Physical Assessment NCLEX Practice Questions

Correct Answer: B

Rationale: Peripheral arterial disease (PAD) is considered a coronary heart disease risk equivalent, meaning it confers a similar risk as having a history of coronary heart disease itself. Individuals with PAD have a significantly increased risk of cardiovascular events such as heart attack and stroke. Therefore, when assessing the 10-year coronary heart disease risk of the 40-year-old banker, having peripheral arterial disease would be a crucial factor to consider in addition to other risk factors like hypertension, exercise habits, and smoking history.

Correct Answer: B

Rationale: The information provided about Mr. M's shortness of breath being present for the past 10 days, worsening with activity, and relieved by rest are all objective findings. These are measurable and observable facts that can be documented by healthcare professionals through physical examination, assessment, and potentially diagnostic tests. Subjective information would involve Mr. M's personal feelings or descriptions of his symptoms, which are not included in the given information.

Correct Answer: B

Rationale: Jugular venous pressure (JVP) is measured as the vertical height of the blood column in centimeters above the sternal angle (Angle of Louis). To measure the JVP accurately, the patient should be positioned at a 30-45 degree angle (not 45-degree angle as in choice A). The value obtained by measuring the JVP in centimeters is then added to 5 cm, which represents the distance from the sternal angle to the right atrium. Therefore, the formula for calculating JVP is the vertical height of the blood column in cm + 5 cm. A JVP below 9 cm (not 9 cm or choice C) is generally considered normal, while a JVP above that level is considered elevated. It is important to measure the JVP correctly and interpret the findings in the context of the patient's

Correct Answer: C

Rationale: Beau's lines are transverse grooves or depressions in the nails that occur from a temporary disruption in nail growth. These lines can be caused by a variety of factors, including systemic diseases, medication use, trauma, or environmental stressors. However, one of the most common causes of Beau's lines is a significant physiological stress such as a severe illness or major surgery that occurred about 3 months prior to the appearance of the lines. Therefore, looking for information from family and records regarding any problems that occurred around 3 months ago is the most appropriate next step to understand the underlying cause of Beau's lines in this unconscious patient. This information can provide crucial insights into the patient's medical history and potential underlying health issues that may need to be addressed.

Correct Answer: C

Rationale: The characteristics described - being louder and higher in pitch, with a short silence between inspiration and expiration, and expiration being longer than inspiration - are indicative of the bronchial lung sound. The bronchial sound is typically heard over the trachea area and can be louder and higher-pitched than other lung sounds due to conduction of sounds through the bronchial tree. The short silence between inspiration and expiration is due to the short expiratory phase during which air rushes out quickly, whereas expiration is longer than inspiration in this sound due to the increased airflow velocity during expiration.