ATI RN
Physical Examination and Health Assessment 9th Edition Test Bank Questions
Question 1 of 9
Which of the following conditions involves a tight prepuce which, once retracted, cannot be returned?
Correct Answer: B
Rationale: Paraphimosis is a condition where the foreskin is retracted behind the glans penis and cannot be returned to its original position. This can lead to swelling and constriction of the penis, causing pain and potential damage to the tissue due to decreased blood flow. Phimosis (Choice A) refers to a tight prepuce that cannot be retracted over the glans penis. Balanitis (Choice C) is inflammation of the glans penis, often associated with poor hygiene or infections. Balanoposthitis (Choice D) refers to inflammation of both the glans penis and the foreskin.
Question 2 of 9
Which of the following is true regarding breast self-examination?
Correct Answer: C
Rationale: The statement that a high proportion of breast masses are detected by breast self-examination is true. Studies have shown that only a small percentage of breast cancers are actually detected by women themselves through self-examination. In fact, most breast cancers are detected through clinical breast exams and mammograms. Therefore, while it is still important for women to be breast aware and report any changes they notice to their healthcare provider, the practice of routine breast self-examinations is no longer universally recommended. Instead, the focus has shifted towards regular clinical breast exams and mammograms based on individual risk factors.
Question 3 of 9
A 26-year-old violinist comes to your clinic, complaining of anxiety. He is a first chair violinist in the local symphony orchestra and has started having symptoms during performances, such as sweating, shaking, and hyperventilating. It has gotten so bad that he has thought about giving up his first chair status so he does not have to play the solo during one of the movements. He says that he never has these symptoms during rehearsals or when he is practicing. He denies having any of these symptoms at any other time. His past medical history is unremarkable. He denies any tobacco use, drug use, or alcohol abuse. His parents are both healthy. On examination you see a young man who appears worried. His vital signs and physical examination are unremarkable. What type of anxiety disorder best describes his situation?
Correct Answer: C
Rationale: The young violinist is experiencing symptoms of anxiety specifically related to performing in front of others, which is characteristic of social phobia (also known as social anxiety disorder). The symptoms occur only during performances, indicating the anxiety is triggered by social situations where he is the center of attention. His ability to perform without symptoms during rehearsals or practice sessions further supports the diagnosis of social phobia, as the anxiety is specifically related to public performance. In contrast, panic disorder is characterized by recurrent, unexpected panic attacks that are not situation-specific, and specific phobia involves an intense fear of a specific object or situation, neither of which fully match this patient's presentation. Generalized anxiety disorder involves excessive worry and anxiety about various aspects of life, which is not the main feature of this case.
Question 4 of 9
Mrs. Lenzo weighs herself every day with a very accurate balance-type scale. She has noticed that over the past 2 days she has gained 4 pounds. How would you best explain this?
Correct Answer: C
Rationale: The most likely explanation for Mrs. Lenzo noticing a 4-pound weight gain over just 2 days is fluctuations in body fluid. Our body weight can fluctuate throughout the day due to factors such as hydration levels, sodium intake, and hormonal changes. It is not physically possible to gain 4 pounds of actual body mass (e.g., fat or muscle) in such a short period of time by overeating or wearing different clothing. Additionally, if Mrs. Lenzo's scale is very accurate as mentioned, it is less likely that the weight gain is due to instrument inaccuracy. Therefore, the most plausible reason for the sudden weight gain is fluctuations in body fluid retention.
Question 5 of 9
You are performing a routine check-up on an 81-year-old retired cotton farmer in the vascular surgery clinic. You note that he has a history of chronic arterial insufficiency. Which of the following physical examination findings in the lower extremities would be expected with this disease?
Correct Answer: D
Rationale: Chronic arterial insufficiency results in poor blood flow to the lower extremities. This leads to inadequate oxygen and nutrient supply to the tissues, causing damage and changes in the skin. A common physical examination finding in chronic arterial insufficiency is thin, shiny, atrophic skin. The skin may appear pale, cool to the touch, and may have decreased hair growth. It is important to note that other findings such as diminished or absent pulses and reduced temperatures may also be present with chronic arterial insufficiency.
Question 6 of 9
A 67-year-old lawyer comes to your clinic for an annual examination. He denies any history of eye trauma. He denies any visual changes. You inspect his eyes and find a triangular thickening of the bulbar conjunctiva across the outer surface of the cornea. He has a normal pupillary reaction to light and accommodation. Based on this description, what is the most likely diagnosis?
Correct Answer: D
Rationale: The described findings of a triangular thickening of the bulbar conjunctiva across the outer surface of the cornea are characteristic of a pterygium. A pterygium is a benign growth of conjunctival tissue that extends onto the cornea. It is often associated with chronic exposure to ultraviolet light and typically occurs on the nasal side of the eye. Pterygiums are usually asymptomatic but can cause irritation, redness, and foreign body sensation in some cases. Surgical removal may be considered if the pterygium causes significant symptoms or affects vision.
Question 7 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 8 of 9
On visual confrontation testing, a stroke patient is unable to see your fingers on his entire right side with either eye covered. Which of the following terms would describe this finding?
Correct Answer: C
Rationale: A right homonymous hemianopsia refers to a visual field defect in which the patient is unable to see objects in the right half of the visual field in both eyes. In the case described, the stroke patient is unable to see your fingers on his entire right side with either eye covered, which is consistent with a right homonymous hemianopsia. This type of visual field defect typically occurs as a result of damage to the optic tract or optic radiation on one side of the brain, which affects the processing of visual information from the opposite visual field. It is important to note that bitemporal hemianopsia, right temporal hemianopsia, and binasal hemianopsia involve different patterns of visual field loss and are not fitting descriptions for the presented scenario.
Question 9 of 9
He works in a sales office to support his family. Recently he has injured his back and you are thinking he would benefit from physical therapy, three times a week, for an hour per session. What would be your next step?
Correct Answer: C
Rationale: The next step would be to discuss the physical therapy plan with Mr. Larson. It is important to communicate openly with him, explain the recommendation for physical therapy, and ensure that he understands and agrees with the plan before proceeding further. This allows for any questions or concerns to be addressed, and ensures that the treatment plan is tailored to his needs and preferences. By discussing the plan with Mr. Larson first, you can also provide him with the opportunity to ask any questions and actively involve him in his own care, which can lead to better compliance and outcomes.