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
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 3 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 4 of 9
A 62-year-old smoker complains of "coughing up small amounts of blood," so you consider hemoptysis. Which of the following should you also consider?
Correct Answer: C
Rationale: Epistaxis, also known as a nosebleed, should be considered in a patient complaining of coughing up blood along with a history of smoking. Epistaxis can sometimes lead to blood trickling down the throat and being coughed up. It is important to consider this differential diagnosis, especially in patients with risk factors such as smoking. Intestinal bleeding (choice A) has a different presentation and cause compared to epistaxis. Hematoma of the nasal septum (choice B) is unlikely to cause coughing up blood. Bruising of the tongue (choice D) is also less likely to be the cause of hemoptysis in this case.
Question 5 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 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
A 28-year-old musician comes to your clinic, complaining of a "spot" on his penis. He states his partner noticed it 2 days ago and it hasn't gone away. He says it doesn't hurt. He has had no burning with urination and no pain during intercourse. He has had several partners in the last year and uses condoms occasionally. His past medical history consists of nongonococcal urethritis from Chlamydia and prostatitis. He denies any surgeries. He smokes two packs of cigarettes a day, drinks a case of beer a week, and smokes marijuana and occasionally crack. He has injected IV drugs before but not in the last few years. He is single and currently unemployed. His mother has rheumatoid arthritis and he doesn't know anything about his father. On examination you see a young man appearing deconditioned but pleasant. His vital signs are unremarkable. On visualization of his penis there is a 6-mm red, oval ulcer with an indurated base just proximal to the corona. There is no prepuce because of neonatal circumcision. On palpation the ulcer is nontender. In the inguinal region there is nontender lymphadenopathy. What disorder of the penis is most likely the diagnosis?
Correct Answer: C
Rationale: The presentation described in the scenario is consistent with a syphilitic chancre, which is the primary lesion of syphilis. Syphilitic chancres are painless, indurated ulcers that occur at the site of initial infection with Treponema pallidum. These chancres are typically 0.5-2 cm in size, have a clean base, and are often accompanied by regional lymphadenopathy. The red oval ulcer with an indurated base in this patient, along with the absence of pain and presence of lymphadenopathy, is consistent with a syphilitic chancre.
Question 8 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 9 of 9
Ms. Whiting is a 68-year-old who comes in for her usual follow-up visit. You notice a few flat red and purple lesions, about 6 centimeters in diameter, on the ulnar aspect of her forearms but nowhere else. She doesn't mention them. They are tender when you examine them. What should you do?
Correct Answer: C
Rationale: The presence of new flat red and purple lesions that are tender on the ulnar aspect of Ms. Whiting's forearms raises concerns and warrants further investigation. Since she did not mention them, it is important to ask how she acquired them to gather more information. This will help determine the cause of the lesions and provide clues to potential underlying conditions or recent activities that could be related to their development. It is important not to dismiss these lesions as old without proper evaluation, as they could indicate a recent injury, infection, or other medical issues that may require attention.