ATI RN
bates physical assessment test bank Questions
Question 1 of 5
The nurse is teaching a client with osteoarthritis how to manage pain. Which of the following interventions would be most helpful?
Correct Answer: A
Rationale: The correct answer is A) Use heat pads for 30 minutes on painful joints. This intervention is effective for managing pain in osteoarthritis because heat therapy can help relax muscles, increase blood flow, and reduce stiffness in the affected joints. It can provide relief and improve the client's comfort level without the need for additional pharmacological interventions. Option B) Perform joint exercises only when pain is absent is incorrect because regular, gentle exercises are important in managing osteoarthritis pain and improving joint function. Waiting for pain to completely disappear before exercising may lead to decreased mobility and increased stiffness. Option C) Avoid using joint protection devices is incorrect because joint protection devices such as splints or braces can help support and stabilize the affected joints, reducing pain and preventing further damage in osteoarthritis. Option D) Rely solely on pharmacological interventions is incorrect because a holistic approach to managing osteoarthritis pain is recommended, including non-pharmacological interventions like heat therapy, exercise, weight management, and joint protection devices to complement pharmacological treatments. In an educational context, it is crucial for nurses to understand the multifaceted approach to pain management in osteoarthritis. Teaching clients about non-pharmacological interventions empowers them to actively participate in their care and improve their quality of life. Heat therapy, exercise, and joint protection devices are valuable tools in the comprehensive management of osteoarthritis pain.
Question 2 of 5
An 84-year-old male with a history of stroke without residual deficit, systolic heart failure, and type 2 diabetes presents to clinic for follow-up. He is independently living in a retirement community and still works part-time on a golf course. He currently takes aspirin 81 mg, metoprolol tartrate 25 mg BID (twice a day), furosemide 20 mg BID, and lisinopril 10 mg daily. He reports his last colonoscopy was 8 years ago, with no abnormality. He reports he is sexually active with men and women, engaging in receptive oral, receptive anal, and penetrative sex. He states he has had over three sexual partners in the last year with intermittent condom use.
Correct Answer: D
Rationale: The correct answer is D) Urine testing, blood testing, anal swab, and oropharyngeal swab. In this case, the patient's sexual history, including engaging in high-risk sexual behaviors, puts him at risk for sexually transmitted infections (STIs). Given his age and medical history, it is crucial to conduct a comprehensive screening for STIs. Urine testing can detect infections like chlamydia and gonorrhea, while blood testing can screen for HIV and syphilis. An anal swab is necessary to check for infections like rectal chlamydia and gonorrhea, which are common in individuals engaging in receptive anal sex. Additionally, an oropharyngeal swab is important to screen for STIs like gonorrhea and chlamydia in the throat, especially considering the patient's sexual practices. Options A, B, and C are incorrect because they do not encompass the comprehensive testing needed for this patient based on his sexual history. Failing to conduct the appropriate screenings could result in undiagnosed and untreated STIs, leading to serious health consequences for the patient. From an educational standpoint, this case highlights the importance of taking a thorough sexual history and conducting appropriate screenings for STIs in all patients, especially in older adults who may engage in risky behaviors. It emphasizes the need for healthcare providers to be nonjudgmental, thorough, and proactive in addressing sexual health concerns to provide comprehensive care for their patients.
Question 3 of 5
Which is the most reasonable first step in the treatment of older men with erectile dysfunction?
Correct Answer: B
Rationale: In older men with erectile dysfunction, the most reasonable first step in treatment is often addressing any underlying hormonal imbalances. Testosterone supplementation (Option B) can be a crucial intervention as testosterone levels naturally decline with age and can contribute to erectile dysfunction. By replenishing testosterone levels, improvements in sexual function may be observed. Regarding the other options: - Sex therapy (Option A) may be beneficial in some cases, but addressing hormonal imbalances should be prioritized in older men with erectile dysfunction. - Yohimbine (Option C) is an herbal supplement that has shown some efficacy in treating erectile dysfunction, but it is not typically recommended as the first-line treatment. - Sildenafil (Option D) is a phosphodiesterase type 5 inhibitor commonly prescribed for erectile dysfunction. While effective, it is usually considered after ruling out hormonal issues in older men due to the potential side effects and interactions with other medications. Educationally, understanding the importance of assessing and addressing hormonal imbalances in older men with erectile dysfunction is crucial for healthcare providers. This knowledge helps in tailoring treatment plans to individual needs, considering both the efficacy and safety of interventions. By prioritizing the correction of hormonal imbalances, healthcare professionals can optimize outcomes for this patient population.
Question 4 of 5
On admission to the hospital, an 85-year-old woman was found to have a fungating mass on her right breast. The mass is 9 cm in diameter, partially ulcerated, and associated with edema of the arm and obvious pain. The patient has no children and had lived alone until recently, when a neighbor became concerned for what appeared to be a progressive loss of memory and neglect of the house. A nephew living in another city eventually came to take care of the situation and arranged for the admission. The patient appears confused and withdrawn; her appearance is disheveled, but she seems to be independent in her ADLs. The medical history is negative for any serious illnesses. She was able to drive her own car until shortly before this admission. The nephew does not wish to authorize hospice “right now.” A positron-emission tomography scan was negative for metastatic disease. In addition to determining the cause of her delirium, which of the following is the best way to address the breast mass?
Correct Answer: E
Rationale: The correct answer is likely missing from the options provided, but based on the scenario described, the best way to address the breast mass in this 85-year-old woman would be to consider a multidisciplinary approach involving a palliative care team. Given her advanced age, presence of a fungating mass, associated pain, edema, and confusion, focusing on quality of life and symptom management would be paramount. Option A suggests initiating Tamoxifen and potentially chemotherapy, which may not be appropriate in a palliative care context where the primary goal is to alleviate symptoms and improve quality of life rather than aggressive treatment for cure. Option B recommends biopsying the mass to study hormone receptor and HER2/neu antigen status. While this information may be valuable in certain cases, in this scenario with a patient who is elderly, confused, and with advanced disease, the focus should be on symptom management rather than further invasive procedures. Option C suggests surgery as initial treatment, which may not be suitable for a patient of this age with advanced disease and multiple comorbidities. Surgical interventions can be aggressive and may not align with the patient's goals of care and quality of life at this stage. Option D proposes radiation therapy, which again may not be the most appropriate choice for a patient in palliative care. Radiation therapy can be burdensome for elderly patients, especially those with advanced disease and limited life expectancy. In an educational context, it is crucial for healthcare providers to understand the principles of palliative care and individualized treatment plans based on a patient's goals, values, and quality of life. Palliative care focuses on holistic symptom management, psychosocial support, and enhancing the patient's comfort and well-being in situations where curative treatment is not the primary goal.
Question 5 of 5
A 75-year-old man presents with the chief concern, “I may have a bladder infection.” Further questioning reveals for several months he has been needing to void every couple of hours (can’t sit through a whole ball game), feels he must go as soon as he feels the urge (he tried putting it off and had urinary leakage), and is getting up two to three times at night to void. He denies delay in voiding or straining to initiate voiding, slow stream, feeling of incomplete emptying, or dribbling after completion of urination. He also denies dysuria and abdominal pain. Which of the following best describes the category or type of his lower urinary tract symptoms?
Correct Answer: D
Rationale: The correct answer is D) Storage (irritative) lower urinary tract symptoms. In this case, the patient's symptoms of needing to void frequently, urgency, nocturia, and urinary leakage when trying to delay voiding are indicative of storage symptoms. These symptoms suggest an overactive bladder, where there is involuntary detrusor muscle contractions causing urgency, frequency, and sometimes urge incontinence. Option A) Prostatism typically presents with symptoms such as slow stream, hesitancy, incomplete emptying, and dribbling, which are not seen in this patient. Option C) Postmicturition symptoms refer to issues that occur after urination, such as dribbling or incomplete emptying, which the patient denies. Educationally, understanding the different types of lower urinary tract symptoms is crucial in diagnosing and managing urological conditions. Recognizing the specific symptomatology helps healthcare providers differentiate between conditions like overactive bladder, benign prostatic hyperplasia, or other urinary issues, leading to appropriate treatment interventions. It is essential for healthcare professionals to be able to accurately assess and categorize lower urinary tract symptoms to provide optimal care for patients presenting with these complaints.