ATI RN
health assessment practice questions Questions
Question 1 of 9
A patient comes into the emergency department after an accident at work. He had not been wearing safety glasses, and a machine had blown dust into his eyes. The nurse examines his corneas by shining a light from the side across the cornea. What findings would suggest that he has suffered corneal abrasion?
Correct Answer: D
Rationale: The correct answer is D. A shattered look to the light rays reflecting off the cornea indicates corneal abrasion. When the cornea is scratched or abraded, light rays reflecting off it appear shattered due to irregularities on the corneal surface. This is a classic sign of corneal abrasion. A: Smooth and clear corneas (incorrect) - This would not indicate corneal abrasion as abrasions cause irregularities on the corneal surface. B: Opacity of the lens behind the cornea (incorrect) - This suggests a different issue related to the lens, not corneal abrasion. C: Bleeding from the areas across the cornea (incorrect) - This suggests a more severe injury like a corneal laceration, not a simple abrasion. In summary, choice D is correct as the shattered look of light rays is a characteristic finding in corneal abrasion, while the other choices do not
Question 2 of 9
A physician tells the nurse that a patient's vertebra prominens is tender and asks the nurse to reevaluate the area in 1 hour. The area of the body the nurse will assess will be:
Correct Answer: C
Rationale: The correct answer is C: at the level of the C7 vertebra. The vertebra prominens refers to the spinous process of the C7 vertebra, which is the most prominent bony landmark at the base of the neck. Assessing this area allows the nurse to accurately locate and evaluate tenderness reported by the physician. Choices A, B, and D are incorrect as they do not correspond to the location of the vertebra prominens. Option A is too high, above the diaphragm; option B is too low, lateral to the knee cap; and option D is too low, at the level of the T11 vertebra.
Question 3 of 9
During examination of a 4-year-old Aboriginal child, the nurse notices that her uvula is partially split. Which of the following statements about this condition is accurate?
Correct Answer: B
Rationale: The correct answer is B: This is a bifid uvula, which is a common occurrence in some Aboriginal groups. 1. A bifid uvula is a condition where the uvula is split or divided, which is a common variation seen in some Aboriginal populations. 2. Cleft palate is a different condition involving a gap in the roof of the mouth, not specifically related to Aboriginal people. 3. Uvular injury is not a common cause of a split uvula in children, so reporting to authorities is unnecessary. 4. Torus palatinus is a bony growth on the roof of the mouth and not related to a split uvula or specific to Aboriginal populations.
Question 4 of 9
Tests have shown that a patient has sensorineural hearing loss. During the assessment, it would be important for the nurse to:
Correct Answer: B
Rationale: The correct answer is B: assess for middle ear infection as a possible cause. Sensorineural hearing loss is usually caused by damage to the inner ear or the nerve pathway to the brain. Middle ear infection can sometimes lead to conductive hearing loss, but it's important to rule out this possibility during assessment. Speaking loudly (A) is not effective for sensorineural hearing loss. Asking about medications (C) may be relevant but not as crucial as assessing for a possible cause. Looking for external ear obstruction (D) is more relevant for conductive hearing loss, not sensorineural.
Question 5 of 9
In a patient with anisocoria, the nurse would expect to observe:
Correct Answer: C
Rationale: Step-by-step rationale: 1. Anisocoria is a condition where pupils are of unequal size. 2. It is typically caused by issues in the eye muscles or nerves controlling pupil size. 3. The nurse would expect to observe pupils of different sizes. 4. Dilated pupils (choice A) and excessive tearing (choice B) are not indicative of anisocoria. 5. An uneven curvature of the lens (choice D) does not directly relate to pupil size differences. Summary: Correct answer C is supported by the definition of anisocoria and its usual presentation. Choices A, B, and D are incorrect as they do not align with the characteristic feature of anisocoria.
Question 6 of 9
During a well-baby checkup, the nurse notices that a 1-week-old infant's face looks small, compared with an enlarged cranium. On further examination, the nurse also notes dilated scalp veins and downcast, or"setting sun," eyes. What condition does the nurse suspect?
Correct Answer: C
Rationale: The correct answer is C: Hydrocephalus. The nurse suspects hydrocephalus due to the symptoms presented by the infant: enlarged cranium, small face, dilated scalp veins, and "setting sun" eyes. Hydrocephalus is the abnormal accumulation of cerebrospinal fluid in the brain, leading to increased intracranial pressure and characteristic physical signs such as an enlarged head. Craniotabes (A) is softening of the skull bones, not associated with these symptoms. Microcephaly (B) is characterized by a smaller head size, opposite to what is described in the question. Caput succedaneum (D) is swelling of the soft tissues of the infant's scalp, which is unrelated to the symptoms mentioned.
Question 7 of 9
The nurse is conducting an eye clinic at the day care centre. When examining a 2-year-old child, if"lazy eye" is suspected, the nurse would:
Correct Answer: D
Rationale: The correct answer is D because testing for strabismus by performing the corneal light reflex test is crucial in diagnosing "lazy eye" or amblyopia in children. Strabismus is a condition where the eyes are misaligned, leading to poor vision in one eye. By performing the corneal light reflex test, the nurse can assess if the child's eyes are aligned or if there is deviation, which could indicate lazy eye. Options A, B, and C are incorrect as they do not specifically address the assessment of strabismus, which is the key indicator for lazy eye in this scenario.
Question 8 of 9
During the assessment of an infant, the nurse notes that the fontanelles are depressed and sunken. Which condition does the nurse suspect?
Correct Answer: B
Rationale: The correct answer is B: Dehydration. Depressed and sunken fontanelles in an infant indicate dehydration due to decreased fluid volume. Dehydration causes a decrease in tissue turgor, leading to the fontanelles appearing sunken. Rickets (A) is a condition characterized by weak or soft bones due to vitamin D deficiency. Mental retardation (C) is a developmental disorder, not related to fontanelle appearance. Increased intracranial pressure (D) would cause bulging fontanelles, not depressed fontanelles. Therefore, the most likely condition in this case is dehydration.
Question 9 of 9
During the examination of a patient in her third trimester of pregnancy, the nurse notices that the patient's thyroid gland is slightly enlarged. No enlargement had been noted previously. The nurse suspects that:
Correct Answer: C
Rationale: Step-by-step rationale for why choice C is correct: 1. Enlargement of the thyroid gland during pregnancy is a normal finding due to hormonal changes. 2. The thyroid gland enlarges to meet the increased demands of thyroid hormone production. 3. This condition is known as gestational thyrotoxicosis and is usually benign. 4. No further testing is needed for thyroid cancer unless other concerning symptoms are present. Summary: A: Not relevant as iodine deficiency is not typically associated with thyroid enlargement in pregnancy. B: Incorrect as early signs of goitre would involve more pronounced symptoms than just slight enlargement. D: Unnecessary as thyroid cancer is not a common concern in this scenario of a slightly enlarged thyroid in the third trimester of pregnancy.