A young woman comes to you with a cut on her finger caused by the lid of a can she was opening. She is pacing about the room, crying loudly, and through her sobs she says, "My career as a pianist is finished!" Which personality type exhibits these features?

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Jarvis Physical Examination and Health Assessment Practice Questions Questions

Question 1 of 9

A young woman comes to you with a cut on her finger caused by the lid of a can she was opening. She is pacing about the room, crying loudly, and through her sobs she says, "My career as a pianist is finished!" Which personality type exhibits these features?

Correct Answer: C

Rationale: The young woman in this scenario is exhibiting characteristics of histrionic personality disorder. Individuals with histrionic personality disorder tend to be overly dramatic, attention-seeking, and have a tendency to be excessively emotional in their reactions. The young woman's exaggerated response to a minor cut on her finger, along with her dramatic declaration that her career as a pianist is over, reflects the emotional and attention-seeking behaviors commonly associated with histrionic personality traits.

Question 2 of 9

Today her pressure is 168/94 and pressure on the other arm is similar. What would you do next?

Correct Answer: B

Rationale: In this scenario, with a blood pressure of 168/94 on both arms, it indicates poorly controlled hypertension. Hypertension can have various causes, including kidney-related issues. Referring the patient to nephrology would be the appropriate next step to evaluate and manage any potential underlying kidney conditions contributing to the uncontrolled blood pressure. The nephrologist can conduct further tests and assessments to determine the root cause and provide specialized care for the patient's condition. This approach ensures a comprehensive evaluation and targeted management plan for the patient's hypertension.

Question 3 of 9

Which is true of a third heart sound (S )?

Correct Answer: B

Rationale: The third heart sound (S3) is a low-frequency sound heard in early diastole, immediately following the second heart sound (S2). It is generated by the abrupt deceleration of the column of blood against the ventricular wall during the rapid passive filling phase (early diastole) when the ventricle is suddenly stretched by a large volume of blood. The S3 sound typically reflects decreased ventricular compliance, rather than normal compliance. An S3 sound is often considered pathological and is commonly associated with conditions such as heart failure, volume overload, and dilated cardiomyopathy. Therefore, the statement that the third heart sound reflects normal compliance of the left ventricle (Choice B) is incorrect.

Question 4 of 9

A man's wife is upset because when she hugs him with her hands on his left shoulder blade, "it feels creepy." This came on gradually after a recent severe left-sided rotator cuff tear. How long does it usually take to develop muscular atrophy with increased prominence of the scapular spine following a rotator cuff tear?

Correct Answer: D

Rationale: Following a severe rotator cuff tear, it typically takes around 2-3 months for muscular atrophy to develop with increased prominence of the scapular spine. This is due to disuse of the affected shoulder muscles leading to muscle wasting and changes in the bony structures around the shoulder blade. Over time, the lack of muscle activity causes the shoulder blade to become more prominent and noticeable, which can result in altered sensations during activities like hugging. The gradual onset of these changes aligns with the timeline provided in the question, where the wife started to feel discomfort in her husband's left shoulder blade after the recent severe rotator cuff tear.

Question 5 of 9

His head, ears, nose, throat, and neck examinations are normal. His cardiac, lung, and abdominal examinations are also normal. On visualization of the anus there is no inflammation, masses, or fissures. Digital rectal examination elicits an irregular, asymmetric, hard nodule on the otherwise normal posterior surface of the prostate. Examination of the scrotum and penis are normal. Laboratory results are pending. What disorder of the anus, rectum, or prostate is mostly likely in this case?

Correct Answer: C

Rationale: The presence of an irregular, asymmetric, hard nodule on the posterior surface of the prostate detected during digital rectal examination raises suspicion for prostate cancer. Prostate cancer commonly presents with nodules or indurations on the prostate gland during physical examination. Other findings, such as no inflammation, masses, or fissures in the anus and normal examinations of the scrotum and penis, further support the likelihood of prostate cancer as the most probable diagnosis in this case. Additional laboratory results, including prostate-specific antigen (PSA) levels, can help confirm the diagnosis. Both benign prostatic hyperplasia (BPH) and prostatitis typically present with different symptoms than those described in the scenario, making prostate cancer the most likely disorder based on the provided information. Anorectal cancer is less likely given the absence of findings indicating involvement of the anus or rectum in this case.

Question 6 of 9

A young man feels something in his scrotum and comes to you for clarification. On your examination, you note what feels like a "bag of worms" in the left scrotum, superior to the testicles. Which of the following is most likely?

Correct Answer: B

Rationale: A varicocele is a common cause of a "bag of worms" feeling in the scrotum. It occurs due to the dilation of the veins within the spermatic cord, leading to a palpable mass above the testicle. Varicoceles are more commonly found on the left side due to the anatomy of the left testicular vein, which drains into the left renal vein at a right angle, making it more susceptible to increased pressure and dilation.

Question 7 of 9

A 30-year-old man notices a firm, 2-cm mass under his areola. He has no other symptoms and no diagnosis of breast cancer in his first-degree relatives. What is the most likely diagnosis?

Correct Answer: A

Rationale: In a 30-year-old man with a firm, 2-cm mass under his areola and no other symptoms, the most likely diagnosis is breast tissue. Gynecomastia is a common condition in males where there is proliferation of breast tissue. It typically presents as a firm subareolar mass and can occur due to hormonal imbalances, medication use, or underlying medical conditions. Given the lack of family history of breast cancer, absence of other symptoms, and the age of the patient, breast tissue is the most probable diagnosis in this case. Breast cancer is less likely in this scenario, especially without any additional concerning findings or family history. Fibrocystic disease and lymph node involvement are also less likely given the presentation of a firm mass under the areola.

Question 8 of 9

For which of the following patients would a comprehensive health history be appropriate?

Correct Answer: C

Rationale: For a new patient with the chief complaint of "I am here to establish care," a comprehensive health history would be appropriate. In this scenario, since the patient is new to the healthcare provider, it is important to gather detailed information about the patient's past medical history, family history, social history, medications, allergies, and specific health concerns. This comprehensive health history will help the healthcare provider establish a baseline of the patient's overall health and identify any potential risk factors or underlying conditions that may impact future care and treatment decisions. Additionally, obtaining a thorough health history is essential in building a strong patient-provider relationship and providing patient-centered care.

Question 9 of 9

A young woman comes to you with a cut on her finger caused by the lid of a can she was opening. She is pacing about the room, crying loudly, and through her sobs she says, "My career as a pianist is finished!" Which personality type exhibits these features?

Correct Answer: C

Rationale: The young woman in this scenario is exhibiting characteristics of histrionic personality disorder. Individuals with histrionic personality disorder tend to be overly dramatic, attention-seeking, and have a tendency to be excessively emotional in their reactions. The young woman's exaggerated response to a minor cut on her finger, along with her dramatic declaration that her career as a pianist is over, reflects the emotional and attention-seeking behaviors commonly associated with histrionic personality traits.

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