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
Mrs. Gloth is an 84-year-old woman whom you are admitting to the nursing home. Her son takes you aside and tells you that she has metastatic ovarian cancer but has not been told the diagnosis. He asks that you not tell her, because she would “lose all hope and die.” Which of the following is an appropriate response?
Correct Answer: C
Rationale: The correct answer is C: Suggest that you discuss this further after getting to know the patient and family a little better. This response allows the healthcare provider to gather more information about the patient's beliefs, values, and preferences before making a decision. It demonstrates respect for the autonomy of the patient and involves a collaborative approach with the family. It also allows time to assess the patient's emotional and psychological readiness to receive the diagnosis. Incorrect answers: A: This answer disregards the patient's autonomy and does not consider the emotional impact of delivering such news without proper assessment. B: While respecting the son's wishes is important, prioritizing the patient's well-being and autonomy should come first. D: Relying solely on the family's perspective without considering the patient's own wishes and understanding may lead to ethical issues and potential harm to the patient.
Question 3 of 9
Disorders in the kidneys and the ureters may cause pain in all of the following areas except the:
Correct Answer: D
Rationale: The correct answer is D: Suprapubic. Disorders in the kidneys and ureters typically cause pain in the flank, abdomen, and back due to the location of these organs. The kidneys are located in the flank region, so kidney issues may cause flank pain. Ureters run down towards the bladder, so issues in this area can cause pain in the abdomen and back. Suprapubic pain usually indicates issues with the bladder or lower urinary tract, not the kidneys or ureters. Therefore, suprapubic pain is not typically associated with disorders in the kidneys and ureters.
Question 4 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 5 of 9
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 6 of 9
Hyperkalemia is associated with
Correct Answer: C
Rationale: Hyperkalemia is associated with diminished renal function because the kidneys play a crucial role in regulating potassium levels in the body. When renal function is impaired, the kidneys may not be able to excrete excess potassium effectively, leading to elevated potassium levels in the blood. - Choice A (Increase BP) is incorrect because hyperkalemia is not directly associated with increased blood pressure. - Choice B (Alpha-blockers) is incorrect as alpha-blockers are not typically linked to hyperkalemia. - Choice D (Loop diuretics) is incorrect as loop diuretics can actually lower potassium levels, not cause hyperkalemia.
Question 7 of 9
In healthy adults over 20, how often should blood pressure, body mass index, waist circumference, and pulse be assessed, according to American Heart Association guidelines?
Correct Answer: B
Rationale: The correct answer is B: Every year. Annual assessment aligns with American Heart Association guidelines to monitor these key health indicators regularly for early detection and management of potential cardiovascular risks. More frequent assessments (A) may be unnecessary and burdensome. Less frequent assessments (C, D) increase the risk of missing important changes in health status that could lead to adverse outcomes. Regular yearly assessments allow for timely interventions and adjustments to promote optimal cardiovascular health.
Question 8 of 9
Ms. Wright comes to your office, complaining of palpitations. While checking her pulse you notice an irregular rhythm. When you listen to her heart, every fourth beat sounds different. It sounds like a triplet rather than the usual "lub dup." How would you document your examination?
Correct Answer: C
Rationale: The correct answer is C: Regularly irregular rhythm. This is the appropriate documentation for Ms. Wright's presentation as her pulse demonstrates a pattern of irregularity with every fourth beat sounding different. This indicates a regularly irregular rhythm, where there is a discernible pattern to the irregularity. Rationale: 1. Regular rate and rhythm (Choice A) is incorrect as Ms. Wright's palpitations and the irregularity in her pulse indicate an irregular rhythm. 2. Irregularly irregular rhythm (Choice B) is incorrect as this term is used to describe arrhythmias like atrial fibrillation, which do not have a discernible pattern of irregularity. 3. Bradycardia (Choice D) is incorrect as it refers to a slow heart rate, which is not the primary concern in this scenario where the focus is on the irregular rhythm. In summary, the correct choice (C) accurately describes the specific irregular pattern observed in Ms. Wright's pulse, distinguishing it from
Question 9 of 9
You are palpating the apical impulse in a patient with heart disease and find that the amplitude is diffuse and increased. Which of the following conditions could be a potential cause of an increase in the amplitude of the impulse?
Correct Answer: D
Rationale: The correct answer is D, cardiomyopathy. Cardiomyopathy is a disease of the heart muscle that can lead to an increase in the size and strength of the heart muscle, resulting in an increased amplitude of the apical impulse. This is due to the heart working harder to pump blood effectively. Hypothyroidism (choice A) typically does not cause an increase in the amplitude of the apical impulse. Aortic stenosis (choice B) and mitral stenosis (choice C) both result in pressure or volume overload on specific chambers of the heart, but they do not directly lead to diffuse and increased amplitude of the apical impulse like cardiomyopathy does. In summary, an increase in the amplitude of the apical impulse is more likely to be caused by cardiomyopathy due to the increased workload on the heart muscle, compared to the other conditions provided in the choices.