ATI RN
Physical Examination and Health Assessment 8th Edition Test Bank Questions
Question 1 of 5
A 24-year-old secretary comes to your clinic, complaining of difficulty sleeping, severe nightmares, and irritability. She states it all began 6 months ago when she went to a fast food restaurant at midnight. While she was waiting in her car a man entered through the passenger door and put a gun to her head. He had her drive to a remote area, where he took her money and threatened to kill her. When the gun jammed he panicked and ran off. Ever since this occurred the patient has been having these symptoms. She states she jumps at every noise and refuses to drive at night. She states her anxiety has had such a marked influence on her job performance she is afraid she will be fired. She denies any recent illnesses or injuries. Her past medical history is unremarkable. On examination you find a nervous woman appearing her stated age. Her physical examination is unremarkable. You recommend medication and counseling. What anxiety disorder to you think this young woman has?
Correct Answer: C
Rationale: The young woman in this scenario is experiencing symptoms consistent with post-traumatic stress disorder (PTSD). PTSD is an anxiety disorder that can develop after a person is exposed to a traumatic event, such as a life-threatening situation like a robbery with a gun involved. The symptoms she is experiencing, including difficulty sleeping, severe nightmares, irritability, hypervigilance, and avoidance of triggers such as driving at night, are all classic features of PTSD. These symptoms have persisted for at least 6 months since the traumatic event occurred, which is a key criterion for making a diagnosis of PTSD. Treatment for PTSD typically involves a combination of medication and therapy to help the individual process and cope with the traumatic experience.
Question 2 of 5
A 25-year-old type 1 diabetic clerk presents to the emergency room with shortness of breath and states that his blood sugar was 605 at home. You diagnose the patient with diabetic ketoacidosis. What is the expected pattern of breathing?
Correct Answer: C
Rationale: In diabetic ketoacidosis (DKA), the body is in a state of metabolic acidosis due to the accumulation of ketones in the blood. One of the compensatory mechanisms to decrease the acidity in the body is increased breathing, known as Kussmaul breathing. This type of breathing is characterized by a rapid and deep pattern to blow off excess carbon dioxide and decrease the acidity of the blood. Therefore, in a patient with DKA, you would expect to observe rapid and deep breathing.
Question 3 of 5
A 15-year-old high school sophomore presents to the emergency room with his mother for evaluation of an area of blood in the left eye. He denies trauma or injury but has been coughing forcefully with a recent cold. He denies visual disturbances, eye pain, or discharge from the eye. On physical examination, the pupils are equal, round, and reactive to light, with a visual acuity of 20/20 in each eye and 20/20 bilaterally. There is a homogeneous, sharply demarcated area at the lateral aspect of the base of the left eye. The cornea is clear. Based on this description, what is the most likely diagnosis?
Correct Answer: D
Rationale: A subconjunctival hemorrhage is a common and benign condition characterized by blood in the space between the conjunctiva and sclera of the eye. The condition often presents as a painless, sharply demarcated area of redness on the white part of the eye, typically without associated discharge or visual disturbances. In this case, the absence of eye pain, discharge, visual disturbances, and clear cornea make subconjunctival hemorrhage the most likely diagnosis. The history of forceful coughing with a recent cold is also consistent with the increased intraocular pressure leading to a rupture of a small blood vessel, resulting in the hemorrhage. Treatment is not usually required as the condition is self-limiting and resolves on its own over time.
Question 4 of 5
Steve has just seen a 5-year-old girl who wheezes when exposed to cats. The patient's family history is positive for asthma. You think the child most likely has asthma. What have you just accomplished?
Correct Answer: C
Rationale: By connecting the patient's presenting symptoms (wheezing when exposed to cats) and family history of asthma, you have identified asthma as the most likely diagnosis for the 5-year-old girl. This initial conclusion, based on the available information, is known as a working diagnosis. Further evaluation and testing may be required to confirm the diagnosis, but at this stage, you have established a preliminary understanding of the likely condition affecting the patient.
Question 5 of 5
Mr. Martin is a 72-year-old smoker who comes to you for his hypertension visit. You note that with deep palpation you feel a pulsatile mass which is about 4 centimeters in diameter. What should you do next?
Correct Answer: D
Rationale: The presence of a palpable pulsatile abdominal mass in a patient like Mr. Martin, who is a smoker and at risk for vascular diseases, is concerning for an abdominal aortic aneurysm (AAA). Immediate referral to a vascular surgeon is essential for further evaluation and management. AAA can be a life-threatening condition if left untreated, as it can lead to rupture and severe internal bleeding. Therefore, prompt specialist evaluation and monitoring are crucial in such cases. Waiting for 3 or 6 months for reevaluation could potentially lead to a delayed diagnosis and increase the risk of complications. Abdominal ultrasound is typically the diagnostic test of choice to confirm the presence and size of the aneurysm.