ATI ASN Physical Assessment NSG1530 Foundational Physical Assessment Exam 2 .
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Free ATI ASN Physical Assessment NSG1530 Foundational Physical Assessment Exam 2 . Questions
A nurse is caring for a client who reports chronic pain but appears calm and does not request medication. Which factors may contribute to the client's underreporting of pain? (Select All that Apply.)
- Desire to receive stronger pain medication
- Belief that pain is a normal part of aging
- Preference for non-pharmacological pain relief
- Fear of becoming dependent on pain medication
- Cultural norms that discourage expression of pain
Explanation
Correct Answer: B) Belief that pain is a normal part of aging, C) Preference for non-pharmacological pain relief, D) Fear of becoming dependent on pain medication, E) Cultural norms that discourage expression of pain
Multiple factors can cause clients to underreport pain. Older adults commonly believe pain is an inevitable part of aging and therefore do not report it. Some clients prefer non-pharmacological methods such as heat, massage, or relaxation techniques and may not request medication as a result. Fear of opioid dependence or addiction is a well-documented barrier to adequate pain reporting and management. Cultural backgrounds that value stoicism or discourage verbal expression of pain significantly influence how clients communicate their pain experience.
The nurse is assessing the client's olfactory nerve (cranial nerve I). What action would the nurse take?
- Romberg's test
- Smelling test
- Visual acuity test
- Whisper test
Explanation
Correct Answer: B) Smelling test
Cranial Nerve I, the Olfactory nerve, is solely responsible for the sense of smell. To assess its function, the nurse asks the client to close their eyes and identify familiar scents such as coffee, vanilla, or cinnamon presented under each nostril separately. An inability to identify scents may indicate anosmia, which can result from nasal obstruction, head trauma, or neurological conditions. The Romberg test assesses balance and proprioception, visual acuity tests Cranial Nerve II, and the whisper test assesses hearing function related to Cranial Nerve VIII.
A nurse is assessing a client with painful, grouped vesicles on an erythematous base near their mouth. The client reports the lesions appeared after several days of stress. Which viral infection should the nurse suspect?
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Herpes zoster
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Warts (HPV)
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Herpes varicella
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Herpes simplex
Explanation
Correct Answer: D) Herpes simplex
Herpes simplex virus type 1 (HSV-1) classically presents as painful grouped vesicles on an erythematous base located around the mouth, commonly known as cold sores or fever blisters. A hallmark feature of HSV-1 is that the virus remains dormant in the trigeminal nerve ganglia and reactivates during periods of physical or emotional stress, illness, or sun exposure. Herpes zoster follows a dermatomal pattern on the trunk or face. Warts caused by HPV are painless raised lesions. Herpes varicella presents as widespread scattered lesions across the entire body and is not triggered by stress.
A nurse is assessing a client with an itchy, erythematous rash in skin folds of the abdomen. Which condition is most likely present?
- Contact dermatitis
- Psoriasis
- Eczema
- Candidiasis
Explanation
Correct Answer: D) Candidiasis
Candidiasis is a fungal infection caused by Candida albicans that thrives in warm, moist skin fold areas such as the abdomen, groin, and under the breasts. It characteristically presents as an itchy, erythematous rash specifically located in skin folds, making it the most likely diagnosis given this presentation.
A nurse is performing a physical assessment on a client and begins the eye assessment. Which of the following findings during the eye exam would require further follow-up?
- Loss of peripheral vision in the left eye
- Conjunctiva pink and moist
- Symmetrical corneal light reflex
- Pupils equal and reactive to light
Explanation
Correct Answer: A) Loss of peripheral vision in the left eye
Loss of peripheral vision is an abnormal finding that requires immediate further follow-up as it may indicate serious conditions such as glaucoma, retinal detachment, or a neurological lesion affecting the visual pathways. Pink and moist conjunctiva, symmetrical corneal light reflex, and pupils that are equal and reactive to light are all normal expected findings during an eye assessment and do not require further investigation.
When palpating a client's sinuses, the nurse notes tenderness over the maxillary area. Which condition does this most likely indicate?
- Otitis media
- Temporomandibular joint disorder
- Acute sinusitis
- Migraine headache
Explanation
Correct Answer: C) Acute sinusitis
The maxillary sinuses are located in the cheekbone area below the eyes. Tenderness upon palpation or percussion over the maxillary area is a classic clinical sign of acute sinusitis, indicating inflammation and fluid accumulation within the sinus cavity. Otitis media is an infection of the middle ear and does not cause sinus tenderness. Temporomandibular joint disorder causes pain near the jaw joint, not over the sinuses. Migraine headaches cause unilateral head pain but do not produce localized sinus tenderness on palpation.
A nurse is assessing a client who reports recurrent headaches. Which of the following are common characteristics of migraines? (Select All that Apply.)
- Aura, such as visual disturbances
- Nausea and vomiting
- Lasts up to 72 hours
- Sudden loss of consciousness
- Photophobia
Explanation
Correct Answer: A) Aura such as visual disturbances, B) Nausea and vomiting, C) Lasts up to 72 hours, E) Photophobia
Migraines are a complex neurological condition with well-established characteristics. An aura, which commonly presents as visual disturbances such as flashing lights or blind spots, occurs in approximately one-third of migraine sufferers before the headache begins. Nausea and vomiting are hallmark accompanying symptoms.
Migraines typically last between 4 to 72 hours if untreated. Photophobia, or sensitivity to light, along with phonophobia are classic features that distinguish migraines from other headache types. Sudden loss of consciousness is not a characteristic of migraines and would instead suggest a seizure or syncopal episode requiring urgent evaluation.
Which of the following client statements indicate the need for further assessment of mental health status? (Select All that Apply.)
-
"I've started having frequent mood swings for no reason."
-
"I try to exercise at least 3 times a week to relieve stress."
-
"Sometimes I feel so down that I don't want to get out of bed."
-
"I've been feeling overwhelmed since losing my job last month."
-
"I try to eat a well balanced diet everyday."
Explanation
Correct Answer: A) "I've started having frequent mood swings for no reason," C) "Sometimes I feel so down that I don't want to get out of bed," D) "I've been feeling overwhelmed since losing my job last month."
Frequent unexplained mood swings may indicate mood disorders such as bipolar disorder or depression requiring further evaluation. Feeling so down that the client cannot get out of bed is a significant indicator of depression and functional impairment that warrants immediate mental health assessment. Feeling overwhelmed following a major life stressor such as job loss is a risk factor for adjustment disorder, anxiety, or depression. Options B and E reflect positive healthy coping behaviors and lifestyle choices that do not indicate mental health concerns.
A nurse is assessing a client with facial drooping. The nurse observes an asymmetrical smile and inability to fully close the left eye. Which cranial nerve is most likely affected?
- Cranial Nerve XII
- Cranial Nerve VII
- Cranial Nerve III
- Cranial Nerve V
Explanation
Correct Answer: B) Cranial Nerve VII
Cranial Nerve VII, the Facial nerve, is responsible for controlling all muscles of facial expression, including smiling, frowning, raising eyebrows, and closing the eyes. Damage or dysfunction of this nerve results in the classic presentation of facial drooping, asymmetrical smile, and inability to fully close the eye on the affected side — findings consistent with conditions such as Bell's palsy or stroke. Cranial Nerve XII controls tongue movement, Cranial Nerve III controls eye movement and pupil constriction, and Cranial Nerve V controls facial sensation and mastication, none of which match this presentation.
A nurse notes that her client has an area of intact, red skin that does not blanch with fingertip pressure. Which pressure ulcer stage should the nurse document?
- Stage I
- Stage IV
- Stage II
- Stage III
Explanation
Correct Answer: A) Stage I
A Stage I pressure ulcer is characterized by intact, non-blanchable erythema of a localized area, typically over a bony prominence. The skin is unbroken but appears red and does not blanch when fingertip pressure is applied, indicating that the underlying capillaries are damaged and there is early tissue injury. Stage II involves partial thickness skin loss. Stage III involves full thickness skin loss without exposed bone. Stage IV involves full thickness tissue loss with exposed bone, tendon, or muscle.
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