ATI RN
Jarvis Physical Examination and Health Assessment 9th Edition Test Bank Questions
Question 1 of 5
A patient tells you about her experience with prolonged therapy for her breast cancer. You comment, "That must have been a very trying time for you." What is this an example of?
Correct Answer: B
Rationale: The correct answer is B: Empathy. By acknowledging the patient's emotional experience and showing understanding of her feelings, the response demonstrates empathy. This response validates the patient's emotions and fosters a sense of connection and understanding. Choice A: Reassurance implies providing comfort or support, but in this scenario, the focus is on acknowledging the patient's feelings rather than providing reassurance. Choice C: Summarization involves restating key points or information, which is not demonstrated in the given scenario where the focus is on acknowledging the patient's emotional experience. Choice D: Validation involves recognizing and affirming the patient's emotions as legitimate, which aligns closely with empathy. However, in this specific scenario, the response does not explicitly confirm the validity of the patient's emotions, making it less appropriate than the answer choice of empathy.
Question 2 of 5
A 19-year-old college student, Todd, is brought to your clinic by his mother. She is concerned that there is something seriously wrong with him. She states for the past 6 months his behavior has become peculiar and he has flunked out of college. Todd denies any recent illness or injuries. His past medical history is remarkable only for a broken foot. His parents are both healthy. He has a paternal uncle who had similar symptoms in college. The patient admits to smoking cigarettes and drinking alcohol. He also admits to marijuana use but none in the last week. He denies using any other substances. He denies any feelings of depression or anxiety. While speaking with Todd and his mother you do a complete physical examination, which is essentially normal. When you question him on how he is feeling, he says that he is very worried that Microsoft has stolen his software for creating a better browser. He tells you he has seen a black van in his neighborhood at night and he is sure that it is full of computer tech workers stealing his work through special gamma waves. You ask him why he believes they are trying to steal his programs. He replies that the technicians have been telepathing their intents directly into his head. He says he hears these conversations at night so he knows this is happening. Todd's mother then tells you, "See, I told you . . . he's crazy. What do I do about it?" While arranging for a psychiatry consult, what psychotic disorder do you think Todd has?
Correct Answer: D
Rationale: The correct answer is D: Schizophrenia. Todd presents with a history of peculiar behavior, academic decline, paranoid delusions, and auditory hallucinations. These are classic symptoms of schizophrenia, a chronic and severe mental disorder. Schizoaffective disorder (A) involves a mix of schizophrenia symptoms and mood disturbances, but Todd does not exhibit significant mood symptoms. Psychotic disorder due to a medical illness (B) would require evidence of a medical condition causing Todd's symptoms, which is not present. Substance-induced psychotic disorder (C) would require Todd's symptoms to be solely due to substance use, but his symptoms persist despite marijuana abstinence. Therefore, based on Todd's symptoms and history, the most likely diagnosis is schizophrenia.
Question 3 of 5
A 28-year-old patient comes to the office for evaluation of a rash. At first there was only one large patch, but then more lesions erupted suddenly on the back and torso; the lesions itch. On physical examination, you note that the pattern of eruption is like a Christmas tree and that there are a variety of erythematous papules and macules on the cleavage lines of the back. Based on this description, what is the most likely diagnosis?
Correct Answer: A
Rationale: The correct answer is A: Pityriasis rosea. The key features that point towards this diagnosis include the sudden eruption of lesions in a Christmas tree pattern on the back and torso, along with itching. Pityriasis rosea commonly presents with a single large patch followed by smaller lesions in a distinct pattern. Other choices can be ruled out based on the description provided. Tinea versicolor typically presents with hypo- or hyperpigmented patches, not the erythematous papules and macules described. Psoriasis usually presents with thick, silvery scales, not erythematous lesions in a Christmas tree pattern. Atopic eczema may present with erythematous papules, but the Christmas tree pattern and acute onset described are not typical.
Question 4 of 5
A young man comes to you with an extremely pruritic rash over his knees and elbows which has come and gone for several years. It seems to be worse in the winter and improves with some sun exposure. On examination, you notice scabbing and crusting with some silvery scale, and you are observant enough to notice small "pits" in his nails. What would account for these findings?
Correct Answer: C
Rationale: The correct answer is C: Psoriasis. The key clinical features described, such as pruritic rash with scabbing, crusting, silvery scale, and nail pitting, are classic signs of psoriasis. The presence of small "pits" in the nails, known as nail pitting, is a common finding in psoriasis. The worsening of symptoms in winter and improvement with sun exposure is also typical of psoriasis. Eczema (choice A) typically presents with red, inflamed, and weeping skin lesions. Pityriasis rosea (choice B) presents with a herald patch followed by smaller similar lesions. Tinea infection (choice D) presents with scaling, redness, and itching but does not typically cause nail pitting. In this case, the combination of symptoms and nail pitting point to psoriasis as the most likely diagnosis.
Question 5 of 5
A 12-year-old presents to the clinic with his father for evaluation of a painful lump in the left eye. It started this morning. He denies any trauma or injury. There is no visual disturbance. Upon physical examination, there is a red raised area at the margin of the eyelid that is tender to palpation; no tearing occurs with palpation of the lesion. Based on this description, what is the most likely diagnosis?
Correct Answer: C
Rationale: The correct answer is C: Hordeolum. A hordeolum, also known as a stye, presents as a red raised tender area at the margin of the eyelid. In this case, the absence of tearing upon palpation of the lesion suggests it is localized to the eyelid itself. Dacryocystitis (choice A) involves the lacrimal sac and would present with tearing. A chalazion (choice B) is a painless nodule on the eyelid, unlike the tender lesion described here. Xanthelasma (choice D) is characterized by yellowish plaques on the eyelids, not a red raised tender area.