ATI RN
Test Bank Physical Examination and Health Assessment Questions
Question 1 of 5
Linda is a 29-year-old who had excruciating pain which started under her lower ribs on the right side. The pain eventually moved to her lateral abdomen and then into her right lower quadrant. Which is most likely, given this presentation?
Correct Answer: A
Rationale: The progression of excruciating pain starting under the lower ribs on the right side, then moving to the lateral abdomen, and finally settling in the right lower quadrant is classic for appendicitis. Appendicitis is an inflammation of the appendix, a small tube-like structure attached to the cecum (beginning of the large intestine). The pain typically starts around the umbilicus and then migrates to the right lower quadrant, where the appendix is located. Other symptoms that may accompany appendicitis include fever, nausea, vomiting, loss of appetite, and tenderness at McBurney's point (a specific area in the abdomen). It is a medical emergency that requires immediate attention to avoid complications such as perforation and peritonitis.
Question 2 of 5
A 77-year-old retired nurse has an ulcer on a lower extremity that you are asked to evaluate when you do your weekly rounds at a local long-term care facility. All of the following are responsible for causing ulcers in the lower extremities except for which condition?
Correct Answer: D
Rationale: Hypertension, or high blood pressure, is not typically associated with causing ulcers in the lower extremities. The most common causes of lower extremity ulcers are arterial insufficiency, venous insufficiency, and diminished sensation in pressure points. Arterial insufficiency leads to decreased blood flow to the lower extremities, causing tissue damage and ulcers. Venous insufficiency results in poor circulation and increased pressure in the veins, leading to ulcers. Diminished sensation in pressure points, often seen in conditions like diabetes, can cause ulcers due to lack of feeling and increased risk of trauma. So, hypertension is not directly related to the development of lower extremity ulcers.
Question 3 of 5
A 20-year-old part-time college student comes to your clinic, complaining of growths on his penile shaft. They have been there for about 6 weeks and haven't gone away. In fact, he thinks there may be more now. He denies any pain with intercourse or urination. He has had three former partners and has been with his current girlfriend for 6 months. He says that because she is on the pill they don't use condoms. He denies any fever, weight loss, or night sweats. His past medical history is unremarkable. In addition to college, he works part-time for his father in construction. He is engaged to be married and has no children. His father is healthy, and his mother has hypothyroidism. On examination the young man appears healthy. His vital signs are unremarkable. On visualization of his penis you see several moist papules along all sides of his penile shaft and even two on the corona. He has been circumcised. On palpation of his inguinal region there is no inguinal lymphadenopathy. Which abnormality of the penis does this patient most likely have?
Correct Answer: A
Rationale: The patient in the case presented has multiple moist papules on the penile shaft and corona, which are classic features of condylomata acuminata, also known as genital warts. Condylomata acuminata are caused by the human papillomavirus (HPV) and are typically painless, unlike other conditions such as genital herpes or syphilitic chancre which may be associated with pain or tender sores. Given the patient's history of multiple sexual partners and lack of condom use with his current girlfriend, there is a higher likelihood of exposure to HPV. Condylomata acuminata can be treated with various options including topical agents, cryotherapy, or surgical removal, and it is important to address the potential risk of HPV transmission to sexual partners.
Question 4 of 5
Induration along the ventral surface of the penis suggests which of the following?
Correct Answer: C
Rationale: Peyronie's disease is a condition characterized by the formation of fibrous scar tissue in the penis, leading to the development of plaques or indurations along the shaft of the penis, typically on the ventral surface. These plaques can cause penile curvature, pain, and erectile dysfunction. Urethral stricture, testicular carcinoma, and epidermoid cysts are not typically associated with indurations along the ventral surface of the penis.
Question 5 of 5
A 55-year-old married homemaker comes to your clinic, complaining of 6 months of vaginal itching and discomfort with intercourse. She has not had a discharge and has had no pain with urination. She has not had a period in over 2 years. She has no other symptoms. Her past medical history consists of removal of her gallbladder. She denies use of tobacco, alcohol, and illegal drugs. Her mother has breast cancer, and her father has coronary artery disease, high blood pressure, and Alzheimer's disease. On examination she appears healthy and has unremarkable vital signs. There is no lymphadenopathy with palpation of the inguinal nodes. Visualization of the vulva shows dry skin but no lesions or masses. The labia are somewhat smaller than usual. Speculum examination reveals scant discharge, and the vaginal walls are red, dry, and bleed easily. Bimanual examination is unremarkable. The KOH whiff test produces no unusual odor and there are no clue cells on the wet prep. What form of vaginitis is this patient most likely to have?
Correct Answer: D
Rationale: The patient's presentation is consistent with atrophic vaginitis, also known as vaginal atrophy. This condition typically occurs in postmenopausal women due to a decrease in estrogen levels, leading to thinning, drying, and inflammation of the vaginal walls. Symptoms of atrophic vaginitis include vaginal dryness, itching, discomfort with intercourse, and sometimes light bleeding after intercourse. The absence of vaginal discharge and the presence of vaginal dryness and bleeding easily upon examination suggest atrophic vaginitis as the most likely cause in this patient. Other causes of vaginitis such as Trichomonas vaginitis, Candida vaginitis, and bacterial vaginosis typically present with different symptoms and findings on examination.