ATI RN
jarvis physical examination and health assessment test bank Questions
Question 1 of 9
Guidelines for the primary prevention of stroke recommend that aspirin be used in which one of the following?
Correct Answer: A
Rationale: The correct answer is A because guidelines for primary stroke prevention recommend using aspirin in individuals whose risk of stroke is high enough for the benefits to outweigh the risks. This is based on assessing individual risk factors such as age, hypertension, diabetes, smoking, and history of cardiovascular diseases to determine if the potential benefits of aspirin therapy in reducing the risk of stroke outweigh the potential risks such as gastrointestinal bleeding. Choices B, C, and D are incorrect because aspirin should not be used regardless of risk level, based on gender, or in specific populations without considering individual risk factors to ensure the benefits outweigh the risks.
Question 2 of 9
Mr. Roberts, a 72-year-old patient who has sought medical care on an intermittent basis in the past, complains of aching discomfort in his perineal area, urinary urgency, and frequency for the past few years. He also complains of insomnia and intermittent anxiety that he attributes to loneliness after his wife’s death about a year ago. Digital rectal examination (DRE) reveals a slightly enlarged, nontender prostate with no palpable nodules. Perineal examination is normal. Bladder scan is unremarkable and postvoid residual urine volume is 50 mL. Urinalysis shows no WBCs or RBCs. Urine culture is negative. Previous treatment has included dietary modifications and alpha-blocker medication. What is the most appropriate next step?
Correct Answer: D
Rationale: The correct answer is D: Screen for depression. The patient's symptoms of insomnia, anxiety, and loneliness after his wife's death suggest he may be experiencing depression, which can manifest as physical symptoms like urinary urgency and frequency. Since the patient has already received appropriate treatment for his urinary symptoms, addressing his mental health is the next crucial step. This can help improve his overall well-being and quality of life. Starting an antibiotic course (choice A) is not indicated as there are no signs of infection. Initiating a 5-alpha-reductase inhibitor (choice B) is not necessary given the absence of specific indications such as obstructive voiding symptoms. Urodynamic testing (choice C) is not warranted at this stage as the patient's history and findings do not suggest underlying bladder dysfunction.
Question 3 of 9
A 20-year-old male living in a college dorm complains of a dry cough for the past month. Assessment findings associated with atypical, community-acquired pneumonia would include:
Correct Answer: A
Rationale: The correct answer is A because atypical, community-acquired pneumonia often presents with subtle symptoms like a low-grade fever and malaise. Clear lung fields on auscultation are typical as atypical pneumonia affects the interstitium rather than the alveoli. Choice B is incorrect as crackles throughout the lung fields are indicative of typical pneumonia affecting the alveoli. Choice C is incorrect because a sore throat is not a typical symptom of atypical pneumonia, and diminished breath sounds are not typically associated with atypical pneumonia. Choice D is incorrect because a temperature of 102°F and dyspnea are more indicative of a more severe pneumonia, and diminished lung sounds are not typically associated with atypical pneumonia.
Question 4 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 5 of 9
A 19-year-old-college student presents to the emergency room with fever, headache, and neck pain/stiffness. She is concerned about the possibility of meningococcal meningitis. Several of her dorm mates have been vaccinated, but she hasn't been. Which of the following physical examination descriptions is most consistent with meningitis?
Correct Answer: C
Rationale: The correct answer is C. Meningitis typically presents with neck stiffness due to meningeal irritation. In choice C, the patient has a tender neck to palpation and is unable to perform range of motion, indicating meningeal inflammation. Choices A, B, and D all describe a normal head and fundi exam, which is not consistent with meningitis. Choice B mentions muscle spasm and limited range of motion to the right, but this is more suggestive of a musculoskeletal issue rather than meningitis. Choice D describes a normal neck exam, which is not in line with the presentation of meningitis.
Question 6 of 9
Why would a combined hormonal contraceptive be contraindicated in a 36-year-old patient with a past medical history of type 2 diabetes, obesity, chronic smoking, and a sedentary lifestyle?
Correct Answer: C
Rationale: The correct answer is C. The patient's age (36 years) and chronic smoking are the main reasons why a combined hormonal contraceptive would be contraindicated. Age over 35 and tobacco use increase the risk of cardiovascular complications with hormonal contraceptives. Obesity (choice A), type 2 diabetes (choice B), and a sedentary lifestyle (choice D) are also risk factors, but they are not the primary reasons for contraindicating combined hormonal contraceptives in this case.
Question 7 of 9
Pregnant women are evaluated for syphilis with serology testing because:
Correct Answer: A
Rationale: The correct answer is A because syphilis during pregnancy can lead to adverse outcomes for the fetus, such as spontaneous abortion or congenital syphilis. This is due to the ability of the Treponema pallidum bacterium to cross the placenta and infect the fetus. Testing pregnant women for syphilis helps identify and treat the infection early to prevent these complications. Choice B is incorrect because hormonal changes do not trigger activation of latent syphilis. Choice C is incorrect as syphilis can be transmitted to the fetus at any point during pregnancy, not just in the third trimester. Choice D is incorrect because while untreated syphilis can have various complications, neonatal respiratory distress is not a direct consequence of syphilis infection during pregnancy.
Question 8 of 9
What was the primary significance of the Crookes tube in the development of modern imaging technologies?
Correct Answer: B
Rationale: The correct answer is B: It was the first device to produce X-rays. The Crookes tube, invented by William Crookes, was crucial in the development of modern imaging technologies because it was the first device to produce X-rays. X-rays revolutionized medical diagnostics and imaging, leading to significant advancements in healthcare. Choices A, C, and D are incorrect because the primary significance of the Crookes tube was its role in producing X-rays, not demonstrating electromagnetic radiation principles, paving the way for the electron microscope, or advancements in nuclear medicine.
Question 9 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.