ATI RN
jarvis physical examination and health assessment test bank Questions
Question 1 of 9
A 20-year-old male living in a college dorm complains of a dry cough for the past month. Assessment findings associated with atypical, community-acquired pneumonia would include:
Correct Answer: A
Rationale: The correct answer is A because atypical, community-acquired pneumonia often presents with subtle symptoms like a low-grade fever and malaise. Clear lung fields on auscultation are typical as atypical pneumonia affects the interstitium rather than the alveoli. Choice B is incorrect as crackles throughout the lung fields are indicative of typical pneumonia affecting the alveoli. Choice C is incorrect because a sore throat is not a typical symptom of atypical pneumonia, and diminished breath sounds are not typically associated with atypical pneumonia. Choice D is incorrect because a temperature of 102°F and dyspnea are more indicative of a more severe pneumonia, and diminished lung sounds are not typically associated with atypical pneumonia.
Question 2 of 9
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 9
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 4 of 9
An 85-year-old man with newly diagnosed nonvalvular atrial fibrillation comes to the office for a follow-up. Which medication change would be most appropriate for reducing his stroke risk?
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.
Question 5 of 9
A 78-year-old man with multi-infarct dementia, chronic kidney disease, congestive heart failure, and uncontrolled hypertension develops confusion, restlessness, and combativeness. Which of the pharmacologic agents would be the best choice for treating the agitation associated with his delirium?
Correct Answer: B
Rationale: The correct answer is B: Haloperidol. Haloperidol is a first-line antipsychotic commonly used to manage agitation in delirium due to its rapid onset and minimal sedative effects. It acts by blocking dopamine receptors in the brain, which helps to reduce agitation and combativeness. Melatonin (A) is not effective for acute agitation. Diazepam (C) can worsen confusion in elderly patients and is not recommended for delirium. Gabapentin (D) is not indicated for managing agitation in delirium and may not be effective in this scenario.
Question 6 of 9
Which one of the following is most true about the staffing of a typical nursing home?
Correct Answer: C
Rationale: The correct answer is C because Certified Nursing Assistants (CNAs) typically provide the majority of direct patient care in nursing homes. CNAs assist with activities of daily living, monitoring patients' health, and providing emotional support. This is true in most nursing homes as they play a crucial role in patient care. Rationale: - A: Most nurses in nursing homes are not necessarily Registered Nurses (RNs), as there are also Licensed Practical Nurses (LPNs) and Certified Nursing Assistants (CNAs) who provide care. - B: LPNs or LVNs may assist with the patient care plan under the supervision of an RN, but they do not typically develop the plan themselves. - D: Staff turnover is a major issue in nursing homes due to various factors such as workload, stress, and burnout among healthcare workers.
Question 7 of 9
A patient who is taking an oral glucocorticosteroid should be advised to
Correct Answer: D
Rationale: The correct answer is D: Take it with food. Glucocorticosteroids can irritate the stomach lining, leading to gastritis or ulcers. Taking them with food helps reduce stomach irritation and the risk of gastrointestinal side effects. Crushing it in applesauce (A) or chewing it prior to a high-fat meal (B) can exacerbate stomach irritation. Taking it on an empty stomach (C) can increase the risk of stomach upset and decrease absorption. Therefore, taking it with food (D) is the best option to minimize stomach irritation and improve medication effectiveness.
Question 8 of 9
You are assessing a patient for peripheral vascular disease in the arms, secondary to a complaint of increased weakness and a history of coronary artery disease and diabetes. You assess the brachial and radial pulses and note that they are bounding. What does that translate to on a scale of 0 to 3?
Correct Answer: B
Rationale: The correct answer is B: 3+. Bounding pulses indicate a 3+ strength on a scale of 0 to 3. This reflects increased blood flow or pressure in the arteries, which can be a sign of conditions like peripheral vascular disease. A strength of 0 indicates no palpable pulse, 1+ is weak and thready, 2+ is normal, and 3+ is bounding. In this case, the patient's history of coronary artery disease and diabetes may contribute to the increased blood flow, leading to bounding pulses. Choices A, C, and D are incorrect as they do not accurately reflect the strength of the pulses based on the given assessment findings.
Question 9 of 9
Treatment for early PD in an otherwise healthy older patient without significant functional impairment should begin with:
Correct Answer: B
Rationale: The correct answer is B: Dopamine agonist. In early PD, dopamine agonists are preferred due to their lower risk of motor complications compared to levodopa. Dopamine agonists help improve motor symptoms by directly stimulating dopamine receptors. COMT inhibitors are usually used in combination with levodopa to prolong its effects. Levodopa is effective but can lead to motor complications with long-term use. Careful observation is not a treatment strategy and delays symptom management. Therefore, starting with a dopamine agonist is the most suitable option for early PD to manage symptoms effectively with minimal risk of motor complications.