ATI RN
Physical Assessment Nursing Practice Questions Questions
Question 1 of 9
A 47-year-old contractor presents for evaluation of neck pain, which has been intermittent for several years. He normally takes over-the-counter medications to ease the pain, but this time they haven't worked as well, and he still has discomfort. He recently wallpapered the entire second floor in his house, which caused him great discomfort. The pain resolved with rest. He denies fever, chills, rash, upper respiratory symptoms, trauma, or injury to the neck. Based on this description, what is the most likely pathologic process?
Correct Answer: C
Rationale: The most likely pathologic process in this scenario is degenerative. The history provided includes chronic intermittent neck pain that worsened after a specific activity (wallpapering) but resolved with rest. The patient's age (47 years old) is also suggestive of degenerative changes in the spine. Additionally, the use of over-the-counter medications to manage the pain points towards a chronic condition such as degenerative changes in the cervical spine, possibly cervical spondylosis or osteoarthritis. There is no mention of any infectious symptoms, trauma, or neoplastic features in the presentation.
Question 2 of 9
A 47-year-old contractor presents for evaluation of neck pain, which has been intermittent for several years. He normally takes over-the-counter medications to ease the pain, but this time they haven't worked as well, and he still has discomfort. He recently wallpapered the entire second floor in his house, which caused him great discomfort. The pain resolved with rest. He denies fever, chills, rash, upper respiratory symptoms, trauma, or injury to the neck. Based on this description, what is the most likely pathologic process?
Correct Answer: C
Rationale: The most likely pathologic process in this scenario is degenerative. The history provided includes chronic intermittent neck pain that worsened after a specific activity (wallpapering) but resolved with rest. The patient's age (47 years old) is also suggestive of degenerative changes in the spine. Additionally, the use of over-the-counter medications to manage the pain points towards a chronic condition such as degenerative changes in the cervical spine, possibly cervical spondylosis or osteoarthritis. There is no mention of any infectious symptoms, trauma, or neoplastic features in the presentation.
Question 3 of 9
In obtaining a history, you note that a patient uses the word "largely" repeatedly, to the point of being a distraction to your task. Which word best describes this speech pattern?
Correct Answer: D
Rationale: Perseveration is a speech pattern characterized by repeating a particular word, phrase, or topic excessively, even when it is no longer relevant to the conversation. In this scenario, the patient's repetitive use of the word "largely" to the point of distraction is indicative of perseveration. This can be a symptom of various neurological or psychiatric conditions, highlighting the importance of recognizing and addressing this speech pattern during the patient interview.
Question 4 of 9
A 25-year-old accountant presents to your clinic, complaining of intermittent lower right- sided chest pain for several days. He describes it as knifelike and states it only lasts for 3 to 5 seconds, taking his breath away. He states he feels like he has to breathe shallowly to keep it from recurring. The only thing that makes it better is lying quietly on his right side. It is much worse when he takes a deep breath. He has taken some Tylenol and put a heating pad on his side but neither has helped. He remembers that 2 weeks ago he had an upper respiratory infection with a severe hacking cough. He denies any recent trauma. His past medical history is unremarkable. His parents and siblings are in good health. He has recently married, and his wife has a baby due in 2 months. He denies any smoking or illegal drug use. He drinks two to three beers once a month. He states that he eats a healthy diet and runs regularly, but not since his recent illness. He denies any cardiac, gastrointestinal, or musculoskeletal symptoms. On examination he is lying on his right side but appears quite comfortable. His temperature, blood pressure, pulse, and respirations are unremarkable. His chest has normal breath sounds on auscultation. Percussion of the chest is unremarkable. During palpation the ribs are nontender. What disorder of the chest best describes his symptoms?
Correct Answer: C
Rationale: The patient's symptoms of intermittent, sharp chest pain with breathing that worsens with deep breaths and is relieved by lying on the right side are suggestive of pleural pain. Pleuritic chest pain is often described as sharp or stabbing and occurs when the parietal pleura, the outer lining of the lungs, becomes inflamed or irritated. In this case, the patient's history of an upper respiratory infection with a severe hacking cough two weeks ago suggests that the pleural pain may be related to pleurisy or pleuritis, which can occur as a complication of respiratory infections.
Question 5 of 9
A high school football player injured his wrist in a game. He is tender between the two tendons at the base of the thumb. Which of the following should be considered?
Correct Answer: A
Rationale: DeQuervain's tenosynovitis is a condition that involves inflammation of the tendons located at the base of the thumb. The tendons affected are the abductor pollicis longus and extensor pollicis brevis. It typically causes pain and tenderness at the base of the thumb, which can worsen with certain movements of the wrist and thumb. In the case of the high school football player, his tenderness between the two tendons at the base of the thumb is suggestive of DeQuervain's tenosynovitis. It is a common overuse injury in athletes, especially those involved in activities that require repetitive hand and wrist movements, such as gripping a football during play. Treatment usually involves rest, splinting, ice, anti-inflammatory medications, and physical therapy.
Question 6 of 9
A patient complains of shortness of breath for the past few days. On examination, you note late inspiratory crackles in the lower third of the chest that were not present a week ago. What is the most likely explanation for these?
Correct Answer: D
Rationale: The presence of late inspiratory crackles in the lower third of the chest that were not present previously is suggestive of pulmonary edema, a common finding in patients with heart failure. Heart failure can lead to fluid accumulation in the lungs, causing crackles on auscultation. These crackles are typically heard at the lung bases and can be more prominent during inspiration. Other clinical features of heart failure may include orthopnea, paroxysmal nocturnal dyspnea, lower extremity edema, and fatigue. Therefore, in this case, the most likely explanation for the patient's shortness of breath with late inspiratory crackles is heart failure.
Question 7 of 9
You are examining a patient with emphysema in exacerbation and are having difficulty hearing his heart sounds. What should you do to obtain a good examination?
Correct Answer: D
Rationale: In a patient with emphysema, lung hyperinflation can make it difficult to hear heart sounds anteriorly. Listening posteriorly, especially between the scapulae, can often provide a clearer auscultation of the heart sounds due to reduced interference from lung sounds. The posterior approach can also help avoid any abdominal sounds that might obscure the cardiac sounds when auscultating in the epigastrium. It is important to make sure the patient is in a comfortable position for better examination, and in this case, listening posteriorly would be the best choice for assessing heart sounds in a patient with emphysema in exacerbation.
Question 8 of 9
You arrive at the bedside of an elderly woman who has had a stroke, affecting her entire right side. She cannot speak (aphasia). You are supposed to examine her. You notice that the last examiner left her socks at the bottom of the bed, and although sensitive areas are covered by a sheet, the blanket is heaped by her feet at the bottom of the bed. What would you do next?
Correct Answer: C
Rationale: The best course of action would be to put her socks back on and cover her completely before beginning the evaluation. It is important to prioritize the patient's dignity and comfort by ensuring they are appropriately covered. This also helps in maintaining the patient's sense of privacy during the examination, especially considering the sensitive nature of the situation with the elderly woman having a stroke and aphasia. By taking the time to properly dress and cover the patient before conducting the examination, you are showing respect and compassion for the patient's well-being.
Question 9 of 9
It is accompanied by nausea and vomiting. It is located in the mid- epigastric area." Which of these categories does it belong to?
Correct Answer: B
Rationale: The description provided, "It is accompanied by nausea and vomiting. It is located in the mid-epigastric area," indicates the current symptoms and location of the discomfort the patient is experiencing. This information is typically included in the Present Illness section of a medical history, which focuses on the patient's current health concerns, symptoms, and complaints. It helps the healthcare provider understand the nature of the problem and guide further evaluation and treatment. The Chief Complaint is usually a concise statement of the patient's main reason for seeking medical attention, the Personal and Social History includes information about the patient's lifestyle habits and social support, and the Review of Systems is a systematic inquiry about the patient's overall health.