ATI RN
Neurological Vital Signs Assessment Questions
Question 1 of 5
A 50-year-old man presents with weight loss, night sweats, and fatigue. He has a history of smoking and coughing up blood. Chest X-ray shows a mass in the left upper lobe of the lung. Which of the following is the most likely diagnosis?
Correct Answer: C
Rationale: The most likely diagnosis for the 50-year-old man with weight loss, night sweats, coughing up blood, and a mass in the left upper lobe of the lung is lung cancer (Choice C). Here's the rationale: 1. Weight loss, night sweats, and fatigue are common symptoms of advanced cancer. 2. History of smoking is a significant risk factor for developing lung cancer. 3. Coughing up blood (hemoptysis) is a classic symptom of lung cancer. 4. Chest X-ray showing a mass in the left upper lobe is indicative of a tumor. 5. Pneumonia (Choice A) typically presents with fever, productive cough, and infiltrates on imaging. 6. Tuberculosis (Choice B) usually presents with chronic cough, weight loss, night sweats, and upper lobe infiltrates. 7. Chronic obstructive pulmonary disease (Choice D) is characterized by progressive difficulty breathing, cough, and sputum production.
Question 2 of 5
The nurse is assessing a patient's lungs and notes that the patient has a dull percussion note over the left lower lung field. What is the most likely cause of this finding?
Correct Answer: B
Rationale: The dull percussion note indicates fluid accumulation in the lung field, typical of pleural effusion. This fluid-filled space dampens sound transmission, resulting in a dull sound. This finding is consistent with pleural effusion, making choice B the correct answer. Normal lung tissue (Choice A) would produce a resonant percussion note. Pneumothorax (Choice C) would typically produce hyperresonant or tympanic sounds. Bronchitis (Choice D) affects airways and does not directly impact percussion notes.
Question 3 of 5
A 55-year-old woman presents with difficulty walking and reports a feeling of 'pins and needles' in her legs. She has a history of diabetes mellitus. On examination, she has decreased sensation in the lower extremities and absent ankle reflexes. What is the most likely diagnosis?
Correct Answer: A
Rationale: The correct answer is A: Peripheral neuropathy. Given the patient's age, symptoms, history of diabetes mellitus, decreased sensation in lower extremities, and absent ankle reflexes, peripheral neuropathy is the most likely diagnosis. Peripheral neuropathy is a common complication of diabetes and presents with sensory symptoms like 'pins and needles,' decreased sensation, and loss of reflexes. Multiple sclerosis (B) typically presents with symptoms that involve the central nervous system and often presents with visual disturbances and muscle weakness. Spinal cord compression (C) typically presents with symptoms like weakness and sensory changes in specific dermatomal patterns, which are not consistent with the patient's presentation. Parkinson's disease (D) presents with motor symptoms such as tremors, rigidity, and bradykinesia, which are not seen in this patient.
Question 4 of 5
During a respiratory assessment, the nurse observes that the patient has bilateral crackles on inspiration. What is the most likely cause of this finding?
Correct Answer: B
Rationale: The presence of bilateral crackles on inspiration suggests fluid in the lungs, which is characteristic of pulmonary edema. Pulmonary fibrosis is associated with fine, late inspiratory crackles. Pneumonia typically presents with focal crackles in the affected area. Asthma is characterized by wheezing rather than crackles. Therefore, the correct answer is B as it aligns with the clinical presentation of bilateral crackles on inspiration in pulmonary edema.
Question 5 of 5
The nurse is performing a cardiovascular assessment and notes that the patient has a bounding pulse. What condition is most likely associated with this finding?
Correct Answer: B
Rationale: The correct answer is B: Hypervolemia. A bounding pulse is characterized by a strong and forceful heartbeat, which is typically associated with an increased volume of blood in the circulatory system. In hypervolemia, there is an excess of fluid in the blood vessels, leading to increased pressure and volume, resulting in a bounding pulse. Hypovolemia (choice A) is characterized by decreased blood volume and would not cause a bounding pulse. Aortic stenosis (choice C) is a narrowing of the aortic valve that leads to reduced blood flow from the heart and would not typically result in a bounding pulse. Bradycardia (choice D) is a slow heart rate and is not directly related to the strength or forcefulness of the pulse.