ATI RN
Jarvis Physical Examination and Health Assessment Test Bank Questions
Question 1 of 5
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 2 of 5
Which area of the fundus is the central focal point for incoming images?
Correct Answer: A
Rationale: The correct answer is A: The fovea. The fovea is the central focal point for incoming images because it contains a high concentration of cones, which are responsible for detailed central vision. Cones are essential for color vision and visual acuity. The macula, while important for central vision, refers to the area surrounding the fovea. The optic disk is where the optic nerve exits the eye, and it does not receive incoming images. The physiologic cup is a normal depression in the optic nerve head and is not involved in image reception. In conclusion, the fovea is the correct answer as it is the area with the highest visual acuity due to the dense concentration of cones.
Question 3 of 5
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 5
A grandmother brings her 13-year-old grandson to you for evaluation. She noticed last week when he took off his shirt that his breastbone seemed collapsed. He seems embarrassed and tells you that it has been that way for quite a while. He states he has no symptoms from it and he just tries not to take off his shirt in front of anyone. He denies any shortness of breath, chest pain, or lightheadedness on exertion. His past medical history is unremarkable. He is in sixth grade and just moved in with his grandmother after his father was deployed to the Middle East. His mother died several years ago in a car accident. He states that he does not smoke and has never touched alcohol. On examination you see a teenage boy appearing his stated age. On visual examination of his chest, you see that the lower portion of the sternum is depressed. Auscultation of the lungs and heart are unremarkable. What disorder of the thorax best describes your findings?
Correct Answer: B
Rationale: The correct answer is B: Funnel chest (pectus excavatum). Pectus excavatum is characterized by a depressed or sunken appearance of the sternum, which matches the description provided in the case. In this condition, the chest wall is abnormally shaped inward. This can be a congenital condition or develop during growth spurts in adolescence. The lack of symptoms such as shortness of breath, chest pain, or lightheadedness on exertion is consistent with pectus excavatum, as these symptoms are not typically associated with this condition. The other choices (A: Barrel chest, C: Pigeon chest, D: Thoracic kyphoscoliosis) do not match the specific findings described in the case and are not associated with the characteristic sternal depression seen in pectus excavatum.
Question 5 of 5
A patient with longstanding COPD was told by another practitioner that his liver was enlarged and this needed to be assessed. Which of the following would be reasonable to do next?
Correct Answer: D
Rationale: The correct answer is D: Obtain an ultrasound of the liver. This is the most appropriate next step to assess the patient's enlarged liver in the context of COPD. Ultrasound can provide detailed images of the liver to identify potential causes of enlargement, such as fatty liver disease or liver cirrhosis. Percussing the lower border (Choice A) or measuring the span of the liver (Choice B) may provide some information but are less specific and may not identify the underlying cause. Ordering a hepatitis panel (Choice C) would focus only on viral hepatitis as a potential cause, while an ultrasound can provide a broader evaluation of liver structure and function.