ATI RN
jarvis physical examination and health assessment 9th edition test bank Questions
Question 1 of 5
In which of the following patients is chemical or surgical castration likely to prolong survival?
Correct Answer: C
Rationale: The correct answer is C. In this scenario, the patient had a radical prostatectomy and external beam radiation therapy, indicating aggressive treatment. Despite this, the PSA level is high (24.5 ng/mL), suggesting biochemical recurrence and possible metastasis. The positive bone scan and enlarged pelvic lymph node indicate disease progression beyond the prostate. Chemical or surgical castration, such as androgen deprivation therapy, can help delay disease progression and prolong survival by reducing the levels of testosterone that fuel prostate cancer growth. Summary: A: In advanced dementia and metastatic bone disease, castration is unlikely to impact survival as the disease is already advanced. B: A rising PSA level post-radical prostatectomy with negative imaging indicates biochemical recurrence, but without evidence of metastasis, making castration less beneficial. D: Prostate cancer limited to the prostate with a Gleason score of 6 is low risk and may not benefit significantly from castration as it is less likely to progress rapidly.
Question 2 of 5
Mr. Hunter, a 69-year-old man, complains of urinary frequency and urgency that have increased over the past several months. There is no dysuria, hematuria, or sensation of incomplete voiding. He drinks 2 cups of coffee daily and diet cola multiple times a day. His International Prostate Symptom Score (IPSS) is 6, with a bother score of 1 indicating mild voiding symptoms with low impact on his quality of life. His medical history includes hypertension, coronary artery disease, and benign prostatic hyperplasia. Current medications are aspirin, metoprolol, and hydrochlorothiazide. Physical examination reveals normal sized prostate. Which of the following is the best next step?
Correct Answer: C
Rationale: The correct next step is C: Lifestyle modifications. Given the patient's history of mild voiding symptoms and benign prostatic hyperplasia, the first approach should be conservative management. Lifestyle modifications, such as reducing caffeine intake from coffee and diet cola, can help alleviate urinary symptoms. Additionally, optimizing fluid intake and bladder habits can also improve symptoms. Urinalysis (choice A) may be considered later if symptoms persist or worsen. Cystoscopy (choice B) is invasive and not indicated at this stage. Tamsulosin (choice D) is a medication for BPH, but since the patient's symptoms are mild and bother score is low, starting with lifestyle modifications is more appropriate.
Question 3 of 5
Even though older adults are less likely to get counseled for smoking cessation, they have which one of the following?
Correct Answer: C
Rationale: The correct answer is C: Approximately 25% better quit rates than younger individuals. Older adults tend to have higher quit rates compared to younger individuals due to factors like increased motivation, life experience, and health concerns. Older adults often have more resources and support systems in place to help them quit smoking successfully. Choice A is incorrect because older adults do not necessarily have the same quit rates as younger individuals. Choice B is also incorrect as the difference in quit rates is not as high as 50%. Choice D is incorrect as older adults do not generally have much lower quit rates than younger individuals.
Question 4 of 5
A 69-year-old female presents to your office for routine primary care. Her elder sister was recently diagnosed with Alzheimer's disease, and she wonders what steps she can take to reduce her own risk of developing dementia. Which of the following statements is true about the prevention of dementia?
Correct Answer: C
Rationale: The correct answer is C: There is moderate quality evidence to suggest control of cardiovascular and metabolic risk factors, such as blood pressure, weight, and blood sugar, may reduce the risk of dementia. This statement is true because studies have shown that managing cardiovascular and metabolic risk factors can help reduce the risk of developing dementia. High blood pressure, obesity, and diabetes have been linked to an increased risk of cognitive decline and dementia. By controlling these risk factors through lifestyle changes or medication, individuals can potentially lower their risk of developing dementia. Choice A is incorrect because while vitamin B12 and fish oil may have some benefits for cognitive health, the evidence supporting their use in preventing dementia is not strong. Choice B is incorrect because while genetics and family history play a role in dementia risk, there are behavioral interventions, such as maintaining a healthy lifestyle and managing risk factors, that can help reduce the risk of dementia. Choice D is incorrect because there is not enough strong evidence to support the claim that cannabinoids can reduce rates
Question 5 of 5
You want to start pharmacologic treatment for depression in an older patient who is taking numerous medications. Which of the following antidepressants is the least likely to cause drug-drug interactions?
Correct Answer: E
Rationale: I believe you made a typo in listing the correct answer as "E" while there is no "E" option in the choices provided. Could you please confirm the correct answer choice so I can provide you with a detailed explanation and summary of why the correct answer is correct and why the other choices are incorrect?