ATI RN
jarvis physical examination and health assessment test bank Questions
Question 1 of 9
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.
Question 2 of 9
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 3 of 9
Which of the following is true of a grade 4-intensity murmur?
Correct Answer: A
Rationale: The correct answer is A: It is moderately loud. A grade 4-intensity murmur indicates a moderately loud murmur that is readily heard with the stethoscope lightly on the chest. This intensity suggests a significant level of turbulence in blood flow, typically indicating a more pronounced cardiac abnormality. Explanation for why other choices are incorrect: B: It can be heard with the stethoscope off the chest - This is incorrect because a murmur would not be audible without the stethoscope. C: It can be heard with the stethoscope partially off the chest - This is incorrect as a murmur would still require direct contact with the chest for auscultation. D: It is associated with a "thrill" - This is incorrect as a thrill is a palpable vibration indicating turbulent blood flow and is not directly related to murmur intensity.
Question 4 of 9
Louise, a 60-year-old, complains of left knee pain associated with tenderness throughout, redness, and warmth over the joint. Which of the following is least helpful in determining if a joint problem is inflammatory?
Correct Answer: B
Rationale: The correct answer is B (Pain) because pain is a common symptom in both inflammatory and non-inflammatory joint conditions. Tenderness, warmth, and redness are more specific to inflammatory joint problems. Tenderness indicates localized inflammation, warmth suggests increased blood flow and inflammation, and redness signifies dilated blood vessels and inflammation. Therefore, pain alone is less helpful in determining if a joint problem is inflammatory compared to the other symptoms.
Question 5 of 9
Which of the following is true about cultural humility?
Correct Answer: C
Rationale: The correct answer is C because cultural humility emphasizes recognizing power imbalances and fostering interpersonal sensitivity through partnerships with and learning from patients. This approach encourages self-awareness, openness, and willingness to engage in respectful dialogues. Option A is incorrect because cultural humility is not solely achieved through professional development courses. Option B is incorrect as anyone, regardless of their background, can practice cultural humility. Option D is incorrect as cultural humility does consider the impacts of structural factors on health disparities, including biological, socioeconomic, and racial influences.
Question 6 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 7 of 9
Estrogen-progestin contraceptives should be avoided in women with:
Correct Answer: B
Rationale: The correct answer is B: Migraines with aura. Estrogen in contraceptives can increase the risk of stroke in patients with migraines with aura due to its effect on blood clotting. Estrogen-progestin contraceptives should be avoided in these patients to reduce the risk of adverse cardiovascular events. Choices A, C, and D do not have a direct contraindication to estrogen-progestin contraceptives based on current guidelines.
Question 8 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 9 of 9
The nurse is caring for an older adult who is having difficulty with swallowing. Which intervention should the nurse implement to prevent aspiration?
Correct Answer: B
Rationale: The correct answer is B: Provide thickened liquids and soft foods. This intervention helps prevent aspiration by reducing the risk of food or liquids entering the airway. Thickened liquids are easier to control while swallowing, decreasing the chance of aspiration. Soft foods are also easier to chew and swallow, further reducing the risk. Choice A is incorrect because eating quickly can increase the risk of choking and aspiration. Choice C is incorrect as lying down after meals can actually increase the risk of aspiration. Choice D is incorrect as large meals can increase the likelihood of swallowing difficulties and aspiration.