ATI RN
Physical Examination and Health Assessment 9th Edition Test Bank Questions
Question 1 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 2 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 3 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.
Question 4 of 9
Her head, eyes, ears, nose, throat, cardiac, lung, and abdominal examinations are unremarkable. Palpation of the inguinal lymph nodes is unremarkable. On visualization of the vulva, a thick, white, curdy discharge is seen at the introitus. On speculum examination there is a copious amount of this discharge. The pH of the discharge is 1 and the KOH whiff test is negative, with no unusual smell. Wet prep shows budding hyphae. What vaginitis does this patient most likely have?
Correct Answer: B
Rationale: The clinical presentation described in the question is consistent with Candida vaginitis, also known as vaginal yeast infection. Candida vaginitis typically presents with a thick, white, curdy discharge that can be visualized on examination. The low pH of 1 is characteristic of Candida infection. The negative KOH whiff test and absence of an unusual smell help differentiate Candida vaginitis from other types of vaginitis.
Question 5 of 9
Mr. Maxwell has noticed that he is gaining weight and has increasing girth. Which of the following would argue for the presence of ascites?
Correct Answer: B
Rationale: Ascites is the abnormal accumulation of fluid in the abdominal cavity. When ascites is present, dullness is typically heard on percussion due to the fluid in the abdomen. This dullness does not shift with changes in the patient's position. Therefore, the finding of dullness which remains despite a change in position would argue for the presence of ascites. The other choices (A, C, D) describe findings that are more consistent with gaseous distention rather than ascites.
Question 6 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 7 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 8 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 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.