ATI RN
Vital Signs Assessment Questions
Question 1 of 5
A 42-year-old realtor comes to your clinic, complaining of 'growths' in her vulvar area. She is currently undergoing a divorce and is convinced she has a sexually transmitted disease. She denies any vaginal discharge or pain with urination. She has had no fever, malaise, or night sweats. Her past medical history consists of depression and hypothyroidism. She has had two spontaneous vaginal deliveries and one cesarean section. She has had no other surgeries. She denies smoking or drug use. She has two to three drinks weekly. Her mother also has hypothyroidism and her father has high blood pressure and hypercholesterolemia. On examination you see a woman who is anxious but appears otherwise healthy. Her blood pressure, pulse, and temperature are unremarkable. On visualization of the perineum you see two 2- to 3-mm, round, yellow nodules on the left labia. On palpation they are nontender and quite firm. What diagnosis best fits this description of her examination?
Correct Answer: D
Rationale: The correct diagnosis is D: Epidermoid cyst. The presentation of firm, non-tender, round, yellow nodules on the labia, in the absence of pain, discharge, or systemic symptoms, is consistent with an epidermoid cyst. These cysts are common in the vulvar area and result from blockage of hair follicles. The patient's lack of symptoms related to sexually transmitted infections rules out choices A, B, and C. Genital herpes typically presents with painful vesicles, condylomata acuminata (genital warts) are soft, fleshy growths caused by HPV, and a syphilitic chancre would present as a painless ulcer. Given the patient's clinical presentation and examination findings, the most likely diagnosis is an epidermoid cyst.
Question 2 of 5
A 25-year-old accountant presents with intermittent lower right-sided chest pain for several days. The pain is knifelike, lasts 3-5 seconds, worsens with deep breathing, and improves when lying on the affected side.
Correct Answer: C
Rationale: The correct answer is C: Pleural pain. The key features here are the sharp, knifelike pain that worsens with deep breathing, which is typical of pleuritic pain due to inflammation of the pleura. This pain pattern is distinct from pericarditis (A) which typically worsens with lying flat and improves when sitting up. Chest wall pain (B) is usually reproducible with palpation, and angina pectoris (D) is typically described as a pressure or squeezing sensation, often triggered by exertion. Therefore, based on the pain characteristics described by the patient, pleural pain is the most likely diagnosis.
Question 3 of 5
The nurse is conducting a patient interview. Which statement made by the patient should the nurse more fully explore during the interview?
Correct Answer: C
Rationale: The correct answer is C: "I never did too good in school." This statement indicates potential underlying issues like learning disabilities or lack of education, affecting the patient's understanding of health information. The nurse should explore this further to assess the patient's health literacy. Choices A, B, and D are less critical as they do not directly impact the patient's health status or the interview process.
Question 4 of 5
The nurse makes which adjustment in the physical environment to promote the success of an interview?
Correct Answer: A
Rationale: The correct answer is A because reducing noise helps create a conducive environment for effective communication during the interview. Noise can be distracting and hinder the patient's ability to focus and share information. Turning off televisions and radios promotes a quiet and focused setting. Choice B is incorrect because reducing the distance between the interviewer and the patient to 2 feet or less may invade the patient's personal space and make them uncomfortable. Choice C is incorrect as dim lighting may not be suitable for all patients and can affect visibility and communication. Choice D is incorrect because arranging seating across a desk or table can create a barrier and may not allow for a comfortable and open conversation.
Question 5 of 5
The nurse is preparing to perform a physical assessment. Which statement is true about the physical assessment? The inspection phase:
Correct Answer: B
Rationale: The correct answer is B: Takes time and reveals a surprising amount of information. During the inspection phase of a physical assessment, the nurse carefully observes the patient's appearance, behavior, and movements. This phase is crucial as it provides valuable visual information about the patient's overall health status, potential abnormalities, and clues for further assessment. By taking time and paying attention to detail during inspection, the nurse can gather significant data that can guide the rest of the assessment process. The other choices are incorrect because: A) Inspecting usually yields valuable information, C) Discomfort is not a typical characteristic of the inspection phase, and D) Inspection requires thorough observation, not just a quick glance before palpation.