ATI RN
Physical Assessment Nursing Practice Questions Questions
Question 1 of 9
A 58-year-old man comes to your office complaining of bilateral back pain that now awakens him at night. This has been steadily increasing for the past 2 months. Which one of the following is the most reassuring in this patient with back pain?
Correct Answer: D
Rationale: In this patient with bilateral back pain that awakens him at night, the most reassuring finding is that the pain is bilateral. Bilateral symptoms are less likely to be associated with red flags such as malignancy or infection compared to unilateral symptoms. While back pain in individuals over the age of 50, pain at night, and pain lasting more than 1 month are concerning features, the fact that the pain in this patient is bilateral provides some reassurance. However, further evaluation is still warranted to determine the exact cause of the pain and appropriate management.
Question 2 of 9
Mrs. Patton, a 48-year-old woman, comes to your office with a complaint of a breast mass. Without any other information, what is the risk of this mass being cancerous?
Correct Answer: D
Rationale: When a woman over the age of 40 presents with a breast mass, the risk of the mass being cancerous is around 40%. This risk is higher in older women compared to younger women. It is important for Mrs. Patton to undergo further evaluation, which may include imaging tests, a biopsy, and consultation with a specialist to confirm the diagnosis and determine the appropriate treatment. It is crucial to address breast masses promptly to ensure timely management and optimal outcomes.
Question 3 of 9
A 27-year-old policewoman comes to your clinic, complaining of severe left-sided back pain radiating down into her groin. It began in the middle of the night and woke her up suddenly. It hurts in her bladder to urinate but she has no burning on the outside. She has had no frequency or urgency with urination but she has seen blood in her urine. She has had nausea with the pain but no vomiting or fever. She denies any other recent illness or injuries. Her past medical history is unremarkable. She denies tobacco or drug use and drinks alcohol rarely. Her mother has high blood pressure and her father is healthy. On examination she looks her stated age and is in obvious pain. She is lying on her left side trying to remain very still. Her cardiac, pulmonary, and abdominal examinations are unremarkable. She has tenderness just inferior to the left costovertebral angle. Her urine pregnancy test is negative and her urine analysis shows red blood cells. What type of urinary tract pain is she most likely to have?
Correct Answer: B
Rationale: The policewoman's presentation of severe left-sided back pain radiating down into her groin, associated with nausea, blood in urine, and tenderness just inferior to the left costovertebral angle is highly suggestive of a kidney stone causing ureteral colic. Kidney stones are solid masses made of crystals that form in the kidneys and can cause sudden severe pain as they move through the urinary tract, leading to blockage and subsequent stretching of the ureter (the tube connecting the kidney to the bladder), resulting in pain that radiates from the flank down to the groin region. The presence of blood in the urine (hematuria) is a common finding with kidney stones due to irritation and damage to the ureteral lining as the stone passes. The negative urine pregnancy test rules out pregnancy-related causes of urinary symptoms. Musculoskeletal pain is less likely given the location and character of the pain
Question 4 of 9
You are beginning the examination of a patient. All of the following areas are important to observe as part of the General Survey except:
Correct Answer: D
Rationale: Blood pressure is not typically included in the initial assessment during the General Survey. The General Survey primarily focuses on obtaining an overall impression of the patient's health status and any noticeable cues such as level of consciousness, signs of distress, and appearance including dress, grooming, and personal hygiene. While blood pressure is an important vital sign to assess during a comprehensive examination, it is usually measured later in the assessment process and not part of the initial general observation.
Question 5 of 9
You are conducting a workshop on the measurement of jugular venous pulsation. As part of your instruction, you tell the students to make sure that they can distinguish between the jugular venous pulsation and the carotid pulse. Which one of the following characteristics is typical of the carotid pulse?
Correct Answer: A
Rationale: The carotid pulse is typically palpable, meaning that you can feel it when you place your fingers lightly on the carotid artery located in the neck. In contrast, jugular venous pulsation is not typically palpable. When examining jugular venous pulsation, it is important to differentiate it from the carotid pulse by considering factors such as the quality of pulsation, response to pressure, and changes with position.
Question 6 of 9
Dakota is a 14-year-old boy who just noticed a rash at his ankles. There is no history of exposure to ill people or other agents in the environment. He has a slight fever in the office. The rash consists of small, bright red marks. When they are pressed, the red color remains. What should you do?
Correct Answer: B
Rationale: Dakota's presentation of a rash with small, bright red marks that do not fade when pressed (non-blanching) along with a slight fever raises concern for a serious condition such as meningococcal infection. Non-blanching rashes, especially when associated with fever, can be a sign of meningococcal sepsis, a life-threatening condition that requires urgent medical attention. Admission to the hospital is warranted for close monitoring, further evaluation, and initiation of appropriate treatment if needed. It is important to err on the side of caution in such cases to ensure the best possible outcome for the patient.
Question 7 of 9
A young woman undergoes cranial nerve testing. On touching the soft palate, her uvula deviates to the left. Which of the following is likely?
Correct Answer: C
Rationale: When the uvula deviates to one side upon touching the soft palate, it indicates a dysfunction of the vagus nerve (CN X) on the side toward which the uvula deviates. In this case, the uvula deviates to the left, suggesting a lesion affecting the left CN X. This is because the palate and uvula are innervated by the vagus nerve (cranial nerve X), and damage to this nerve may result in an asymmetric elevation or deviation of the uvula upon stimulation. Therefore, a CN X lesion on the left side is the most likely explanation for the observed deviation of the uvula in this scenario.
Question 8 of 9
A 55-year-old secretary with a recent history of breast cancer, for which she underwent surgery and radiation therapy, and a history of hypertension comes to your office for a routine checkup. Which of the following aspects of the physical are important to note when assessing the patient for peripheral vascular disease in the arms?
Correct Answer: D
Rationale: When assessing a patient for peripheral vascular disease in the arms, it is important to examine the pulses in the upper extremities. The pulses to be assessed in this context include the radial pulse (located on the wrist at the base of the thumb) and the brachial pulse (located in the upper arm near the elbow). These pulses provide important information about blood flow and circulation in the arms. Changes in the strength, regularity, or absence of these pulses can indicate potential issues related to peripheral vascular disease. While the femoral and popliteal pulses (Choice A) are important for assessing the lower extremities, and the dorsalis pedis and posterior tibial pulses (Choice B) are also crucial for evaluating peripheral vascular disease in the legs, the radial and brachial pulses are specifically relevant for assessing the arms. The carotid pulse (Choice C) is important for evaluating the vascular status of
Question 9 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.