A 19-year-old-college student presents to the emergency room with fever, headache, and neck pain/stiffness. She is concerned about the possibility of meningococcal meningitis. Several of her dorm mates have been vaccinated, but she hasn't been. Which of the following physical examination descriptions is most consistent with meningitis?

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Jarvis Physical Examination and Health Assessment Test Bank Questions

Question 1 of 5

A 19-year-old-college student presents to the emergency room with fever, headache, and neck pain/stiffness. She is concerned about the possibility of meningococcal meningitis. Several of her dorm mates have been vaccinated, but she hasn't been. Which of the following physical examination descriptions is most consistent with meningitis?

Correct Answer: C

Rationale: The correct answer is C. Meningitis typically presents with neck stiffness due to meningeal irritation. In choice C, the patient has a tender neck to palpation and is unable to perform range of motion, indicating meningeal inflammation. Choices A, B, and D all describe a normal head and fundi exam, which is not consistent with meningitis. Choice B mentions muscle spasm and limited range of motion to the right, but this is more suggestive of a musculoskeletal issue rather than meningitis. Choice D describes a normal neck exam, which is not in line with the presentation of meningitis.

Question 2 of 5

A 79-year-old client is admitted with pneumonia. Which symptom would most likely indicate the need for further evaluation?

Correct Answer: B

Rationale: The correct answer is B: Chest pain and pleuritic breathing. This indicates possible complications like pleurisy or pleural effusion, requiring further evaluation. A: Persistent cough with sputum production is common in pneumonia. C: Shortness of breath is a typical symptom of pneumonia. D: Fever and chills are also common in pneumonia. However, chest pain and pleuritic breathing are more indicative of potential complications that may require immediate attention.

Question 3 of 5

An 86-year-old female comes to your office for a wellness visit. Her blood pressure is 125/70 mmHg, pulse 69 beats per minute, and respiratory rate 18 breaths per minute. She is well-appearing and reports she is up to date on her routine vaccinations. She introduces her partner of 35 years, whom she would like to make medical decisions for her in case she becomes unable to make decisions for herself. She reports that she and her partner are not married. She asks if she needs any further documentation to ensure her goals of care are followed.

Correct Answer: C

Rationale: The correct answer is C: Advise them to file an advanced directive. An advanced directive is a legal document that allows individuals to specify their healthcare preferences in advance, including who they want to make medical decisions for them if they are unable to do so. In this scenario, since the patient and her partner are not married, it is important for her to have an advanced directive in place to ensure that her partner is legally recognized as the decision-maker. This documentation will help ensure her goals of care are followed in case she becomes incapacitated. Choice A (Advise them to complete a POLST) is incorrect because a POLST (Physician Orders for Life-Sustaining Treatment) form is used to specify a patient's wishes for end-of-life care, not for designating a medical decision-maker. Choice B (Advise them that they have adequate documentation to be recognized legally) is incorrect because without an advanced directive, there may be legal challenges to the partner's authority to make medical decisions

Question 4 of 5

Guidelines for the primary prevention of stroke recommend that aspirin be used in which one of the following?

Correct Answer: A

Rationale: The correct answer is A because guidelines for primary stroke prevention recommend using aspirin in individuals whose risk of stroke is high enough for the benefits to outweigh the risks. This is based on assessing individual risk factors such as age, hypertension, diabetes, smoking, and history of cardiovascular diseases to determine if the potential benefits of aspirin therapy in reducing the risk of stroke outweigh the potential risks such as gastrointestinal bleeding. Choices B, C, and D are incorrect because aspirin should not be used regardless of risk level, based on gender, or in specific populations without considering individual risk factors to ensure the benefits outweigh the risks.

Question 5 of 5

What intervention does the American College of Rheumatology recommend as first-line therapy for osteoarthritis, rheumatoid arthritis, or something else?

Correct Answer: D

Rationale: The correct answer is D: Exercise and weight loss. The American College of Rheumatology recommends this intervention as first-line therapy for osteoarthritis and rheumatoid arthritis due to its proven benefits in reducing pain, improving joint function, and overall quality of life. Exercise helps strengthen muscles around the joints, improve flexibility, and reduce stiffness. Weight loss can also alleviate pressure on the joints, especially in weight-bearing joints. A: Diagnostic workup to rule out rheumatoid arthritis - This is not the first-line therapy but rather a step in the diagnostic process. B: NSAID use at the lowest effective dose - While NSAIDs may help with pain management, they are not recommended as the first-line therapy due to potential side effects. C: Acetaminophen use up to 4 grams/day - Acetaminophen can be used for pain relief, but it is not as effective as exercise and weight loss in managing osteoarthritis or rheumatoid arthritis symptoms

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