ATI RN
Physical Examination and Health Assessment 8th Edition Test Bank Questions
Question 1 of 9
A 55-year-old smoker complains of chest pain and gestures with a closed fist over her sternum to describe it. Which of the following diagnoses should you consider because of her gesture?
Correct Answer: D
Rationale: The closed fist gesture over the sternum to describe chest pain is a typical characteristic of angina pectoris. Angina pectoris is chest pain or discomfort that occurs when the heart muscle does not receive enough oxygen-rich blood. The gesture of clenching a fist over the sternum is often used to describe the tight, squeezing, or pressure-like discomfort experienced with angina. This type of chest pain is typically triggered by physical or emotional stress and is relieved by rest or medications like nitroglycerin. Considering the patient's age, smoking history, and the description of the chest pain gesture, angina pectoris should be a top consideration in this case.
Question 2 of 9
A 25-year-old type 1 diabetic clerk presents to the emergency room with shortness of breath and states that his blood sugar was 605 at home. You diagnose the patient with diabetic ketoacidosis. What is the expected pattern of breathing?
Correct Answer: C
Rationale: In diabetic ketoacidosis (DKA), the body is in a state of metabolic acidosis due to the accumulation of ketones in the blood. One of the compensatory mechanisms to decrease the acidity in the body is increased breathing, known as Kussmaul breathing. This type of breathing is characterized by a rapid and deep pattern to blow off excess carbon dioxide and decrease the acidity of the blood. Therefore, in a patient with DKA, you would expect to observe rapid and deep breathing.
Question 3 of 9
Which is true of prostate cancer?
Correct Answer: D
Rationale: Prostate cancer is more prevalent in certain ethnic groups, with African-American men having the highest risk of developing prostate cancer compared to men of other ethnicities. Additionally, men of Caribbean and West African descent also have an increased risk compared to men of Asian descent. This indicates that ethnicity plays a role in the risk of developing prostate cancer.
Question 4 of 9
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: Mrs. R. is exhibiting characteristics of a silent patient because she does not respond or engage in conversation when directly asked a question by the healthcare provider. In this case, Mrs. R.'s lack of verbal response could be due to various reasons such as shyness, anxiety, cognitive impairment, or communication barriers. It is important for healthcare providers to recognize and adapt to different communication styles and preferences of patients to ensure effective patient-provider interaction and care. In situations like these, it may be helpful to provide alternative communication methods or allow more time for the patient to respond comfortably.
Question 5 of 9
You are working in a college health clinic and seeing a young woman with a red, painful, swollen DIP joint on the left index finger. There are also a few papules, pustules, and vesicles on reddened bases, located on the distal extremities. This would be consistent with which of the following?
Correct Answer: D
Rationale: The description provided indicates a presentation consistent with gonococcal arthritis. Gonococcal arthritis is an infectious arthritis caused by the bacteria Neisseria gonorrhoeae. Symptoms typically include red, swollen, and painful joints, especially affecting the distal joints of the limbs. The presence of papules, pustules, and vesicles on reddened bases at the distal extremities is characteristic of disseminated gonococcal infection. In women, the DIP joint involvement in the finger can be indicative of this condition. Prompt diagnosis and treatment with antibiotics are essential to prevent complications associated with gonococcal arthritis. It is important to consider a sexually transmitted infection like gonorrhea in young patients presenting with joint symptoms and cutaneous findings.
Question 6 of 9
A patient is assigned a visual acuity of 20/100 in her left eye. Which of the following is true?
Correct Answer: C
Rationale: In the context of visual acuity, the numbers in the ratio 20/100 represent a comparison between the patient's vision and normal vision. Specifically, a visual acuity of 20/100 means that the patient can see at 20 feet what a person with normal vision can see at 100 feet. This indicates that the patient's vision is reduced, as she needs to be closer to see the same level of detail compared to someone with normal vision.
Question 7 of 9
The following information is best placed in which category? "The patient has had three cesarean sections."
Correct Answer: C
Rationale: The information provided, specifically about the patient having three cesarean sections, is most appropriate to be placed under the Obstetrics/gynecology category. This category focuses on the healthcare of women, particularly during pregnancy, childbirth, and postpartum period, which includes details about cesarean sections. This information is not related to adult illnesses, surgeries in general, or psychiatric conditions.
Question 8 of 9
You are performing a thorough cardiac examination. Which of the following chambers of the heart can you assess by palpation?
Correct Answer: C
Rationale: The right ventricle is the only chamber of the heart that can be assessed by palpation during a cardiac examination. The right ventricle is located close to the sternum on the anterior chest wall, making it accessible for palpation. By palpating the area near the lower left sternal border, just beside the sternum, a healthcare provider can assess the size and function of the right ventricle. It is important to note that the other chambers of the heart (left atrium and right atrium) are not typically assessed by palpation due to their deeper location within the chest cavity. The sinus node, which is responsible for generating the heart's electrical impulses, is also not directly palpable during a cardiac examination.
Question 9 of 9
Mr. Martin is a 72-year-old smoker who comes to you for his hypertension visit. You note that with deep palpation you feel a pulsatile mass which is about 4 centimeters in diameter. What should you do next?
Correct Answer: D
Rationale: The presence of a palpable pulsatile abdominal mass in a patient like Mr. Martin, who is a smoker and at risk for vascular diseases, is concerning for an abdominal aortic aneurysm (AAA). Immediate referral to a vascular surgeon is essential for further evaluation and management. AAA can be a life-threatening condition if left untreated, as it can lead to rupture and severe internal bleeding. Therefore, prompt specialist evaluation and monitoring are crucial in such cases. Waiting for 3 or 6 months for reevaluation could potentially lead to a delayed diagnosis and increase the risk of complications. Abdominal ultrasound is typically the diagnostic test of choice to confirm the presence and size of the aneurysm.