ATI RN
Physical Assessment NCLEX Practice Questions Questions
Question 1 of 5
A 49-year-old administrative assistant comes to your office for evaluation of dizziness. You elicit the information that the dizziness is a spinning sensation of sudden onset, worse with head position changes. The episodes last a few seconds and then go away, and they are accompanied by intense nausea. She has vomited one time. She denies tinnitus. You perform a physical examination of the head and neck and note that the patient's hearing is intact to Weber and Rinne and that there is nystagmus. Her gait is normal. Based on this description, what is the most likely diagnosis?
Correct Answer: A
Rationale: The patient's presentation of sudden-onset spinning sensation triggered by head position changes, accompanied by nausea and vomiting without tinnitus, is characteristic of benign positional vertigo (BPV). BPV is caused by displaced otoconia (calcium crystals) within the semicircular canals of the inner ear. These crystals disrupt the normal flow of fluid in the inner ear, leading to false signals being sent to the brain about head movement. This results in brief episodes of vertigo triggered by specific head positions.
Question 2 of 5
When should a woman conduct breast self-examination with respect to her menses?
Correct Answer: C
Rationale: It is recommended for women to conduct breast self-examination immediately prior to their menses. This is because the breasts are less likely to be tender, lumpy, or swollen during this time of the menstrual cycle, making it easier to detect any abnormalities such as lumps or changes in the breast tissue. Conducting breast self-examination around this time each month can help women become familiar with the normal look and feel of their breasts, making it easier to detect any changes that may indicate a potential issue.
Question 3 of 5
Which of the following synovial joints would be an example of a condylar joint?
Correct Answer: B
Rationale: A condylar joint is a type of synovial joint that allows movement in two planes, typically flexion/extension and abduction/adduction. The interphalangeal joints of the hand, which are the joints between the phalanges (finger bones), exhibit this type of movement, making them an example of a condylar joint. The hip joint (choice A) is a ball-and-socket joint, the temporomandibular joint (choice C) is a hinge joint, and the intervertebral joint (choice D) is a cartilaginous joint, none of which are examples of condylar joints.
Question 4 of 5
Her abdominal examination reveals a gravid uterus but is otherwise unremarkable. On visualization of the anus there is a slight red, moist- appearing protrusion from the anus. As you have her bear down, the protrusion grows larger. On digital rectal examination you can feel an enlarged tender area on the posterior side. There is some blood on the glove after the examination. What disorder of the anus or rectum best fits this presentation?
Correct Answer: C
Rationale: The described clinical presentation is consistent with internal hemorrhoids. The typical symptoms of internal hemorrhoids include painless rectal bleeding, protrusion from the anus during straining, and a feeling of incomplete evacuation. In this case, the protrusion is observed to be red, moist, and enlarges with bearing down, all indicative of internal hemorrhoids. The enlarged tender area felt on digital rectal examination supports the diagnosis. Additionally, the presence of blood on the glove after the examination is also suggestive of internal hemorrhoids causing bleeding. Anal fissures typically present with sharp pain during defecation and may have visible tears in the anal mucosa. External hemorrhoids are usually more painful and can be felt as a lump around the anus. Anorectal fistulas have different signs and symptoms, including discharge of pus and recurrent infections.
Question 5 of 5
Her right carotid pulse is bounding but the left carotid pulse is weak. She is afebrile but her respirations are 24 times a minute. On auscultation her lungs are clear and her cardiac examination is unremarkable. You call EMS and have her taken to the hospital's ER for further evaluation. What disorder of the chest best describes her symptoms?
Correct Answer: C
Rationale: A dissecting aortic aneurysm is the most likely disorder that best describes the symptoms presented. In this condition, the inner layer of the aorta tears and blood can flow between the layers of the aortic wall, causing a number of potential symptoms. A patient with a dissecting aortic aneurysm may present with a difference in pulses between the right and left sides due to decreased blood flow to one side. The bounding pulse on one side and weak pulse on the other are indicative of uneven blood flow distribution. Additionally, a dissecting aortic aneurysm can lead to respiratory symptoms such as increased respiratory rate if there is associated pain or discomfort, although clear lung sounds would not typically be expected with this condition. The condition is a life-threatening emergency that requires immediate evaluation and treatment.
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