A middle-aged man comes in because he has noticed multiple small, blood-red, raised lesions over his anterior chest and abdomen for the past several months. They are not painful and he has not noted any bleeding or bruising. He is concerned this may be consistent with a dangerous condition. What should you do?

Questions 27

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ATI RN Test Bank

Test Bank Physical Examination and Health Assessment Questions

Question 1 of 9

A middle-aged man comes in because he has noticed multiple small, blood-red, raised lesions over his anterior chest and abdomen for the past several months. They are not painful and he has not noted any bleeding or bruising. He is concerned this may be consistent with a dangerous condition. What should you do?

Correct Answer: C

Rationale: The presentation of multiple small, blood-red, raised lesions over the anterior chest and abdomen in a middle-aged man raises concern for a condition known as cherry angiomas. Cherry angiomas are common benign vascular growths often seen in middle-aged and older individuals. They are typically asymptomatic and do not require treatment unless they are bothersome to the patient cosmetically.

Question 2 of 9

Dawn is a 55-year-old woman who comes in today for her yearly wellness examination. You carefully perform the rectal examination in the lithotomy position and feel a mass against the bowel wall which is firm and immobile. Which of the following is most likely?

Correct Answer: A

Rationale: The presence of a firm and immobile mass felt against the bowel wall during a rectal examination is concerning for a potential malignancy, such as colon cancer. Other conditions such as hemorrhoids or anal fissures are typically not associated with a mass that is firm and immobile. The "Valve of Houston" is a term that does not pertain to this scenario and is not a recognized medical entity. Therefore, the most likely diagnosis based on the given information is colon cancer, and further evaluation such as a colonoscopy would be warranted for definitive diagnosis and management.

Question 3 of 9

Mr. Curtiss has a history of obesity, diabetes, osteoarthritis of the knees, HTN, and obstructive sleep apnea. His BMI is 43 and he has been discouraged by his difficulty in losing weight. He is also discouraged that his goal weight is 158 pounds away. What would you tell him?

Correct Answer: D

Rationale: Weight loss can have a significant impact on the health problems associated with obesity. Even a modest weight loss of around 10% can lead to noticeable improvements in conditions such as diabetes, hypertension, osteoarthritis, and obstructive sleep apnea. Encouraging Mr. Curtiss to focus on achieving a meaningful but achievable goal, such as a 10% weight loss, can help him experience positive changes in his health and overall wellbeing, even if his ultimate goal weight seems far away. This approach can also help to boost his motivation and confidence in his ability to make progress towards better health.

Question 4 of 9

Susanne is a 27-year-old who has had headaches, muscle aches, and fatigue for the last 2 months. You have completed a thorough history, examination, and laboratory workup but have not found a cause. What would your next action be?

Correct Answer: D

Rationale: Since the patient, Susanne, has been experiencing headaches, muscle aches, and fatigue for the last 2 months, and a thorough history, examination, and laboratory workup have not revealed a definitive cause, the next step would be to screen for depression. Depression can present with physical symptoms such as headaches, muscle aches, and fatigue. It is important to consider mental health factors that could be contributing to Susanne's symptoms before proceeding with further referrals to specialists. Screening for depression would help in determining if psychological factors are playing a role in her physical symptoms.

Question 5 of 9

You find a bounding carotid pulse on a 62-year-old patient. Which murmur should you search out?

Correct Answer: D

Rationale: Finding a bounding carotid pulse suggests a wide pulse pressure, which can be associated with aortic insufficiency. Aortic insufficiency (also known as aortic regurgitation) is characterized by the backflow of blood from the aorta into the left ventricle during diastole due to incomplete closure of the aortic valve. This results in increased stroke volume and left ventricular pressure, leading to widened pulse pressure and a bounding arterial pulse. Therefore, when a bounding carotid pulse is detected in a patient, it is important to search for signs and symptoms of aortic insufficiency, such as a diastolic murmur heard best at the left sternal border and radiating to the neck.

Question 6 of 9

Mrs. H. comes to your clinic, wanting antibiotics for a sinus infection. When you enter the room, she appears to be very angry. She has a raised tone of voice and states that she has been waiting for the past hour and has to get back to work. She states that she is unimpressed by the reception staff, the nurse, and the clinic in general and wants to know why the office wouldn't call in an antibiotic for her. Which of the following techniques is not useful in helping to calm this patient?

Correct Answer: A

Rationale: Acknowledging and taking responsibility for any part you may have played in provoking the patient's anger is important in effectively addressing the situation. By avoiding admission of your lateness, you may come across as dismissive of the patient's feelings and not addressing the issue at hand. It is essential to validate the patient's feelings and work towards finding a solution rather than avoiding the issue.

Question 7 of 9

A 77-year-old retired nurse has an ulcer on a lower extremity that you are asked to evaluate when you do your weekly rounds at a local long-term care facility. All of the following are responsible for causing ulcers in the lower extremities except for which condition?

Correct Answer: D

Rationale: Hypertension, or high blood pressure, is not typically associated with causing ulcers in the lower extremities. The most common causes of lower extremity ulcers are arterial insufficiency, venous insufficiency, and diminished sensation in pressure points. Arterial insufficiency leads to decreased blood flow to the lower extremities, causing tissue damage and ulcers. Venous insufficiency results in poor circulation and increased pressure in the veins, leading to ulcers. Diminished sensation in pressure points, often seen in conditions like diabetes, can cause ulcers due to lack of feeling and increased risk of trauma. So, hypertension is not directly related to the development of lower extremity ulcers.

Question 8 of 9

A 25-year-old optical technician comes to your clinic for evaluation of fatigue. As part of your physical examination, you listen to her heart and hear a murmur only at the cardiac apex. Which valve is most likely to be involved, based on the location of the murmur?

Correct Answer: A

Rationale: A murmur heard only at the cardiac apex is most likely due to mitral valve pathology. The mitral valve is located near the apex of the heart, and murmurs related to mitral valve issues are typically best heard at the apex during auscultation. Mitral valve diseases such as mitral valve prolapse, mitral stenosis, or mitral regurgitation can lead to the development of a murmur in this location.

Question 9 of 9

Which of the following is consistent with obturator sign?

Correct Answer: C

Rationale: The obturator sign is a physical examination maneuver used to assess for irritation of the obturator muscle due to an inflamed appendix that is in close proximity. This pain is typically felt in the right lower quadrant or hypogastric region. The sign is elicited by passively flexing the hip and knee of the patient, then internally rotating the hip. An alternative method is to position the patient on her left side and ask her to raise her right thigh against resistance while the examiner provides counterpressure. Pain experienced by the patient with these maneuvers is consistent with obturator sign, indicating possible appendicitis. Hence, option C is the correct answer.

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