Physical Assessment NCLEX Practice Questions

Correct Answer: C

Rationale: A dissecting aortic aneurysm is the most likely disorder that best describes the symptoms presented. In this condition, the inner layer of the aorta tears and blood can flow between the layers of the aortic wall, causing a number of potential symptoms. A patient with a dissecting aortic aneurysm may present with a difference in pulses between the right and left sides due to decreased blood flow to one side. The bounding pulse on one side and weak pulse on the other are indicative of uneven blood flow distribution. Additionally, a dissecting aortic aneurysm can lead to respiratory symptoms such as increased respiratory rate if there is associated pain or discomfort, although clear lung sounds would not typically be expected with this condition. The condition is a life-threatening emergency that requires immediate evaluation and treatment.

Correct Answer: D

Rationale: In this situation, it is important to prioritize active listening over taking detailed notes. By pushing away from the keyboard or putting down your pen, you are signaling to the patient that you are fully present and engaged in listening to their story. This will help foster trust and encourage the patient to continue sharing their personal history. Taking notes can be done later, but the immediate focus should be on providing a supportive and attentive environment for the patient to share their experiences.

Correct Answer: A

Rationale: The patient's presentation of sudden-onset spinning sensation triggered by head position changes, accompanied by nausea and vomiting without tinnitus, is characteristic of benign positional vertigo (BPV). BPV is caused by displaced otoconia (calcium crystals) within the semicircular canals of the inner ear. These crystals disrupt the normal flow of fluid in the inner ear, leading to false signals being sent to the brain about head movement. This results in brief episodes of vertigo triggered by specific head positions.

Correct Answer: C

Rationale: The described clinical presentation is consistent with internal hemorrhoids. The typical symptoms of internal hemorrhoids include painless rectal bleeding, protrusion from the anus during straining, and a feeling of incomplete evacuation. In this case, the protrusion is observed to be red, moist, and enlarges with bearing down, all indicative of internal hemorrhoids. The enlarged tender area felt on digital rectal examination supports the diagnosis. Additionally, the presence of blood on the glove after the examination is also suggestive of internal hemorrhoids causing bleeding. Anal fissures typically present with sharp pain during defecation and may have visible tears in the anal mucosa. External hemorrhoids are usually more painful and can be felt as a lump around the anus. Anorectal fistulas have different signs and symptoms, including discharge of pus and recurrent infections.

Correct Answer: C

Rationale: Lateral epicondylitis, commonly known as tennis elbow, is a condition characterized by pain and tenderness on the lateral (outside) aspect of the elbow. It is typically caused by overuse or repetitive strain of the extensor muscles in the forearm, leading to inflammation of the tendons attached to the lateral epicondyle of the humerus.