ATI RN
ATI Vital Signs Assessment Questions
Question 1 of 5
A 29-year-old married computer programmer comes to your clinic, complaining of 'something strange' going on in his scrotum. Last month while he was doing his testicular self-examination he felt a lump in his left testis. He waited a month and felt the area again, but the lump was still there. He has had some aching in his left testis but denies any pain with urination or sexual intercourse. He denies any fever, malaise, or night sweats. His past medical history consists of groin surgery when he was a baby and a tonsillectomy as a teenager. He eats a healthy diet and works out at the gym five times a week. He denies any tobacco or illegal drugs and drinks alcohol occasionally. His parents are both healthy. On examination you see a muscular, healthy, young-appearing man with unremarkable vital signs. On visualization the penis is circumcised with no lesions; there is a scar in his right inguinal region. There is no lymphadenopathy. Palpation of his scrotum is unremarkable on the right but indicates a large mass on the left. Placing a finger through the inguinal ring on the right, you have the patient bear down. Nothing is felt. You attempt to place your finger through the left inguinal ring but cannot get above the mass. On rectal examination his prostate is unremarkable. What disorder of the testes is most likely the diagnosis?
Correct Answer: B
Rationale: The correct answer is B: Scrotal hernia. The patient's presentation of a long-standing lump in the left testis, aching in the left testis, and a palpable mass in the left scrotum that cannot be pushed back through the inguinal ring suggests a scrotal hernia. The inability to palpate above the mass through the left inguinal ring indicates a hernia that has descended into the scrotum. Other choices are incorrect because a hydrocele presents as a painless scrotal swelling, scrotal edema would typically be bilateral and associated with systemic conditions, and varicocele is a benign condition that feels like a bag of worms and is more common on the left side.
Question 2 of 5
A patient has hard, nonpitting edema of the left lower leg and ankle. The right leg has no edema. Based on these findings, the nurse recalls that:
Correct Answer: A
Rationale: The correct answer is A. Nonpitting, hard edema is commonly associated with lymphatic obstruction. Lymphatic obstruction prevents the drainage of interstitial fluid, leading to accumulation and the characteristic nonpitting, hard edema. In this case, the presence of edema in only the left lower leg and ankle suggests localized lymphatic obstruction. Choice B is incorrect because alterations in arterial function typically result in arterial insufficiency and not edema. Choice C is incorrect because phlebitis of a superficial vein usually causes unilateral edema rather than bilateral edema. Choice D is incorrect as long-standing arterial obstruction typically leads to tissue ischemia rather than pitting edema.
Question 3 of 5
Mrs. R. is a 92-year-old retired teacher who comes to your clinic accompanied by her daughter. You ask Mrs. R. why she came to your clinic today. She looks at her daughter and doesn't say anything in response to your question. This is an example of which type of challenging patient?
Correct Answer: C
Rationale: The correct answer is C: Silent patient. Mrs. R.'s lack of response to the question despite being asked directly indicates she is a silent patient. This type of patient may be non-communicative due to various reasons such as anxiety, cognitive impairment, or being passive in decision-making. In this case, Mrs. R. may be relying on her daughter to communicate for her. The other choices are incorrect because Mrs. R. is not talkative, angry, or necessarily hearing-impaired based on the information provided. It is important for healthcare providers to recognize and adapt their communication strategies to effectively engage with silent patients.
Question 4 of 5
Dakota is a 14-year-old boy who just noticed a rash at his ankles. There is no history of exposure to ill people or other agents in the environment. He has a slight fever in the office. The rash consists of small, bright red marks. When they are pressed, the red colour remains. What should you do?
Correct Answer: B
Rationale: Correct Answer: B (Consider admitting the patient to the hospital) Rationale: 1. Dakota is a 14-year-old boy with a sudden rash, slight fever, and no known exposure. 2. The rash is non-blanching which indicates a serious underlying condition like meningococcal infection. 3. Meningococcal infection can progress rapidly, leading to life-threatening complications. 4. Hospital admission allows for close monitoring, diagnostic tests, and prompt treatment if needed. Summary of other choices: A: Steroid cream is not appropriate as the rash could be a sign of a serious infection, not just inflammation. C: Relying on reassurance without proper evaluation can delay necessary treatment. D: Following up in 3 days may be too late if the condition worsens rapidly.
Question 5 of 5
When teaching a client how to effectively manage their new medication regimen, the nurse recognizes that the best method of communicating therapeutically with the client is to:
Correct Answer: D
Rationale: The correct answer is D because facing the client while leaning slightly forward shows active listening and engagement, conveying respect and attentiveness. This posture encourages open communication and trust-building. Choice A is incorrect as the visitors' lounge may not provide privacy. Choice B may invade personal space and affect rapport. Choice C may not be appropriate as touch should only be used if culturally acceptable and with consent.