Physical Assessment Nursing Practice Questions

Correct Answer: D

Rationale: Perseveration is a speech pattern characterized by repeating a particular word, phrase, or topic excessively, even when it is no longer relevant to the conversation. In this scenario, the patient's repetitive use of the word "largely" to the point of distraction is indicative of perseveration. This can be a symptom of various neurological or psychiatric conditions, highlighting the importance of recognizing and addressing this speech pattern during the patient interview.

Correct Answer: B

Rationale: The description of the rash on Mr. Garcia's chest associated with a burning pain that worsens with light touch indicates neuropathic pain. Neuropathic pain arises from damage or dysfunction of the nervous system, leading to abnormal pain sensations such as burning, tingling, or shooting pain. In this case, the presence of small blisters (vesicles) on reddened skin overlying an entire rib on one side suggests involvement of nerve fibers, characteristic of neuropathic pain. It is important to differentiate neuropathic pain from other types of pain (such as nociceptive/somatic, idiopathic, or psychogenic) as management strategies differ based on the underlying mechanisms of pain perception.

Correct Answer: A

Rationale: The findings described in the scenario point towards rectal prolapse. Rectal prolapse, also known as procidentia or rectal procidentia, is the full-thickness protrusion of the rectal wall through the anus. The characteristic presentation often includes the protrusion of a rosette of red mucosa from the anus when the patient bears down. This is consistent with the visual assessment mentioned in the scenario.

Correct Answer: B

Rationale: The description provided by Alexandra includes information about the location (right upper quadrant), intensity (3 to 8 on a scale), duration (2 to 3 hours), periodicity (coming and going, worse after eating), exacerbating factors (greasy foods), frequency (initially once a week, now every other day), and aggravating factors (nothing makes it better). However, there is no mention of any associated manifestations such as nausea, vomiting, fever, or other symptoms that may be occurring alongside the abdominal pain. Associated manifestations are important for a comprehensive assessment and differential diagnosis of the symptom.

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.