ATI RN
Vital Signs Assessment Questions
Question 1 of 5
A middle-aged, overweight adult man has had hypertension for 15 years. What pathologic event is he most at risk for?
Correct Answer: A
Rationale: Stroke is the greatest risk with long-term hypertension, per the answer key, due to arterial damage. Anemia , cancer , and infection aren't directly linked. Nurses prioritize stroke prevention in hypertensive patients, a key chronic disease outcome.
Question 2 of 5
A 42-year-old realtor comes to your clinic, complaining of 'growths' in her vulvar area. She is currently undergoing a divorce and is convinced she has a sexually transmitted disease. She denies any vaginal discharge or pain with urination. She has had no fever, malaise, or night sweats. Her past medical history consists of depression and hypothyroidism. She has had two spontaneous vaginal deliveries and one cesarean section. She has had no other surgeries. She denies smoking or drug use. She has two to three drinks weekly. Her mother also has hypothyroidism and her father has high blood pressure and hypercholesterolemia. On examination you see a woman who is anxious but appears otherwise healthy. Her blood pressure, pulse, and temperature are unremarkable. On visualization of the perineum you see two 2- to 3-mm, round, yellow nodules on the left labia. On palpation they are nontender and quite firm. What diagnosis best fits this description of her examination?
Correct Answer: D
Rationale: The correct diagnosis is D: Epidermoid cyst. The presentation of firm, non-tender, round, yellow nodules on the labia, in the absence of pain, discharge, or systemic symptoms, is consistent with an epidermoid cyst. These cysts are common in the vulvar area and result from blockage of hair follicles. The patient's lack of symptoms related to sexually transmitted infections rules out choices A, B, and C. Genital herpes typically presents with painful vesicles, condylomata acuminata (genital warts) are soft, fleshy growths caused by HPV, and a syphilitic chancre would present as a painless ulcer. Given the patient's clinical presentation and examination findings, the most likely diagnosis is an epidermoid cyst.
Question 3 of 5
A 63-year-old nurse comes to your office, upset because she has found an enlarged lymph node under her right arm. She states she found it last week while taking a shower. She isn't sure if she has any breast lumps because she doesn't know how to do self-exams. She states her last mammogram was 5 years ago and it was normal. Her past medical history is significant for high blood pressure and chronic obstructive pulmonary disease. She quit smoking 2 years ago after a 55-packs/year history. She denies using any illegal drugs and drinks alcohol rarely. Her mother died of a heart attack and her father died of a stroke. She has no children. On examination you see an older female appearing her stated age. On visual inspection of her right axilla you see nothing unusual. Palpating this area, you feel a 2-cm hard, fixed lymph node. She denies any tenderness. Visualization of both breasts is normal. Palpation of her left axilla and breast is unremarkable. On palpation of her right breast you feel a nontender 1-cm lump in the tail of Spence. What disorder of the axilla is most likely responsible for her symptoms?
Correct Answer: A
Rationale: The correct answer is A: Breast cancer. The presence of an enlarged, hard, fixed lymph node in the right axilla, along with a nontender lump in the tail of Spence (an area of the breast where breast cancer commonly occurs), strongly suggests breast cancer as the most likely cause. The patient's age, gender, history of smoking, and lack of breast self-exams increase her risk for breast cancer. The absence of tenderness in the lymph node also raises suspicion. Other choices are less likely: B (lymphadenopathy of infectious origin) would typically present with other symptoms like fever or localized infection; C (hidradenitis suppurativa) is a chronic skin condition affecting the sweat glands, not typically presenting with an enlarged lymph node. The patient's history and examination findings align more with breast cancer.
Question 4 of 5
A 25-year-old accountant presents with intermittent lower right-sided chest pain for several days. The pain is knifelike, lasts 3-5 seconds, worsens with deep breathing, and improves when lying on the affected side.
Correct Answer: C
Rationale: The correct answer is C: Pleural pain. The key features here are the sharp, knifelike pain that worsens with deep breathing, which is typical of pleuritic pain due to inflammation of the pleura. This pain pattern is distinct from pericarditis (A) which typically worsens with lying flat and improves when sitting up. Chest wall pain (B) is usually reproducible with palpation, and angina pectoris (D) is typically described as a pressure or squeezing sensation, often triggered by exertion. Therefore, based on the pain characteristics described by the patient, pleural pain is the most likely diagnosis.
Question 5 of 5
The nurse is conducting a patient interview. Which statement made by the patient should the nurse more fully explore during the interview?
Correct Answer: C
Rationale: The correct answer is C: "I never did too good in school." This statement indicates potential underlying issues like learning disabilities or lack of education, affecting the patient's understanding of health information. The nurse should explore this further to assess the patient's health literacy. Choices A, B, and D are less critical as they do not directly impact the patient's health status or the interview process.