ATI RN
Physical Assessment NCLEX Practice Questions Questions
Question 1 of 5
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 2 of 5
Jean has just given birth 6 months ago and is breast-feeding her child. She has not had a period since giving birth. What does this most likely represent?
Correct Answer: B
Rationale: Secondary amenorrhea refers to the absence of menstruation for 3-6 months in a woman who previously had regular menstrual cycles. In this case, Jean's lack of menstruation after giving birth and while breastfeeding her child for 6 months likely indicates secondary amenorrhea. This temporary suppression of ovulation and menstruation commonly occurs during breastfeeding due to the high levels of the hormone prolactin, which is responsible for milk production and can inhibit ovulation and menstruation. It is a natural phenomenon known as lactational amenorrhea. Once breastfeeding decreases or stops, menstruation usually resumes within a few months.
Question 3 of 5
When should a woman conduct breast self-examination with respect to her menses?
Correct Answer: C
Rationale: It is recommended for women to conduct breast self-examination immediately prior to their menses. This is because the breasts are less likely to be tender, lumpy, or swollen during this time of the menstrual cycle, making it easier to detect any abnormalities such as lumps or changes in the breast tissue. Conducting breast self-examination around this time each month can help women become familiar with the normal look and feel of their breasts, making it easier to detect any changes that may indicate a potential issue.
Question 4 of 5
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 5 of 5
Her abdominal examination reveals a gravid uterus but is otherwise unremarkable. On visualization of the anus there is a slight red, moist- appearing protrusion from the anus. As you have her bear down, the protrusion grows larger. On digital rectal examination you can feel an enlarged tender area on the posterior side. There is some blood on the glove after the examination. What disorder of the anus or rectum best fits this presentation?
Correct Answer: C
Rationale: The described clinical presentation is consistent with internal hemorrhoids. The typical symptoms of internal hemorrhoids include painless rectal bleeding, protrusion from the anus during straining, and a feeling of incomplete evacuation. In this case, the protrusion is observed to be red, moist, and enlarges with bearing down, all indicative of internal hemorrhoids. The enlarged tender area felt on digital rectal examination supports the diagnosis. Additionally, the presence of blood on the glove after the examination is also suggestive of internal hemorrhoids causing bleeding. Anal fissures typically present with sharp pain during defecation and may have visible tears in the anal mucosa. External hemorrhoids are usually more painful and can be felt as a lump around the anus. Anorectal fistulas have different signs and symptoms, including discharge of pus and recurrent infections.