ATI RN
Physical Assessment Nursing Practice Questions Questions
Question 1 of 5
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 5
Mr. Garcia comes to your office for a rash on his chest associated with a burning pain. Even a light touch causes this burning sensation to worsen. On examination, you note a rash with small blisters (vesicles) on a background of reddened skin. The rash overlies an entire rib on his right side. What type of pain is this?
Correct Answer: B
Rationale: The description of the rash on Mr. Garcia's chest associated with a burning pain that worsens with light touch indicates neuropathic pain. Neuropathic pain arises from damage or dysfunction of the nervous system, leading to abnormal pain sensations such as burning, tingling, or shooting pain. In this case, the presence of small blisters (vesicles) on reddened skin overlying an entire rib on one side suggests involvement of nerve fibers, characteristic of neuropathic pain. It is important to differentiate neuropathic pain from other types of pain (such as nociceptive/somatic, idiopathic, or psychogenic) as management strategies differ based on the underlying mechanisms of pain perception.
Question 3 of 5
Which of the following regarding jugular venous pulsations is a systolic phenomenon?
Correct Answer: C
Rationale: The upstroke of the "a" wave in the jugular venous pulsations coincides with systole. The "a" wave is caused by atrial contraction, which occurs during ventricular systole. In contrast, the "x" descent is a diastolic phenomenon representing the atrial relaxation, the "y" descent follows atrial emptying in early diastole, and the "v" wave corresponds to venous filling during late diastole.
Question 4 of 5
A 25-year-old accountant presents to your clinic, complaining of intermittent lower right- sided chest pain for several days. He describes it as knifelike and states it only lasts for 3 to 5 seconds, taking his breath away. He states he feels like he has to breathe shallowly to keep it from recurring. The only thing that makes it better is lying quietly on his right side. It is much worse when he takes a deep breath. He has taken some Tylenol and put a heating pad on his side but neither has helped. He remembers that 2 weeks ago he had an upper respiratory infection with a severe hacking cough. He denies any recent trauma. His past medical history is unremarkable. His parents and siblings are in good health. He has recently married, and his wife has a baby due in 2 months. He denies any smoking or illegal drug use. He drinks two to three beers once a month. He states that he eats a healthy diet and runs regularly, but not since his recent illness. He denies any cardiac, gastrointestinal, or musculoskeletal symptoms. On examination he is lying on his right side but appears quite comfortable. His temperature, blood pressure, pulse, and respirations are unremarkable. His chest has normal breath sounds on auscultation. Percussion of the chest is unremarkable. During palpation the ribs are nontender. What disorder of the chest best describes his symptoms?
Correct Answer: C
Rationale: The patient's symptoms of intermittent, sharp chest pain with breathing that worsens with deep breaths and is relieved by lying on the right side are suggestive of pleural pain. Pleuritic chest pain is often described as sharp or stabbing and occurs when the parietal pleura, the outer lining of the lungs, becomes inflamed or irritated. In this case, the patient's history of an upper respiratory infection with a severe hacking cough two weeks ago suggests that the pleural pain may be related to pleurisy or pleuritis, which can occur as a complication of respiratory infections.
Question 5 of 5
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.