NCLEX Practice Questions Physical Assessment

Correct Answer: A

Rationale: Otosclerosis is a condition characterized by abnormal bone growth in the middle ear, specifically around the stapes bone. In cases of otosclerosis, the bone conduction is greater than air conduction on the affected side, which is seen in the scenario described. The Weber test localizes to the affected ear, meaning the patient hears the sound of the tuning fork better in the left ear in this case. This is because the abnormal bone growth can restrict the movement of the ossicles, leading to a conductive hearing loss. Otosclerosis typically affects one ear, and its presentation aligns with the results of the hearing tests performed in this case.

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.

Correct Answer: D

Rationale: The symptoms described in the scenario point towards pleural pain. The examination findings of normal breath sounds, no abnormalities with percussion and palpation of the chest, and a normal heart sound (S1 and S2) suggest that the issue is more likely related to the pleura rather than the heart or major blood vessels. Pleural pain is typically sharp and worsens with deep breathing or coughing. This differs from angina pectoris, which is chest pain caused by reduced blood flow to the heart muscles due to coronary artery disease. Pericarditis involves inflammation of the pericardium, the membrane surrounding the heart, and usually presents with chest pain that is relieved by sitting up and leaning forward. Dissecting aortic aneurysm is a life-threatening condition characterized by severe, tearing chest pain that can radiate to the back. In this case, the lack of significant abnormalities on cardiac and vascular examination points towards ple

Correct Answer: C

Rationale: The pectoral lymph node group, also known as the Level III lymph nodes, is the most commonly involved in breast cancer metastasis. These lymph nodes are located along the lower border of the pectoralis minor muscle and are an important regional drainage site for breast tissue. Therefore, in cases of breast cancer, the pectoral lymph nodes are frequently affected due to their proximity to the breast tissue.