ATI RN
jarvis physical examination and health assessment test bank Questions
Question 1 of 9
An 85-year-old woman with congestive heart failure and frailty asks about hastening her death. Which of the following is legal throughout the United States?
Correct Answer: C
Rationale: The correct answer is C: Voluntary stopping of eating and drinking. This is legal throughout the United States because it is considered a patient's right to refuse food and water, even if it may lead to death. This decision is based on the principle of patient autonomy and respects the patient's wishes. Euthanasia (A) involves actively causing death, which is illegal in the United States. Palliative sedation (B) is providing medication to relieve suffering, but not with the intention of hastening death. Physician-assisted death (D) involves a physician providing medication for a patient to self-administer to end their life, which is not legal in all states.
Question 2 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 3 of 9
You feel a small mass that you think is a lymph node. It is mobile in both the up-and- down and side-to-side directions. Which of the following is most likely?
Correct Answer: B
Rationale: The correct answer is B: Lymph node. A mobile mass that is palpable and moves in multiple directions is characteristic of a lymph node. Lymph nodes are small, bean-shaped structures that are part of the immune system and can move freely when touched. Incorrect choices: A: Cancer - A cancerous mass would typically be fixed and not mobile. C: Deep scar - Scars are usually fixed and do not move when touched. D: Muscle - Muscles are usually deeper in the body and not typically palpable as a mobile mass.
Question 4 of 9
A 78-year-old male is being treated for hypertension. The nurse knows that the most appropriate first-line therapy in older adults is:
Correct Answer: A
Rationale: The correct answer is A: Diuretics. In older adults, diuretics are considered the most appropriate first-line therapy for hypertension due to their effectiveness in reducing blood pressure and preventing complications such as heart failure. Diuretics are well-tolerated, have a long history of use, and are cost-effective. They are especially beneficial in older adults with volume overload or fluid retention. Beta-blockers (B) may be less effective in older adults and can have more side effects. ACE inhibitors (C) are commonly used but may pose risks of hyperkalemia and renal dysfunction in older adults. Calcium channel blockers (D) are effective but may increase the risk of falls and fractures in older adults.
Question 5 of 9
A 64-year-old man complains of leg pain and occasional numbness that worsens with ambulation and improves with lumbar flexion. The symptoms are consistent with:
Correct Answer: B
Rationale: The correct answer is B: Spinal stenosis. The symptoms described suggest neurogenic claudication, which is a hallmark of spinal stenosis. Pain worsening with ambulation and improving with lumbar flexion is characteristic of spinal stenosis due to narrowing of the spinal canal leading to compression of nerves. Ankylosing spondylitis (A) presents with inflammatory back pain and stiffness, not neurogenic claudication. Bursitis (C) involves inflammation of bursae, not typically associated with leg pain and numbness. Cauda equina syndrome (D) presents with sudden-onset severe back pain, urinary retention, and saddle anesthesia, which are not consistent with the described symptoms.
Question 6 of 9
An 85-year-old man with newly diagnosed nonvalvular atrial fibrillation comes to the office for a follow-up. Which medication change would be most appropriate for reducing his stroke risk?
Correct Answer: C
Rationale: The correct answer is C: Stop aspirin and begin apixaban 5 mg twice a day. The rationale is that for stroke risk reduction in nonvalvular atrial fibrillation, anticoagulation therapy with direct oral anticoagulants (DOACs) like apixaban is preferred over antiplatelet therapy like aspirin. DOACs have been shown to be more effective in reducing stroke risk with a lower bleeding risk compared to warfarin. Choice A is incorrect as aspirin alone is not sufficient for stroke prevention in atrial fibrillation. Choice B is incorrect as warfarin has more monitoring requirements and potential drug interactions compared to DOACs like apixaban. Choice D is incorrect as aspirin and apixaban together are not recommended due to increased bleeding risk.
Question 7 of 9
Ms. J, who is 82 years old, complains of urine leakage while playing golf. This has gotten worse over the past year, and she rarely makes it through nine holes without feeling like she needs to “run into the bushes and go.” Leakage is usually small volume, but causes her extreme embarrassment because she is afraid she will smell of urine. She has tried limiting caffeine in the morning before she golfs and avoiding drinking water while playing, to no effect. She also tried “those Kegel exercises” in the past without success. Which of the following is the most appropriate recommendation for Ms. J?
Correct Answer: B
Rationale: The correct answer is B: Referral for biofeedback training in pelvic muscle exercise. Biofeedback training helps Ms. J improve her pelvic muscle control, which can address her urinary leakage issue. It is specifically tailored to strengthen the pelvic floor muscles, which can help with urinary incontinence. This option is appropriate for Ms. J as she has already tried Kegel exercises without success. Option A: Bladder training focuses on scheduling toilet trips and gradually increasing the time between trips. It may not be as effective for Ms. J's specific issue with leakage during physical activity. Option C: Solifenacin is a medication for overactive bladder symptoms, which may not be the best approach for Ms. J who has stress urinary incontinence. Option D: Topical estrogen is used for menopausal symptoms and genitourinary atrophy, which may not directly address Ms. J's issue with urinary leakage during physical activity.
Question 8 of 9
When deciding on an initial treatment option for an acute flare of atopic dermatitis, unresponsive to emollient therapy, the next best choice for treatment is:
Correct Answer: B
Rationale: The correct answer is B: Betamethasone dipropionate 0.05% (Betanate). When managing an acute flare of atopic dermatitis unresponsive to emollient therapy, topical corticosteroids like betamethasone are often the first-line treatment due to their anti-inflammatory properties. Betamethasone is a potent corticosteroid that can help reduce inflammation, itching, and redness associated with atopic dermatitis. Oral corticosteroids (Choice A) are generally reserved for severe cases due to potential systemic side effects. Desonide (Choice C) is a milder topical corticosteroid suitable for maintenance therapy but may not be potent enough for acute flares. Pimecrolimus (Choice D) is a calcineurin inhibitor used for moderate to severe atopic dermatitis and is generally not the first choice for initial treatment of acute flares.
Question 9 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.