ATI RN
Physical Assessment Practice Questions Questions
Question 1 of 9
On visualization of the penis he is circumcised and there are no lesions and no discharge from the meatus. His scrotal skin is tense and red. Palpation of the left testicle causes severe pain and the patient begins to cry. His prostate examination is unremarkable. His cremasteric reflex is absent on the left but is normal on the right. By catheter you get a urine sample and the analysis is unremarkable. You send the boy with his mother to the emergency room for further workup. What is the most likely diagnosis for this young man's symptoms?
Correct Answer: C
Rationale: The presentation of severe testicular pain with a red, tense scrotum, and absent cremasteric reflex on one side is highly concerning for testicular torsion. Testicular torsion is a urologic emergency that occurs when the spermatic cord twists, leading to compromised blood flow to the testicle. The affected testicle can become ischemic and necrotic within hours, necessitating prompt diagnosis and intervention to avoid permanent damage or loss of the testicle.
Question 2 of 9
A 15-year-old high school sophomore comes to the clinic for evaluation of a 3-week history of sneezing; itchy, watery eyes; clear nasal discharge; ear pain; and nonproductive cough. Which is the most likely pathologic process?
Correct Answer: C
Rationale: The symptoms described, such as sneezing, itchy watery eyes, clear nasal discharge, ear pain, and nonproductive cough, are classic signs of allergic rhinitis, commonly known as seasonal allergies. Allergic rhinitis is an inflammatory response triggered by allergens in the environment such as pollen, dust mites, or pet dander. The immune system overreacts to these allergens, releasing histamine and other chemicals that cause the symptoms experienced by the patient. In this case, the most likely pathologic process underlying the symptoms is an allergic response rather than infection, inflammation, or vascular issues.
Question 3 of 9
A 50-year-old body builder is upset by a letter of denial from his life insurance company. He is very lean but has gained 2 pounds over the past 6 months. You personally performed his health assessment and found no problems whatsoever. He says he is classified as "high risk" because of obesity. What should you do next?
Correct Answer: D
Rationale: Since the life insurance company is classifying the body builder as "high risk" due to obesity, it is important to assess whether his weight gain is primarily fat accumulation around the waist. Measuring his waist circumference can provide valuable information about the distribution of body fat. Abdominal obesity, indicated by an increased waist measurement, is a significant risk factor for health issues such as heart disease, diabetes, and metabolic syndrome. By measuring his waist, you can determine if his weight gain is indeed a cause for concern in terms of health risks, rather than just considering the overall weight gain. This information can help you provide more targeted advice on how to address any potential health concerns related to the weight gain.
Question 4 of 9
Jason is a 41-year-old electrician who presents to the clinic for evaluation of shortness of breath. The shortness of breath occurs with exertion and improves with rest. It has been going on for several months and initially occurred only a couple of times a day with strenuous exertion; however, it has started to occur with minimal exertion and is happening more than a dozen times per day. The shortness of breath lasts for less than 5 minutes at a time. He has no cough, chest pressure, chest pain, swelling in his feet, palpitations, orthopnea, or paroxysmal nocturnal dyspnea. Which of the following symptom attributes was not addressed in this description?
Correct Answer: A
Rationale: While the description provides information about the duration, frequency, onset, and relieving factors of Jason's shortness of breath, it does not mention the severity of the symptom. Severity refers to the intensity or degree of the symptom, such as mild, moderate, or severe. In this case, we do not have information about how Jason would rate the severity of his shortness of breath. It can be an important attribute to consider when assessing the impact of the symptom on the individual's quality of life and the potential urgency of intervention.
Question 5 of 9
Mrs. Hill is a 28-year-old African-American with a history of SLE (systemic lupus erythematosus). She has noticed a raised, dark red rash on her legs. When you press on the rash, it doesn't blanch. What would you tell her regarding her rash?
Correct Answer: A
Rationale: The raised, dark red rash that does not blanch when pressed on, typically known as erythema nodosum, is a common skin manifestation of systemic lupus erythematosus (SLE). Given Mrs. Hill's history of SLE, it is likely that her rash is related to her autoimmune condition rather than an exposure to a chemical or an allergic reaction. It is important for her to discuss this new symptom with her healthcare provider to ensure appropriate management and monitoring of her lupus.
Question 6 of 9
How often, according to American Cancer Society recommendations, should a woman undergo a screening breast examination by a skilled clinician?
Correct Answer: A
Rationale: According to American Cancer Society recommendations, a woman should undergo a screening breast examination by a skilled clinician every year. Regular breast exams help in early detection of breast cancer, which can significantly improve outcomes and treatment options. Annual screenings are crucial in monitoring changes in breast health and detecting any abnormalities at the earliest stage possible. Therefore, it is advised that women follow this guideline to prioritize their breast health and well-being.
Question 7 of 9
His cardiac, lung, and abdominal examinations are normal. He has no inguinal hernia, but on his digital rectal examination you palpate a soft, smooth, nontender pedunculated mass on the posterior wall of the rectum. What anal, rectal, or prostate disorder best fits his presentation?
Correct Answer: D
Rationale: A rectal polyp is a growth that originates from the inner lining of the rectum and protrudes into the rectal canal. It may present as a soft, smooth, nontender mass on digital rectal examination. Rectal polyps are usually benign, but some may have the potential to become cancerous if left untreated. Therefore, it is important to evaluate and remove polyps to prevent complications. In this case, the description of a pedunculated mass on the posterior wall of the rectum is most suggestive of a rectal polyp.
Question 8 of 9
A 35-year-old archaeologist comes to your office (located in Phoenix, Arizona) for a regular skin check-up. She has just returned from her annual dig site in Greece. She has fair skin and reddish-blonde hair. She has a family history of melanoma. She has many freckles scattered across her skin. From this description, which of the following is not a risk factor for melanoma in this patient?
Correct Answer: B
Rationale: In the given scenario, being a 35-year-old archaeologist with fair skin, a family history of melanoma, and many freckles scattered across her skin are all risk factors for melanoma. Age (choice A) is a relevant risk factor as melanoma incidence increases with age. Actinic lentigines (choice C), also known as sunspots, are precancerous skin lesions that can increase the risk of developing melanoma. Heavy sun exposure (choice D) is a significant risk factor as cumulative sun exposure over time can contribute to the development of melanoma.
Question 9 of 9
On visualization of the penis he is circumcised and there are no lesions and no discharge from the meatus. His scrotal skin is tense and red. Palpation of the left testicle causes severe pain and the patient begins to cry. His prostate examination is unremarkable. His cremasteric reflex is absent on the left but is normal on the right. By catheter you get a urine sample and the analysis is unremarkable. You send the boy with his mother to the emergency room for further workup. What is the most likely diagnosis for this young man's symptoms?
Correct Answer: C
Rationale: The presentation of severe testicular pain with a red, tense scrotum, and absent cremasteric reflex on one side is highly concerning for testicular torsion. Testicular torsion is a urologic emergency that occurs when the spermatic cord twists, leading to compromised blood flow to the testicle. The affected testicle can become ischemic and necrotic within hours, necessitating prompt diagnosis and intervention to avoid permanent damage or loss of the testicle.