthy. Her entire physical examination is unremarkable. What is most likely the etiology of her diarrhea?
Correct Answer: C
Rationale: The patient's history of frequent loose stools with cramping, occurring since high school and worsening during periods of nervousness, along with occasional constipation, is characteristic of irritable bowel syndrome (IBS). IBS is a functional gastrointestinal disorder that presents with symptoms such as abdominal pain or discomfort, bloating, and altered bowel habits (diarrhea, constipation, or both) without any evidence of organic disease. The absence of systemic symptoms like fever, weight loss, or blood in the stool, as well as normal physical examination findings, also support the diagnosis of IBS in this case. This condition is often triggered or exacerbated by stress or anxiety. Monitoring stress levels, dietary modifications, and possibly prescription medications may help manage IBS symptoms in this patient.
Question 2 of 5
Which of the following is consistent with obturator sign?
Correct Answer: C
Rationale: The obturator sign is a physical examination maneuver used to assess for irritation of the obturator muscle due to an inflamed appendix that is in close proximity. This pain is typically felt in the right lower quadrant or hypogastric region. The sign is elicited by passively flexing the hip and knee of the patient, then internally rotating the hip. An alternative method is to position the patient on her left side and ask her to raise her right thigh against resistance while the examiner provides counterpressure. Pain experienced by the patient with these maneuvers is consistent with obturator sign, indicating possible appendicitis. Hence, option C is the correct answer.
Question 3 of 5
A 77-year-old retired nurse has an ulcer on a lower extremity that you are asked to evaluate when you do your weekly rounds at a local long-term care facility. All of the following are responsible for causing ulcers in the lower extremities except for which condition?
Correct Answer: D
Rationale: Hypertension, or high blood pressure, is not typically associated with causing ulcers in the lower extremities. The most common causes of lower extremity ulcers are arterial insufficiency, venous insufficiency, and diminished sensation in pressure points. Arterial insufficiency leads to decreased blood flow to the lower extremities, causing tissue damage and ulcers. Venous insufficiency results in poor circulation and increased pressure in the veins, leading to ulcers. Diminished sensation in pressure points, often seen in conditions like diabetes, can cause ulcers due to lack of feeling and increased risk of trauma. So, hypertension is not directly related to the development of lower extremity ulcers.
Question 4 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 5 of 5
Induration along the ventral surface of the penis suggests which of the following?
Correct Answer: C
Rationale: Peyronie's disease is a condition characterized by the formation of fibrous scar tissue in the penis, leading to the development of plaques or indurations along the shaft of the penis, typically on the ventral surface. These plaques can cause penile curvature, pain, and erectile dysfunction. Urethral stricture, testicular carcinoma, and epidermoid cysts are not typically associated with indurations along the ventral surface of the penis.