ATI RN
Physical Assessment Practice Questions Questions
Question 1 of 9
Chris is a 20-year-old college student who has had abdominal pain for 3 days. It started at his umbilicus and was associated with nausea and vomiting. He was unable to find a comfortable position. Yesterday, the pain became more severe and constant. Now, he hesitates to walk, because any motion makes the pain much worse. It is localized just medial and inferior to his iliac crest on the right. Which of the following is most likely?
Correct Answer: D
Rationale: The presentation is highly suggestive of appendicitis, especially given the migration of pain from the periumbilical region to the right lower quadrant (just medial and inferior to the iliac crest). The worsening of pain with motion, along with associated symptoms such as nausea, vomiting, anorexia, and fever, are typical features of appendicitis. The classic presentation of appendicitis is pain starting around the umbilicus (due to visceral innervation) and then shifting to the right lower quadrant (due to irritation of the parietal peritoneum). Surgical intervention is usually required promptly to prevent complications like perforation, which can lead to peritonitis and sepsis.
Question 2 of 9
A 73-year-old nurse comes to your office for evaluation of new onset of tremors. She is not on any medications and does not take herbs or supplements. She has no chronic medical conditions. She does not smoke or drink alcohol. She walks into the examination room with slow movements and shuffling steps. She has decreased facial mobility and a blunt expression, without any changes in hair distribution on her face. Based on this description, what is the most likely reason for the patient's symptoms?
Correct Answer: D
Rationale: The patient's presentation of new onset tremors, slow movements with shuffling steps (bradykinesia), decreased facial mobility, and blunt expression are characteristic features of Parkinson's disease. Parkinson's disease is a neurodegenerative disorder that affects movement, typically presenting with tremors, rigidity, and bradykinesia. The presence of these symptoms in this patient, along with the absence of any other medical conditions or medication use, points toward a diagnosis of Parkinson's disease. Other conditions like Cushing's syndrome, nephrotic syndrome, and myxedema are unlikely based on the patient's clinical presentation.
Question 3 of 9
Frank is a 24-year-old man who presents with multiple burning erosions on the shaft of his penis and some tender inguinal adenopathy. Which of the following is most likely?
Correct Answer: B
Rationale: The presentation of multiple burning erosions on the shaft of the penis along with tender inguinal adenopathy is indicative of genital herpes caused by the herpes simplex virus (HSV). Primary herpes simplex infection typically presents with painful ulcers and lymphadenopathy. The ulcers are often shallow with well-defined borders and can be associated with systemic symptoms such as fever and malaise. In contrast, primary syphilis is characterized by a painless chancre at the site of infection, usually on the genitals. Chancroid can also present with painful ulcers, but it is less common in developed countries. Gonorrhea typically presents with urethral discharge, dysuria, or other symptoms of urethritis, rather than erosions on the penis shaft.
Question 4 of 9
A 35-year-old archaeologist comes to your office (located in Phoenix, Arizona) for a regular skin check-up. She has just returned from her annual dig site in Greece. She has fair skin and reddish-blonde hair. She has a family history of melanoma. She has many freckles scattered across her skin. From this description, which of the following is not a risk factor for melanoma in this patient?
Correct Answer: B
Rationale: In the given scenario, being a 35-year-old archaeologist with fair skin, a family history of melanoma, and many freckles scattered across her skin are all risk factors for melanoma. Age (choice A) is a relevant risk factor as melanoma incidence increases with age. Actinic lentigines (choice C), also known as sunspots, are precancerous skin lesions that can increase the risk of developing melanoma. Heavy sun exposure (choice D) is a significant risk factor as cumulative sun exposure over time can contribute to the development of melanoma.
Question 5 of 9
Marion presents to your office with back pain associated with constipation and urinary retention. Which of the following is most likely?
Correct Answer: C
Rationale: Marion's presentation of back pain associated with constipation and urinary retention is concerning for cauda equina syndrome. Cauda equina syndrome is a rare but serious condition caused by the compression of the bundle of nerves at the bottom of the spinal cord, known as the cauda equina. This compression can result in a variety of symptoms, including back pain, sciatica, changes in bowel and bladder function (such as constipation and urinary retention), as well as lower extremity weakness or numbness.
Question 6 of 9
Jason is a 41-year-old electrician who presents to the clinic for evaluation of shortness of breath. The shortness of breath occurs with exertion and improves with rest. It has been going on for several months and initially occurred only a couple of times a day with strenuous exertion; however, it has started to occur with minimal exertion and is happening more than a dozen times per day. The shortness of breath lasts for less than 5 minutes at a time. He has no cough, chest pressure, chest pain, swelling in his feet, palpitations, orthopnea, or paroxysmal nocturnal dyspnea. Which of the following symptom attributes was not addressed in this description?
Correct Answer: A
Rationale: While the description provides information about the duration, frequency, onset, and relieving factors of Jason's shortness of breath, it does not mention the severity of the symptom. Severity refers to the intensity or degree of the symptom, such as mild, moderate, or severe. In this case, we do not have information about how Jason would rate the severity of his shortness of breath. It can be an important attribute to consider when assessing the impact of the symptom on the individual's quality of life and the potential urgency of intervention.
Question 7 of 9
The following information is recorded in the health history: "The patient completed 8th grade. He currently lives with his wife and two children. He works on old cars on the weekend. He works in a glass factory during the week." Which category does it belong to?
Correct Answer: C
Rationale: The information provided pertains to the patient's educational background, living situation, family status, and work activities. This type of information falls under the personal and social history category, as it provides important context about the patient's lifestyle, living conditions, and social support network. Personal and social history is essential for understanding the patient's overall well-being and can impact their health and healthcare needs.
Question 8 of 9
You are listening carefully for S splitting. Which of the following will help?
Correct Answer: A
Rationale: In order to listen carefully for S splitting, one should use the diaphragm with light pressure over the 2nd right intercostal space. S splitting refers to a split of the second heart sound (S2) into its two components - A2 and P2. The A2 component is normally heard as the main heart sound when the aortic valve closes, and the P2 component is heard when the pulmonic valve closes. By placing the diaphragm lightly over the 2nd right intercostal space, one can best auscultate the aortic area and listen for the timing and splitting of the S2 components. Using the bell or applying firm pressure may not allow for optimal detection of S splitting in this specific case.
Question 9 of 9
Diminished radial pulses may be seen in patients with which of the following?
Correct Answer: C
Rationale: Diminished radial pulses may be seen in patients with arterial emboli. Arterial emboli are blood clots that travel through the bloodstream and get lodged in a blood vessel, blocking blood flow to a certain area. When an embolus affects the arteries supplying the arm, it can lead to diminished pulses in the affected arm, such as the radial pulse in the wrist. This diminished pulse is due to decreased blood flow to the area beyond the blockage caused by the embolus. This distinguishes arterial emboli from the other options listed, as aortic insufficiency, hyperthyroidism, and early "warm" septic shock typically do not cause isolated diminished radial pulses.