ATI RN
health assessment practice questions nursing Questions
Question 1 of 9
A 68-year-old woman is in the eye clinic for a checkup. She tells the nurse that she has been having trouble reading the paper, sewing, and even seeing the faces of her grandchildren. On examination, the nurse notes that she has some loss of central vision but her peripheral vision is normal. These findings suggest that:
Correct Answer: A
Rationale: The correct answer is A: she may have macular degeneration. Macular degeneration is characterized by loss of central vision while peripheral vision remains intact. In this case, the woman's difficulty with tasks that require central vision, such as reading and recognizing faces, points towards macular degeneration. The other choices are incorrect because: B: Her symptoms indicate a specific vision problem, not just age-related changes. C: Cataracts typically cause blurred vision, not loss of central vision. D: Glaucoma typically affects peripheral vision first before progressing to central vision loss.
Question 2 of 9
While performing the otoscopic examination of a 3-year-old boy who has been pulling on his left ear, the nurse finds that his left tympanic membrane is bright red and the light reflex is not visible. The most likely cause is:
Correct Answer: B
Rationale: The correct answer is B: acute otitis media. In this case, the presentation of a bright red tympanic membrane and absence of the light reflex are indicative of inflammation and fluid accumulation in the middle ear, which are classic signs of acute otitis media. This condition commonly occurs in young children, especially after a recent upper respiratory infection. Incorrect choices: A: Fungal infection is less likely in this case as the symptoms are more consistent with acute bacterial infection seen in otitis media. C: Rupture of the drum would typically present with sudden relief of pain and discharge from the ear, which is not described in the scenario. D: Blood behind the drum (hemotympanum) is uncommon in children with acute otitis media and would usually be associated with trauma or barotrauma.
Question 3 of 9
A patient has been admitted for severe iron-deficiency anemia. What can the nurse expect to find in the patient's fingernails?
Correct Answer: C
Rationale: The correct answer is C: Spoon nails. In iron-deficiency anemia, the nails may develop a concave or spoon-like shape (koilonychia). This is due to the decreased oxygen supply to the nail bed. The characteristic spoon nails are indicative of severe iron deficiency. Splinter hemorrhages (choice A) are small areas of bleeding under the nails and are more commonly associated with conditions like endocarditis. Paronychia (choice B) is an infection around the nail, not specific to anemia. Beau's lines (choice D) are horizontal depressions in the nails, typically seen after a period of severe illness or stress, rather than specifically in iron-deficiency anemia.
Question 4 of 9
Which of the following statements about otoscopic examination of a newborn would be true?
Correct Answer: C
Rationale: The correct answer is C because the normal eardrum of a newborn can appear thick and opaque due to the presence of vernix or desquamated epithelium. Immobility of the drum (Choice A) is not a normal finding in a newborn and could indicate a problem. An "injected" membrane (Choice B) would suggest inflammation or infection, not necessarily infection. The appearance of the membrane in a newborn is not identical to that of an adult (Choice D) as it may have a different color, thickness, or opacity due to developmental differences.
Question 5 of 9
The nurse is assessing a patient with a history of intravenous drug abuse. While assessing his mouth, the nurse notices a dark red confluent macule on the hard palate. This could be an early sign of:
Correct Answer: A
Rationale: The correct answer is A: acquired immunodeficiency syndrome (AIDS). The dark red confluent macule on the hard palate is known as Kaposi's sarcoma, a common manifestation of AIDS. This lesion is caused by Human Herpesvirus 8 and is often seen in patients with compromised immune systems. Measles (B) typically presents with a rash, not a dark red macule. Leukemia (C) does not typically manifest as a dark red macule in the mouth. Carcinoma (D) refers to cancer and would present differently than Kaposi's sarcoma. In summary, the presence of a dark red confluent macule on the hard palate in a patient with a history of intravenous drug abuse is highly suggestive of AIDS, specifically Kaposi's sarcoma.
Question 6 of 9
A few days after a summer hiking trip, a 25-year-old man comes to the clinic with a rash. On examination, the nurse notes that the rash is red and circular with central clearing, and is located across his midriff and behind his knees. The nurse suspects:
Correct Answer: B
Rationale: The correct answer is B: Lyme disease. The presentation of a red circular rash with central clearing, known as erythema migrans, following a hiking trip in the summer is highly indicative of Lyme disease. The specific distribution of the rash across the midriff and behind the knees aligns with typical areas where the rash appears in Lyme disease cases. This rash is a hallmark sign of early Lyme disease caused by the bacterium Borrelia burgdorferi transmitted through the bite of an infected tick. Other answer choices are incorrect because rubeola presents with a different rash pattern, an allergy to mosquito bites would not typically present in this manner, and Rocky Mountain spotted fever typically presents with a different rash appearance and distribution.
Question 7 of 9
During an examination of a 3-year-old child, the nurse notes a bruit over the left temporal area. What should the nurse do?
Correct Answer: D
Rationale: The correct answer is D because a bruit in a 3-year-old child, especially over the temporal area, is not a normal finding and could indicate a serious underlying issue such as an arteriovenous malformation or other vascular abnormality. Stopping the examination and notifying the physician is crucial for further evaluation and management. A: Continuing the examination is not appropriate as the bruit should prompt further investigation. B: Checking again in 1 hour is unnecessary delay in addressing a potentially serious issue. C: Notifying the parents alone without medical intervention may delay necessary evaluation and treatment.
Question 8 of 9
The physician has diagnosed a tracheal shift in a patient. The nurse is aware that this means that the patient's trachea is:
Correct Answer: D
Rationale: The correct answer is D because tracheal shift due to thyroid enlargement occurs when the thyroid gland enlarges and displaces the trachea to the opposite side. This is a common clinical finding in conditions like a goiter. Other choices are incorrect because: A is incorrect as tracheal shift is not related to systole; B is incorrect as tracheal shift is typically caused by a mass pushing the trachea; C is incorrect as pleural adhesions don't typically cause tracheal shift.
Question 9 of 9
A 40-year-old woman reports a change in mole size, accompanied by colour changes, itching, burning, and bleeding over the past month. She has a dark complexion and has no family history of skin cancer, but she has had many blistering sunburns in the past. The nurse would:
Correct Answer: B
Rationale: The correct answer is B because the patient's symptoms (change in mole size, color changes, itching, burning, bleeding) are concerning for melanoma, a type of skin cancer. Given her history of blistering sunburns, early evaluation and referral are crucial for timely intervention. Option A is incorrect as it delays necessary evaluation. Option C is irrelevant as the symptoms suggest a serious condition, not environmental irritants. Option D is incorrect as compound nevi typically do not present with the described symptoms and are not common in this age group.