ATI RN
Physical Assessment Nursing Practice Questions Questions
Question 1 of 5
Glaucoma is the leading cause of blindness in African Americans and the second leading cause of blindness overall. What features would be noted on funduscopic examination?
Correct Answer: A
Rationale: Glaucoma is a progressive optic neuropathy characterized by changes to the optic nerve head. One of the hallmark features seen on funduscopic examination in glaucoma is an increased cup-to-disc ratio. This refers to the ratio of the size of the optic cup (depression in the center of the optic nerve head) to the size of the optic disc (the pinkish-orange area around the cup). In glaucoma, there is typically an enlargement of the cup relative to the disc due to damage of the retinal ganglion cell axons. This change is often associated with thinning of the neuroretinal rim and loss of nerve fibers.
Question 2 of 5
A 25-year-old accountant presents to your clinic, complaining of intermittent lower right- sided chest pain for several days. He describes it as knifelike and states it only lasts for 3 to 5 seconds, taking his breath away. He states he feels like he has to breathe shallowly to keep it from recurring. The only thing that makes it better is lying quietly on his right side. It is much worse when he takes a deep breath. He has taken some Tylenol and put a heating pad on his side but neither has helped. He remembers that 2 weeks ago he had an upper respiratory infection with a severe hacking cough. He denies any recent trauma. His past medical history is unremarkable. His parents and siblings are in good health. He has recently married, and his wife has a baby due in 2 months. He denies any smoking or illegal drug use. He drinks two to three beers once a month. He states that he eats a healthy diet and runs regularly, but not since his recent illness. He denies any cardiac, gastrointestinal, or musculoskeletal symptoms. On examination he is lying on his right side but appears quite comfortable. His temperature, blood pressure, pulse, and respirations are unremarkable. His chest has normal breath sounds on auscultation. Percussion of the chest is unremarkable. During palpation the ribs are nontender. What disorder of the chest best describes his symptoms?
Correct Answer: C
Rationale: The patient's symptoms of intermittent, sharp chest pain with breathing that worsens with deep breaths and is relieved by lying on the right side are suggestive of pleural pain. Pleuritic chest pain is often described as sharp or stabbing and occurs when the parietal pleura, the outer lining of the lungs, becomes inflamed or irritated. In this case, the patient's history of an upper respiratory infection with a severe hacking cough two weeks ago suggests that the pleural pain may be related to pleurisy or pleuritis, which can occur as a complication of respiratory infections.
Question 3 of 5
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 4 of 5
You are conducting a workshop on the measurement of jugular venous pulsation. As part of your instruction, you tell the students to make sure that they can distinguish between the jugular venous pulsation and the carotid pulse. Which one of the following characteristics is typical of the carotid pulse?
Correct Answer: A
Rationale: The carotid pulse is typically palpable, meaning that you can feel it when you place your fingers lightly on the carotid artery located in the neck. In contrast, jugular venous pulsation is not typically palpable. When examining jugular venous pulsation, it is important to differentiate it from the carotid pulse by considering factors such as the quality of pulsation, response to pressure, and changes with position.
Question 5 of 5
Which of the following regarding jugular venous pulsations is a systolic phenomenon?
Correct Answer: C
Rationale: The upstroke of the "a" wave in the jugular venous pulsations coincides with systole. The "a" wave is caused by atrial contraction, which occurs during ventricular systole. In contrast, the "x" descent is a diastolic phenomenon representing the atrial relaxation, the "y" descent follows atrial emptying in early diastole, and the "v" wave corresponds to venous filling during late diastole.