ATI RN
Health Assessment and Physical Examination Test Bank Questions
Question 1 of 9
A patient is examined with the ophthalmoscope and found to have red reflexes bilaterally. Which of the following have you essentially excluded from your differential?
Correct Answer: A
Rationale: Retinoblastoma typically presents with a white reflex, known as leukocoria or a cat's eye reflex, instead of the normal red reflex seen during ophthalmoscopy. The presence of red reflexes bilaterally in this case essentially rules out retinoblastoma as a differential diagnosis.
Question 2 of 9
It started a few hours ago, and she has noted nausea with sensitivity to light; she has had headaches like this in the past, usually less than one per week, but not as severe. She does not know of any inciting factors. There has been no change in the frequency of her headaches. She usually takes an over- the-counter analgesic, and this results in resolution of the headache. Based on this description, what is the most likely diagnosis of the type of headache?
Correct Answer: B
Rationale: The description of the headache as starting a few hours ago, associated with nausea, sensitivity to light, and being severe in intensity suggests a migraine headache. Migraine headaches are often accompanied by these symptoms, known as migraine features. The fact that the patient experiences headaches like this less than once a week and typically uses over-the-counter analgesics to relieve them is also suggestive of migraines. Tension headaches typically present as a more mild to moderate, band-like pressure around the head, without the associated symptoms of nausea and sensitivity to light. Cluster headaches are characterized by excruciating pain around one eye, often accompanied by other symptoms like redness or tearing in the eye. Analgesic rebound headaches occur due to overuse of pain medications and typically present as daily headaches that improve with the same medication that caused them in the first place.
Question 3 of 9
A 72-year-old teacher comes to a skilled nursing facility for rehabilitation after being in the hospital for 6 weeks. She was treated for sepsis and respiratory failure and had to be on the ventilator for 3 weeks. You are completing your initial assessment and are evaluating her skin condition. On her sacrum there is full-thickness skin loss that is 5 cm in diameter, with damage to the subcutaneous tissue. The underlying muscle is not affected. You diagnose this as a pressure ulcer. What is the stage of this ulcer?
Correct Answer: C
Rationale: A stage 3 pressure ulcer involves full-thickness skin loss with damage and necrosis of the subcutaneous tissue, but the underlying muscle is not affected. In this case, the description of the full-thickness skin loss with involvement of the subcutaneous tissue but not the muscle corresponds to a stage 3 pressure ulcer. Stage 1 involves intact skin with non-blanchable redness, stage 2 involves partial-thickness skin loss with a shallow open ulcer, and stage 4 involves full-thickness tissue loss with the involvement of muscle, bone, or supporting structures.
Question 4 of 9
Mrs. LaFarge is a 60-year-old who presents with urinary incontinence. She is unable to get to the bathroom quickly enough when she senses the need to urinate. She has normal mobility. Which of the following is most likely?
Correct Answer: B
Rationale: Urge incontinence, also known as overactive bladder, is characterized by a sudden and strong urge to urinate which is difficult to control. In this case, Mrs. LaFarge is unable to get to the bathroom quickly enough when she senses the need to urinate, which indicates a lack of control over the urge to urinate. This is typically caused by involuntary contractions of the bladder muscle. Stress incontinence, on the other hand, is leakage of urine during activities that increase intra-abdominal pressure, such as coughing or exercising. Overflow incontinence is characterized by urinary retention and constant dribbling of urine due to the bladder being unable to empty properly. Functional incontinence occurs when a person has normal bladder control but is unable to reach the bathroom in time due to physical or cognitive impairments. Since Mrs. LaFarge is experiencing a sudden and strong urge to urinate that she cannot
Question 5 of 9
You ask a patient to draw a clock. He fills in all the numbers on the right half of the circle. What do you suspect?
Correct Answer: A
Rationale: Filling in all the numbers on just one side of the clock when asked to draw a clock suggests a visual field deficit, typically seen in hemianopsia. Hemianopsia is a visual impairment where half of the visual field is lost due to neurological damage or injury, such as a stroke. This causes the individual to have difficulty perceiving or attending to objects in the affected visual field. In this case, the patient's right visual field may be affected, leading to the specific pattern of filling numbers on the right half of the clock. It is essential to further assess and refer the patient for a complete visual field evaluation and neurological examination.
Question 6 of 9
A 29-year-old married computer programmer comes to your clinic, complaining of "something strange" going on in his scrotum. Last month while he was doing his testicular self- examination he felt a lump in his left testis. He waited a month and felt the area again, but the lump was still there. He has had some aching in his left testis but denies any pain with urination or sexual intercourse. He denies any fever, malaise, or night sweats. His past medical history consists of groin surgery when he was a baby and a tonsillectomy as a teenager. He eats a healthy diet and works out at the gym five times a week. He denies any tobacco or illegal drugs and drinks alcohol occasionally. His parents are both healthy. On examination you see a muscular, healthy, young-appearing man with unremarkable vital signs. On visualization the penis is circumcised with no lesions; there is a scar in his right inguinal region. There is no lymphadenopathy. Palpation of his scrotum is unremarkable on the right but indicates a large mass on the left. Placing a finger through the inguinal ring on the right, you have the patient bear down. Nothing is felt. You attempt to place your finger through the left inguinal ring but cannot get above the mass. On rectal examination his prostate is unremarkable. What disorder of the testes is most likely the diagnosis?
Correct Answer: B
Rationale: The most likely diagnosis in this case is a scrotal hernia. The patient's history of a previous groin surgery as a baby is a key clue, as it increases the risk for developing a hernia. The lump in the left testis with aching, along with the inability to palpate above the mass through the left inguinal ring, suggests that the lump may be a hernia protruding through the inguinal canal into the scrotum. The presence of a scar in the right inguinal region also supports the likelihood of a hernia. The normal prostate on rectal examination rules out any involvement of the prostate in the presentation. Scrotal hernias may present as painless masses in the scrotum, often increasing in size with activities that increase intra-abdominal pressure, such as straining or coughing. Surgical repair is often necessary to prevent complications such as incarceration or strangulation
Question 7 of 9
A sudden, painless unilateral vision loss may be caused by which of the following?
Correct Answer: A
Rationale: A sudden, painless unilateral vision loss may be caused by a retinal detachment. Retinal detachment occurs when the retina, which is the light-sensitive tissue lining the back of the eye, pulls away from its normal position. This can lead to visual disturbances, including sudden loss of vision in one eye. Retinal detachment can be a medical emergency and requires prompt evaluation and treatment to prevent permanent vision loss. Other conditions mentioned in the choices, such as corneal ulcer, acute glaucoma, and uveitis, may also cause vision problems but are less likely to present with a sudden and painless unilateral vision loss as a primary symptom.
Question 8 of 9
His abdominal examination is normal. Visualization of the anus shows no masses, inflammation, or fissures. Digital rectal examination reveals a warm, boggy, tender prostate. No discrete masses are felt and there is no blood on the glove. The scrotum and penis appear normal. Urinalysis shows moderate amounts of white blood cells and bacteria. What disorder of the anus, prostate, or rectum best describes this situation?
Correct Answer: B
Rationale: Prostatitis is the most likely disorder based on the symptoms described. The warm, boggy, tender prostate upon digital rectal examination, along with the presence of moderate white blood cells and bacteria in the urinalysis, suggests an inflammatory condition of the prostate. In this case, there are no signs of masses or blood in the rectal examination, which would be more indicative of prostate cancer. Epididymitis typically presents with symptoms involving the scrotum and may be associated with testicular pain and swelling, which are not described in this scenario. Benign prostatic hyperplasia (BPH) is a nonmalignant enlargement of the prostate gland that typically presents with symptoms of urinary urgency, frequency, and nocturia, rather than the inflammatory signs seen in this case.
Question 9 of 9
Which of the following is consistent with good percussion technique?
Correct Answer: C
Rationale: Leaving the plexor finger on the pleximeter after each strike is consistent with good percussion technique. This helps to maintain stability and precision during percussion by providing a consistent point of contact for accurate assessment of the underlying structures. This technique also helps to control the force and angle of the percussive strike, ensuring accurate interpretation of the resulting sounds produced. Maintaining this contact can enhance the effectiveness of percussion as a diagnostic tool in physical examinations.