Physical Examination and Health Assessment 9th Edition Test Bank

Questions 27

ATI RN

ATI RN Test Bank

Physical Examination and Health Assessment 9th Edition Test Bank Questions

Question 1 of 5

Important techniques in performing the rectal examination include which of the following?

Correct Answer: D

Rationale: All of the mentioned techniques are important in performing a rectal examination.

Question 2 of 5

A 26-year-old violinist comes to your clinic, complaining of anxiety. He is a first chair violinist in the local symphony orchestra and has started having symptoms during performances, such as sweating, shaking, and hyperventilating. It has gotten so bad that he has thought about giving up his first chair status so he does not have to play the solo during one of the movements. He says that he never has these symptoms during rehearsals or when he is practicing. He denies having any of these symptoms at any other time. His past medical history is unremarkable. He denies any tobacco use, drug use, or alcohol abuse. His parents are both healthy. On examination you see a young man who appears worried. His vital signs and physical examination are unremarkable. What type of anxiety disorder best describes his situation?

Correct Answer: C

Rationale: The young violinist is experiencing symptoms of anxiety specifically related to performing in front of others, which is characteristic of social phobia (also known as social anxiety disorder). The symptoms occur only during performances, indicating the anxiety is triggered by social situations where he is the center of attention. His ability to perform without symptoms during rehearsals or practice sessions further supports the diagnosis of social phobia, as the anxiety is specifically related to public performance. In contrast, panic disorder is characterized by recurrent, unexpected panic attacks that are not situation-specific, and specific phobia involves an intense fear of a specific object or situation, neither of which fully match this patient's presentation. Generalized anxiety disorder involves excessive worry and anxiety about various aspects of life, which is not the main feature of this case.

Question 3 of 5

On visual confrontation testing, a stroke patient is unable to see your fingers on his entire right side with either eye covered. Which of the following terms would describe this finding?

Correct Answer: C

Rationale: A right homonymous hemianopsia refers to a visual field defect in which the patient is unable to see objects in the right half of the visual field in both eyes. In the case described, the stroke patient is unable to see your fingers on his entire right side with either eye covered, which is consistent with a right homonymous hemianopsia. This type of visual field defect typically occurs as a result of damage to the optic tract or optic radiation on one side of the brain, which affects the processing of visual information from the opposite visual field. It is important to note that bitemporal hemianopsia, right temporal hemianopsia, and binasal hemianopsia involve different patterns of visual field loss and are not fitting descriptions for the presented scenario.

Question 4 of 5

He works in a sales office to support his family. Recently he has injured his back and you are thinking he would benefit from physical therapy, three times a week, for an hour per session. What would be your next step?

Correct Answer: C

Rationale: The next step would be to discuss the physical therapy plan with Mr. Larson. It is important to communicate openly with him, explain the recommendation for physical therapy, and ensure that he understands and agrees with the plan before proceeding further. This allows for any questions or concerns to be addressed, and ensures that the treatment plan is tailored to his needs and preferences. By discussing the plan with Mr. Larson first, you can also provide him with the opportunity to ask any questions and actively involve him in his own care, which can lead to better compliance and outcomes.

Question 5 of 5

He is afebrile. His cardiac, lung, and abdominal examinations are normal. Visualization of the anus shows no erythema, masses, or inflammation. Digital rectal examination elicits an irregular, firm mass on the posterior side of the rectum. After you remove your finger you notice frank blood on your glove. What anal or rectal disorder is this patient most likely to have?

Correct Answer: D

Rationale: The patient in this scenario presents with symptoms suggestive of an anorectal disorder. The presence of an irregular, firm mass on the posterior side of the rectum, along with frank blood seen on the glove after a digital rectal examination, raises suspicion for an underlying anorectal cancer. Anorectal cancer can present with symptoms such as rectal bleeding, changes in bowel habits, palpable masses, and weight loss. In this case, the findings of an irregular mass and rectal bleeding are concerning for a malignant process such as anorectal cancer. Further evaluation with imaging studies and biopsy would be warranted for confirmation and to guide appropriate management.

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