ATI RN
Test Bank Physical Examination and Health Assessment Questions
Question 1 of 9
The following information is best placed in which category? "The patient was treated for an asthma exacerbation in the hospital last year; the patient has never been intubated."
Correct Answer: A
Rationale: The information provided about the patient being treated for an asthma exacerbation and not being intubated falls under the category of adult illnesses. Asthma is a common respiratory condition that affects people of various ages but is more prevalent in adults. The fact that the patient was treated for an asthma exacerbation and has not required intubation indicates a relevant medical history related to adult illnesses and respiratory conditions. This information would be considered when evaluating and managing the patient's current health status and potential risks related to respiratory issues.
Question 2 of 9
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 3 of 9
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 4 of 9
You find a bounding carotid pulse on a 62-year-old patient. Which murmur should you search out?
Correct Answer: D
Rationale: Finding a bounding carotid pulse suggests a wide pulse pressure, which can be associated with aortic insufficiency. Aortic insufficiency (also known as aortic regurgitation) is characterized by the backflow of blood from the aorta into the left ventricle during diastole due to incomplete closure of the aortic valve. This results in increased stroke volume and left ventricular pressure, leading to widened pulse pressure and a bounding arterial pulse. Therefore, when a bounding carotid pulse is detected in a patient, it is important to search for signs and symptoms of aortic insufficiency, such as a diastolic murmur heard best at the left sternal border and radiating to the neck.
Question 5 of 9
Where is the point of maximal impulse (PMI) normally located?
Correct Answer: A
Rationale: The point of maximal impulse (PMI), also known as the apical impulse, is the point where the left ventricle is closest to the chest wall. Normally, the PMI is located in the left 5th intercostal space, around 7 to 9 cm lateral to the sternum. This area corresponds to the apex of the heart. By palpating the PMI, healthcare providers can assess the size, strength, and regularity of the heart's contractions, which can provide important diagnostic information about cardiac health. Locating the PMI accurately is essential for physical examination and diagnosis of cardiac conditions.
Question 6 of 9
Based on this information, which of the following is appropriate?
Correct Answer: D
Rationale: The most appropriate response based on the information provided would be to give the patient information concerning the reduction of fat and cholesterol in her diet because she is obese. The patient's weight falls in the obese category, and addressing diet is an important step in managing obesity. Providing guidance on reducing fat and cholesterol intake can help the patient make healthier food choices and work towards achieving a healthier weight. Additionally, diet plays a significant role in overall health, so addressing nutrition is crucial when managing obesity. It is important to approach the topic sensitively and provide support and resources to help the patient make positive changes for their health.
Question 7 of 9
A 21-year-old receptionist comes to your clinic, complaining of frequent diarrhea. She states that the stools are very loose and there is some cramping beforehand. She states this has occurred on and off since she was in high school. She denies any nausea, vomiting, or blood in her stool. Occasionally she has periods of constipation, but that is rare. She thinks the diarrhea is much worse when she is nervous. Her past medical history is not significant. She is single and a junior in college majoring in accounting. She smokes when she drinks alcohol but denies using any illegal drugs. Both of her parents are healthy. Her entire physical examination is unremarkable. What is most likely the etiology of her diarrhea?
Correct Answer: C
Rationale: The patient's history of frequent loose stools with cramping, occurring since high school and worsening during periods of nervousness, along with occasional constipation, is characteristic of irritable bowel syndrome (IBS). IBS is a functional gastrointestinal disorder that presents with symptoms such as abdominal pain or discomfort, bloating, and altered bowel habits (diarrhea, constipation, or both) without any evidence of organic disease. The absence of systemic symptoms like fever, weight loss, or blood in the stool, as well as normal physical examination findings, also support the diagnosis of IBS in this case. This condition is often triggered or exacerbated by stress or anxiety. Monitoring stress levels, dietary modifications, and possibly prescription medications may help manage IBS symptoms in this patient.
Question 8 of 9
Susanne is a 27-year-old who has had headaches, muscle aches, and fatigue for the last 2 months. You have completed a thorough history, examination, and laboratory workup but have not found a cause. What would your next action be?
Correct Answer: D
Rationale: Since the patient, Susanne, has been experiencing headaches, muscle aches, and fatigue for the last 2 months, and a thorough history, examination, and laboratory workup have not revealed a definitive cause, the next step would be to screen for depression. Depression can present with physical symptoms such as headaches, muscle aches, and fatigue. It is important to consider mental health factors that could be contributing to Susanne's symptoms before proceeding with further referrals to specialists. Screening for depression would help in determining if psychological factors are playing a role in her physical symptoms.
Question 9 of 9
You note that a patient has anisocoria on examination. Pathologic causes of this include which of the following?
Correct Answer: A
Rationale: Anisocoria refers to a condition where the pupils are of unequal size. Pathologic causes of anisocoria can include conditions such as Horner's syndrome. Horner's syndrome is a rare disorder caused by damage to the sympathetic nerves of the face and eye. Symptoms can include a constricted pupil (miosis), drooping of the upper eyelid (ptosis), and decreased sweating in the affected area. This results in anisocoria, where the affected pupil is smaller than the unaffected pupil. Other options listed (B-D) do not typically lead to pathologic anisocoria.