ATI RN
Jarvis Physical Examination and Health Assessment Practice Questions Questions
Question 1 of 9
Mr. Q. is a 45-year-old salesman who comes to your office for evaluation of fatigue. He has come to the office many times in the past with a variety of injuries, and you suspect that he has a problem with alcohol. Which one of the following questions will be most helpful in diagnosing this problem?
Correct Answer: B
Rationale: Asking Mr. Q. when his last drink was is an open-ended question that can provide valuable information regarding his alcohol consumption patterns. This question allows Mr. Q. to disclose whether he has been drinking recently and can help determine the frequency and quantity of his alcohol consumption. It avoids leading or judgmental language, which can help build rapport and facilitate a more honest conversation about his alcohol use. By knowing when his last drink was, you can better assess the potential impact of alcohol on his current symptoms of fatigue and further explore any potential issues related to alcohol abuse.
Question 2 of 9
An 8-year-old girl comes with her mother for evaluation of hair loss. She denies pulling or twisting her hair, and her mother has not noted this behavior at all. She does not put her hair in braids. On physical examination, you note a clearly demarcated, round patch of hair loss without visible scaling or inflammation. There are no hair shafts visible. Based on this description, what is your most likely diagnosis?
Correct Answer: A
Rationale: The description provided, which includes a clearly demarcated, round patch of hair loss without visible scaling or inflammation and absence of hair shafts, is characteristic of alopecia areata. Alopecia areata is an autoimmune condition that causes hair loss in round or oval patches on the scalp or other parts of the body. It is not associated with pulling or twisting of hair (trichotillomania), fungal infection (tinea capitis), or hair loss due to constant pulling force (traction alopecia). In alopecia areata, the affected area usually appears smooth and without visible signs of irritation. Treatment options for alopecia areata may include corticosteroid injections, topical immunotherapy, or minoxidil.
Question 3 of 9
Ray works a physical job and notes pain when he attempts to lift his arm over his head. When you move the shoulder passively, he has full range of motion without pain and there is no gross swelling or tenderness. What type of joint disease does this most likely represent?
Correct Answer: B
Rationale: The scenario described suggests that Ray experiences pain only when actively lifting his arm over his head, which indicates the issue is likely originating from structures outside of the joint itself. When the shoulder is moved passively (moved by an external force), there is full range of motion without pain, suggesting that the limitation and pain occur due to muscles, tendons, or ligaments surrounding the joint rather than within the joint itself. In this case, the joint disease is likely to be extra-articular, involving structures such as muscles or tendons rather than being articular in nature.
Question 4 of 9
For which of the following patients would a comprehensive health history be appropriate?
Correct Answer: C
Rationale: For a new patient with the chief complaint of "I am here to establish care," a comprehensive health history would be appropriate. In this scenario, since the patient is new to the healthcare provider, it is important to gather detailed information about the patient's past medical history, family history, social history, medications, allergies, and specific health concerns. This comprehensive health history will help the healthcare provider establish a baseline of the patient's overall health and identify any potential risk factors or underlying conditions that may impact future care and treatment decisions. Additionally, obtaining a thorough health history is essential in building a strong patient-provider relationship and providing patient-centered care.
Question 5 of 9
He is afebrile. His abdominal examination reveals normal bowel sounds, but he is very tender in the left upper quadrant and epigastric area. He has no Murphy's sign or tenderness in the right lower quadrant. The remainder of his abdominal examination is normal. His rectal, prostate, penile, and testicular examinations are normal. He has no inguinal hernias or tenderness with that examination. Blood work is pending. What etiology of abdominal pain is most likely causing his symptoms?
Correct Answer: D
Rationale: The patient's presentation of tenderness in the left upper quadrant and epigastric area, along with normal bowel sounds, is suggestive of acute pancreatitis. This condition typically presents with severe, steady epigastric pain that may radiate to the back or left upper quadrant. Patients may also have tenderness on physical examination in these areas. Acute pancreatitis is commonly associated with risk factors such as gallstones or excessive alcohol consumption.
Question 6 of 9
Today her pressure is 168/94 and pressure on the other arm is similar. What would you do next?
Correct Answer: B
Rationale: In this scenario, with a blood pressure of 168/94 on both arms, it indicates poorly controlled hypertension. Hypertension can have various causes, including kidney-related issues. Referring the patient to nephrology would be the appropriate next step to evaluate and manage any potential underlying kidney conditions contributing to the uncontrolled blood pressure. The nephrologist can conduct further tests and assessments to determine the root cause and provide specialized care for the patient's condition. This approach ensures a comprehensive evaluation and targeted management plan for the patient's hypertension.
Question 7 of 9
A patient comes to the emergency room for evaluation of shortness of breath. To which anatomic region would you assign the symptom?
Correct Answer: C
Rationale: Shortness of breath is commonly associated with issues related to the heart and cardiovascular system. Conditions such as heart failure, coronary artery disease, or arrhythmias can lead to symptoms like shortness of breath. Therefore, the symptom of shortness of breath would be assigned to the cardiac anatomic region.
Question 8 of 9
A patient presents with ear pain. She is an avid swimmer. The history includes pain and drainage from the left ear. On examination, she has pain when the ear is manipulated, including manipulation of the tragus. The canal is narrowed and erythematous, with some white debris in the canal. The rest of the examination is normal. What diagnosis would you assign this patient?
Correct Answer: B
Rationale: The patient's history of swimming and presenting symptoms of ear pain, drainage, and manipulation tenderness are suggestive of external otitis, commonly known as swimmer's ear. External otitis is an infection of the outer ear canal, which can be caused by prolonged moisture exposure, trauma, or bacterial/fungal infections. The narrowed and erythematous canal with white debris is characteristic of this condition. Otitis media (Choice A) typically presents with deep ear pain, hearing loss, and sometimes fever, but does not involve the ear canal. Perforation of the tympanum (Choice C) would present with sudden relief of pain and possible drainage from the ear. Cholesteatoma (Choice D) is characterized by a painless cyst or mass in the middle ear, not presenting with these acute ear canal symptoms.
Question 9 of 9
A 30-year-old man notices a firm, 2-cm mass under his areola. He has no other symptoms and no diagnosis of breast cancer in his first-degree relatives. What is the most likely diagnosis?
Correct Answer: A
Rationale: In a 30-year-old man with a firm, 2-cm mass under his areola and no other symptoms, the most likely diagnosis is breast tissue. Gynecomastia is a common condition in males where there is proliferation of breast tissue. It typically presents as a firm subareolar mass and can occur due to hormonal imbalances, medication use, or underlying medical conditions. Given the lack of family history of breast cancer, absence of other symptoms, and the age of the patient, breast tissue is the most probable diagnosis in this case. Breast cancer is less likely in this scenario, especially without any additional concerning findings or family history. Fibrocystic disease and lymph node involvement are also less likely given the presentation of a firm mass under the areola.