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
A patient presents with pain in the shoulder. The nurse practitioner knows that there are four rotator cuff muscles. The muscle that initiates abduction movement at the shoulder is known as the:
Correct Answer: A
Rationale: Rationale: The correct answer is A: Supraspinatus. This muscle is responsible for initiating abduction movement at the shoulder joint. It is located on the top of the shoulder blade and assists in lifting the arm away from the body. The other choices, B: Infraspinatus, C: Levator scapulae muscle, and D: Subscapularis, are not involved in initiating abduction movement at the shoulder. Infraspinatus is responsible for external rotation, Levator scapulae muscle elevates the scapula, and Subscapularis assists in internal rotation of the shoulder joint.
Question 3 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 4 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 5 of 9
Jacob, a 33-year-old construction worker, complains of a "lump on his back" over his scapula. It has been there for about a year and is getting larger. He says his wife has been able to squeeze out a cheesy-textured substance on occasion. He worries this may be cancer. When gently pinched from the side, a prominent dimple forms in the middle of the mass. What is most likely?
Correct Answer: B
Rationale: The correct answer is B: A sebaceous cyst. A sebaceous cyst typically presents as a lump underneath the skin that can be squeezed to release a cheesy substance, consistent with Jacob's description. The formation of a prominent dimple when gently pinched is characteristic of a cyst, indicating it is filled with fluid or semi-solid material. Sebaceous cysts are usually benign and can grow slowly over time. Incorrect choices: A: An enlarged lymph node - Unlikely as lymph nodes are typically not associated with cheesy discharge or the formation of a dimple when pinched. C: An actinic keratosis - Unlikely as actinic keratosis is a precancerous skin condition caused by sun exposure, not presenting with cheesy discharge or a dimple. D: A malignant lesion - Unlikely as malignant lesions usually do not produce cheesy discharge and are more aggressive in growth compared to a sebaceous cyst.
Question 6 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 7 of 9
A 65-year-old has a history of one kidney with early renal insufficiency. He is diagnosed with pneumonia and will require:
Correct Answer: C
Rationale: The correct answer is C: Lower dose of antibiotics. The rationale is that the patient has early renal insufficiency, which means the kidney may have difficulty clearing medications from the body. Therefore, a lower dose of antibiotics is needed to prevent potential drug toxicity. A shorter course of antibiotics (choice A) may not be effective in treating pneumonia adequately. A longer course of antibiotics (choice B) may increase the risk of drug accumulation in the body. A higher dose of antibiotics (choice D) can lead to increased toxicity in a patient with renal insufficiency. Thus, the most appropriate option is to reduce the dose to ensure safe and effective treatment.
Question 8 of 9
A 49-year-old truck driver comes to the emergency room for shortness of breath and swelling in his ankles. He is diagnosed with congestive heart failure and admitted to the hospital. You are the student assigned to do the patient's complete history and physical examination. When you palpate the pulse, what do you expect to feel?
Correct Answer: B
Rationale: The correct answer is B: Small amplitude, weak. In congestive heart failure, the heart's ability to pump effectively is compromised, leading to decreased cardiac output. This results in a weakened pulse with reduced amplitude. Palpating a small, weak pulse in this patient is expected due to poor cardiac function. Choices A and C are incorrect because a large, forceful pulse is not expected in congestive heart failure, and a normal pulse may not reflect the compromised cardiac function. Choice D, bigeminal, refers to an abnormal rhythm characterized by every other heartbeat being premature and is not typically associated with congestive heart failure.
Question 9 of 9
An 86-year-old female comes to your office for a wellness visit. Her blood pressure is 125/70 mmHg, pulse 69 beats per minute, and respiratory rate 18 breaths per minute. She is well-appearing and reports she is up to date on her routine vaccinations. She introduces her partner of 35 years, whom she would like to make medical decisions for her in case she becomes unable to make decisions for herself. She reports that she and her partner are not married. She asks if she needs any further documentation to ensure her goals of care are followed.
Correct Answer: C
Rationale: The correct answer is C: Advise them to file an advanced directive. An advanced directive is a legal document that allows individuals to specify their healthcare preferences in advance, including who they want to make medical decisions for them if they are unable to do so. In this scenario, since the patient and her partner are not married, it is important for her to have an advanced directive in place to ensure that her partner is legally recognized as the decision-maker. This documentation will help ensure her goals of care are followed in case she becomes incapacitated. Choice A (Advise them to complete a POLST) is incorrect because a POLST (Physician Orders for Life-Sustaining Treatment) form is used to specify a patient's wishes for end-of-life care, not for designating a medical decision-maker. Choice B (Advise them that they have adequate documentation to be recognized legally) is incorrect because without an advanced directive, there may be legal challenges to the partner's authority to make medical decisions