ATI RN
Jarvis Physical Examination and Health Assessment Test Bank Questions
Question 1 of 9
A 29-year-old physical therapist presents for evaluation of an eyelid problem. On observation, the right eyeball appears to be protruding forward. Based on this description, what is the most likely diagnosis?
Correct Answer: B
Rationale: The correct answer is B: Exophthalmos. Exophthalmos refers to protrusion of the eyeball, which is a hallmark sign of thyroid eye disease. This condition commonly presents with forward bulging of one or both eyes due to inflammation and swelling of the eye muscles and tissues behind the eye. It is often associated with hyperthyroidism. A: Ptosis is drooping of the upper eyelid, not protrusion of the eyeball. C: Ectropion is an outward turning of the eyelid, not protrusion of the eyeball. D: Epicanthus is a vertical fold of skin on the upper eyelid near the nose, not protrusion of the eyeball.
Question 2 of 9
A grandmother brings her 13-year-old grandson to you for evaluation. She noticed last week when he took off his shirt that his breastbone seemed collapsed. He seems embarrassed and tells you that it has been that way for quite a while. He states he has no symptoms from it and he just tries not to take off his shirt in front of anyone. He denies any shortness of breath, chest pain, or lightheadedness on exertion. His past medical history is unremarkable. He is in sixth grade and just moved in with his grandmother after his father was deployed to the Middle East. His mother died several years ago in a car accident. He states that he does not smoke and has never touched alcohol. On examination you see a teenage boy appearing his stated age. On visual examination of his chest, you see that the lower portion of the sternum is depressed. Auscultation of the lungs and heart are unremarkable. What disorder of the thorax best describes your findings?
Correct Answer: B
Rationale: The correct answer is B: Funnel chest (pectus excavatum). Pectus excavatum is characterized by a depressed or sunken appearance of the sternum, which matches the description provided in the case. In this condition, the chest wall is abnormally shaped inward. This can be a congenital condition or develop during growth spurts in adolescence. The lack of symptoms such as shortness of breath, chest pain, or lightheadedness on exertion is consistent with pectus excavatum, as these symptoms are not typically associated with this condition. The other choices (A: Barrel chest, C: Pigeon chest, D: Thoracic kyphoscoliosis) do not match the specific findings described in the case and are not associated with the characteristic sternal depression seen in pectus excavatum.
Question 3 of 9
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 9
Which is the appropriate medication for a 31-year-old pregnant woman diagnosed with a UTI?
Correct Answer: A
Rationale: Rationale: 1. Cefuroxime and nitrofurantoin are safe for use in pregnancy and effective against UTIs. 2. Cefuroxime is a cephalosporin antibiotic, considered safe in pregnancy. 3. Nitrofurantoin is a first-line agent for UTIs in pregnancy due to its safety profile. 4. Ciprofloxacin and tetracycline are contraindicated in pregnancy due to potential harm to the fetus. 5. Amoxicillin is considered safe in pregnancy but not as effective as nitrofurantoin for UTIs.
Question 5 of 9
An 85-year-old woman with congestive heart failure and frailty asks about hastening her death. Which of the following is legal throughout the United States?
Correct Answer: C
Rationale: The correct answer is C: Voluntary stopping of eating and drinking. This is legal throughout the United States because it is considered a patient's right to refuse food and water, even if it may lead to death. This decision is based on the principle of patient autonomy and respects the patient's wishes. Euthanasia (A) involves actively causing death, which is illegal in the United States. Palliative sedation (B) is providing medication to relieve suffering, but not with the intention of hastening death. Physician-assisted death (D) involves a physician providing medication for a patient to self-administer to end their life, which is not legal in all states.
Question 6 of 9
Which of the following is most likely benign on breast examination?
Correct Answer: B
Rationale: The correct answer is B: One breast larger than the other is most likely benign on breast examination. This is because breast asymmetry is a common and typically benign finding in women. It is important to note that a significant difference in breast size may warrant further evaluation, but in general, slight variations in size are normal. Now, let's discuss why the other choices are incorrect: A: Dimpling of the skin resembling that of an orange is concerning for peau d'orange appearance, which can be a sign of underlying breast cancer. C: One nipple inverted can be a sign of an underlying breast issue, such as a mass or tumor. D: One breast with a dimple when the patient leans forward can be a sign of an underlying breast abnormality, such as a tumor pulling on the skin. In summary, breast asymmetry (Choice B) is the most likely benign finding, while the other choices may indicate underlying breast issues that require further evaluation.
Question 7 of 9
During a clinical examination, you observe that a patient's ears are positioned significantly below the level of the lateral eye canthi. What might this indicate about the patient's head and neck anatomy?
Correct Answer: B
Rationale: The correct answer is B: Potential congenital deformity. This observation suggests a condition called "low-set ears," which can be a sign of certain congenital anomalies affecting the development of the head and neck structures during fetal growth. It is important to investigate further to rule out any associated syndromes or genetic disorders. Choice A: Normal anatomical variation is incorrect because this positioning is not commonly considered a normal variation in the general population. Choice C: Increased risk of hearing loss is incorrect as the position of the ears alone does not directly correlate with hearing loss. Choice D: No clinical significance is incorrect because this observation warrants further evaluation to assess for potential underlying issues.
Question 8 of 9
On examination of the neck, a dome-shaped lesion in the dermis forming a benign closed firm sac attached to the epidermis is noted on the right lateral side of the neck. The type of lesion is known as:
Correct Answer: C
Rationale: Step 1: Identify the characteristics of the lesion described - dome-shaped, in dermis, benign, closed sac attached to epidermis. Step 2: A cutaneous cyst fits all these characteristics - it is a benign closed sac in the dermis with attachment to the epidermis. Step 3: Keloid (A) is an overgrowth of scar tissue, not a closed sac lesion. Tophi (B) are deposits of uric acid crystals, not a sac. Chondrodermatitis (D) is inflammation of cartilage and skin, not a closed sac lesion. Summary: A cutaneous cyst is the correct choice as it matches all the characteristics given, while the other options do not fit the description provided.
Question 9 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.