A young woman undergoes cranial nerve testing. On touching the soft palate, her uvula deviates to the left. Which of the following is likely?- Skildor

Question 1 of 5

A young woman undergoes cranial nerve testing. On touching the soft palate, her uvula deviates to the left. Which of the following is likely?

A. CN IX lesion on the left B. CN IX lesion on the right C. CN X lesion on the left D. CN X lesion on the right

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.

Question 2 of 5

A 22-year-old unemployed roofer presents to your clinic, complaining of pain in his testicle and penis. He states the pain began last night and has steadily become worse. He states it hurts when he urinates and he has not attempted intercourse since the pain began. He has tried Tylenol and ibuprofen without improvement. He denies any fever or night sweats. His past medical history is unremarkable. He has had four previous sexual partners and has had a new partner for the last month. She is on oral contraceptives so he has not used condoms. His parents are both in good health. On examination you see a young man lying on his side. He appears mildly ill. His temperature is 2 and his blood pressure, respirations, and pulse are normal. On visualization of the penis he is circumcised, with no lesions or discharge from the meatus. Visualization of the scrotal skin appears unremarkable. Palpation of the testes shows severe tenderness at the superior pole of the normal-sized left testicle. He also has tenderness when you palpate the structures superior to the testicle through the scrotal wall. The right testicle is unremarkable. An examining finger is placed through each inguinal ring without bulges being noted with bearing down. His prostate examination is unremarkable. Urine analysis shows white blood cells and bacteria. What diagnosis of the male genitalia is most likely in this case?

A. Acute orchitis B. Acute epididymitis C. Torsion of the spermatic cord D. Prostatitis

Correct Answer: B

Rationale: The history and physical examination findings in this case are most consistent with acute epididymitis. Acute epididymitis is characterized by inflammation and infection of the epididymis, which is a tubular structure located behind the testicle that stores and carries sperm. Common symptoms of acute epididymitis include pain and swelling in the scrotum, testicular pain, pain with urination, and sometimes penile discharge. The patient's symptoms of testicular and penile pain, as well as pain with urination, are classic for epididymitis. The severe tenderness at the superior pole of the left testicle and tenderness on palpation of structures superior to the testicle through the scrotal wall further support this diagnosis. In addition, the presence of white blood cells and bacteria on urine analysis is consistent with an infectious process like epididymitis.

Question 3 of 5

Francis is a middle-aged man who noted right-sided lower abdominal pain after straining with yard work. Which of the following would make a hernia more likely?

A. Absence of pain with straining B. Absence of bowel sounds in the scrotum C. Absence of a varicocele D. Absence of symmetry of the inguinal areas with straining

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.

Question 4 of 5

You are palpating the abdomen and feel a small mass. Which of the following would you do next?

A. Ultrasound B. Examination with the abdominal muscles tensed C. Surgery referral D. Determine size by percussion

Correct Answer: A

Rationale: When palpating the abdomen and feeling a small mass, the next step would be to perform an ultrasound. Ultrasound imaging is a non-invasive and reliable way to further evaluate the size, location, and characteristics of the mass. It can provide valuable information to determine the nature of the mass, such as whether it is a cyst, a solid mass, or another type of abnormality. This imaging modality can help guide further management and treatment decisions, such as determining if surgery is necessary or if further monitoring is required. Ultrasound is a safe and commonly used tool in assessing abdominal masses, making it an appropriate next step in this scenario.

Question 5 of 5

Asymmetric BPs are seen in which of the following conditions?

A. Coronary artery disease B. Congenital narrowing of the aorta C. Diffuse atherosclerosis D. Vasculitis, as seen in systemic lupus erythematosus

Correct Answer: B

Rationale: Asymmetric blood pressures (BPs) refer to a significant difference in blood pressures between the two arms. This is commonly seen in conditions like congenital narrowing of the aorta, also known as coarctation of the aorta. In this condition, there is a localized narrowing of the aorta, leading to higher blood pressure in the upper extremities compared to the lower extremities. This results in a significant asymmetry in blood pressure readings between the arms. It is crucial to identify this sign as it can have important diagnostic and treatment implications.

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Physical Assessment Nursing Practice Questions

Skildor

ATI RN