ATI Custom ASN Physical Assessment NSG1530 Final Winter
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Free ATI Custom ASN Physical Assessment NSG1530 Final Winter Questions
During an otoscopic exam, a nurse observes a pearly gray, translucent tympanic membrane. Which conclusion should the nurse make based on this finding?
- The client has an ear infection
- The ear canal is impacted with cerumen
- The tympanic membrane is perforated
- The tympanic membrane is normal
Explanation
Correct Answer: D) The tympanic membrane is normal
A healthy tympanic membrane is described as pearly gray and translucent with a visible light reflex — this is a normal otoscopic finding. A red, bulging, or opaque membrane suggests infection (otitis media). Cerumen impaction would obstruct visualization of the membrane entirely, and a perforated membrane would show a visible hole or tear.
A nurse obtains a blood pressure reading of 160/100 mmHg on a client with a history of hypertension. The client denies headache or dizziness. The nurse notes the cuff was too small for the client's upper arm. Which interpretation is most appropriate?
- The reading may be falsely elevated due to cuff size
- The client is experiencing a hypertensive emergency
- The client's blood pressure is within expected range
- The client is at risk for orthostatic hypotension
Explanation
Correct Answer: A) The reading may be falsely elevated due to cuff size
Using a blood pressure cuff that is too small for the client's arm is a well-documented source of measurement error that produces falsely elevated readings. Accurate blood pressure assessment requires proper cuff sizing — the bladder should encircle at least 80% of the arm. Since the nurse identified this technical error and the client is asymptomatic, the most appropriate interpretation is that the reading may not be accurate before escalating to a hypertensive emergency diagnosis.
A nurse is teaching a client about monthly self-breast examinations. Which technique should the nurse recommend?
- Assess quarterly (every 3 months)
- Examining only the right breast unless symptoms occur
- Using the palms to press deeply into breast tissue
- Lifting arms overhead to inspect for skin retraction
Explanation
Correct Answer: D) Lifting arms overhead to inspect for skin retraction
Lifting the arms overhead during breast self-examination is a key inspection technique that helps reveal skin retraction, dimpling, or asymmetry that may not be visible with arms at rest. These changes can be early visual indicators of an underlying breast mass pulling on the surrounding tissue, making this an important step in the self-examination process.
A nurse is assigned to measure the temperature of a client who reports chills and sweating. The nurse uses a tympanic thermometer and obtains a reading of 101.3°F (38.5°C). Which action should the nurse take next?
- Retake the temperature using the oral method.
- Administer acetaminophen without provider order.
- Apply a cool compress and reassess in 2 hours.
- Document the temperature and recheck in one hour.
Explanation
Correct Answer: D) Document the temperature and recheck in one hour.
A temperature of 101.3°F (38.5°C) confirms a low-grade fever. The tympanic method is a validated and reliable measurement route, so retaking it is unnecessary. The nurse should accurately document the finding, continue monitoring the client's temperature trend, assess for other signs of infection, ensure adequate hydration, and notify the provider if the fever persists, worsens, or is accompanied by other concerning symptoms. Administering medication without an order violates scope of practice.
A nurse assesses a client who is disoriented to time and place. Which finding should the nurse evaluate as a potential contributing factor?
- Use of antihypertensive medication.
- History of recent head injury.
- Elevated blood glucose level.
- Report of chronic back pain.
Explanation
Correct Answer: B) History of recent head injury.
A recent head injury is the most direct and clinically significant potential contributing factor to disorientation to time and place. Head trauma can cause concussion, intracranial bleeding, increased intracranial pressure, or diffuse axonal injury, all of which directly impair the brain's ability to process and orient to person, place, and time. This finding requires urgent neurological assessment and must be prioritized given its immediate life-threatening implications.
A nurse is teaching a client about healthy body mass index (BMI) ranges during a wellness visit. Which BMI range should the nurse identify as normal?
- 18.5–24.9
- 35–39.9
- 25–29.9
- Less than 18.5
Explanation
Correct Answer: A) 18.5–24.9
A BMI of 18.5–24.9 is classified as normal or healthy weight. A BMI below 18.5 indicates underweight, 25–29.9 is classified as overweight, and 35–39.9 falls within the obese range (Class II obesity). BMI is a widely used screening tool to assess whether a client's weight is appropriate for their height.
A medication is ordered as 0.5 grams (g) PO. How many milligrams (mg) does this convert to?
(Include numerical value only. Round to the nearest whole number.)
Explanation
Correct Answer: 500 mg
The standard conversion is 1 gram = 1,000 milligrams. Therefore:
A nurse asks a client to perform the Romberg test. Which instruction should the nurse give?
- Stand with your feet together and close your eyes
- Raise one leg and hop in place
- Walk heel to toe in a straight line
- Bend over and touch your toes
Explanation
Correct Answer: A) Stand with your feet together and close your eyes
The Romberg test assesses balance and proprioception by having the client stand with feet together and eyes closed. A positive Romberg sign — excessive swaying or loss of balance — indicates impaired proprioception or cerebellar dysfunction. Walking heel to toe assesses coordination (tandem gait), hopping assesses motor strength, and bending to touch toes assesses flexibility — none of which are the Romberg test.
A nurse auscultates a bruit over the carotid artery. Which of the following describes the finding?
- Complete block of venous blood flow
- Decreased venous blood flow
- Turbulent arterial blood flow
- Expected finding for all ages
Explanation
Correct Answer: C) Turbulent arterial blood flow
A bruit is an abnormal swooshing or blowing sound heard on auscultation caused by turbulent blood flow through a narrowed or partially obstructed artery. Over the carotid artery, a bruit indicates atherosclerotic narrowing (stenosis), which disrupts the normally smooth laminar flow of blood. It is a significant clinical finding as carotid stenosis is a major risk factor for stroke.
A nurse is performing the general survey of a client during a routine physical assessment. Which of the following findings related to the client's physical appearance should the nurse further investigate?
- The client appears stated age, has even skin tone, and symmetrical facial features.
- The client's facial expression appears flat and unchanging throughout the interview.
- The client's body movements are smooth and coordinated.
- The client's clothing is clean and appropriate for the weather.
Explanation
Correct Answer: B) The client's facial expression appears flat and unchanging throughout the interview.
A flat, unchanging facial affect throughout an interview is an abnormal finding that warrants further assessment. It may indicate depression, Parkinson's disease, neurological damage, medication side effects, or emotional blunting associated with psychiatric conditions such as schizophrenia. During a general survey, the nurse observes affect and expression as key indicators of neurological and psychological well-being.
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