ATI RN
Physical Assessment Nursing Practice Questions Questions
Question 1 of 5
A 27-year-old policewoman comes to your clinic, complaining of severe left-sided back pain radiating down into her groin. It began in the middle of the night and woke her up suddenly. It hurts in her bladder to urinate but she has no burning on the outside. She has had no frequency or urgency with urination but she has seen blood in her urine. She has had nausea with the pain but no vomiting or fever. She denies any other recent illness or injuries. Her past medical history is unremarkable. She denies tobacco or drug use and drinks alcohol rarely. Her mother has high blood pressure and her father is healthy. On examination she looks her stated age and is in obvious pain. She is lying on her left side trying to remain very still. Her cardiac, pulmonary, and abdominal examinations are unremarkable. She has tenderness just inferior to the left costovertebral angle. Her urine pregnancy test is negative and her urine analysis shows red blood cells. What type of urinary tract pain is she most likely to have?
Correct Answer: B
Rationale: The policewoman's presentation of severe left-sided back pain radiating down into her groin, associated with nausea, blood in urine, and tenderness just inferior to the left costovertebral angle is highly suggestive of a kidney stone causing ureteral colic. Kidney stones are solid masses made of crystals that form in the kidneys and can cause sudden severe pain as they move through the urinary tract, leading to blockage and subsequent stretching of the ureter (the tube connecting the kidney to the bladder), resulting in pain that radiates from the flank down to the groin region. The presence of blood in the urine (hematuria) is a common finding with kidney stones due to irritation and damage to the ureteral lining as the stone passes. The negative urine pregnancy test rules out pregnancy-related causes of urinary symptoms. Musculoskeletal pain is less likely given the location and character of the pain
Question 2 of 5
A 55-year-old secretary with a recent history of breast cancer, for which she underwent surgery and radiation therapy, and a history of hypertension comes to your office for a routine checkup. Which of the following aspects of the physical are important to note when assessing the patient for peripheral vascular disease in the arms?
Correct Answer: D
Rationale: When assessing a patient for peripheral vascular disease in the arms, it is important to examine the pulses in the upper extremities. The pulses to be assessed in this context include the radial pulse (located on the wrist at the base of the thumb) and the brachial pulse (located in the upper arm near the elbow). These pulses provide important information about blood flow and circulation in the arms. Changes in the strength, regularity, or absence of these pulses can indicate potential issues related to peripheral vascular disease. While the femoral and popliteal pulses (Choice A) are important for assessing the lower extremities, and the dorsalis pedis and posterior tibial pulses (Choice B) are also crucial for evaluating peripheral vascular disease in the legs, the radial and brachial pulses are specifically relevant for assessing the arms. The carotid pulse (Choice C) is important for evaluating the vascular status of
Question 3 of 5
Asymmetric BPs are seen in which of the following conditions?
Correct Answer: B
Rationale: Asymmetric blood pressures (BPs) refer to a significant difference in blood pressures between the two arms. This is commonly seen in conditions like congenital narrowing of the aorta, also known as coarctation of the aorta. In this condition, there is a localized narrowing of the aorta, leading to higher blood pressure in the upper extremities compared to the lower extremities. This results in a significant asymmetry in blood pressure readings between the arms. It is crucial to identify this sign as it can have important diagnostic and treatment implications.
Question 4 of 5
A 22-year-old unemployed roofer presents to your clinic, complaining of pain in his testicle and penis. He states the pain began last night and has steadily become worse. He states it hurts when he urinates and he has not attempted intercourse since the pain began. He has tried Tylenol and ibuprofen without improvement. He denies any fever or night sweats. His past medical history is unremarkable. He has had four previous sexual partners and has had a new partner for the last month. She is on oral contraceptives so he has not used condoms. His parents are both in good health. On examination you see a young man lying on his side. He appears mildly ill. His temperature is 2 and his blood pressure, respirations, and pulse are normal. On visualization of the penis he is circumcised, with no lesions or discharge from the meatus. Visualization of the scrotal skin appears unremarkable. Palpation of the testes shows severe tenderness at the superior pole of the normal-sized left testicle. He also has tenderness when you palpate the structures superior to the testicle through the scrotal wall. The right testicle is unremarkable. An examining finger is placed through each inguinal ring without bulges being noted with bearing down. His prostate examination is unremarkable. Urine analysis shows white blood cells and bacteria. What diagnosis of the male genitalia is most likely in this case?
Correct Answer: B
Rationale: The history and physical examination findings in this case are most consistent with acute epididymitis. Acute epididymitis is characterized by inflammation and infection of the epididymis, which is a tubular structure located behind the testicle that stores and carries sperm. Common symptoms of acute epididymitis include pain and swelling in the scrotum, testicular pain, pain with urination, and sometimes penile discharge. The patient's symptoms of testicular and penile pain, as well as pain with urination, are classic for epididymitis. The severe tenderness at the superior pole of the left testicle and tenderness on palpation of structures superior to the testicle through the scrotal wall further support this diagnosis. In addition, the presence of white blood cells and bacteria on urine analysis is consistent with an infectious process like epididymitis.
Question 5 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.