ATI RN
Physical Assessment Practice Questions Questions
Question 1 of 9
A 73-year-old nurse comes to your office for evaluation of new onset of tremors. She is not on any medications and does not take herbs or supplements. She has no chronic medical conditions. She does not smoke or drink alcohol. She walks into the examination room with slow movements and shuffling steps. She has decreased facial mobility and a blunt expression, without any changes in hair distribution on her face. Based on this description, what is the most likely reason for the patient's symptoms?
Correct Answer: D
Rationale: The patient's presentation of new onset tremors, slow movements with shuffling steps (bradykinesia), decreased facial mobility, and blunt expression are characteristic features of Parkinson's disease. Parkinson's disease is a neurodegenerative disorder that affects movement, typically presenting with tremors, rigidity, and bradykinesia. The presence of these symptoms in this patient, along with the absence of any other medical conditions or medication use, points toward a diagnosis of Parkinson's disease. Other conditions like Cushing's syndrome, nephrotic syndrome, and myxedema are unlikely based on the patient's clinical presentation.
Question 2 of 9
Josh is a 14-year-old boy who presents with a sore throat. On examination, you notice dullness in the last intercostal space in the anterior axillary line on his left side with a deep breath. What does this indicate?
Correct Answer: B
Rationale: The dullness in the last intercostal space in the anterior axillary line on the left side with a deep breath is suggestive of splenomegaly. However, this finding alone is not definitive for an enlarged spleen. The size of the spleen can vary, and further examination is required to confirm if the spleen is indeed enlarged. Therefore, Option B is the most appropriate choice as it indicates that the spleen is possibly enlarged, and close attention should be paid to further examination to confirm its status. Further workup, such as imaging studies or blood tests, may be necessary to evaluate the size and function of the spleen in this case.
Question 3 of 9
A 35-year-old archaeologist comes to your office (located in Phoenix, Arizona) for a regular skin check-up. She has just returned from her annual dig site in Greece. She has fair skin and reddish-blonde hair. She has a family history of melanoma. She has many freckles scattered across her skin. From this description, which of the following is not a risk factor for melanoma in this patient?
Correct Answer: B
Rationale: In the given scenario, being a 35-year-old archaeologist with fair skin, a family history of melanoma, and many freckles scattered across her skin are all risk factors for melanoma. Age (choice A) is a relevant risk factor as melanoma incidence increases with age. Actinic lentigines (choice C), also known as sunspots, are precancerous skin lesions that can increase the risk of developing melanoma. Heavy sun exposure (choice D) is a significant risk factor as cumulative sun exposure over time can contribute to the development of melanoma.
Question 4 of 9
Frank is a 24-year-old man who presents with multiple burning erosions on the shaft of his penis and some tender inguinal adenopathy. Which of the following is most likely?
Correct Answer: B
Rationale: The presentation of multiple burning erosions on the shaft of the penis along with tender inguinal adenopathy is indicative of genital herpes caused by the herpes simplex virus (HSV). Primary herpes simplex infection typically presents with painful ulcers and lymphadenopathy. The ulcers are often shallow with well-defined borders and can be associated with systemic symptoms such as fever and malaise. In contrast, primary syphilis is characterized by a painless chancre at the site of infection, usually on the genitals. Chancroid can also present with painful ulcers, but it is less common in developed countries. Gonorrhea typically presents with urethral discharge, dysuria, or other symptoms of urethritis, rather than erosions on the penis shaft.
Question 5 of 9
A 50-year-old body builder is upset by a letter of denial from his life insurance company. He is very lean but has gained 2 pounds over the past 6 months. You personally performed his health assessment and found no problems whatsoever. He says he is classified as "high risk" because of obesity. What should you do next?
Correct Answer: D
Rationale: Since the life insurance company is classifying the body builder as "high risk" due to obesity, it is important to assess whether his weight gain is primarily fat accumulation around the waist. Measuring his waist circumference can provide valuable information about the distribution of body fat. Abdominal obesity, indicated by an increased waist measurement, is a significant risk factor for health issues such as heart disease, diabetes, and metabolic syndrome. By measuring his waist, you can determine if his weight gain is indeed a cause for concern in terms of health risks, rather than just considering the overall weight gain. This information can help you provide more targeted advice on how to address any potential health concerns related to the weight gain.
Question 6 of 9
On visualization of the penis he is circumcised and there are no lesions and no discharge from the meatus. His scrotal skin is tense and red. Palpation of the left testicle causes severe pain and the patient begins to cry. His prostate examination is unremarkable. His cremasteric reflex is absent on the left but is normal on the right. By catheter you get a urine sample and the analysis is unremarkable. You send the boy with his mother to the emergency room for further workup. What is the most likely diagnosis for this young man's symptoms?
Correct Answer: C
Rationale: The presentation of severe testicular pain with a red, tense scrotum, and absent cremasteric reflex on one side is highly concerning for testicular torsion. Testicular torsion is a urologic emergency that occurs when the spermatic cord twists, leading to compromised blood flow to the testicle. The affected testicle can become ischemic and necrotic within hours, necessitating prompt diagnosis and intervention to avoid permanent damage or loss of the testicle.
Question 7 of 9
A 55-year-old bookkeeper comes to your office for a routine visit. You note that on a previous visit for treatment of contact dermatitis, her blood pressure was elevated. She does not have prior elevated readings and her family history is negative for hypertension. You measure her blood pressure in your office today. Which of the following factors can result in a false high reading?
Correct Answer: A
Rationale: A tightly fitted blood pressure cuff can result in a false high reading by compressing the underlying artery too much, causing an inaccurate measurement. It is important to ensure that the blood pressure cuff is appropriately sized for the patient's arm to obtain an accurate reading. The other factors listed, such as the patient being seated quietly, measuring on a bare arm, and supporting the patient's arm at the correct level, all contribute to obtaining an accurate measurement of blood pressure.
Question 8 of 9
A 19-year-old college sophomore comes to the clinic for evaluation of joint pains. The student has been back from spring break for 2 weeks; during her holiday, she went camping. She notes that she had a red spot, shaped like a target, but then it started spreading, and then the joint pains started. She used insect repellant but was in an area known to have ticks. She has never been sick and takes no medications routinely; she has never been sexually active. What is the most likely cause of her joint pain?
Correct Answer: D
Rationale: The most likely cause of the 19-year-old college sophomore's joint pain is Lyme disease. The presentation of a red spot shaped like a target (erythema migrans) that spreads, along with joint pain, is classic for Lyme disease. Additionally, the history of camping in an area known to have ticks and the history of using insect repellent support the likelihood of a tick-borne illness like Lyme disease.
Question 9 of 9
Jason is a 41-year-old electrician who presents to the clinic for evaluation of shortness of breath. The shortness of breath occurs with exertion and improves with rest. It has been going on for several months and initially occurred only a couple of times a day with strenuous exertion; however, it has started to occur with minimal exertion and is happening more than a dozen times per day. The shortness of breath lasts for less than 5 minutes at a time. He has no cough, chest pressure, chest pain, swelling in his feet, palpitations, orthopnea, or paroxysmal nocturnal dyspnea. Which of the following symptom attributes was not addressed in this description?
Correct Answer: A
Rationale: While the description provides information about the duration, frequency, onset, and relieving factors of Jason's shortness of breath, it does not mention the severity of the symptom. Severity refers to the intensity or degree of the symptom, such as mild, moderate, or severe. In this case, we do not have information about how Jason would rate the severity of his shortness of breath. It can be an important attribute to consider when assessing the impact of the symptom on the individual's quality of life and the potential urgency of intervention.