ATI RN
NCLEX Practice Questions Physical Assessment Questions
Question 1 of 5
How should you determine whether a murmur is systolic or diastolic?
Correct Answer: C
Rationale: To determine whether a murmur is systolic or diastolic, you should judge the relative length of systole and diastole by auscultation. Systolic murmurs occur during systole, which is the phase of the cardiac cycle when the heart is contracting and pushing blood out of the chambers. Diastolic murmurs occur during diastole, which is the phase when the heart is relaxing and filling with blood. By carefully listening to the timing of the murmur in relation to the cardiac cycle, you can determine if it is systolic or diastolic. Palpating the carotid pulse (Choice A) or radial pulse (Choice B) can help assess the pulse characteristics, but it does not directly determine whether a murmur is systolic or diastolic. Correlating the murmur with a bedside heart monitor (Choice D) may provide additional information about heart rate or rhythm, but it does not specifically indicate
Question 2 of 5
Which of the following would lead you to suspect a hydrocele versus other causes of scrotal swelling?
Correct Answer: C
Rationale: A positive transillumination test is a key finding that would lead you to suspect a hydrocele as the cause of scrotal swelling. In a hydrocele, the scrotal fluid transilluminates well, meaning that when a light is shone through the scrotum, it will appear as a fluid-filled sac with a clear glow. This is a characteristic feature of a hydrocele and helps differentiate it from other causes of scrotal swelling, such as hernias or testicular tumors. Presence of bowel sounds in the scrotum (Choice A) would be concerning for a hernia rather than a hydrocele. Being unable to palpate superior to the mass (Choice B) may suggest a large hydrocele but is not specific to diagnosing a hydrocele. The normal thickness of the skin of the scrotum (Choice D) can be found in various scrotal conditions and is not specific
Question 3 of 5
How should you determine whether a murmur is systolic or diastolic?
Correct Answer: C
Rationale: To determine whether a murmur is systolic or diastolic, you should judge the relative length of systole and diastole by auscultation. Systolic murmurs occur during systole, which is the phase of the cardiac cycle when the heart is contracting and pushing blood out of the chambers. Diastolic murmurs occur during diastole, which is the phase when the heart is relaxing and filling with blood. By carefully listening to the timing of the murmur in relation to the cardiac cycle, you can determine if it is systolic or diastolic. Palpating the carotid pulse (Choice A) or radial pulse (Choice B) can help assess the pulse characteristics, but it does not directly determine whether a murmur is systolic or diastolic. Correlating the murmur with a bedside heart monitor (Choice D) may provide additional information about heart rate or rhythm, but it does not specifically indicate
Question 4 of 5
A 26-year-old woman comes to your clinic, complaining of leakage of stool despite generally normal, pain-free bowel movements. She denies any blood in her stool or on the toilet paper. She has had no recent episodes of diarrhea. Her past medical history includes a spontaneous vaginal delivery 3 months ago. She had a fourth-degree tear of the perineal area (from the vagina through the rectum) that was surgically repaired after delivery. A few days later the patient developed an abscess in the anal area that had to be incised and drained. She denies using any tobacco, alcohol, or illegal drugs. Her mother and father are both in good health. She denies any weight gain, weight loss, fever, or night sweats. She is still breast-feeding without any problems. On examination you visualize a small opening anterior to the anus with some surrounding erythema. There is not a mass or other inflammation on inspection. Digital rectal examination reveals smooth rectal walls with no blood. She has no pain during the rectal examination. Bimanual vaginal examination is also normal. What anal or rectal disorder is the most likely cause of her symptom?
Correct Answer: D
Rationale: The most likely cause of the woman's symptom of stool leakage despite normal bowel movements is an anorectal fistula. An anorectal fistula is an abnormal, tunnel-like connection between the anal canal or rectum and the skin around the anus. In this case, the small opening anterior to the anus with surrounding erythema on examination suggests the presence of a fistula.
Question 5 of 5
Adam is a very successful 15-year-old student and athlete. His mother brings him in today because he no longer studies, works out, or sees his friends. This has gone on for a month and a half. When you speak with him alone in the room, he states it "would be better if he were not here." What would you do next?
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.
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