ATI RN
Physical Assessment NCLEX Practice Questions Questions
Question 1 of 9
Which of the following is true of jugular venous pressure (JVP) measurement?
Correct Answer: B
Rationale: Jugular venous pressure (JVP) is measured as the vertical height of the blood column in centimeters above the sternal angle (Angle of Louis). To measure the JVP accurately, the patient should be positioned at a 30-45 degree angle (not 45-degree angle as in choice A). The value obtained by measuring the JVP in centimeters is then added to 5 cm, which represents the distance from the sternal angle to the right atrium. Therefore, the formula for calculating JVP is the vertical height of the blood column in cm + 5 cm. A JVP below 9 cm (not 9 cm or choice C) is generally considered normal, while a JVP above that level is considered elevated. It is important to measure the JVP correctly and interpret the findings in the context of the patient's
Question 2 of 9
A patient is describing a very personal part of her history very quickly and in great detail. How should you react to this?
Correct Answer: D
Rationale: In this situation, it is important to prioritize active listening over taking detailed notes. By pushing away from the keyboard or putting down your pen, you are signaling to the patient that you are fully present and engaged in listening to their story. This will help foster trust and encourage the patient to continue sharing their personal history. Taking notes can be done later, but the immediate focus should be on providing a supportive and attentive environment for the patient to share their experiences.
Question 3 of 9
Which of the following synovial joints would be an example of a condylar joint?
Correct Answer: B
Rationale: A condylar joint is a type of synovial joint that allows movement in two planes, typically flexion/extension and abduction/adduction. The interphalangeal joints of the hand, which are the joints between the phalanges (finger bones), exhibit this type of movement, making them an example of a condylar joint. The hip joint (choice A) is a ball-and-socket joint, the temporomandibular joint (choice C) is a hinge joint, and the intervertebral joint (choice D) is a cartilaginous joint, none of which are examples of condylar joints.
Question 4 of 9
A patient complains of epistaxis. Which other cause should be considered?
Correct Answer: A
Rationale: When a patient presents with epistaxis (nosebleed), other causes such as intracranial hemorrhage should be considered. Intracranial hemorrhage refers to bleeding within the skull, which can sometimes manifest as epistaxis. Common symptoms of intracranial hemorrhage include severe headache, altered mental status, focal neurological deficits, and sometimes, epistaxis. It is essential to assess for signs of increased intracranial pressure or neurological deficits if a patient with epistaxis has a history of trauma or other risk factors for intracranial bleeding. Immediate medical evaluation and imaging studies may be necessary to rule out intracranial hemorrhage in such cases to prevent serious consequences.
Question 5 of 9
A 36-year-old security officer comes to your clinic, complaining of a painless mass in his scrotum. He found it 3 days ago during a testicular self-examination. He has had no burning with urination and no pain during sexual intercourse. He denies any weight loss, weight gain, fever, or night sweats. His past medical history is notable for high blood pressure. He is married and has three healthy children. He denies using illegal drugs, smokes two to three cigars a week, and drinks six to eight alcoholic beverages per week. His mother is in good health and his father had high blood pressure and coronary artery disease. On physical examination he appears anxious but in no pain. His vital signs are unremarkable. On visualization of his penis, he is circumcised and has no lesions. His inguinal region has no lymphadenopathy. Palpation of his scrotum shows a soft cystic-like lesion measuring 2 cm over his right testicle. There is no difficulty getting a gloved finger through either inguinal ring. With weight bearing there are no bulges. His prostate examination is unremarkable. What disorder of the scrotum does he most likely have?
Correct Answer: A
Rationale: The patient most likely has a hydrocele based on the presentation of a painless, soft cystic-like lesion measuring 2 cm over his right testicle. A hydrocele is a collection of fluid surrounding the testicle within the tunica vaginalis, resulting in a painless scrotal swelling. It is common and can occur at any age but is more common in older individuals. A key feature of a hydrocele is that the swelling is not reducible, meaning it cannot be pushed back into the abdomen. In this patient, there was no difficulty getting a gloved finger through either inguinal ring, ruling out a scrotal hernia. Testicular tumors typically present as painless testicular masses but are usually solid rather than cystic. Varicoceles are enlarged veins within the scrotum and have a characteristic "bag of worms" appearance on palpation, which is not described in this case.
Question 6 of 9
Common or concerning symptoms to inquire about in the General Survey and vital signs include all of the following except:
Correct Answer: C
Rationale: Changes in weight, fatigue and weakness, fever and chills are common symptoms that can provide valuable information about a person's overall health. These symptoms may indicate underlying medical conditions and merit further investigation. However, a cough, while it can be a symptom of various respiratory or systemic illnesses, is not typically part of the General Survey and vital signs assessment. It is usually addressed in a more focused respiratory assessment.
Question 7 of 9
A 22-year-old advertising copywriter presents for evaluation of joint pain. The pain is new, located in the wrists and fingers bilaterally, with some subjective fever. The patient denies a rash; she also denies recent travel or camping activities. She has a family history significant for rheumatoid arthritis. Based on this information, which of the following pathologic processes would be the most correct?
Correct Answer: B
Rationale: The most likely pathologic process based on the patient's symptoms and history would be an inflammatory process. The patient's joint pain, fever, and family history of rheumatoid arthritis suggest the possibility of an autoimmune inflammatory condition like rheumatoid arthritis. Rheumatoid arthritis is a chronic inflammatory disorder that primarily affects the joints, causing pain, swelling, and stiffness. The bilateral involvement of the wrists and fingers along with a family history of rheumatoid arthritis make this diagnosis more likely than an infectious, hematologic, or traumatic process in this case.
Question 8 of 9
You are examining a newborn and note that the right testicle is not in the scrotum. What should you do next?
Correct Answer: A
Rationale: When examining a newborn and noting that the right testicle is not in the scrotum, it is important to refer the newborn to a pediatric urologist for further evaluation and management. This condition could be a case of undescended testis (cryptorchidism), where the testicle fails to descend into the scrotum. Early intervention is crucial as the undescended testis may lead to complications such as infertility, testicular cancer, and inguinal hernia. Urology specialists can determine the best course of action to bring down the testis and ensure proper testicular development. Waiting or attempting manual descent without expertise could lead to complications, so it is best to involve a urologist for proper assessment and management.
Question 9 of 9
A 68-year-old retired truck driver comes to your office for evaluation of swelling in his legs. He is a smoker and has been taking medications to control his hypertension for the past 25 years. You are concerned about his risk for peripheral vascular disease. Which of the following tests are appropriate to order to initially evaluate for this condition?
Correct Answer: C
Rationale: The ankle-brachial index (ABI) is the appropriate test to initially evaluate for peripheral vascular disease in this case. ABI is a simple, non-invasive test that compares the blood pressure in the arms to the blood pressure in the legs. A lower ABI value indicates a higher likelihood of peripheral arterial disease (PAD). Given the patient's presentation of leg swelling and risk factors like smoking and hypertension, ABI can help determine the presence and severity of PAD, guiding further management and treatment decisions.