ATI RN
Physical Examination and Health Assessment 9th Edition Test Bank Questions
Question 1 of 9
What is responsible for the inspiratory splitting of S ?
Correct Answer: A
Rationale: Inspiratory splitting of S occurs due to the normal physiological delay in the closure of the aortic and pulmonic valves during inspiration. During inspiration, the negative intrathoracic pressure leads to increased venous return to the right side of the heart, causing a slight delay in the closure of the pulmonic valve. This results in the aortic valve closing first, followed by the closure of the pulmonic valve, leading to the splitting of S during inspiration.
Question 2 of 9
Suzanne is a 20-year-old college student who complains of chest pain. This is intermittent and is located to the left of her sternum. There are no associated symptoms. On examination, you hear a short, high-pitched sound in systole, followed by a murmur which increases in intensity until S . This is heard best over the apex. When she squats, this noise moves later in systole along with the murmur. Which of the following is the most likely diagnosis?
Correct Answer: C
Rationale: The clinical presentation described in the question is consistent with mitral valve prolapse (MVP). MVP is characterized by the improper closure of the mitral valve leaflets during systole, leading to the prolapse of one or both leaflets into the left atrium. The classic auscultatory findings in MVP include a mid-systolic click followed by a late systolic murmur. The click is the result of sudden tensing of the chordae tendineae as the mitral valve prolapses, and the murmur occurs as blood leaks backward (mitral regurgitation) due to imperfect valve closure.
Question 3 of 9
Mrs. T. comes for her regular visit to the clinic. She is on your schedule because her regular provider is on vacation and she wanted to be seen. You have heard about her many times from your colleague and are aware that she is a very talkative person. Which of the following is a helpful technique to improve the quality of the interview for both the provider and the patient?
Correct Answer: B
Rationale: Option B, briefy summarizing what you heard from the patient in the first 5 minutes and then trying to have her focus on one aspect of what she told you, is the best technique to facilitate a more focused and efficient interview. This approach acknowledges the patient's need to talk while also guiding the conversation towards more relevant topics. By summarizing at the beginning, you demonstrate that you are listening, and by redirecting the conversation to specific points, you can ensure that important issues are addressed within the time constraints of the appointment. It can help streamline the visit and prevent it from meandering off track due to the patient's chattiness.
Question 4 of 9
A 28-year-old graduate student comes to your clinic for evaluation of pain "all over." With further questioning, she is able to relate that the pain is worse in the neck, shoulders, hands, low back, and knees. She denies swelling in her joints; she states that the pain is worse in the morning; there is no limitation in her range of motion. On physical examination, she has several points on the muscles of the neck, shoulders, and back that are tender to palpation; muscle strength and range of motion are normal. Which of the following is likely the cause of her pain?
Correct Answer: C
Rationale: Fibromyalgia is a chronic pain syndrome characterized by widespread musculoskeletal pain, fatigue, and multiple tender points on palpation, especially in the neck, shoulders, back, and hips. The patient's symptoms of widespread pain and tenderness at specific points on the muscles without arthritis, joint swelling, or limitation in range of motion are consistent with fibromyalgia. Fibromyalgia is often associated with poor sleep quality, morning stiffness, and fatigue, which the patient in the case provided experiences. Other conditions like rheumatoid arthritis, osteoarthritis, or polymyalgia rheumatica would typically present differently with specific joint involvement, swelling, and additional systemic symptoms, which are not seen in this patient.
Question 5 of 9
Important techniques in performing the rectal examination include which of the following?
Correct Answer: D
Rationale: All of the mentioned techniques are important in performing a rectal examination.
Question 6 of 9
A daycare worker presents to your office with jaundice. She denies IV drug use, blood transfusion, and travel and has not been sexually active for the past 10 months. Which type of hepatitis is most likely?
Correct Answer: B
Rationale: Among the options presented, Hepatitis B (HBV) is most likely in this scenario. HBV can be transmitted through mucous membrane exposure to infectious blood or body fluids, including sexual contact. The daycare worker's history of not being sexually active for the past 10 months would not completely rule out the possibility of acquiring HBV through a past sexual encounter. Also, HBV can persist in the blood for prolonged periods, making it a likely cause of jaundice in this case. The other types of hepatitis (A, C, D) are less likely based on the information provided concerning the daycare worker's history and risk factors.
Question 7 of 9
Her blood pressure and pulse are unremarkable. Her head, eyes, ears, nose, and throat examinations are unremarkable except for edema of the nasal turbinates. On auscultation she has decreased air movement, and coarse crackles are heard over the left lower lobe. There is dullness on percussion, increased fremitus during palpation, and egophony and whispered pectoriloquy on auscultation. What disorder of the thorax or lung best describes her symptoms?
Correct Answer: D
Rationale: The patient's symptoms point towards pneumonia. Pneumonia is characterized by infection and inflammation in the lung tissue, leading to symptoms such as decreased air movement, crackles on auscultation, dullness on percussion, increased fremitus on palpation, and abnormal breath sounds like egophony and whispered pectoriloquy. These findings are consistent with consolidation of the lung, which occurs in pneumonia as a result of fluid, inflammatory cells, and tissue debris filling the alveoli. The presence of nasal turbinates edema indicates a possible upper respiratory tract infection that may have preceded the development of pneumonia. Spontaneous pneumothorax would typically present with sudden-onset chest pain and dyspnea but would not typically cause findings of lung consolidation. Chronic obstructive pulmonary disease (COPD) and asthma are characterized by different patterns of lung damage and symptoms, such as chronic inflammation, airflow obstruction, and hyper
Question 8 of 9
The following information is best placed in which category? "The patient had a stent placed in the left anterior descending artery (LAD) in "
Correct Answer: B
Rationale: The information provided - "The patient had a stent placed in the left anterior descending artery (LAD)" - is related to a medical procedure, specifically a surgical intervention involving the placement of a stent in a coronary artery. This information falls under the category of surgeries because it describes a surgical treatment to address a cardiovascular issue. It does not pertain to adult illnesses, obstetrics/gynecology, or psychiatric conditions, making option B the most appropriate category for this information.
Question 9 of 9
An obese 55-year-old woman went through menarche at age 16 and menopause 2 years ago. She is concerned because an aunt had severe osteoporosis. Which of the following is a risk factor for osteoporosis?
Correct Answer: C
Rationale: Family history of osteoporosis is a significant risk factor, as genetics play a key role in determining a person's risk for developing osteoporosis. Having a close relative, such as an aunt, with severe osteoporosis increases this woman's risk as there is a strong genetic component to the disease. Factors such as obesity (choice A), late menopause (choice B), and delayed menarche (choice D) do not directly increase the risk of osteoporosis, unlike having a familial history of the condition.