ATI RN
health assessment practice questions nursing Questions
Question 1 of 9
In assessing the sclera of a patient of African descent, which of the following would be an expected finding?
Correct Answer: B
Rationale: The correct answer is B because people of African descent commonly have a pigmented layer near the outer canthus of the lower lid called the "plica semilunaris." This is a normal anatomical variation in this population. Yellow fatty deposits over the cornea (choice A) are not typical findings in this demographic. Yellow color of the sclera extending up to the iris (choice C) is not a characteristic feature. The presence of small brown macules on the sclera (choice D) is also not a common finding in individuals of African descent.
Question 2 of 9
Which of the following statements about the outer layer of the eye is true?
Correct Answer: C
Rationale: The correct answer is C because the trigeminal (CN V) and the trochlear (CN IV) nerves are indeed stimulated when the outer surface of the eye is stimulated. The trigeminal nerve is responsible for the sensation of touch in the face and controls the muscles involved in chewing. The trochlear nerve controls the superior oblique muscle of the eye, which helps with downward and inward eye movements. Therefore, when the outer layer of the eye is touched or stimulated, these nerves are activated to convey the sensation to the brain. Choices A, B, and D are incorrect: A: The outer layer of the eye is not particularly sensitive to touch compared to other areas like the cornea or conjunctiva. B: The outer layer of the eye is not darkly pigmented; the pigmented layer is actually the uvea inside the eye. D: The visual receptive layer of the eye, known as the retina, is located deeper within the eye, not
Question 3 of 9
When a light is directed across the iris of the eye from the temporal side, the examiner is assessing for:
Correct Answer: C
Rationale: The correct answer is C: the presence of shadows, which may indicate glaucoma. When a light is directed across the iris from the temporal side, it helps in evaluating the presence of shadows in the anterior chamber angle, which can suggest a narrow or closed angle glaucoma. This technique is known as transillumination test and is important in detecting potential glaucoma cases. A: Drainage from dacryocystitis is incorrect as it is typically assessed by pressing on the lacrimal sac area to observe for discharge. B: Conjunctivitis over the iris is incorrect as conjunctivitis is an inflammation of the conjunctiva, not the iris. D: A scattered light reflex indicative of cataracts is incorrect as cataracts cause clouding of the lens, not scattering of light across the iris.
Question 4 of 9
To assess colour vision in a male child, the nurse would:
Correct Answer: C
Rationale: The correct answer is C because testing for color vision once between the ages of 4 and 8 is appropriate to assess any potential color vision deficiencies. This age range is crucial as color vision development is mostly completed by the age of 8. Annual checks (A) are not necessary unless there are specific concerns. Asking the child to identify clothing color (B) may not be a reliable indicator of color vision deficiency. No information is provided for option D.
Question 5 of 9
While performing the otoscopic examination of a 3-year-old boy who has been pulling on his left ear, the nurse finds that his left tympanic membrane is bright red and the light reflex is not visible. The most likely cause is:
Correct Answer: B
Rationale: The correct answer is B: acute otitis media. In this case, the presentation of a bright red tympanic membrane and absence of the light reflex are indicative of inflammation and fluid accumulation in the middle ear, which are classic signs of acute otitis media. This condition commonly occurs in young children, especially after a recent upper respiratory infection. Incorrect choices: A: Fungal infection is less likely in this case as the symptoms are more consistent with acute bacterial infection seen in otitis media. C: Rupture of the drum would typically present with sudden relief of pain and discharge from the ear, which is not described in the scenario. D: Blood behind the drum (hemotympanum) is uncommon in children with acute otitis media and would usually be associated with trauma or barotrauma.
Question 6 of 9
When examining the ear with an otoscope, the nurse would expect to find that the tympanic membrane is:
Correct Answer: B
Rationale: The correct answer is B: pearly grey and slightly concave. This is because a healthy tympanic membrane should appear pearly grey in color and slightly concave in shape. The pearly grey color indicates normal transparency and reflection of light, while the slightly concave shape is indicative of a normal eardrum. Choice A is incorrect as a light pink color and slight bulge are not characteristic of a healthy tympanic membrane. Choice C is incorrect because a pulled-in appearance at the base of the cone of light suggests retraction, which is abnormal. Choice D is incorrect as a whitish color with a small fleck of light is not a typical presentation of a healthy tympanic membrane.
Question 7 of 9
Which of the following would the nurse expect to find when examining the eyes of a patient of African descent?
Correct Answer: B
Rationale: The correct answer is B: A dark retinal background. This is because individuals of African descent typically have a higher concentration of melanin in their eyes, resulting in a darker retinal background. This can affect the appearance of the fundus during eye examinations. Incorrect choices: A: Increased night vision - Night vision is not directly influenced by melanin levels in the eyes and is more related to the function of rods and cones in the retina. C: Increased photosensitivity - Melanin provides some protection against UV light, so individuals with darker retinas may have lower photosensitivity. D: Narrowed palpebral fissures - Palpebral fissures refer to the opening between the eyelids and are not typically influenced by melanin levels in the eyes.
Question 8 of 9
The nurse is assessing a patient's eyes for the accommodation response and would expect to see:
Correct Answer: D
Rationale: The correct answer is D: convergence of the axes of the eyes. During the accommodation response, the eyes converge to focus on a near object. This is necessary to maintain clear vision when looking at close objects. Dilation of the pupils (A) is not part of the accommodation response. A consensual light reflex (B) refers to both pupils constricting simultaneously in response to light, not specific to accommodation. Conjugate movement of the eyes (C) refers to both eyes moving together in the same direction, which is not the primary action during accommodation.
Question 9 of 9
Which of the following statements about air conduction is true?
Correct Answer: D
Rationale: The correct answer is D because a loss of air conduction, known as conductive hearing loss, refers to a problem conducting sound waves through the outer or middle ear. This type of hearing loss can be caused by issues such as earwax buildup, fluid in the middle ear, or problems with the ear canal or eardrum. Choices A, B, and C are incorrect because air conduction is not the most efficient pathway for hearing (choice A), it is not caused by vibrations of bones in the skull (choice B), and the pitch of sound is determined by the frequency, not the amplitude (choice C). Conductive hearing loss specifically relates to the transmission of sound through the outer and middle ear structures, making choice D the correct statement.