Physical Assessment Nursing Practice Questions

Correct Answer: C

Rationale: When the uvula deviates to one side upon touching the soft palate, it indicates a dysfunction of the vagus nerve (CN X) on the side toward which the uvula deviates. In this case, the uvula deviates to the left, suggesting a lesion affecting the left CN X. This is because the palate and uvula are innervated by the vagus nerve (cranial nerve X), and damage to this nerve may result in an asymmetric elevation or deviation of the uvula upon stimulation. Therefore, a CN X lesion on the left side is the most likely explanation for the observed deviation of the uvula in this scenario.

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.

Correct Answer: B

Rationale: The description of the rash on Mr. Garcia's chest associated with a burning pain that worsens with light touch indicates neuropathic pain. Neuropathic pain arises from damage or dysfunction of the nervous system, leading to abnormal pain sensations such as burning, tingling, or shooting pain. In this case, the presence of small blisters (vesicles) on reddened skin overlying an entire rib on one side suggests involvement of nerve fibers, characteristic of neuropathic pain. It is important to differentiate neuropathic pain from other types of pain (such as nociceptive/somatic, idiopathic, or psychogenic) as management strategies differ based on the underlying mechanisms of pain perception.

Correct Answer: D

Rationale: Inguinal hernias are common types of hernias that occur in the groin area. When a person strains, the hernia may become more noticeable as the abdominal contents push through a weak spot in the abdominal wall. The absence of symmetry of the inguinal areas with straining indicates that there is a hernia present, as the bulge or protrusion in the groin area becomes more prominent with straining. This makes a hernia more likely in this case. Therefore, option D is the correct choice in this scenario. The other options do not directly point to the presence of a hernia.

Correct Answer: C

Rationale: The best course of action would be to put her socks back on and cover her completely before beginning the evaluation. It is important to prioritize the patient's dignity and comfort by ensuring they are appropriately covered. This also helps in maintaining the patient's sense of privacy during the examination, especially considering the sensitive nature of the situation with the elderly woman having a stroke and aphasia. By taking the time to properly dress and cover the patient before conducting the examination, you are showing respect and compassion for the patient's well-being.