ATI RN
Physical Assessment Nursing Practice Questions Questions
Question 1 of 9
Alexandra is a 28-year-old editor who presents to the clinic with abdominal pain. The pain is a dull ache, located in the right upper quadrant, that she rates as a 3 at the least and an 8 at the worst. The pain started a few weeks ago, it lasts for 2 to 3 hours at a time, it comes and goes, and it seems to be worse a couple of hours after eating. She has noticed that it starts after eating greasy foods, so she has cut down on these as much as she can. Initially it occurred once a week, but now it is occurring every other day. Nothing makes it better. From this description, which of the seven attributes of a symptom has been omitted?
Correct Answer: B
Rationale: The description provided by Alexandra includes information about the location (right upper quadrant), intensity (3 to 8 on a scale), duration (2 to 3 hours), periodicity (coming and going, worse after eating), exacerbating factors (greasy foods), frequency (initially once a week, now every other day), and aggravating factors (nothing makes it better). However, there is no mention of any associated manifestations such as nausea, vomiting, fever, or other symptoms that may be occurring alongside the abdominal pain. Associated manifestations are important for a comprehensive assessment and differential diagnosis of the symptom.
Question 2 of 9
A 55-year-old secretary with a recent history of breast cancer, for which she underwent surgery and radiation therapy, and a history of hypertension comes to your office for a routine checkup. Which of the following aspects of the physical are important to note when assessing the patient for peripheral vascular disease in the arms?
Correct Answer: D
Rationale: When assessing a patient for peripheral vascular disease in the arms, it is important to examine the pulses in the upper extremities. The pulses to be assessed in this context include the radial pulse (located on the wrist at the base of the thumb) and the brachial pulse (located in the upper arm near the elbow). These pulses provide important information about blood flow and circulation in the arms. Changes in the strength, regularity, or absence of these pulses can indicate potential issues related to peripheral vascular disease. While the femoral and popliteal pulses (Choice A) are important for assessing the lower extremities, and the dorsalis pedis and posterior tibial pulses (Choice B) are also crucial for evaluating peripheral vascular disease in the legs, the radial and brachial pulses are specifically relevant for assessing the arms. The carotid pulse (Choice C) is important for evaluating the vascular status of
Question 3 of 9
Alexandra is a 28-year-old editor who presents to the clinic with abdominal pain. The pain is a dull ache, located in the right upper quadrant, that she rates as a 3 at the least and an 8 at the worst. The pain started a few weeks ago, it lasts for 2 to 3 hours at a time, it comes and goes, and it seems to be worse a couple of hours after eating. She has noticed that it starts after eating greasy foods, so she has cut down on these as much as she can. Initially it occurred once a week, but now it is occurring every other day. Nothing makes it better. From this description, which of the seven attributes of a symptom has been omitted?
Correct Answer: B
Rationale: The description provided by Alexandra includes information about the location (right upper quadrant), intensity (3 to 8 on a scale), duration (2 to 3 hours), periodicity (coming and going, worse after eating), exacerbating factors (greasy foods), frequency (initially once a week, now every other day), and aggravating factors (nothing makes it better). However, there is no mention of any associated manifestations such as nausea, vomiting, fever, or other symptoms that may be occurring alongside the abdominal pain. Associated manifestations are important for a comprehensive assessment and differential diagnosis of the symptom.
Question 4 of 9
A patient complains of shortness of breath for the past few days. On examination, you note late inspiratory crackles in the lower third of the chest that were not present a week ago. What is the most likely explanation for these?
Correct Answer: D
Rationale: The presence of late inspiratory crackles in the lower third of the chest that were not present previously is suggestive of pulmonary edema, a common finding in patients with heart failure. Heart failure can lead to fluid accumulation in the lungs, causing crackles on auscultation. These crackles are typically heard at the lung bases and can be more prominent during inspiration. Other clinical features of heart failure may include orthopnea, paroxysmal nocturnal dyspnea, lower extremity edema, and fatigue. Therefore, in this case, the most likely explanation for the patient's shortness of breath with late inspiratory crackles is heart failure.
Question 5 of 9
You are palpating the abdomen and feel a small mass. Which of the following would you do next?
Correct Answer: A
Rationale: When palpating the abdomen and feeling a small mass, the next step would be to perform an ultrasound. Ultrasound imaging is a non-invasive and reliable way to further evaluate the size, location, and characteristics of the mass. It can provide valuable information to determine the nature of the mass, such as whether it is a cyst, a solid mass, or another type of abnormality. This imaging modality can help guide further management and treatment decisions, such as determining if surgery is necessary or if further monitoring is required. Ultrasound is a safe and commonly used tool in assessing abdominal masses, making it an appropriate next step in this scenario.
Question 6 of 9
In obtaining a history, you note that a patient uses the word "largely" repeatedly, to the point of being a distraction to your task. Which word best describes this speech pattern?
Correct Answer: D
Rationale: Perseveration is a speech pattern characterized by repeating a particular word, phrase, or topic excessively, even when it is no longer relevant to the conversation. In this scenario, the patient's repetitive use of the word "largely" to the point of distraction is indicative of perseveration. This can be a symptom of various neurological or psychiatric conditions, highlighting the importance of recognizing and addressing this speech pattern during the patient interview.
Question 7 of 9
You are beginning the examination of a patient. All of the following areas are important to observe as part of the General Survey except:
Correct Answer: D
Rationale: Blood pressure is not typically included in the initial assessment during the General Survey. The General Survey primarily focuses on obtaining an overall impression of the patient's health status and any noticeable cues such as level of consciousness, signs of distress, and appearance including dress, grooming, and personal hygiene. While blood pressure is an important vital sign to assess during a comprehensive examination, it is usually measured later in the assessment process and not part of the initial general observation.
Question 8 of 9
A 55-year-old bank teller comes to your office for persistent episodes of dizziness. The first episode started suddenly and lasted 3 to 4 hours. He experienced a lot of nausea with vomiting; the episode resolved spontaneously. He has had five episodes in the past 1½ weeks. He does note some tinnitus that comes and goes. Upon physical examination, you note that he has a normal gait. The Weber localizes to the right side and the air conduction is equal to the bone conduction in the right ear. Nystagmus is present. Based on this description, what is the most likely diagnosis?
Correct Answer: C
Rationale: The clinical presentation described in the case, including recurrent episodes of dizziness, nausea with vomiting, tinnitus, nystagmus, and normal gait, is suggestive of Menière's disease. Menière's disease is a disorder of the inner ear characterized by episodes of vertigo, fluctuating hearing loss, tinnitus, and aural fullness. The presence of tinnitus, episodic vertigo lasting for several hours, and nystagmus are key features that point towards Menière's disease. The Weber test result (localization to the right ear) can also be seen in Menière's disease due to sensorineural hearing loss in the affected ear. This set of symptoms and findings is more consistent with Menière's disease than the other options provided. Benign paroxysmal positional vertigo (BPPV) typically presents with brief episodes of vertigo triggered by changes in
Question 9 of 9
A high school football player injured his wrist in a game. He is tender between the two tendons at the base of the thumb. Which of the following should be considered?
Correct Answer: A
Rationale: DeQuervain's tenosynovitis is a condition that involves inflammation of the tendons located at the base of the thumb. The tendons affected are the abductor pollicis longus and extensor pollicis brevis. It typically causes pain and tenderness at the base of the thumb, which can worsen with certain movements of the wrist and thumb. In the case of the high school football player, his tenderness between the two tendons at the base of the thumb is suggestive of DeQuervain's tenosynovitis. It is a common overuse injury in athletes, especially those involved in activities that require repetitive hand and wrist movements, such as gripping a football during play. Treatment usually involves rest, splinting, ice, anti-inflammatory medications, and physical therapy.