Physical Examination and Health Assessment 9th Edition Test Bank

Questions 27

ATI RN

ATI RN Test Bank

Physical Examination and Health Assessment 9th Edition Test Bank Questions

Question 1 of 5

A 26-year-old violinist comes to your clinic, complaining of anxiety. He is a first chair violinist in the local symphony orchestra and has started having symptoms during performances, such as sweating, shaking, and hyperventilating. It has gotten so bad that he has thought about giving up his first chair status so he does not have to play the solo during one of the movements. He says that he never has these symptoms during rehearsals or when he is practicing. He denies having any of these symptoms at any other time. His past medical history is unremarkable. He denies any tobacco use, drug use, or alcohol abuse. His parents are both healthy. On examination you see a young man who appears worried. His vital signs and physical examination are unremarkable. What type of anxiety disorder best describes his situation?

Correct Answer: C

Rationale: The young violinist is experiencing symptoms of anxiety specifically related to performing in front of others, which is characteristic of social phobia (also known as social anxiety disorder). The symptoms occur only during performances, indicating the anxiety is triggered by social situations where he is the center of attention. His ability to perform without symptoms during rehearsals or practice sessions further supports the diagnosis of social phobia, as the anxiety is specifically related to public performance. In contrast, panic disorder is characterized by recurrent, unexpected panic attacks that are not situation-specific, and specific phobia involves an intense fear of a specific object or situation, neither of which fully match this patient's presentation. Generalized anxiety disorder involves excessive worry and anxiety about various aspects of life, which is not the main feature of this case.

Question 2 of 5

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 3 of 5

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 5

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 5 of 5

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.

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