NCLEX Practice Questions Physical Assessment

Correct Answer: A

Rationale: Scotomas refer to areas of partial alteration in the field of vision. These blind spots can be caused by various eye conditions such as glaucoma, retinal detachment, or optic nerve damage. Symptoms involving the eye like scotomas are important to recognize and address promptly to prevent potential vision loss or other complications. Tinnitus (choice B) refers to ringing in the ears, dysphagia (choice C) refers to difficulty swallowing, and rhinorrhea (choice D) refers to a runny nose, none of which are symptoms involving the eye.

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

Correct Answer: C

Rationale: Diplopia occurring when one eye is covered is a condition known as monocular diplopia. This symptom is typically not caused by problems within the eye itself, such as irregularities in the cornea or lens. Instead, monocular diplopia with one eye covered is more likely to be an indication of a neurological issue, often involving the brainstem. Lesions or damage in the brainstem can disrupt the normal coordination of eye movements, leading to the perception of double vision when one eye is closed. Weakness of CN III (oculomotor nerve) or CN IV (trochlear nerve) may cause diplopia when both eyes are open, but it would not typically manifest as monocular diplopia.

Correct Answer: B

Rationale: When conducting a health history assessment, the components typically include the review of systems, present illness, and personal and social items. The review of systems involves asking specific questions related to each system of the body to gather comprehensive information about the patient's overall health. Present illness focuses on the current chief complaint and symptoms the patient is experiencing. Personal and social items encompass details such as lifestyle habits, family history, medical history, and social support systems. The thorax and lungs are typically assessed as part of the physical examination, not specifically in the health history documentation.

Correct Answer: A

Rationale: The most likely diagnosis for this patient's symptoms and signs is acute diverticulitis. His presentation of abdominal pain, constipation, and low-grade fever, along with tenderness over the left lower quadrant, is consistent with diverticulitis, which is inflammation or infection of small pouches (diverticula) that can develop in the colon. The history of recent onset of symptoms after consuming popcorn, typically a high-fiber food that can exacerbate diverticulitis, further supports this diagnosis. The negative fecal occult blood test makes more acute intra-abdominal processes like acute appendicitis less likely. Acute cholecystitis would present with right upper quadrant pain, and mesenteric ischemia typically presents with severe abdominal pain, nausea, and vomiting, as well as signs of abdominal distress.