ATI RN
Health Assessment and Physical Examination Test Bank Questions
Question 1 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 2 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 3 of 9
Which of the following events occurs at the start of diastole?
Correct Answer: B
Rationale: At the start of diastole, the ventricles relax and begin to fill with blood from the atria. As this relaxation phase begins, the pulmonic valve opens to allow blood to flow from the right ventricle to the pulmonary artery and then to the lungs for oxygenation. This marks the beginning of diastole, the period of the cardiac cycle when the heart is filling with blood. The closure of the tricuspid valve, closure of the aortic valve, and production of the first heart sound (S1) occur during systole, the phase of the cardiac cycle when the heart is contracting to pump blood out to the body.
Question 4 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 5 of 9
He is concerned about his weight. Based on this information, what is appropriate counsel for the patient during the visit?
Correct Answer: C
Rationale: The appropriate counsel for the patient during the visit would be to give information about the reduction of fat, cholesterol, and calories because he is concerned about his weight. This option addresses the patient's concern and provides guidance on making healthier choices to manage weight. Referring the patient to a nutritionist because he is anorexic (Option A) is not appropriate based on the information provided. Reassuring the patient that he has a normal body weight (Option B) may not address his concerns about weight. Giving the patient information about reducing fat and cholesterol only because he is obese (Option D) does not cover all aspects of a healthy diet such as managing calorie intake.
Question 6 of 9
A 58-year-old teacher presents to your clinic with a complaint of breathlessness with activity. The patient has no chronic conditions and does not take any medications, herbs, or supplements. Which of the following symptoms is appropriate to ask about in the cardiovascular review of systems?
Correct Answer: B
Rationale: Orthopnea is a symptom characterized by difficulty breathing while lying flat that improves when sitting or standing upright. This symptom is specifically related to cardiovascular conditions, such as heart failure, in which fluid accumulates in the lungs when lying down. Considering the patient's complaint of breathlessness with activity and the need to assess for cardiovascular issues, asking about orthopnea would be most appropriate to gain insights into potential heart-related causes of the symptoms. Abdominal pain (A), hematochezia (C), and tenesmus (D) are not typically associated with cardiovascular conditions and are less relevant to the patient's presentation.
Question 7 of 9
An elderly woman with a history of coronary bypass comes in with severe, diffuse, abdominal pain. Strangely, during your examination, the pain is not made worse by pressing on the abdomen. What do you suspect?
Correct Answer: B
Rationale: In an elderly woman with a history of coronary bypass surgery presenting with severe, diffuse abdominal pain that is not worsened by abdominal palpation, neuropathy should be suspected. Neuropathy refers to nerve damage, which can result in abnormal sensations of pain, often described as burning, shooting, or stabbing. Abdominal neuropathy can be caused by various conditions such as diabetes, alcohol abuse, vitamin deficiencies, or certain medications. The absence of worsening pain upon palpation makes organic abdominal pathology less likely, suggesting a neuropathic etiology. In this case, further evaluation and testing for neuropathy would be warranted.
Question 8 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 9 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