ATI RN
Physical Examination and Health Assessment 8th Edition Test Bank Questions
Question 1 of 5
You are assessing a 59-year-old gas station owner for atherosclerosis in the lower extremities. In which of the following locations would the patient's pain make you concerned for this disease process?
Correct Answer: C
Rationale: Pain in the calf is a common symptom of atherosclerosis in the lower extremities, also known as peripheral artery disease (PAD). Atherosclerosis is the buildup of plaque in the arteries, leading to reduced blood flow. The calf pain associated with PAD is often described as cramping, aching, or fatigue that occurs during walking and is relieved with rest. This is called intermittent claudication. Thigh, knee, and ankle pain could have other causes, but calf pain specifically raises concerns for atherosclerosis in the lower extremities.
Question 2 of 5
Jim is a 47-year-old man who is having difficulties with sexual function. He is recently separated from his wife of 20 years. He notes that he has early morning erections but otherwise cannot function. Which of the following is a likely cause for his problem?
Correct Answer: B
Rationale: Given the information provided about Jim's recent separation from his wife after a long marriage, coupled with the fact that he still experiences early morning erections, the likely cause for his sexual function difficulties is psychological issues. Separation, divorce, or relationship problems can have a significant impact on a person's sexual function due to emotional stress, anxiety, depression, or other mental health issues. In Jim's case, the presence of early morning erections suggests that there may not be a physiological issue like decreased testosterone levels, abnormal circulation, or impaired neural innervation. Instead, the situation seems more related to his emotional state and psychological well-being following the separation. It would be advisable for Jim to seek counseling or therapy to address these psychological factors affecting his sexual function.
Question 3 of 5
A 30-year-old paralegal analyst comes to your clinic, complaining of a bad-smelling vaginal discharge with some mild itching, present for about 3 weeks. She tried douching but it did not help. She has had no pain with urination or with sexual intercourse. She has noticed the smell increased after intercourse and during her period last week. She denies any upper respiratory, gastrointestinal, cardiac, or pulmonary symptoms. Her past medical history consists of one spontaneous vaginal delivery. She is married and has one child. She denies tobacco, alcohol, or drug use. Her mother has high blood pressure and her father died from a heart disease. On examination she appears healthy and has unremarkable vital signs. On examination of the perineum there are no lesions noted. On palpation of the inguinal nodes there is no lymphadenopathy. On speculum examination a thin gray-white discharge is seen in the vault. The pH of the discharge is over 5 and there is a fishy odor when potassium hydroxide (KOH) is applied to the vaginal secretions on the slide. Wet prep shows epithelial cells with stippled borders (clue cells). What type of vaginitis best describes her findings?
Correct Answer: C
Rationale: The clinical presentation described in the scenario is classic for bacterial vaginosis (BV). BV is the most common cause of vaginal discharge in women of childbearing age. Key features of BV include a thin gray-white discharge with a fishy odor, which typically worsens after sexual intercourse and during menstruation. The discharge characteristically has a pH over 4.5, and the presence of clue cells on wet prep is diagnostic. Clue cells are vaginal epithelial cells covered with bacteria, giving them a stippled appearance when viewed under the microscope. These features are consistent with the findings in this patient.
Question 4 of 5
His cardiac, lung, and abdominal examinations are normal. He is wearing a sling on his left arm. On observation of his anus you find a swollen bluish ovoid mass that appears to contain a blood clot. Digital rectal examination is extremely painful for the patient. No other mass is palpated within the anus or rectum. What disorder of the anus is this patient likely to have?
Correct Answer: B
Rationale: The patient described is most likely suffering from an external hemorrhoid. External hemorrhoids are swollen veins located near the opening of the anus, often resulting from increased pressure in the rectal area. The presence of a swollen bluish ovoid mass containing a blood clot is characteristic of an external hemorrhoid. The pain experienced during digital rectal examination further supports this diagnosis, as external hemorrhoids are typically painful when touched. In this case, there are no palpable masses within the anus or rectum, ruling out anorectal cancer or internal hemorrhoids. Anal fissures are small tears in the lining of the anus, which would present differently from the described swollen mass with a blood clot.
Question 5 of 5
Which is true of prostate cancer?
Correct Answer: D
Rationale: Prostate cancer is more prevalent in certain ethnic groups, with African-American men having the highest risk of developing prostate cancer compared to men of other ethnicities. Additionally, men of Caribbean and West African descent also have an increased risk compared to men of Asian descent. This indicates that ethnicity plays a role in the risk of developing prostate cancer.