Physical Assessment Nursing Practice Questions

Questions 28

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Physical Assessment Nursing Practice Questions Questions

Question 1 of 5

A 55-year-old bank teller comes to your office for persistent episodes of dizziness. The first episode started suddenly and lasted 3 to 4 hours. He experienced a lot of nausea with vomiting; the episode resolved spontaneously. He has had five episodes in the past 1½ weeks. He does note some tinnitus that comes and goes. Upon physical examination, you note that he has a normal gait. The Weber localizes to the right side and the air conduction is equal to the bone conduction in the right ear. Nystagmus is present. Based on this description, what is the most likely diagnosis?

Correct Answer: C

Rationale: The clinical presentation described in the case, including recurrent episodes of dizziness, nausea with vomiting, tinnitus, nystagmus, and normal gait, is suggestive of Meni�re's disease. Meni�re's disease is a disorder of the inner ear characterized by episodes of vertigo, fluctuating hearing loss, tinnitus, and aural fullness. The presence of tinnitus, episodic vertigo lasting for several hours, and nystagmus are key features that point towards Meni�re's disease. The Weber test result (localization to the right ear) can also be seen in Meni�re's disease due to sensorineural hearing loss in the affected ear. This set of symptoms and findings is more consistent with Meni�re's disease than the other options provided. Benign paroxysmal positional vertigo (BPPV) typically presents with brief episodes of vertigo triggered by changes in

Question 2 of 5

A 27-year-old policewoman comes to your clinic, complaining of severe left-sided back pain radiating down into her groin. It began in the middle of the night and woke her up suddenly. It hurts in her bladder to urinate but she has no burning on the outside. She has had no frequency or urgency with urination but she has seen blood in her urine. She has had nausea with the pain but no vomiting or fever. She denies any other recent illness or injuries. Her past medical history is unremarkable. She denies tobacco or drug use and drinks alcohol rarely. Her mother has high blood pressure and her father is healthy. On examination she looks her stated age and is in obvious pain. She is lying on her left side trying to remain very still. Her cardiac, pulmonary, and abdominal examinations are unremarkable. She has tenderness just inferior to the left costovertebral angle. Her urine pregnancy test is negative and her urine analysis shows red blood cells. What type of urinary tract pain is she most likely to have?

Correct Answer: B

Rationale: The policewoman's presentation of severe left-sided back pain radiating down into her groin, associated with nausea, blood in urine, and tenderness just inferior to the left costovertebral angle is highly suggestive of a kidney stone causing ureteral colic. Kidney stones are solid masses made of crystals that form in the kidneys and can cause sudden severe pain as they move through the urinary tract, leading to blockage and subsequent stretching of the ureter (the tube connecting the kidney to the bladder), resulting in pain that radiates from the flank down to the groin region. The presence of blood in the urine (hematuria) is a common finding with kidney stones due to irritation and damage to the ureteral lining as the stone passes. The negative urine pregnancy test rules out pregnancy-related causes of urinary symptoms. Musculoskeletal pain is less likely given the location and character of the pain

Question 3 of 5

You are beginning the examination of a patient. All of the following areas are important to observe as part of the General Survey except:

Correct Answer: D

Rationale: Blood pressure is not typically included in the initial assessment during the General Survey. The General Survey primarily focuses on obtaining an overall impression of the patient's health status and any noticeable cues such as level of consciousness, signs of distress, and appearance including dress, grooming, and personal hygiene. While blood pressure is an important vital sign to assess during a comprehensive examination, it is usually measured later in the assessment process and not part of the initial general observation.

Question 4 of 5

Dakota is a 14-year-old boy who just noticed a rash at his ankles. There is no history of exposure to ill people or other agents in the environment. He has a slight fever in the office. The rash consists of small, bright red marks. When they are pressed, the red color remains. What should you do?

Correct Answer: B

Rationale: Dakota's presentation of a rash with small, bright red marks that do not fade when pressed (non-blanching) along with a slight fever raises concern for a serious condition such as meningococcal infection. Non-blanching rashes, especially when associated with fever, can be a sign of meningococcal sepsis, a life-threatening condition that requires urgent medical attention. Admission to the hospital is warranted for close monitoring, further evaluation, and initiation of appropriate treatment if needed. It is important to err on the side of caution in such cases to ensure the best possible outcome for the patient.

Question 5 of 5

A 47-year-old contractor presents for evaluation of neck pain, which has been intermittent for several years. He normally takes over-the-counter medications to ease the pain, but this time they haven't worked as well, and he still has discomfort. He recently wallpapered the entire second floor in his house, which caused him great discomfort. The pain resolved with rest. He denies fever, chills, rash, upper respiratory symptoms, trauma, or injury to the neck. Based on this description, what is the most likely pathologic process?

Correct Answer: C

Rationale: The most likely pathologic process in this scenario is degenerative. The history provided includes chronic intermittent neck pain that worsened after a specific activity (wallpapering) but resolved with rest. The patient's age (47 years old) is also suggestive of degenerative changes in the spine. Additionally, the use of over-the-counter medications to manage the pain points towards a chronic condition such as degenerative changes in the cervical spine, possibly cervical spondylosis or osteoarthritis. There is no mention of any infectious symptoms, trauma, or neoplastic features in the presentation.

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