ATI RN
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
A 24-year-old travel agent comes to your clinic, complaining of pain and swelling in her vulvar area. She states that 2 days earlier she could feel a small tender spot on the left side of her vagina but now it is larger and extremely tender. Her last period was 1 year ago, and she is sexually active. She uses the Depo-Provera shot for contraception. She denies any nausea, vomiting, constipation, diarrhea, pain with urination, or fever. Her past medical history is significant for ankle surgery. Her mother is healthy, and her father has type 2 diabetes. On examination she appears her stated age and is standing up. She states she cannot sit down without excruciating pain. Her blood pressure, temperature, and pulse are unremarkable. On visualization of her perineum, a large, red, tense swelling is seen to the left of her introitus. Palpation of the mass causes a great deal of pain. What disorder of the vulva is most likely causing her problems?
Correct Answer: A
Rationale: The clinical presentation described is consistent with a Bartholin's gland infection, also known as Bartholin's abscess. The Bartholin's glands are located on each side of the vaginal opening and can become blocked, leading to glandular secretions accumulating and forming an abscess. Symptoms of Bartholin's gland infection include pain, swelling, and tenderness in the vulvar area. The pain can be severe and exacerbated by sitting, similar to what the patient is experiencing. On examination, a red, tense swelling to the side of the introitus is a characteristic finding.
Question 3 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.
Question 4 of 9
A young man feels something in his scrotum and comes to you for clarification. On your examination, you note what feels like a "bag of worms" in the left scrotum, superior to the testicles. Which of the following is most likely?
Correct Answer: B
Rationale: A varicocele is a common cause of a "bag of worms" feeling in the scrotum. It occurs due to the dilation of the veins within the spermatic cord, leading to a palpable mass above the testicle. Varicoceles are more commonly found on the left side due to the anatomy of the left testicular vein, which drains into the left renal vein at a right angle, making it more susceptible to increased pressure and dilation.
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
Which is true of a third heart sound (S )?
Correct Answer: B
Rationale: The third heart sound (S3) is a low-frequency sound heard in early diastole, immediately following the second heart sound (S2). It is generated by the abrupt deceleration of the column of blood against the ventricular wall during the rapid passive filling phase (early diastole) when the ventricle is suddenly stretched by a large volume of blood. The S3 sound typically reflects decreased ventricular compliance, rather than normal compliance. An S3 sound is often considered pathological and is commonly associated with conditions such as heart failure, volume overload, and dilated cardiomyopathy. Therefore, the statement that the third heart sound reflects normal compliance of the left ventricle (Choice B) is incorrect.
Question 7 of 9
A 29-year-old computer programmer comes to your office for evaluation of a headache. The tightening sensation is located all over the head and is of moderate intensity. It used to last minutes, but this time it has lasted for 5 days. He denies photophobia and nausea. He spends several hours each day at a computer monitor/keyboard. He has tried over-the-counter medication; it has dulled the pain but not taken it away. Based on this description, what is your most likely diagnosis?
Correct Answer: A
Rationale: The description provided fits the criteria for tension-type headache. Tension-type headaches are typically described as a mild to moderate, dull, band-like pressure or tightness around the head. They can last from minutes to days and are often triggered by stress, anxiety, poor posture, or prolonged computer use. The absence of symptoms like photophobia and nausea, along with the response to over-the-counter medication, further support the diagnosis of tension-type headache in this case. Other headache types such as migraines or cluster headaches usually present with additional symptoms like nausea, photophobia, or tearing of the eye, which are not mentioned in this scenario. Analgesic rebound headaches typically occur in individuals who overuse pain medications, leading to worsening headaches when the medication wears off, but this patient's history does not suggest such misuse.
Question 8 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 9 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.