A 56-year-old homosexual man presents with itching, anorectal pain, and tenesmus of 1 week's duration. Rectal examination reveals generalized tenderness without frank prostate abnormalities. Which of the following is most likely?

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NCLEX Practice Questions Physical Assessment Questions

Question 1 of 5

A 56-year-old homosexual man presents with itching, anorectal pain, and tenesmus of 1 week's duration. Rectal examination reveals generalized tenderness without frank prostate abnormalities. Which of the following is most likely?

Correct Answer: C

Rationale: Given the patient's presentation of itching, anorectal pain, and tenesmus, along with rectal examination findings of generalized tenderness without prostate abnormalities, proctitis is the most likely diagnosis. Proctitis is inflammation of the rectal lining and is commonly associated with symptoms such as rectal pain, itching, tenesmus (feeling of incomplete defecation), and sometimes rectal bleeding. It can have various causes, including sexually transmitted infections (such as gonorrhea, chlamydia), inflammatory bowel disease, radiation therapy, or trauma.

Question 2 of 5

Phil comes to your office with left "shoulder pain." You find that the pain is markedly worse when his left arm is drawn across his chest (adduction). Which of the following would you suspect?

Correct Answer: A

Rationale: The presentation of pain that is markedly worse when the left arm is drawn across the chest (adduction) is characteristic of a rotator cuff tear. This is because when the arm is adducted, it puts stress on the torn rotator cuff tendons, causing pain. In contrast, subacromial bursitis typically presents with pain during overhead movements, acromioclavicular joint involvement may present with pain localized to the joint itself, and adhesive capsulitis (frozen shoulder) typically presents with pain and stiffness that worsens with all movements.

Question 3 of 5

The components of the health history include all of the following except which one?

Correct Answer: B

Rationale: When conducting a health history assessment, the components typically include the review of systems, present illness, and personal and social items. The review of systems involves asking specific questions related to each system of the body to gather comprehensive information about the patient's overall health. Present illness focuses on the current chief complaint and symptoms the patient is experiencing. Personal and social items encompass details such as lifestyle habits, family history, medical history, and social support systems. The thorax and lungs are typically assessed as part of the physical examination, not specifically in the health history documentation.

Question 4 of 5

A patient presents for evaluation of a cough. Which of the following anatomic regions can be responsible for a cough?

Correct Answer: C

Rationale: A cough can be attributed to various anatomic regions. Cardiac conditions, such as heart failure or fluid overload, can lead to congestion in the lungs and irritation of the airway, resulting in a cough. Ophthalmologic, auditory, and endocrine regions are less commonly associated with causing a cough.

Question 5 of 5

You are running late after your quarterly quality improvement meeting at the hospital and have just gotten paged from the nurses' station because a family member of one of your patients wants to talk with you about that patient's care. You have clinic this afternoon and are double- booked for the first appointment time; three other patients also have arrived and are sitting in the waiting room. Which of the following demeanors is a behavior consistent with skilled interviewing when you walk into the examination room to speak with your first clinic patient?

Correct Answer: D

Rationale: It is important to maintain a calm demeanor when walking into the examination room to speak with your first clinic patient, especially in a busy and high-pressure situation. Demonstrating calmness will help to build rapport with the patient, create a sense of trust, and promote effective communication. This demeanor will also convey professionalism and confidence, which are essential qualities for a healthcare provider. Displaying irritability, impatience, or boredom can negatively impact the patient-provider relationship and hinder effective communication, potentially compromising the quality of care provided.

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