ATI RN
Physical Assessment NCLEX Practice Questions Questions
Question 1 of 5
Suzanne, a 25 year old, comes to your clinic to establish care. You are the student preparing to go into the examination room to interview her. Which of the following is the most logical sequence for the patient-provider interview?
Correct Answer: C
Rationale: The most logical sequence for the patient-provider interview is to greet the patient, establish rapport, invite the patient's story, establish the agenda, expand and clarify the patient's story, and negotiate a plan. This sequence ensures a patient-centered approach by first building a connection with the patient, allowing the patient to share their concerns and story, and then working collaboratively with the patient to address these concerns. It is important to start by building rapport to establish trust and a comfortable environment for the patient to open up about their health concerns. Inviting the patient's story allows the provider to understand the patient's perspective and how their symptoms are impacting their life. Establishing the agenda sets the priorities for the visit and ensures that both the provider and patient are on the same page. Expanding and clarifying the patient's story helps gather more detailed information, leading to a comprehensive assessment. Finally, negotiating a plan together with the patient ensures shared decision-making and a patient-centered approach
Question 2 of 5
Common or concerning symptoms to inquire about in the General Survey and vital signs include all of the following except:
Correct Answer: C
Rationale: Changes in weight, fatigue and weakness, fever and chills are common symptoms that can provide valuable information about a person's overall health. These symptoms may indicate underlying medical conditions and merit further investigation. However, a cough, while it can be a symptom of various respiratory or systemic illnesses, is not typically part of the General Survey and vital signs assessment. It is usually addressed in a more focused respiratory assessment.
Question 3 of 5
You are observing a patient with heart failure and notice that there are pauses in his breathing. On closer examination, you notice that after the pauses the patient takes progressively deeper breaths and then progressively shallower breaths, which are followed by another apneic spell. The patient is not in any distress. You make the diagnosis of:
Correct Answer: B
Rationale: Cheyne-Stokes respiration is characterized by a pattern of breathing with gradual increase and then decrease in depth of breaths, followed by a period of apnea. This cycle repeats itself. It is commonly seen in patients with heart failure and other conditions affecting the central nervous system. The patient in this scenario is not in distress, which is typical of Cheyne-Stokes respiration. Ataxic (Biot's) breathing is characterized by unpredictable irregular breaths with varying depths and irregular pauses; it is seen in patients with damage to the medulla. Kussmaul's respiration is deep, rapid, and labored breathing seen in metabolic acidosis. COPD with prolonged expiration is a characteristic finding in patients with chronic obstructive pulmonary disease, but in this case, the described breathing pattern is more consistent with Cheyne-Stokes respiration.
Question 4 of 5
A 29-year-old woman comes to your office. As you take the history, you notice that she is speaking very quickly, and jumping from topic to topic so rapidly that you have trouble following her. You are able to find some connections between ideas, but it is difficult. Which word describes this thought process?
Correct Answer: B
Rationale: When a person's thought process is characterized by speaking rapidly, jumping from topic to topic, and making loose or tangential connections between ideas, it is referred to as a "flight of ideas." This type of thought process is commonly seen in conditions such as mania, where there is a marked increase in goal-directed activity, energy, and racing thoughts. In contrast, derailment refers to a disorganized thought process where the individual is unable to maintain a logical progression in their speech. Circumstantiality involves providing excessive and unnecessary detail before eventually reaching the main point. Incoherence is used to describe speech that is incomprehensible and disjointed, lacking any logical connection between ideas.
Question 5 of 5
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.