ATI RN
CNS Vital Signs Assessment Questions
Question 1 of 5
The nurse is performing a breast examination. Which of these statements best describes the correct procedure to use when screening for nipple and skin retraction during a breast examination? Have the woman:
Correct Answer: D
Rationale: The correct answer is D. When a woman slowly lifts her arms above her head during a breast examination, it allows for better visualization and detection of any nipple or skin retraction. This position stretches the breast tissue and skin, making any abnormalities more apparent. Additionally, observing for any lag or retraction in movement while the arms are raised can help identify any potential issues. Choice A is incorrect because bending over and touching her toes does not provide the necessary positioning to properly assess for nipple and skin retraction. Choice B is incorrect because lying down on the left side may not provide the same level of stretching and visibility as lifting the arms above the head. Choice C is incorrect because shifting from a supine position to a standing position may not provide the optimal angle for assessing nipple and skin retraction.
Question 2 of 5
A 32-year-old white male comes to your clinic, complaining of aching on the right side of his testicle. He has felt this aching for several months. He states that as the day progresses the aching increases, but when he wakes up in the morning he is pain-free. He denies any pain with urination and states that the pain doesn't change with sexual activity. He denies any fatigue, weight gain, weight loss, fever, or night sweats. His past medical history is unremarkable. He is a married hospital administrator with two children. He notes that he and his wife have been trying to have another baby this year but have so far been unsuccessful despite frequent intercourse. He denies using tobacco, alcohol, or illegal drugs. His father has high blood pressure but his mother is healthy. On examination you see a young man appearing his stated age with unremarkable vital signs. On visualization of his penis, he is circumcised with no lesions. He has no scars along his inguinal area, and palpation of the area shows no lymphadenopathy. On palpation of his scrotum you feel testes with no discrete masses. Upon placing your finger through the right inguinal ring you feel what seems like a bunch of spaghetti. Asking him to bear down, you feel no bulges. The left inguinal ring is unremarkable, with no bulges on bearing down. His prostate examination is unremarkable. What abnormality of the scrotum does he most likely have?
Correct Answer: D
Rationale: The correct answer is D: Varicocele. Varicocele is the most likely abnormality in this case due to the presence of a "bag of worms" feeling upon palpation through the right inguinal ring, especially when the patient bears down. Varicocele is a dilation of the veins within the spermatic cord, leading to a mass resembling a bag of worms. The patient's symptoms of aching in the testicle that worsens throughout the day and improves in the morning are characteristic of varicocele, as increased intra-abdominal pressure exacerbates the symptoms. The absence of discrete masses on palpation and no bulges on bearing down help rule out other conditions like scrotal hernia. Hydrocele presents as a painless fluid-filled sac around the testicle, not a "bag of worms." Scrotal edema would present with swelling and pitting edema, which are not described in this case.
Question 3 of 5
Which vein(s) is(are) responsible for most of the venous return in the arm?
Correct Answer: D
Rationale: The correct answer is D: Superficial. The superficial veins, like the basilic and cephalic veins, are responsible for most of the venous return in the arm due to their larger size and proximity to the surface. These veins run parallel to major arteries, assisting in venous return through the pumping action of nearby muscles. Deep veins are important but less significant in venous return compared to superficial veins in the arm. Ulnar and subclavian veins are not primarily responsible for venous return in the arm.
Question 4 of 5
When assessing a patient's pulse, the nurse notes that the amplitude is weaker during inspiration and stronger during expiration. When the nurse measures the blood pressure, the reading decreases 20 mm Hg during inspiration and increases with expiration. This patient is experiencing pulsus:
Correct Answer: D
Rationale: Step-by-step rationale for why the correct answer is D (Paradoxus): 1. Pulsus paradoxus is characterized by a decrease in pulse strength during inspiration and an increase during expiration, as seen in the patient's pulse assessment. 2. The blood pressure reading decreasing by 20 mm Hg during inspiration is indicative of pulsus paradoxus, as it reflects an exaggeration of the normal inspiratory drop in blood pressure. 3. Pulsus paradoxus is commonly associated with conditions like cardiac tamponade and severe asthma, which can cause this paradoxical pulse and blood pressure pattern. Summary of why the other choices are incorrect: A. Alternans: Alternating strong and weak pulse amplitudes, not related to the respiratory cycle. B. Bisferiens: Pulse with double systolic peaks, not related to respiratory cycle changes. C. Bigeminus: A pattern of every other heartbeat occurring prematurely, not related to respiratory cycle influences.
Question 5 of 5
A 23-year-old graduate student comes to your clinic for evaluation of a urethral discharge. As the provider, you need to get a sexual history. Which one of the following questions is inappropriate for eliciting the information?
Correct Answer: D
Rationale: Correct Answer: D Rationale: 1. Inquiring about the number of sexual partners in the last 6 months is not appropriate as it can be seen as judgmental and might make the patient uncomfortable. 2. The focus should be on gathering relevant information about the patient's sexual practices and behaviors without passing judgment. 3. Questions A, B, and C are relevant and appropriate for eliciting information about the patient's sexual history without making assumptions or causing discomfort. 4. Asking about sexual activity, types of partners, and recent intimate physical contact are essential in assessing the risk factors and providing appropriate care.