ATI RN
Jarvis Physical Examination and Health Assessment Test Bank Questions
Question 1 of 9
A 49-year-old truck driver comes to the emergency room for shortness of breath and swelling in his ankles. He is diagnosed with congestive heart failure and admitted to the hospital. You are the student assigned to do the patient's complete history and physical examination. When you palpate the pulse, what do you expect to feel?
Correct Answer: B
Rationale: The correct answer is B: Small amplitude, weak. In congestive heart failure, the heart's ability to pump effectively is compromised, leading to decreased cardiac output. This results in a weakened pulse with reduced amplitude. Palpating a small, weak pulse in this patient is expected due to poor cardiac function. Choices A and C are incorrect because a large, forceful pulse is not expected in congestive heart failure, and a normal pulse may not reflect the compromised cardiac function. Choice D, bigeminal, refers to an abnormal rhythm characterized by every other heartbeat being premature and is not typically associated with congestive heart failure.
Question 2 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.
Question 3 of 9
Pregnant women are evaluated for syphilis with serology testing because:
Correct Answer: A
Rationale: The correct answer is A because syphilis during pregnancy can lead to adverse outcomes for the fetus, such as spontaneous abortion or congenital syphilis. This is due to the ability of the Treponema pallidum bacterium to cross the placenta and infect the fetus. Testing pregnant women for syphilis helps identify and treat the infection early to prevent these complications. Choice B is incorrect because hormonal changes do not trigger activation of latent syphilis. Choice C is incorrect as syphilis can be transmitted to the fetus at any point during pregnancy, not just in the third trimester. Choice D is incorrect because while untreated syphilis can have various complications, neonatal respiratory distress is not a direct consequence of syphilis infection during pregnancy.
Question 4 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 5 of 9
Salmeterol (Serevent) in combination with an inhaled steroid is prescribed for a patient with moderate persistent asthma. What is the most important teaching point about salmeterol?
Correct Answer: A
Rationale: The correct answer is A: It is not effective during an acute asthma attack. Salmeterol is a long-acting beta agonist used for maintenance therapy, not for acute attacks. It does not provide immediate relief. Choices B and C are incorrect because salmeterol's onset of action is not immediate, and it may take days to weeks to achieve full effect. Choice D is incorrect because salmeterol should not be used in children under 12 years old.
Question 6 of 9
When deciding on an initial treatment option for an acute flare of atopic dermatitis, unresponsive to emollient therapy, the next best choice for treatment is:
Correct Answer: B
Rationale: The correct answer is B: Betamethasone dipropionate 0.05% (Betanate). When managing an acute flare of atopic dermatitis unresponsive to emollient therapy, topical corticosteroids like betamethasone are often the first-line treatment due to their anti-inflammatory properties. Betamethasone is a potent corticosteroid that can help reduce inflammation, itching, and redness associated with atopic dermatitis. Oral corticosteroids (Choice A) are generally reserved for severe cases due to potential systemic side effects. Desonide (Choice C) is a milder topical corticosteroid suitable for maintenance therapy but may not be potent enough for acute flares. Pimecrolimus (Choice D) is a calcineurin inhibitor used for moderate to severe atopic dermatitis and is generally not the first choice for initial treatment of acute flares.
Question 7 of 9
An 86-year-old man with no ADL deficits who has stopped driving because of macular degeneration is evaluated for a urinary tract infection associated with urinary retention. The consulting urologist places a Foley catheter and sends a prostate-specific antigen (PSA) level that comes back 12 ng/mL. Three months later after the Foley has been removed and he has had a good response to tamsulosin, his PSA is still 10 ng/mL. What is the appropriate next step in managing this man’s prostate problem?
Correct Answer: D
Rationale: The correct answer is D: Repeat PSA in 6 months. In this case, the patient's PSA levels have decreased from 12 ng/mL to 10 ng/mL after treatment with tamsulosin and removal of the Foley catheter. Given the improvement in PSA levels, it is reasonable to monitor for further changes before considering invasive procedures like transrectal ultrasound and biopsy (choice A), which may not be necessary at this time. Empiric finasteride (choice B) is not indicated as the patient is already responding well to tamsulosin. A bone scan (choice C) is not necessary at this stage as there are no indications of metastasis. Therefore, repeating the PSA in 6 months allows for continued monitoring of the patient's prostate health without subjecting him to unnecessary procedures.
Question 8 of 9
Mrs. Gloth is an 84-year-old woman whom you are admitting to the nursing home. Her son takes you aside and tells you that she has metastatic ovarian cancer but has not been told the diagnosis. He asks that you not tell her, because she would “lose all hope and die.” Which of the following is an appropriate response?
Correct Answer: C
Rationale: The correct answer is C: Suggest that you discuss this further after getting to know the patient and family a little better. This response allows the healthcare provider to gather more information about the patient's beliefs, values, and preferences before making a decision. It demonstrates respect for the autonomy of the patient and involves a collaborative approach with the family. It also allows time to assess the patient's emotional and psychological readiness to receive the diagnosis. Incorrect answers: A: This answer disregards the patient's autonomy and does not consider the emotional impact of delivering such news without proper assessment. B: While respecting the son's wishes is important, prioritizing the patient's well-being and autonomy should come first. D: Relying solely on the family's perspective without considering the patient's own wishes and understanding may lead to ethical issues and potential harm to the patient.
Question 9 of 9
Jacob, a 33-year-old construction worker, complains of a "lump on his back" over his scapula. It has been there for about a year and is getting larger. He says his wife has been able to squeeze out a cheesy-textured substance on occasion. He worries this may be cancer. When gently pinched from the side, a prominent dimple forms in the middle of the mass. What is most likely?
Correct Answer: B
Rationale: The correct answer is B: A sebaceous cyst. A sebaceous cyst typically presents as a lump underneath the skin that can be squeezed to release a cheesy substance, consistent with Jacob's description. The formation of a prominent dimple when gently pinched is characteristic of a cyst, indicating it is filled with fluid or semi-solid material. Sebaceous cysts are usually benign and can grow slowly over time. Incorrect choices: A: An enlarged lymph node - Unlikely as lymph nodes are typically not associated with cheesy discharge or the formation of a dimple when pinched. C: An actinic keratosis - Unlikely as actinic keratosis is a precancerous skin condition caused by sun exposure, not presenting with cheesy discharge or a dimple. D: A malignant lesion - Unlikely as malignant lesions usually do not produce cheesy discharge and are more aggressive in growth compared to a sebaceous cyst.