jarvis physical examination and health assessment test bank -Nurselytic

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jarvis physical examination and health assessment test bank Questions

Question 1 of 5

Which of these statements about frailty are false?

Correct Answer: C

Rationale: The correct answer is C because clinical diagnosis of anxiety or depression can indeed have an effect on frailty rates. Anxiety and depression can contribute to the development and progression of frailty through various mechanisms such as decreased physical activity, poor nutrition, and social isolation. This can lead to a higher risk of frailty in individuals with mental health issues.

Choices A, B, and D are incorrect because both prominent frailty models (e.g., Fried's phenotype model and Rockwood's accumulation of deficits model) do consider age as a component for defining frailty, individuals who are prefrail are at a higher risk of progressing to frailty rather than becoming robust, and frailty diagnosis has been shown to be valuable in preoperative assessment as it helps identify patients who may not do well with surgical interventions.

Question 2 of 5

A 22-year-old architecture major comes to your office, complaining of severe burning with urination, a fever of 101 degrees, and aching all over. She denies any upper respiratory, gastrointestinal, cardiac, or pulmonary symptoms. Her past medical history consists of severe acne. She is currently on an oral contraceptive. She has had no pregnancies or surgeries. She reports one new partner within the last month. She does not smoke but does drink occasionally. Her parents are both in good health. On examination you see a young woman appearing slightly ill. Her temperature is 3 and her pulse and blood pressure are unremarkable. Her head, ears, eyes, nose, throat, cardiac, pulmonary, and abdominal examinations are unremarkable. Palpation of the inguinal nodes shows lymphadenopathy bilaterally. On visualization of the perineum there are more than 10 shallow ulcers along each side of the vulva. Speculum and bimanual examination are unremarkable for findings, although she is very tender at the introitus. Urine analysis has some white blood cells but no red blood cells or bacteria. Her urine pregnancy test is negative. Which disorder of the vulva is most likely in this case?

Correct Answer: A

Rationale: The correct answer is A: Genital herpes. The patient's symptoms of severe burning with urination, fever, lymphadenopathy, and multiple shallow ulcers along the vulva are classic for genital herpes. The new sexual partner and absence of red blood cells or bacteria in the urine support a sexually transmitted infection. The presence of white blood cells in urine and absence of other systemic symptoms help differentiate it from other choices. Condylomata acuminata (choice
B) present as warty lesions and do not cause the systemic symptoms described. Syphilitic chancre (choice
C) would typically present as a single painless ulcer and is unlikely given the multiple shallow ulcers described. Epidermoid cyst (choice
D) does not match the clinical presentation of fever, burning with urination, and lymphadenopathy.

Question 3 of 5

Ms. J, who is 82 years old, complains of urine leakage while playing golf. This has gotten worse over the past year, and she rarely makes it through nine holes without feeling like she needs to “run into the bushes and go.” Leakage is usually small volume, but causes her extreme embarrassment because she is afraid she will smell of urine. She has tried limiting caffeine in the morning before she golfs and avoiding drinking water while playing, to no effect. She also tried “those Kegel exercises” in the past without success. Which of the following is the most appropriate recommendation for Ms. J?

Correct Answer: B

Rationale: The correct answer is B: Referral for biofeedback training in pelvic muscle exercise. Biofeedback training helps Ms. J improve her pelvic muscle control, which can address her urinary leakage issue. It is specifically tailored to strengthen the pelvic floor muscles, which can help with urinary incontinence. This option is appropriate for Ms. J as she has already tried Kegel exercises without success.

Option A: Bladder training focuses on scheduling toilet trips and gradually increasing the time between trips. It may not be as effective for Ms. J's specific issue with leakage during physical activity.

Option C: Solifenacin is a medication for overactive bladder symptoms, which may not be the best approach for Ms. J who has stress urinary incontinence.

Option D:
Topical estrogen is used for menopausal symptoms and genitourinary atrophy, which may not directly address Ms. J's issue with urinary leakage during physical activity.

Question 4 of 5

Ms. Wright comes to your office, complaining of palpitations. While checking her pulse you notice an irregular rhythm. When you listen to her heart, every fourth beat sounds different. It sounds like a triplet rather than the usual "lub dup." How would you document your examination?

Correct Answer: C

Rationale: The correct answer is C: Regularly irregular rhythm. This is the appropriate documentation for Ms. Wright's presentation as her pulse demonstrates a pattern of irregularity with every fourth beat sounding different. This indicates a regularly irregular rhythm, where there is a discernible pattern to the irregularity.


Rationale:
1. Regular rate and rhythm (
Choice
A) is incorrect as Ms. Wright's palpitations and the irregularity in her pulse indicate an irregular rhythm.
2. Irregularly irregular rhythm (
Choice
B) is incorrect as this term is used to describe arrhythmias like atrial fibrillation, which do not have a discernible pattern of irregularity.
3. Bradycardia (
Choice
D) is incorrect as it refers to a slow heart rate, which is not the primary concern in this scenario where the focus is on the irregular rhythm.

In summary, the correct choice (
C) accurately describes the specific irregular pattern observed in Ms. Wright's pulse, distinguishing it from

Question 5 of 5

A 78-year-old male is being treated for hypertension. The nurse knows that the most appropriate first-line therapy in older adults is:

Correct Answer: A

Rationale: The correct answer is A: Diuretics. In older adults, diuretics are considered the most appropriate first-line therapy for hypertension due to their effectiveness in reducing blood pressure and preventing complications such as heart failure. Diuretics are well-tolerated, have a long history of use, and are cost-effective. They are especially beneficial in older adults with volume overload or fluid retention. Beta-blockers (
B) may be less effective in older adults and can have more side effects. ACE inhibitors (
C) are commonly used but may pose risks of hyperkalemia and renal dysfunction in older adults. Calcium channel blockers (
D) are effective but may increase the risk of falls and fractures in older adults.

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