Questions 9

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Jarvis Physical Examination and Health Assessment Test Bank Questions

Question 1 of 5

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 2 of 5

Symptoms consistent with later-stage human immunodeficiency disease (HIV) typically include all of the following except:

Correct Answer: C

Rationale: The correct answer is C: Persistent vomiting. This is because persistent vomiting is not typically associated with later-stage HIV disease. Night sweats, lymphadenopathy for more than 3 months, and persistent, unexplained fatigue are commonly seen in later-stage HIV. Vomiting may occur in earlier stages due to opportunistic infections, but it is not a hallmark symptom of advanced HIV.

Question 3 of 5

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 4 of 5

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 5 of 5

A young patient presents with a left-sided mass in her abdomen. You confirm that it is present in the left upper quadrant. Which of the following would support that this represents an enlarged kidney rather than her spleen?

Correct Answer: A

Rationale: The correct answer is A: A palpable "notch" along its edge. This supports an enlarged kidney over the spleen because the kidney has a concave shape with a notch where the renal vessels enter. This notch is palpable in an enlarged kidney. Choice B is incorrect because the inability to push fingers between the mass and the costal margin is indicative of a spleen, which is a solid organ located close to the ribs. Choice C is incorrect as normal tympany over the area suggests gas-filled structures like the stomach or intestines, not a solid organ like the kidney or spleen. Choice D is incorrect as the ability to push fingers medial and deep to the mass would be more typical of an enlarged spleen, which can displace other organs medially due to its size.

Similar Questions

A young patient presents with a left-sided mass in her abdomen. You confirm that it is present in the left upper quadrant. Which of the following would support that this represents an enlarged kidney rather than her spleen?
A 65-year-old has a history of one kidney with early renal insufficiency. He is diagnosed with pneumonia and will require:
A patient with longstanding COPD was told by another practitioner that his liver was enlarged and this needed to be assessed. Which of the following would be reasonable to do next?
A 16-year-old high school junior is brought to your clinic by his father. The teenager was taught in his health class at school to do monthly testicular self-examinations. Yesterday when he felt his left testicle it was enlarged and tender. He isn't sure if he has had burning with urination and he says he has never had sexual intercourse. He has had a sore throat, cough, and runny nose for the last 3 days. His past medical history is significant for a tonsillectomy as a small child. His father has high blood pressure and his mother is healthy. On examination you see a teenager in no acute distress. His temperature is 8 and his blood pressure and pulse are unremarkable. On visualization of his penis, he is uncircumcised and has no lesions or discharge. His scrotum is red and tense on the left and normal appearing on the right. Palpating his left testicle reveals a mildly sore swollen testicle. The right testicle is unremarkable. An examining finger is put through both inguinal rings, and there are no bulges with bearing down. His prostate examination is unremarkable. Urine analysis is also unremarkable. What abnormality of the testes does this teenager most likely have?
Which of the following symptoms would be a clinical manifestation noted during the secondary stage of syphilis?

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