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 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 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.
While assessing a client's neck, the nurse palpates the thyroid gland. Which is a normal finding?
- Gland is easily visible without palpation
- Gland is nodular, firm, and painful to palpation
- Gland moves independently from swallowing
- Gland is smooth, non-tender, and barely palpable
Explanation
Correct Answer: D) Gland is smooth, non-tender, and barely palpable
The normal thyroid gland is small, smooth, non-tender, and barely palpable on physical examination. It moves upward with swallowing, which is a key characteristic used to confirm that the structure being palpated is indeed the thyroid. A thyroid gland that is easily visible without palpation indicates enlargement or goiter. A nodular, firm, and painful gland suggests thyroiditis, malignancy, or other pathology. A gland that moves independently from swallowing would suggest it is not the thyroid or that it is an abnormal mass.
A nurse is assessing a client's cranial nerves during a head and neck examination. Which of the following actions demonstrates proper assessment of cranial nerve XI?
- Instructing the client to shrug their shoulders against resistance.
- Asking the client to smile and raise their eyebrows.
- Having the client close their eyes and identify a familiar scent.
- Placing a cotton ball on the client's face to assess light touch.
Explanation
Correct Answer: A) Instructing the client to shrug their shoulders against resistance.
Cranial Nerve XI, the Accessory nerve, innervates the trapezius and sternocleidomastoid muscles. The correct assessment technique is to instruct the client to shrug their shoulders upward while the nurse applies downward resistance, and to turn their head against resistance. Weakness or inability to perform these movements indicates dysfunction of Cranial Nerve XI. Option B assesses Cranial Nerve VII, Option C assesses Cranial Nerve I, and Option D assesses the sensory component of Cranial Nerve V.
Which documentation best describes normal findings of nail assessment?
- Nails concave, white, capillary refill 5 seconds
- Nails brown, bulb like, capillary refill 5 seconds
- Nails smooth, pink, capillary refill less than 2 seconds
- Nails brittle with ridges, capillary refill 4 seconds
Explanation
Correct Answer: C) Nails smooth, pink, capillary refill less than 2 seconds
Normal nail findings include smooth texture, pink coloration indicating adequate oxygenation and perfusion, and a capillary refill time of less than 2 seconds confirming good peripheral circulation. Concave nails suggest iron deficiency anemia. Brown discoloration may indicate fungal infection or systemic disease. Bulb-like or clubbing appearance suggests chronic hypoxia. Brittle nails with ridges indicate nutritional deficiencies or aging changes. A capillary refill greater than 2 seconds is abnormal and indicates poor peripheral perfusion.
Which of the following best describes exophthalmos?
- Inward turning of the eyelid margin toward the eyeball
- Drooping of the upper eyelid due to muscle weakness
- Bulging or protrusion of the eyeball
- Constriction of the pupil in response to light
Explanation
Correct Answer: C) Bulging or protrusion of the eyeball
Exophthalmos, also known as proptosis, refers to the abnormal bulging or forward protrusion of one or both eyeballs from the eye socket. It is most commonly associated with Graves' disease, a form of hyperthyroidism, where inflammation and swelling of the orbital tissues push the eye forward. Option A describes entropion. Option B describes ptosis, which is associated with Cranial Nerve III dysfunction or myasthenia gravis. Option D describes a normal pupillary response to light, not a structural eye abnormality.
A nurse is assessing for cyanosis on a client with darker pigmented skin. Which area provides the best site for evaluation?
- Oral mucosa
- Ears
- Abdomen
- Palms of the hands
Explanation
Correct Answer: A) Oral mucosa
In clients with darker pigmented skin, cyanosis cannot be reliably detected by examining the skin surface as melanin masks color changes. The oral mucosa, particularly the lips and gums, contains less melanin and has highly vascularized tissue close to the surface, making it the most reliable site to detect the bluish discoloration of cyanosis regardless of skin tone. The conjunctiva and nail beds are also acceptable alternative sites.
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 client presents with eye redness, itching, and thick yellow discharge that causes the eyelids to stick together upon waking. Which condition is most consistent with these findings?
- Glaucoma
- Conjunctivitis
- Corneal abrasion
- Dry eye syndrome
Explanation
Correct Answer: B) Conjunctivitis
Conjunctivitis, commonly known as pink eye, is an inflammation or infection of the conjunctiva that classically presents with eye redness, itching, and purulent discharge. The thick yellow or green discharge that causes the eyelids to stick together upon waking is characteristic of bacterial conjunctivitis, caused by organisms such as Staphylococcus aureus or Streptococcus pneumoniae. Glaucoma presents with increased intraocular pressure, halos around lights, and gradual vision loss without discharge. Corneal abrasion presents with acute eye pain, tearing, and photophobia. Dry eye syndrome presents with a gritty or burning sensation without purulent discharge.
When assessing eye movement with the six cardinal fields of gaze, the nurse understands which of the following cranial nerves are being assessed?
- Cranial nerves I, II, and IV
- Cranial nerves I, II, and VII
- Cranial nerves IV, V, and IX
- Cranial nerves III, IV, and VI
Explanation
Correct Answer: D) Cranial nerves III, IV, and VI
The six cardinal fields of gaze test the extraocular muscles and the three cranial nerves that control eye movement. Cranial Nerve III (Oculomotor) controls most eye movements including upward, downward, and medial gaze. Cranial Nerve IV (Trochlear) controls downward and inward eye movement. Cranial Nerve VI (Abducens) controls lateral or outward eye movement. Together these three nerves coordinate all directions of eye movement assessed during the six cardinal fields of gaze examination.
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