On auscultation her lung fields have normal breath sounds with no rhonchi, wheezes, or crackles. Percussion and palpation are unremarkable. Auscultation of the heart has an S and S 1 2 with no S or S . A scratching noise is heard at the lower left sternal border, coincident with 3 4 systole; leaning forward relieves some of her pain. She is nontender with palpation of the chest wall. What disorder of the chest best describes this disorder?

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Jarvis Physical Examination and Health Assessment Practice Questions Questions

Question 1 of 9

On auscultation her lung fields have normal breath sounds with no rhonchi, wheezes, or crackles. Percussion and palpation are unremarkable. Auscultation of the heart has an S and S 1 2 with no S or S . A scratching noise is heard at the lower left sternal border, coincident with 3 4 systole; leaning forward relieves some of her pain. She is nontender with palpation of the chest wall. What disorder of the chest best describes this disorder?

Correct Answer: B

Rationale: The clinical presentation described involves a patient with pericarditis. Pericarditis is inflammation of the pericardium, the sac surrounding the heart, which can lead to characteristic findings such as a scratching noise heard on auscultation, leaning forward relieving pain, and normal lung examination findings. The presence of pericarditis can also lead to a pericardial friction rub, which is often described as a scratching or grating sound heard best at the lower left sternal border.

Question 2 of 9

On auscultation her lung fields have normal breath sounds with no rhonchi, wheezes, or crackles. Percussion and palpation are unremarkable. Auscultation of the heart has an S and S 1 2 with no S or S . A scratching noise is heard at the lower left sternal border, coincident with 3 4 systole; leaning forward relieves some of her pain. She is nontender with palpation of the chest wall. What disorder of the chest best describes this disorder?

Correct Answer: B

Rationale: The clinical presentation described involves a patient with pericarditis. Pericarditis is inflammation of the pericardium, the sac surrounding the heart, which can lead to characteristic findings such as a scratching noise heard on auscultation, leaning forward relieving pain, and normal lung examination findings. The presence of pericarditis can also lead to a pericardial friction rub, which is often described as a scratching or grating sound heard best at the lower left sternal border.

Question 3 of 9

Which of the following may be missed unless the patient is placed in the left lateral decubitus position and auscultated with the bell?

Correct Answer: D

Rationale: Placing the patient in the left lateral decubitus position and auscultating with the bell is important to detect subtle sounds like the mitral stenosis murmur, opening snap of the mitral valve, and S3 and S4 gallops. The left lateral decubitus position helps bring the heart closer to the chest wall, allowing for better transmission of these sounds that may be missed in the supine position.

Question 4 of 9

A 32-year-old white male comes to your clinic, complaining of aching on the right side of his testicle. He has felt this aching for several months. He states that as the day progresses the aching increases, but when he wakes up in the morning he is pain-free. He denies any pain with urination and states that the pain doesn't change with sexual activity. He denies any fatigue, weight gain, weight loss, fever, or night sweats. His past medical history is unremarkable. He is a married hospital administrator with two children. He notes that he and his wife have been trying to have another baby this year but have so far been unsuccessful despite frequent intercourse. He denies using tobacco, alcohol, or illegal drugs. His father has high blood pressure but his mother is healthy. On examination you see a young man appearing his stated age with unremarkable vital signs. On visualization of his penis, he is circumcised with no lesions. He has no scars along his inguinal area, and palpation of the area shows no lymphadenopathy. On palpation of his scrotum you feel testes with no discrete masses. Upon placing your finger through the right inguinal ring you feel what seems like a bunch of spaghetti. Asking him to bear down, you feel no bulges. The left inguinal ring is unremarkable, with no bulges on bearing down. His prostate examination is unremarkable. What abnormality of the scrotum does he most likely have?

Correct Answer: D

Rationale: The most likely abnormality of the scrotum that the patient has is a varicocele. This is indicated by the presence of a "bag of worms" feeling upon palpation of the right scrotum through the inguinal ring. Varicoceles are enlarged, twisted veins in the scrotum, similar to varicose veins that occur in the legs. They are more common on the left side, but can occur on the right side as well.

Question 5 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 6 of 9

What is the most appropriate amount for a weekly weight reduction goal?

Correct Answer: A

Rationale: The most appropriate amount for a weekly weight reduction goal is typically .5 to 1 pound per week. This rate of weight loss is considered safe and sustainable in the long term. Losing weight too quickly (options B, C, D) can be harmful to your health and may lead to muscle loss, nutritional deficiencies, and a slow metabolism. Rapid weight loss is also harder to maintain in the long run. Gradual weight loss of .5 to 1 pound per week allows for healthy changes to diet and exercise habits, making it more likely to be maintained over time. It is also more likely to result in lasting weight loss and overall improvements in health and well-being.

Question 7 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 8 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 9 of 9

A young woman comes to you with a cut on her finger caused by the lid of a can she was opening. She is pacing about the room, crying loudly, and through her sobs she says, "My career as a pianist is finished!" Which personality type exhibits these features?

Correct Answer: C

Rationale: The young woman in this scenario is exhibiting characteristics of histrionic personality disorder. Individuals with histrionic personality disorder tend to be overly dramatic, attention-seeking, and have a tendency to be excessively emotional in their reactions. The young woman's exaggerated response to a minor cut on her finger, along with her dramatic declaration that her career as a pianist is over, reflects the emotional and attention-seeking behaviors commonly associated with histrionic personality traits.

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