ATI RN
Physical Assessment Nursing Practice Questions Questions
Question 1 of 5
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 2 of 5
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 3 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 4 of 5
A young woman undergoes cranial nerve testing. On touching the soft palate, her uvula deviates to the left. Which of the following is likely?
Correct Answer: C
Rationale: When the uvula deviates to one side upon touching the soft palate, it indicates a dysfunction of the vagus nerve (CN X) on the side toward which the uvula deviates. In this case, the uvula deviates to the left, suggesting a lesion affecting the left CN X. This is because the palate and uvula are innervated by the vagus nerve (cranial nerve X), and damage to this nerve may result in an asymmetric elevation or deviation of the uvula upon stimulation. Therefore, a CN X lesion on the left side is the most likely explanation for the observed deviation of the uvula in this scenario.
Question 5 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.