ATI RN
Test Bank Physical Examination and Health Assessment Questions
Question 1 of 5
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 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 3 of 5
A 38-year-old woman comes to you and has multiple small joints involved with pain, swelling, and stiffness. Which of the following is the most likely explanation?
Correct Answer: A
Rationale: Rheumatoid arthritis is a systemic autoimmune disease that primarily affects the joints. It commonly presents with pain, swelling, and stiffness in multiple small joints such as those in the hands, wrists, and feet. It is more prevalent in females in their 30s to 50s. Rheumatoid arthritis is characterized by chronic inflammation of the synovial membrane, leading to joint damage and deformities over time. Laboratory tests showing elevated inflammatory markers, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), along with positive rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibodies, can help in confirming the diagnosis of rheumatoid arthritis.
Question 4 of 5
A 68-year-old retired banker comes to your clinic for evaluation of left shoulder pain. He swims for 30 minutes daily, early in the morning. He notes a sharp, catching pain and a sensation of something grating when he tries overhead movements of his arm. On physical examination, you note tenderness just below the tip of the acromion in the area of the tendon insertions. The drop arm test is negative, and there is no limitation with shoulder shrug. The patient is not holding his arm close to his side, and there is no tenderness to palpation in the bicipital groove when the arm is at the patient's side, flexed to 90 degrees, and then supinated against resistance. Based on this description, what is the most likely cause of his shoulder pain?
Correct Answer: C
Rationale: The description of the patient's left shoulder pain, with a sharp catching pain and a sensation of something grating during overhead movements, in addition to tenderness just below the tip of the acromion in the area of tendon insertions, is suggestive of calcific tendinitis. Calcific tendinitis occurs when calcium deposits form within a tendon, most commonly affecting the rotator cuff tendons. This condition can cause pain, tenderness, and limited range of motion, particularly with certain movements like overhead reaching. The negative drop arm test, lack of limitation with shoulder shrug, absence of tenderness to palpation in the bicipital groove, and the patient not holding his arm close to his side help differentiate calcific tendinitis from other shoulder pathologies like rotator cuff tendinitis, rotator cuff tear, and bicipital tendinitis.
Question 5 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.