ATI RN
Test Bank Physical Examination and Health Assessment Questions
Question 1 of 5
Otherwise she has had no health problems. Her father has high blood pressure. Her mother had unilateral breast cancer in her 70s. The patient denies tobacco, alcohol, or drug use. She is a family law attorney and is married. Her examination is essentially unremarkable. Which risk factor of her personal and family history most puts her in danger of getting breast cancer?
Correct Answer: A
Rationale: The most significant risk factor for breast cancer in the patient's personal and family history is having a first-degree relative with premenopausal breast cancer. This is because the age at which a family member was diagnosed with breast cancer can be indicative of potential genetic predispositions that may increase the patient's own risk of developing the disease. Women with a first-degree relative who was diagnosed with breast cancer before menopause (premenopausal) are at a higher risk themselves compared to those with a family history of postmenopausal breast cancer. In this case, the patient's mother had unilateral breast cancer in her 70s, which suggests a higher risk compared to postmenopausal breast cancer. Other factors such as early age at menarche or age at first live birth are also important in assessing breast cancer risk, but having a first-degree relative with premenopausal breast cancer is the most significant
Question 2 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 3 of 5
Which of the following is consistent with obturator sign?
Correct Answer: C
Rationale: The obturator sign is a physical examination maneuver used to assess for irritation of the obturator muscle due to an inflamed appendix that is in close proximity. This pain is typically felt in the right lower quadrant or hypogastric region. The sign is elicited by passively flexing the hip and knee of the patient, then internally rotating the hip. An alternative method is to position the patient on her left side and ask her to raise her right thigh against resistance while the examiner provides counterpressure. Pain experienced by the patient with these maneuvers is consistent with obturator sign, indicating possible appendicitis. Hence, option C is the correct answer.
Question 4 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 5 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.