Physical Assessment Nursing Practice Questions

Correct Answer: D

Rationale: In this patient with bilateral back pain that awakens him at night, the most reassuring finding is that the pain is bilateral. Bilateral symptoms are less likely to be associated with red flags such as malignancy or infection compared to unilateral symptoms. While back pain in individuals over the age of 50, pain at night, and pain lasting more than 1 month are concerning features, the fact that the pain in this patient is bilateral provides some reassurance. However, further evaluation is still warranted to determine the exact cause of the pain and appropriate management.

Correct Answer: D

Rationale: In a patient with emphysema, lung hyperinflation can make it difficult to hear heart sounds anteriorly. Listening posteriorly, especially between the scapulae, can often provide a clearer auscultation of the heart sounds due to reduced interference from lung sounds. The posterior approach can also help avoid any abdominal sounds that might obscure the cardiac sounds when auscultating in the epigastrium. It is important to make sure the patient is in a comfortable position for better examination, and in this case, listening posteriorly would be the best choice for assessing heart sounds in a patient with emphysema in exacerbation.

Correct Answer: B

Rationale: The description provided by Alexandra includes information about the location (right upper quadrant), intensity (3 to 8 on a scale), duration (2 to 3 hours), periodicity (coming and going, worse after eating), exacerbating factors (greasy foods), frequency (initially once a week, now every other day), and aggravating factors (nothing makes it better). However, there is no mention of any associated manifestations such as nausea, vomiting, fever, or other symptoms that may be occurring alongside the abdominal pain. Associated manifestations are important for a comprehensive assessment and differential diagnosis of the symptom.

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.

Correct Answer: D

Rationale: Option D, "Psychosocial reasons may cause this condition," is true. Vaginismus is a condition characterized by involuntary contractions of the muscles around the vaginal entrance, which can make sexual intercourse painful, difficult, or impossible. In many cases, this condition is linked with psychological factors such as anxiety, fear, past trauma, or relationship issues. These psychological factors can lead to the muscles tightening up in anticipation of pain or discomfort during intercourse, hence causing vaginismus. With appropriate psychological interventions like counseling, therapy, or relaxation techniques, individuals experiencing vaginismus can often overcome the condition and engage in pain-free intercourse.