NCLEX Practice Questions Physical Assessment

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: D

Rationale: It is important to maintain a calm demeanor when walking into the examination room to speak with your first clinic patient, especially in a busy and high-pressure situation. Demonstrating calmness will help to build rapport with the patient, create a sense of trust, and promote effective communication. This demeanor will also convey professionalism and confidence, which are essential qualities for a healthcare provider. Displaying irritability, impatience, or boredom can negatively impact the patient-provider relationship and hinder effective communication, potentially compromising the quality of care provided.

Correct Answer: D

Rationale: The most important question to ask in this scenario would be if the patient has tried to lose weight. Given the patient's significant unintentional weight loss (from 140 to 110 pounds in a year), especially in the context of a chronic cough and a long history of smoking, lung cancer becomes a top concern. Unintentional weight loss is a common symptom seen in patients with lung cancer. Therefore, understanding if the weight loss was intentional or unintentional can provide crucial information in the diagnostic evaluation for possible lung cancer.

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.

Correct Answer: A

Rationale: Mr. Patel's case involves an enlarged liver, which warrants further investigation to determine the underlying cause. An ultrasound of the liver would provide valuable information regarding the size, shape, and texture of the liver, helping to identify any potential abnormalities such as liver cirrhosis, fatty liver disease, or liver tumors. This imaging study can also help differentiate between different conditions that may be causing the liver enlargement, guiding subsequent diagnostic and treatment decisions. Therefore, obtaining an ultrasound of the liver is the most appropriate next step in evaluating Mr. Patel's condition.