health assessment practice questions

Questions 45

ATI RN

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health assessment practice questions Questions

Question 1 of 5

A 92-year-old patient has had a stroke, and the right side of his face is drooping. What else would the nurse suspect?

Correct Answer: C

Rationale: The correct answer is C: Dysphagia. In a stroke patient with right-sided facial drooping, dysphagia is highly likely due to the involvement of the facial nerve, leading to difficulty swallowing. Epistaxis (A) is nosebleeds, agenesis (B) is the absence of a body part, and xerostomia (D) is dry mouth, which are not directly related to facial drooping in stroke patients. Dysphagia is a common complication post-stroke due to impaired muscle control, making it the most likely concern for the nurse to suspect in this case.

Question 2 of 5

A 31-year-old patient tells the nurse that he is experiencing a progressive loss of hearing. He says that it does seem to help when people speak more loudly or if he turns up the volume. The most likely cause of his hearing loss is:

Correct Answer: A

Rationale: The correct answer is A: otosclerosis. Otosclerosis is a condition where abnormal bone growth in the middle ear causes hearing loss. In this case, the patient's symptoms of progressive hearing loss improving with louder sounds suggest conductive hearing loss, which is commonly seen in otosclerosis. Other choices are incorrect because presbycusis is age-related hearing loss, trauma to the bones would typically result in sudden hearing loss, and frequent ear infections are more likely to cause temporary hearing loss rather than progressive loss.

Question 3 of 5

In a patient with anisocoria, the nurse would expect to observe:

Correct Answer: C

Rationale: Step-by-step rationale: 1. Anisocoria is a condition where pupils are of unequal size. 2. It is typically caused by issues in the eye muscles or nerves controlling pupil size. 3. The nurse would expect to observe pupils of different sizes. 4. Dilated pupils (choice A) and excessive tearing (choice B) are not indicative of anisocoria. 5. An uneven curvature of the lens (choice D) does not directly relate to pupil size differences. Summary: Correct answer C is supported by the definition of anisocoria and its usual presentation. Choices A, B, and D are incorrect as they do not align with the characteristic feature of anisocoria.

Question 4 of 5

A mother who has brought her newborn infant for assessment tells the nurse that she has noticed that whenever her newborn's head is turned to the right side, the baby straightens out the arm and leg on the same side and flexes the opposite arm and leg. After confirming this on examination, the nurse would tell the mother that this is:

Correct Answer: C

Rationale: Step 1: The described behavior is known as the asymmetric tonic neck reflex (ATNR), a normal infantile reflex. Step 2: The ATNR typically emerges around birth and should disappear between 3 and 4 months of age. Step 3: The reflex helps with hand-eye coordination and development of body awareness. Step 4: Choice A is incorrect as the behavior is not abnormal or related to atonic neck reflex. Step 5: Choice B is incorrect as the reflex typically disappears by 3-4 months, not by the first year of life. Step 6: Choice D is incorrect as it describes a different pattern of movement than what is observed in the ATNR. Summary: The correct answer is C because the behavior described is a normal infantile reflex that typically disappears between 3-4 months of age, aiding in the baby's development.

Question 5 of 5

When examining the face, the nurse is aware that the two pairs of salivary glands that are accessible to examination are the _____ glands.

Correct Answer: C

Rationale: The correct answer is C, parotid and submandibular glands. The parotid and submandibular glands are the two pairs of salivary glands that are accessible for examination in the face. The parotid gland is located near the ear, while the submandibular gland is located under the jaw. The other choices are incorrect because: A: Occipital and submental glands are not salivary glands accessible for examination in the face. B: Parotid gland is correct, but jugulodigastric gland is not a salivary gland. D: Submandibular gland is correct, but occipital gland is not a salivary gland.

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