ATI RN
Jarvis Physical Examination and Health Assessment 9th Edition Test Bank Questions
Question 1 of 5
Monique is a 33-year-old administrative assistant who has had intermittent lower abdominal pain approximately one week a month for the past year. It is not related to her menses. She notes relief with defecation, and a change in form and frequency of her bowel movements with these episodes. Which of the following is most likely?
Correct Answer: D
Rationale: The correct answer is D: Irritable bowel syndrome (IBS). Monique's symptoms of lower abdominal pain relieved by defecation, change in bowel movements' form and frequency, and absence of menses-related pain align with IBS criteria. IBS is a functional gastrointestinal disorder characterized by abdominal pain and altered bowel habits. It is a diagnosis of exclusion, meaning other conditions must be ruled out. Choice A: Colon cancer is less likely due to Monique's age, absence of alarming symptoms like weight loss or blood in stool, and the intermittent nature of her symptoms. Choice B: Cholecystitis typically presents with right upper quadrant pain, nausea, and vomiting, which do not match Monique's symptoms. Choice C: Inflammatory bowel disease (IBD) usually presents with persistent symptoms, blood in stool, and systemic signs, which are not seen in Monique's case.
Question 2 of 5
You are obtaining an arterial blood gas in the radial artery on a retired cab driver who has been hospitalized in the intensive care unit for a stroke. You are concerned about the possibility of arterial insufficiency. You perform the Allen test. This means that you:
Correct Answer: C
Rationale: The Allen test assesses collateral circulation by checking for patency of the ulnar artery. This is important before obtaining an arterial blood gas from the radial artery to ensure adequate blood flow and prevent ischemia. If the ulnar artery is not patent, using the radial artery could lead to arterial insufficiency. Checking the radial artery's patency (Choice A) is not the purpose of the Allen test. Checking the patency of the brachial artery (Choice B) or the femoral artery (Choice D) is not relevant in this context. The correct answer is C because ensuring ulnar artery patency is crucial for arterial blood gas sampling from the radial artery.
Question 3 of 5
A patient presents with claudication symptoms and diminished pulses. Which of the following is consistent with chronic arterial insufficiency?
Correct Answer: A
Rationale: The correct answer is A. Pallor of the foot when raised to 60 degrees for one minute is consistent with chronic arterial insufficiency. When the foot is raised, blood flow decreases, leading to decreased oxygenation and pallor in the presence of arterial insufficiency. This is known as the dependent rubor test, and the delayed return of color is indicative of impaired blood flow. Choice B is incorrect because a quick return of color within 5 seconds suggests normal vascular perfusion. Choice C is incorrect as filling of veins within 10 seconds indicates venous insufficiency rather than arterial insufficiency. Choice D, hyperpigmentation of the skin, is not a typical finding in chronic arterial insufficiency.
Question 4 of 5
A 45-year-old electrical engineer presents to your clinic, complaining of spots on his scrotum. He first noticed the spots several months ago, and they have gotten bigger. He denies any pain with urination or with sexual intercourse. He has had no fever, night sweats, weight gain, or weight loss. His past medical history consists of a vasectomy 10 years ago and mild obesity. He is on medication for hyperlipidemia. He denies any tobacco or illegal drug use and drinks alcohol socially. His mother has Alzheimer's disease and his father died of leukemia. On examination he appears relaxed and has unremarkable vital signs. On visualization of his penis, he is circumcised and has no lesions on his penis. Visualization of his scrotum shows three yellow nodules 2-3 millimeters in diameter. During palpation they are firm and nontender. What abnormality of the male genitalia is this most likely to be?
Correct Answer: D
Rationale: The correct answer is D: Epidermoid cysts. These cysts typically present as firm, non-tender nodules on the scrotum, consistent with the patient's presentation. The history of gradual growth without associated symptoms supports this diagnosis. Additionally, the lack of pain with urination or sexual intercourse rules out sexually transmitted infections like condylomata acuminata (choice A) and syphilitic chancre (choice B). Peyronie's disease (choice C) involves penile curvature and fibrous plaques, not scrotal nodules. In summary, the patient's presentation, physical examination findings, and absence of specific symptoms point towards epidermoid cysts as the most likely diagnosis.
Question 5 of 5
A 42-year-old realtor comes to your clinic, complaining of "growths" in her vulvar area. She is currently undergoing a divorce and is convinced she has a sexually transmitted disease. She denies any vaginal discharge or pain with urination. She has had no fever, malaise, or night sweats. Her past medical history consists of depression and hypothyroidism. She has had two spontaneous vaginal deliveries and one cesarean section. She has had no other surgeries. She denies smoking or drug use. She has two to three drinks weekly. Her mother also has hypothyroidism and her father has high blood pressure and hypercholesterolemia. On examination you see a woman who is anxious but appears otherwise healthy. Her blood pressure, pulse, and temperature are unremarkable. On visualization of the perineum you see two 2- to 3- mm, round, yellow nodules on the left labia. On palpation they are nontender and quite firm. What diagnosis best fits this description of her examination?
Correct Answer: D
Rationale: The correct answer is D: Epidermoid cyst. The key features in the clinical scenario that point towards an epidermoid cyst are the presence of painless, firm, non-tender, round, yellow nodules on the labia. These cysts are common in the vulvar area and often arise from blocked hair follicles. The absence of symptoms suggestive of a sexually transmitted infection (STI) such as vaginal discharge, pain with urination, fever, malaise, or night sweats, along with the patient's history of anxiety and the appearance of the nodules being consistent with an epidermoid cyst support this diagnosis. Choice A: Genital herpes typically presents with painful vesicles or ulcers, which are not described in this case. Choice B: Condylomata acuminata (genital warts) would present as soft, pink, or flesh-colored growths and are associated with HPV infection, which is not suggested in this scenario. Choice C: Sy