ATI RN
Physical Assessment NCLEX Practice Questions Questions
Question 1 of 9
Is the following information subjective or objective? Mr. M. has shortness of breath that has persisted for the past 10 days; it is worse with activity and relieved by rest.
Correct Answer: B
Rationale: The information provided about Mr. M's shortness of breath being present for the past 10 days, worsening with activity, and relieved by rest are all objective findings. These are measurable and observable facts that can be documented by healthcare professionals through physical examination, assessment, and potentially diagnostic tests. Subjective information would involve Mr. M's personal feelings or descriptions of his symptoms, which are not included in the given information.
Question 2 of 9
A 22-year-old advertising copywriter presents for evaluation of joint pain. The pain is new, located in the wrists and fingers bilaterally, with some subjective fever. The patient denies a rash; she also denies recent travel or camping activities. She has a family history significant for rheumatoid arthritis. Based on this information, which of the following pathologic processes would be the most correct?
Correct Answer: B
Rationale: The most likely pathologic process based on the patient's symptoms and history would be an inflammatory process. The patient's joint pain, fever, and family history of rheumatoid arthritis suggest the possibility of an autoimmune inflammatory condition like rheumatoid arthritis. Rheumatoid arthritis is a chronic inflammatory disorder that primarily affects the joints, causing pain, swelling, and stiffness. The bilateral involvement of the wrists and fingers along with a family history of rheumatoid arthritis make this diagnosis more likely than an infectious, hematologic, or traumatic process in this case.
Question 3 of 9
Her right carotid pulse is bounding but the left carotid pulse is weak. She is afebrile but her respirations are 24 times a minute. On auscultation her lungs are clear and her cardiac examination is unremarkable. You call EMS and have her taken to the hospital's ER for further evaluation. What disorder of the chest best describes her symptoms?
Correct Answer: C
Rationale: A dissecting aortic aneurysm is the most likely disorder that best describes the symptoms presented. In this condition, the inner layer of the aorta tears and blood can flow between the layers of the aortic wall, causing a number of potential symptoms. A patient with a dissecting aortic aneurysm may present with a difference in pulses between the right and left sides due to decreased blood flow to one side. The bounding pulse on one side and weak pulse on the other are indicative of uneven blood flow distribution. Additionally, a dissecting aortic aneurysm can lead to respiratory symptoms such as increased respiratory rate if there is associated pain or discomfort, although clear lung sounds would not typically be expected with this condition. The condition is a life-threatening emergency that requires immediate evaluation and treatment.
Question 4 of 9
A 36-year-old security officer comes to your clinic, complaining of a painless mass in his scrotum. He found it 3 days ago during a testicular self-examination. He has had no burning with urination and no pain during sexual intercourse. He denies any weight loss, weight gain, fever, or night sweats. His past medical history is notable for high blood pressure. He is married and has three healthy children. He denies using illegal drugs, smokes two to three cigars a week, and drinks six to eight alcoholic beverages per week. His mother is in good health and his father had high blood pressure and coronary artery disease. On physical examination he appears anxious but in no pain. His vital signs are unremarkable. On visualization of his penis, he is circumcised and has no lesions. His inguinal region has no lymphadenopathy. Palpation of his scrotum shows a soft cystic-like lesion measuring 2 cm over his right testicle. There is no difficulty getting a gloved finger through either inguinal ring. With weight bearing there are no bulges. His prostate examination is unremarkable. What disorder of the scrotum does he most likely have?
Correct Answer: A
Rationale: The patient most likely has a hydrocele based on the presentation of a painless, soft cystic-like lesion measuring 2 cm over his right testicle. A hydrocele is a collection of fluid surrounding the testicle within the tunica vaginalis, resulting in a painless scrotal swelling. It is common and can occur at any age but is more common in older individuals. A key feature of a hydrocele is that the swelling is not reducible, meaning it cannot be pushed back into the abdomen. In this patient, there was no difficulty getting a gloved finger through either inguinal ring, ruling out a scrotal hernia. Testicular tumors typically present as painless testicular masses but are usually solid rather than cystic. Varicoceles are enlarged veins within the scrotum and have a characteristic "bag of worms" appearance on palpation, which is not described in this case.
Question 5 of 9
His bowel sounds are decreased and he has rebound and involuntary guarding, one third of the way between the anterior superior iliac spine and the umbilicus in the right lower quadrant. His rectal, inguinal, prostate, penile, and testicular examinations are normal. What is the most likely cause of his pain?
Correct Answer: A
Rationale: The presentation of decreased bowel sounds, rebound tenderness, and involuntary guarding in the right lower quadrant is highly suggestive of acute appendicitis. These signs indicate inflammation and potential perforation of the appendix, leading to the classic symptoms of appendicitis. The pain in this case is likely due to the inflammatory process involving the appendix. The absence of abnormal findings in the rectal, inguinal, prostate, penile, and testicular examinations further supports the diagnosis of acute appendicitis as the most likely cause of the patient's pain.
Question 6 of 9
A 49-year-old administrative assistant comes to your office for evaluation of dizziness. You elicit the information that the dizziness is a spinning sensation of sudden onset, worse with head position changes. The episodes last a few seconds and then go away, and they are accompanied by intense nausea. She has vomited one time. She denies tinnitus. You perform a physical examination of the head and neck and note that the patient's hearing is intact to Weber and Rinne and that there is nystagmus. Her gait is normal. Based on this description, what is the most likely diagnosis?
Correct Answer: A
Rationale: The patient's presentation of sudden-onset spinning sensation triggered by head position changes, accompanied by nausea and vomiting without tinnitus, is characteristic of benign positional vertigo (BPV). BPV is caused by displaced otoconia (calcium crystals) within the semicircular canals of the inner ear. These crystals disrupt the normal flow of fluid in the inner ear, leading to false signals being sent to the brain about head movement. This results in brief episodes of vertigo triggered by specific head positions.
Question 7 of 9
You are examining an unconscious patient from another region and notice Beau's lines, a transverse groove across all of her nails, about 1 cm from the proximal nail fold. What would you do next?
Correct Answer: C
Rationale: Beau's lines are transverse grooves or depressions in the nails that occur from a temporary disruption in nail growth. These lines can be caused by a variety of factors, including systemic diseases, medication use, trauma, or environmental stressors. However, one of the most common causes of Beau's lines is a significant physiological stress such as a severe illness or major surgery that occurred about 3 months prior to the appearance of the lines. Therefore, looking for information from family and records regarding any problems that occurred around 3 months ago is the most appropriate next step to understand the underlying cause of Beau's lines in this unconscious patient. This information can provide crucial insights into the patient's medical history and potential underlying health issues that may need to be addressed.
Question 8 of 9
Jean has just given birth 6 months ago and is breast-feeding her child. She has not had a period since giving birth. What does this most likely represent?
Correct Answer: B
Rationale: Secondary amenorrhea refers to the absence of menstruation for 3-6 months in a woman who previously had regular menstrual cycles. In this case, Jean's lack of menstruation after giving birth and while breastfeeding her child for 6 months likely indicates secondary amenorrhea. This temporary suppression of ovulation and menstruation commonly occurs during breastfeeding due to the high levels of the hormone prolactin, which is responsible for milk production and can inhibit ovulation and menstruation. It is a natural phenomenon known as lactational amenorrhea. Once breastfeeding decreases or stops, menstruation usually resumes within a few months.
Question 9 of 9
Her abdominal examination reveals a gravid uterus but is otherwise unremarkable. On visualization of the anus there is a slight red, moist- appearing protrusion from the anus. As you have her bear down, the protrusion grows larger. On digital rectal examination you can feel an enlarged tender area on the posterior side. There is some blood on the glove after the examination. What disorder of the anus or rectum best fits this presentation?
Correct Answer: C
Rationale: The described clinical presentation is consistent with internal hemorrhoids. The typical symptoms of internal hemorrhoids include painless rectal bleeding, protrusion from the anus during straining, and a feeling of incomplete evacuation. In this case, the protrusion is observed to be red, moist, and enlarges with bearing down, all indicative of internal hemorrhoids. The enlarged tender area felt on digital rectal examination supports the diagnosis. Additionally, the presence of blood on the glove after the examination is also suggestive of internal hemorrhoids causing bleeding. Anal fissures typically present with sharp pain during defecation and may have visible tears in the anal mucosa. External hemorrhoids are usually more painful and can be felt as a lump around the anus. Anorectal fistulas have different signs and symptoms, including discharge of pus and recurrent infections.