ATI RN
health assessment practice questions nursing Questions
Question 1 of 9
The projections in the nasal cavity that increase the surface area are called the:
Correct Answer: C
Rationale: The correct answer is C: turbinates. Turbinates are bony projections in the nasal cavity that increase the surface area for the warming, humidifying, and filtering of inhaled air. Meatus (A) refers to the passages in the nasal cavity, not the projections. Septum (B) is the partition between the nostrils, not the projections. Kiesselbach's plexus (D) is a collection of blood vessels in the nasal septum, not the projections that increase surface area.
Question 2 of 9
While performing the otoscopic examination of a 3-year-old boy who has been pulling on his left ear, the nurse finds that his left tympanic membrane is bright red and the light reflex is not visible. The most likely cause is:
Correct Answer: B
Rationale: The correct answer is B: acute otitis media. In this case, the presentation of a bright red tympanic membrane and absence of the light reflex are indicative of inflammation and fluid accumulation in the middle ear, which are classic signs of acute otitis media. This condition commonly occurs in young children, especially after a recent upper respiratory infection. Incorrect choices: A: Fungal infection is less likely in this case as the symptoms are more consistent with acute bacterial infection seen in otitis media. C: Rupture of the drum would typically present with sudden relief of pain and discharge from the ear, which is not described in the scenario. D: Blood behind the drum (hemotympanum) is uncommon in children with acute otitis media and would usually be associated with trauma or barotrauma.
Question 3 of 9
While performing a mouth assessment on a patient, the nurse notices a 1-cm ulceration that is crusted and has an elevated border. It is located on the outer third of the lower lip. What other information would be most important for the nurse to obtain?
Correct Answer: B
Rationale: The correct answer is B: When the patient first noticed the lesion. This information is crucial for determining the duration of the ulceration, aiding in diagnosing potential causes like trauma or infections. Nutritional status (Choice A) may not be directly related to the specific lesion. Whether the patient has had a recent cold (Choice C) is less relevant unless there are other symptoms present. Exposure to sick animals (Choice D) is not pertinent to the mouth ulceration. Therefore, obtaining information on when the patient first noticed the lesion is the most important for proper assessment and treatment planning.
Question 4 of 9
Which of the following would the nurse expect to find when examining the eyes of a patient of African descent?
Correct Answer: B
Rationale: The correct answer is B: A dark retinal background. This is because individuals of African descent typically have a higher concentration of melanin in their eyes, resulting in a darker retinal background. This can affect the appearance of the fundus during eye examinations. Incorrect choices: A: Increased night vision - Night vision is not directly influenced by melanin levels in the eyes and is more related to the function of rods and cones in the retina. C: Increased photosensitivity - Melanin provides some protection against UV light, so individuals with darker retinas may have lower photosensitivity. D: Narrowed palpebral fissures - Palpebral fissures refer to the opening between the eyelids and are not typically influenced by melanin levels in the eyes.
Question 5 of 9
The nurse is assessing a patient with a history of intravenous drug abuse. While assessing his mouth, the nurse notices a dark red confluent macule on the hard palate. This could be an early sign of:
Correct Answer: A
Rationale: The correct answer is A: acquired immunodeficiency syndrome (AIDS). The dark red confluent macule on the hard palate is known as Kaposi's sarcoma, a common manifestation of AIDS. This lesion is caused by Human Herpesvirus 8 and is often seen in patients with compromised immune systems. Measles (B) typically presents with a rash, not a dark red macule. Leukemia (C) does not typically manifest as a dark red macule in the mouth. Carcinoma (D) refers to cancer and would present differently than Kaposi's sarcoma. In summary, the presence of a dark red confluent macule on the hard palate in a patient with a history of intravenous drug abuse is highly suggestive of AIDS, specifically Kaposi's sarcoma.
Question 6 of 9
The nurse is testing a patient's visual accommodation, which refers to:
Correct Answer: A
Rationale: Visual accommodation refers to the ability of the eye to adjust focus when shifting gaze between objects at different distances. The correct answer is A, pupillary constriction when looking at a near object, as this is a key component of visual accommodation. When looking at a near object, the eye needs to adjust its focus by constricting the pupil to allow more depth of field and clearer vision. This process helps in bringing near objects into focus. Choices B, C, and D are incorrect: B: Pupillary dilation when looking at a far object is not related to visual accommodation, as the pupil dilates in low light conditions to allow more light to enter the eye. C: Changes in peripheral vision in response to light is not related to visual accommodation, as peripheral vision refers to the ability to see objects outside the direct line of sight. D: Involuntary blinking in the presence of bright light is a protective reflex to shield the eyes from excessive light and is not directly related to visual
Question 7 of 9
The nurse is performing middle ear assessment on a 15-year-old patient who has a history of chronic ear infections. When examining the right tympanic membrane, the nurse sees dense white patches. The tympanic membrane is otherwise unremarkable. It is pearly, with the light reflex at 5 o'clock and visible landmarks. The nurse should:
Correct Answer: B
Rationale: The correct answer is B: know that these are scars caused from frequent ear infections. The presence of dense white patches on the tympanic membrane in a patient with a history of chronic ear infections indicates scarring from previous infections. This is a common finding in individuals who have experienced recurrent middle ear infections. The other choices are incorrect because: A) Fungal infections typically present with different characteristics such as discoloration or debris in the ear canal, not dense white patches on the tympanic membrane. C) Blood in the middle ear would manifest as redness or hemorrhage, not white patches. D) While scarring may affect hearing, the description of the tympanic membrane in this case does not suggest any immediate concern for hearing loss.
Question 8 of 9
A patient is unable to differentiate between sharp and dull stimulation to both sides of her face. The nurse suspects:
Correct Answer: B
Rationale: The correct answer is B: damage to the trigeminal nerve. Trigeminal nerve damage can result in the inability to differentiate between sharp and dull sensations on the face. The trigeminal nerve is responsible for transmitting sensory information from the face to the brain. Bell's palsy (choice A) affects facial muscles, not sensory perception. Frostbite (choice C) typically causes numbness rather than loss of sensation discrimination. Scleroderma (choice D) is a connective tissue disorder that does not directly affect sensory perception on the face.
Question 9 of 9
Which of the following signs would the nurse expect to find on assessment of an individual with otitis externa?
Correct Answer: D
Rationale: The correct answer is D: Enlarged regional lymph nodes. In otitis externa, there may be regional lymphadenopathy due to inflammation and infection. Rhinorrhea (A) is associated with upper respiratory infections, not otitis externa. Periorbital edema (B) is seen in conditions like periorbital cellulitis. Pain over the maxillary sinuses (C) is indicative of sinusitis, not otitis externa.