ATI RN
Jarvis Physical Examination and Health Assessment 9th Edition Test Bank Questions
Question 1 of 5
A patient presents with claudication symptoms and diminished pulses. Which of the following is consistent with chronic arterial insufficiency?
Correct Answer: A
Rationale: The correct answer is A. Pallor of the foot when raised to 60 degrees for one minute is consistent with chronic arterial insufficiency. When the foot is raised, blood flow decreases, leading to decreased oxygenation and pallor in the presence of arterial insufficiency. This is known as the dependent rubor test, and the delayed return of color is indicative of impaired blood flow. Choice B is incorrect because a quick return of color within 5 seconds suggests normal vascular perfusion. Choice C is incorrect as filling of veins within 10 seconds indicates venous insufficiency rather than arterial insufficiency. Choice D, hyperpigmentation of the skin, is not a typical finding in chronic arterial insufficiency.
Question 2 of 5
A 42-year-old realtor comes to your clinic, complaining of "growths" in her vulvar area. She is currently undergoing a divorce and is convinced she has a sexually transmitted disease. She denies any vaginal discharge or pain with urination. She has had no fever, malaise, or night sweats. Her past medical history consists of depression and hypothyroidism. She has had two spontaneous vaginal deliveries and one cesarean section. She has had no other surgeries. She denies smoking or drug use. She has two to three drinks weekly. Her mother also has hypothyroidism and her father has high blood pressure and hypercholesterolemia. On examination you see a woman who is anxious but appears otherwise healthy. Her blood pressure, pulse, and temperature are unremarkable. On visualization of the perineum you see two 2- to 3- mm, round, yellow nodules on the left labia. On palpation they are nontender and quite firm. What diagnosis best fits this description of her examination?
Correct Answer: D
Rationale: The correct answer is D: Epidermoid cyst. The key features in the clinical scenario that point towards an epidermoid cyst are the presence of painless, firm, non-tender, round, yellow nodules on the labia. These cysts are common in the vulvar area and often arise from blocked hair follicles. The absence of symptoms suggestive of a sexually transmitted infection (STI) such as vaginal discharge, pain with urination, fever, malaise, or night sweats, along with the patient's history of anxiety and the appearance of the nodules being consistent with an epidermoid cyst support this diagnosis. Choice A: Genital herpes typically presents with painful vesicles or ulcers, which are not described in this case. Choice B: Condylomata acuminata (genital warts) would present as soft, pink, or flesh-colored growths and are associated with HPV infection, which is not suggested in this scenario. Choice C: Sy
Question 3 of 5
On abdominal examination she has active bowel sounds, is nontender in all quadrants, and has no hepatosplenomegaly. Inspection of the anus reveals inflammation on the posterior side with erythema. Digital rectal examination is painful for the patient, but no abnormalities are palpated. Anoscopic examination reveals no inflammation or bleeding. What is the anal disorder that best describes her symptoms?
Correct Answer: C
Rationale: Rationale: The patient's symptoms of painful digital rectal examination and inflammation on the posterior side of the anus with erythema are consistent with an anal fissure. The absence of palpable abnormalities and bleeding on anoscopic examination further support this diagnosis. Anal fissures are common and typically present with these symptoms due to a tear in the anal lining. Incorrect Choices: A: Anorectal fistula typically presents with discharge, recurrent abscesses, and may have palpable tracks. B: External hemorrhoids usually present with painless bleeding, swelling, and itching, not with the described symptoms. D: Anorectal cancer would typically present with more severe symptoms like rectal bleeding, changes in bowel habits, and weight loss, which are not described in this case.
Question 4 of 5
Which is a sign of benign prostatic hyperplasia?
Correct Answer: D
Rationale: The correct answer is D: Nocturia. Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland, leading to urinary symptoms such as frequent urination at night (nocturia). This occurs due to the prostate pressing against the urethra, causing urinary flow issues. Weight loss (A) is not typically associated with BPH. Bone pain (B) is more indicative of conditions like prostate cancer or metastasis. Fever (C) is not a common symptom of BPH. Therefore, D is the most appropriate sign of BPH.
Question 5 of 5
A 33-year-old construction worker comes for evaluation and treatment of acute onset of low back pain. He notes that the pain is an aching located in the lumbosacral area. It has been present intermittently for several years; there is no known trauma or injury. He points to the left lower back. The pain does not radiate and there is no numbness or tingling in the legs or incontinence. He was moving furniture for a friend over the weekend. On physical examination, you note muscle spasm, with normal deep tendon reflexes and muscle strength. What is the most likely cause of this patient's low back pain?
Correct Answer: C
Rationale: The correct answer is C: Mechanical low back pain. This is the most likely cause as the patient's pain is aching, located in the lumbosacral region, intermittent for years, with no radiation, numbness, tingling, or incontinence. The physical exam findings of muscle spasm, normal reflexes, and muscle strength support this diagnosis. Mechanical low back pain is common and often related to muscle strain or overuse, as seen in this construction worker who was moving furniture. Choice A (Herniated disc) is incorrect as the patient does not have radiation of pain or neurological symptoms. Choice B (Compression fracture) is unlikely without a history of trauma or injury. Choice D (Ankylosing spondylitis) is less likely given the lack of inflammatory symptoms and typical age of onset.