jarvis physical examination and health assessment test bank -Nurselytic

Correct Answer: C

Rationale: The purpose of the expanded assessment when using the LAPSS is to determine whether there are other possible causes of the patient's signs and symptoms. This is because LAPSS primarily focuses on identifying stroke symptoms, so the expanded assessment helps rule out other potential conditions. Option A is incorrect because LAPSS does not primarily assess circulation. Option B is incorrect because LAPSS is not specifically designed to determine compartment syndrome. Option D is incomplete and does not provide any information to support it as the correct answer.

Correct Answer: D

Rationale: The correct answer is D: Screen for depression. The patient's symptoms of insomnia, anxiety, and loneliness after his wife's death suggest he may be experiencing depression, which can manifest as physical symptoms like urinary urgency and frequency. Since the patient has already received appropriate treatment for his urinary symptoms, addressing his mental health is the next crucial step. This can help improve his overall well-being and quality of life. Starting an antibiotic course (choice
A) is not indicated as there are no signs of infection. Initiating a 5-alpha-reductase inhibitor (choice
B) is not necessary given the absence of specific indications such as obstructive voiding symptoms. Urodynamic testing (choice
C) is not warranted at this stage as the patient's history and findings do not suggest underlying bladder dysfunction.

Correct Answer: B

Rationale: The correct answer is B: Spinal stenosis. The symptoms described suggest neurogenic claudication, which is a hallmark of spinal stenosis. Pain worsening with ambulation and improving with lumbar flexion is characteristic of spinal stenosis due to narrowing of the spinal canal leading to compression of nerves. Ankylosing spondylitis (
A) presents with inflammatory back pain and stiffness, not neurogenic claudication. Bursitis (
C) involves inflammation of bursae, not typically associated with leg pain and numbness. Cauda equina syndrome (
D) presents with sudden-onset severe back pain, urinary retention, and saddle anesthesia, which are not consistent with the described symptoms.

Correct Answer: C

Rationale: The correct answer is C: Stop aspirin and begin apixaban 5 mg twice a day. The rationale is that for stroke risk reduction in nonvalvular atrial fibrillation, anticoagulation therapy with direct oral anticoagulants (DOACs) like apixaban is preferred over antiplatelet therapy like aspirin. DOACs have been shown to be more effective in reducing stroke risk with a lower bleeding risk compared to warfarin.
Choice A is incorrect as aspirin alone is not sufficient for stroke prevention in atrial fibrillation.
Choice B is incorrect as warfarin has more monitoring requirements and potential drug interactions compared to DOACs like apixaban.
Choice D is incorrect as aspirin and apixaban together are not recommended due to increased bleeding risk.

Correct Answer: B

Rationale: The correct answer is B: A dull pain or cramp. In peripheral artery disease, calf pain is typically described as a dull ache or cramp due to inadequate blood flow to the muscles during exercise. This pain is known as claudication.
Choice A is incorrect as sharp, stabbing pain is not typically associated with peripheral artery disease.
Choice C, an electric shock, is more indicative of nerve-related conditions.
Choice D, a pulsating pain, is more characteristic of an aneurysm rather than peripheral artery disease.