ATI RN
Vital Signs Assessment 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 correct answer is C: Syphilitic chancre. The key features supporting this diagnosis are a painless, indurated ulcer on the penis with no associated symptoms like burning urination or pain during intercourse. The presence of nontender lymphadenopathy in the inguinal region is also suggestive of syphilis. The risk factors of multiple sexual partners, previous history of nongonococcal urethritis, and IV drug use increase the likelihood of a sexually transmitted infection like syphilis. Condylomata acuminata (choice A) presents as warty growths, not ulcers. Genital herpes (choice B) typically presents with painful vesicles or ulcers. Penile carcinoma (choice D) usually presents with changes in the skin texture or color, not a single ulcer. Therefore, the most likely diagnosis based on the presentation and risk factors is syphilitic chancre.
Question 2 of 5
When auscultating over a patient's femoral arteries, the nurse notices the presence of a bruit on the left side. The nurse knows that bruits:
Correct Answer: D
Rationale: The correct answer is D. When a bruit is heard over the femoral arteries, it indicates turbulent blood flow, which is often a result of partial occlusion in the artery. This turbulent flow causes vibrations that can be heard as a bruit. This finding suggests that there may be a narrowing or blockage in the femoral artery, which can lead to decreased blood flow to the lower extremities. Choices A, B, and C are incorrect because bruits are not typically associated with venous disease, lymphadenopathy, or hypermetabolic states in the context of femoral artery auscultation.
Question 3 of 5
Jason is a 41-year-old electrician who presents to the clinic for evaluation of shortness of breath. The shortness of breath occurs with exertion and improves with rest. It has been going on for several months and initially occurred only a couple of times a day with strenuous exertion; however, it has started to occur with minimal exertion and is happening more than a dozen times per day. The shortness of breath lasts for less than 5 minutes at a time. He has no cough, chest pressure, chest pain, swelling in his feet, palpitations, orthopnea, or paroxysmal nocturnal dyspnea. Which of the following symptom attributes was not addressed in this description?
Correct Answer: A
Rationale: The correct answer is A: Severity. The description of the patient's shortness of breath includes information on the setting (exertion), timing (improves with rest, occurs more frequently), and associated manifestations (no cough, chest pain, etc.). Severity of the symptom, which refers to how intense or distressing it is for the patient, is not explicitly mentioned. In this case, severity may be implied by the progression of symptoms from occurring with strenuous exertion to minimal exertion, but it is not directly addressed in the description. Therefore, the correct answer is A. Choices B, C, and D are incorrect because they were all addressed in the patient's presentation.
Question 4 of 5
What is the expected moisture and texture of the skin of a patient with hypothyroidism?
Correct Answer: D
Rationale: The correct answer is D, dry and rough. In hypothyroidism, there is a decrease in thyroid hormone production, leading to reduced metabolic activity. This results in decreased oil and sweat gland function, leading to dry skin. Additionally, the reduced metabolic rate can cause a buildup of dead skin cells, contributing to rough texture. Choices A and B are incorrect because moisture levels are decreased in hypothyroidism. Choice C is incorrect as dryness is a key characteristic of hypothyroidism, and smooth skin is less likely due to the rough texture caused by decreased cell turnover.
Question 5 of 5
Which of the following are open-ended questions? Select all that apply.
Correct Answer: C
Rationale: The correct answer is C because open-ended questions encourage patients to provide detailed responses without limiting them to specific options. Choice A and B are closed-ended questions as they prompt specific information. Choice D is a leading question that suggests a specific response, making it closed-ended.