ATI RN
Physical Examination and Health Assessment 8th Edition Test Bank Questions
Question 1 of 5
You notice a patient has a strong pulse and then a weak pulse. This pattern continues. Which of the following is likely?
Correct Answer: D
Rationale: The scenario described with a strong pulse followed by a weak pulse is characteristic of pulsus paradoxus, a finding often associated with cardiac tamponade. Cardiac tamponade is a medical emergency where there is an accumulation of fluid (such as blood) in the pericardial sac that exerts pressure on the heart, limiting its ability to pump effectively. As a result, patients may exhibit this pulsus paradoxus, where the pulse strength varies with respiration. The other conditions listed (emphysema, asthma exacerbation, severe left heart failure) are not typically associated with this specific pulsatile pattern.
Question 2 of 5
A 24-year-old secretary comes to your clinic, complaining of difficulty sleeping, severe nightmares, and irritability. She states it all began 6 months ago when she went to a fast food restaurant at midnight. While she was waiting in her car a man entered through the passenger door and put a gun to her head. He had her drive to a remote area, where he took her money and threatened to kill her. When the gun jammed he panicked and ran off. Ever since this occurred the patient has been having these symptoms. She states she jumps at every noise and refuses to drive at night. She states her anxiety has had such a marked influence on her job performance she is afraid she will be fired. She denies any recent illnesses or injuries. Her past medical history is unremarkable. On examination you find a nervous woman appearing her stated age. Her physical examination is unremarkable. You recommend medication and counseling. What anxiety disorder to you think this young woman has?
Correct Answer: C
Rationale: The young woman in this scenario is experiencing symptoms consistent with post-traumatic stress disorder (PTSD). PTSD is an anxiety disorder that can develop after a person is exposed to a traumatic event, such as a life-threatening situation like a robbery with a gun involved. The symptoms she is experiencing, including difficulty sleeping, severe nightmares, irritability, hypervigilance, and avoidance of triggers such as driving at night, are all classic features of PTSD. These symptoms have persisted for at least 6 months since the traumatic event occurred, which is a key criterion for making a diagnosis of PTSD. Treatment for PTSD typically involves a combination of medication and therapy to help the individual process and cope with the traumatic experience.
Question 3 of 5
A 25-year-old type 1 diabetic clerk presents to the emergency room with shortness of breath and states that his blood sugar was 605 at home. You diagnose the patient with diabetic ketoacidosis. What is the expected pattern of breathing?
Correct Answer: C
Rationale: In diabetic ketoacidosis (DKA), the body is in a state of metabolic acidosis due to the accumulation of ketones in the blood. One of the compensatory mechanisms to decrease the acidity in the body is increased breathing, known as Kussmaul breathing. This type of breathing is characterized by a rapid and deep pattern to blow off excess carbon dioxide and decrease the acidity of the blood. Therefore, in a patient with DKA, you would expect to observe rapid and deep breathing.
Question 4 of 5
His cardiac, lung, and abdominal examinations are normal. He is wearing a sling on his left arm. On observation of his anus you find a swollen bluish ovoid mass that appears to contain a blood clot. Digital rectal examination is extremely painful for the patient. No other mass is palpated within the anus or rectum. What disorder of the anus is this patient likely to have?
Correct Answer: B
Rationale: The patient described is most likely suffering from an external hemorrhoid. External hemorrhoids are swollen veins located near the opening of the anus, often resulting from increased pressure in the rectal area. The presence of a swollen bluish ovoid mass containing a blood clot is characteristic of an external hemorrhoid. The pain experienced during digital rectal examination further supports this diagnosis, as external hemorrhoids are typically painful when touched. In this case, there are no palpable masses within the anus or rectum, ruling out anorectal cancer or internal hemorrhoids. Anal fissures are small tears in the lining of the anus, which would present differently from the described swollen mass with a blood clot.
Question 5 of 5
You are performing a thorough cardiac examination. Which of the following chambers of the heart can you assess by palpation?
Correct Answer: C
Rationale: The right ventricle is the only chamber of the heart that can be assessed by palpation during a cardiac examination. The right ventricle is located close to the sternum on the anterior chest wall, making it accessible for palpation. By palpating the area near the lower left sternal border, just beside the sternum, a healthcare provider can assess the size and function of the right ventricle. It is important to note that the other chambers of the heart (left atrium and right atrium) are not typically assessed by palpation due to their deeper location within the chest cavity. The sinus node, which is responsible for generating the heart's electrical impulses, is also not directly palpable during a cardiac examination.
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