NCLEX Practice Questions Physical Assessment

Correct Answer: C

Rationale: Given the patient's presentation of itching, anorectal pain, and tenesmus, along with rectal examination findings of generalized tenderness without prostate abnormalities, proctitis is the most likely diagnosis. Proctitis is inflammation of the rectal lining and is commonly associated with symptoms such as rectal pain, itching, tenesmus (feeling of incomplete defecation), and sometimes rectal bleeding. It can have various causes, including sexually transmitted infections (such as gonorrhea, chlamydia), inflammatory bowel disease, radiation therapy, or trauma.

Correct Answer: A

Rationale: The most likely diagnosis for this patient's symptoms and signs is acute diverticulitis. His presentation of abdominal pain, constipation, and low-grade fever, along with tenderness over the left lower quadrant, is consistent with diverticulitis, which is inflammation or infection of small pouches (diverticula) that can develop in the colon. The history of recent onset of symptoms after consuming popcorn, typically a high-fiber food that can exacerbate diverticulitis, further supports this diagnosis. The negative fecal occult blood test makes more acute intra-abdominal processes like acute appendicitis less likely. Acute cholecystitis would present with right upper quadrant pain, and mesenteric ischemia typically presents with severe abdominal pain, nausea, and vomiting, as well as signs of abdominal distress.

Correct Answer: B

Rationale: When conducting a health history assessment, the components typically include the review of systems, present illness, and personal and social items. The review of systems involves asking specific questions related to each system of the body to gather comprehensive information about the patient's overall health. Present illness focuses on the current chief complaint and symptoms the patient is experiencing. Personal and social items encompass details such as lifestyle habits, family history, medical history, and social support systems. The thorax and lungs are typically assessed as part of the physical examination, not specifically in the health history documentation.

Correct Answer: C

Rationale: It is important to show empathy and address Mrs. Donelan's feelings about missing her husband. By asking why Bill is not there, you are opening the door for her to talk about her emotions and potentially offer support or resources. This can help build a stronger patient-provider relationship and address any underlying emotional concerns she may have. It is important to prioritize the patient's emotional well-being along with their physical health during the visit.

Correct Answer: D

Rationale: It is crucial to assess Adam's suicide risk immediately due to the statements he made about it being better if he were not here. This indicates possible suicidal ideation, which requires urgent attention and intervention. Asking directly about suicidal thoughts and intentions can help determine the level of risk and ensure that appropriate support and resources are provided to Adam. It is important to take any mention of suicide seriously and prioritize the safety and well-being of the individual in such situations.