Physical Assessment Nursing Practice Questions

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: B

Rationale: The description provided, "It is accompanied by nausea and vomiting. It is located in the mid-epigastric area," indicates the current symptoms and location of the discomfort the patient is experiencing. This information is typically included in the Present Illness section of a medical history, which focuses on the patient's current health concerns, symptoms, and complaints. It helps the healthcare provider understand the nature of the problem and guide further evaluation and treatment. The Chief Complaint is usually a concise statement of the patient's main reason for seeking medical attention, the Personal and Social History includes information about the patient's lifestyle habits and social support, and the Review of Systems is a systematic inquiry about the patient's overall health.

Correct Answer: B

Rationale: The history and physical examination findings in this case are most consistent with acute epididymitis. Acute epididymitis is characterized by inflammation and infection of the epididymis, which is a tubular structure located behind the testicle that stores and carries sperm. Common symptoms of acute epididymitis include pain and swelling in the scrotum, testicular pain, pain with urination, and sometimes penile discharge. The patient's symptoms of testicular and penile pain, as well as pain with urination, are classic for epididymitis. The severe tenderness at the superior pole of the left testicle and tenderness on palpation of structures superior to the testicle through the scrotal wall further support this diagnosis. In addition, the presence of white blood cells and bacteria on urine analysis is consistent with an infectious process like epididymitis.

Correct Answer: D

Rationale: In a patient with emphysema, lung hyperinflation can make it difficult to hear heart sounds anteriorly. Listening posteriorly, especially between the scapulae, can often provide a clearer auscultation of the heart sounds due to reduced interference from lung sounds. The posterior approach can also help avoid any abdominal sounds that might obscure the cardiac sounds when auscultating in the epigastrium. It is important to make sure the patient is in a comfortable position for better examination, and in this case, listening posteriorly would be the best choice for assessing heart sounds in a patient with emphysema in exacerbation.

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.