ATI RN
jarvis physical examination and health assessment test bank Questions
Question 1 of 9
An 80-year-old woman that you follow in a nursing home has an acute decline in her mental status. She has a fever >100°F, but no other focal complaints or findings on physical examination except for a chronic indwelling urinary catheter. What statement is true?
Correct Answer: A
Rationale: The correct answer is A because in an older adult with an indwelling urinary catheter, a fever >100°F can be a sign of urinary tract infection (UTI) or urosepsis. Given her acute decline in mental status and fever, empiric antibiotic therapy is warranted to treat a potential infection. Choice B is incorrect because older adults with indwelling catheters are at increased risk for UTIs and bloodstream infections. Choice C is incorrect as obtaining a urine culture is important to confirm the diagnosis and guide appropriate antibiotic therapy. Choice D is incorrect as the duration of antibiotic treatment for a UTI is typically longer than 3 days.
Question 2 of 9
During a clinical examination, you observe that a patient's ears are positioned significantly below the level of the lateral eye canthi. What might this indicate about the patient's head and neck anatomy?
Correct Answer: B
Rationale: The correct answer is B: Potential congenital deformity. This observation suggests a condition called "low-set ears," which can be a sign of certain congenital anomalies affecting the development of the head and neck structures during fetal growth. It is important to investigate further to rule out any associated syndromes or genetic disorders. Choice A: Normal anatomical variation is incorrect because this positioning is not commonly considered a normal variation in the general population. Choice C: Increased risk of hearing loss is incorrect as the position of the ears alone does not directly correlate with hearing loss. Choice D: No clinical significance is incorrect because this observation warrants further evaluation to assess for potential underlying issues.
Question 3 of 9
Which of these statements about frailty are false?
Correct Answer: C
Rationale: The correct answer is C because clinical diagnosis of anxiety or depression can indeed have an effect on frailty rates. Anxiety and depression can contribute to the development and progression of frailty through various mechanisms such as decreased physical activity, poor nutrition, and social isolation. This can lead to a higher risk of frailty in individuals with mental health issues. Choices A, B, and D are incorrect because both prominent frailty models (e.g., Fried's phenotype model and Rockwood's accumulation of deficits model) do consider age as a component for defining frailty, individuals who are prefrail are at a higher risk of progressing to frailty rather than becoming robust, and frailty diagnosis has been shown to be valuable in preoperative assessment as it helps identify patients who may not do well with surgical interventions.
Question 4 of 9
All of the following about the Medicare Part D prescription medication benefit plan are true except:
Correct Answer: D
Rationale: The correct answer is D because beneficiaries do have out-of-pocket expenses for each prescription filled under Medicare Part D. This is typically in the form of copayments or coinsurance. A: Medicare Advantage plans often include Part D coverage, making statement A true. B: There are indeed multiple companies offering Part D plans, so statement B is true. C: The monthly premium for Part D coverage can vary, but in 2019 it was indeed around $30, making statement C true as well.
Question 5 of 9
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.
Question 6 of 9
Treatment for early PD in an otherwise healthy older patient without significant functional impairment should begin with:
Correct Answer: B
Rationale: The correct answer is B: Dopamine agonist. In early PD, dopamine agonists are preferred due to their lower risk of motor complications compared to levodopa. Dopamine agonists help improve motor symptoms by directly stimulating dopamine receptors. COMT inhibitors are usually used in combination with levodopa to prolong its effects. Levodopa is effective but can lead to motor complications with long-term use. Careful observation is not a treatment strategy and delays symptom management. Therefore, starting with a dopamine agonist is the most suitable option for early PD to manage symptoms effectively with minimal risk of motor complications.
Question 7 of 9
Janeway lesions, petechiae, and Osler nodes are associated with:
Correct Answer: B
Rationale: Step-by-step rationale for why B is correct: Janeway lesions, petechiae, and Osler nodes are classic signs of infective endocarditis. Janeway lesions are painless erythematous macules on palms/soles, petechiae are small red/purple spots due to microemboli, and Osler nodes are tender subcutaneous nodules on fingers/toes. These findings indicate systemic embolization and immune complex deposition in infective endocarditis. Other choices are incorrect as they do not typically present with these specific dermatologic findings.
Question 8 of 9
A patient with alcoholism is brought in with confusion. You ask him to "stop traffic" with his palms and notice that every few seconds his palms suddenly move toward the floor. What does this indicate?
Correct Answer: B
Rationale: The correct answer is B: Metabolic problems. The patient's inability to maintain sustained upward hand posture indicates asterixis, a sign of metabolic encephalopathy commonly seen in patients with liver failure due to alcoholism. This is caused by metabolic disturbances affecting the brain's function, leading to confusion and motor abnormalities. It is not indicative of a stroke (A), carpal tunnel syndrome (C), or severe fatigue and weakness (D), as they do not typically present with asterixis or the described palm movements.
Question 9 of 9
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.