ATI RN
Jarvis Physical Examination and Health Assessment Test Bank Questions
Question 1 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.
Question 2 of 5
When assessing temperature of the skin, which portion of your hand should be used?
Correct Answer: A
Rationale: The correct answer is A: Fingertips. Fingertips are the most sensitive part of the hand, allowing for accurate temperature assessment. They provide better tactile discrimination and are more sensitive to changes in temperature compared to other parts of the hand. Palms have thicker skin and are less sensitive, making them less ideal for temperature assessment. Backs of fingers and ulnar aspect of the hand are also less sensitive than fingertips and lack the precision needed for accurate temperature detection.
Question 3 of 5
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?
Correct Answer: A
Rationale: The correct answer is A: Acute orchitis. Orchitis is inflammation of the testicle that can cause testicular enlargement and tenderness. In this case, the teenager presents with a swollen and sore left testicle, which aligns with the symptoms of orchitis. The patient's history of upper respiratory symptoms suggests a viral infection, which can lead to orchitis. The normal prostate exam and urine analysis rule out prostatitis. Acute epididymitis typically presents with pain and swelling in the epididymis, not the testicle itself. Torsion of the spermatic cord would present with sudden, severe testicular pain and is an emergency requiring immediate surgical intervention.
Question 4 of 5
A 22-year-old architecture major comes to your office, complaining of severe burning with urination, a fever of 101 degrees, and aching all over. She denies any upper respiratory, gastrointestinal, cardiac, or pulmonary symptoms. Her past medical history consists of severe acne. She is currently on an oral contraceptive. She has had no pregnancies or surgeries. She reports one new partner within the last month. She does not smoke but does drink occasionally. Her parents are both in good health. On examination you see a young woman appearing slightly ill. Her temperature is 3 and her pulse and blood pressure are unremarkable. Her head, ears, eyes, nose, throat, cardiac, pulmonary, and abdominal examinations are unremarkable. Palpation of the inguinal nodes shows lymphadenopathy bilaterally. On visualization of the perineum there are more than 10 shallow ulcers along each side of the vulva. Speculum and bimanual examination are unremarkable for findings, although she is very tender at the introitus. Urine analysis has some white blood cells but no red blood cells or bacteria. Her urine pregnancy test is negative. Which disorder of the vulva is most likely in this case?
Correct Answer: A
Rationale: The correct answer is A: Genital herpes. The patient's symptoms of severe burning with urination, fever, lymphadenopathy, and multiple shallow ulcers along the vulva are classic for genital herpes. The new sexual partner and absence of red blood cells or bacteria in the urine support a sexually transmitted infection. The presence of white blood cells in urine and absence of other systemic symptoms help differentiate it from other choices. Condylomata acuminata (choice B) present as warty lesions and do not cause the systemic symptoms described. Syphilitic chancre (choice C) would typically present as a single painless ulcer and is unlikely given the multiple shallow ulcers described. Epidermoid cyst (choice D) does not match the clinical presentation of fever, burning with urination, and lymphadenopathy.
Question 5 of 5
Which of the following is true of the HPV vaccine?
Correct Answer: D
Rationale: The correct answer is D: It can protect against anogenital lesions. The HPV vaccine can protect against several types of HPV that are known to cause anogenital warts and lesions. This is based on scientific evidence from clinical trials. A: Ideally it should be administered within 3 years of first intercourse - This statement is not accurate. The HPV vaccine is recommended for both males and females between the ages of 9 and 26, regardless of sexual activity. B: It covers against almost every HPV type - This statement is incorrect. While the HPV vaccine covers the most common high-risk HPV types that cause cervical cancer, it does not cover against every HPV type. C: It can be used as adjuvant therapy in cervical cancer - This statement is incorrect. The HPV vaccine is primarily used as a preventive measure to reduce the risk of HPV infection and related health issues, not as a treatment for existing cervical cancer.