ATI RN
Jarvis Physical Examination and Health Assessment Practice Questions Questions
Question 1 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 2 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 3 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 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
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 6 of 9
An elderly woman with dementia is brought in by her daughter for a "rectal mass." On examination you notice a moist pink mass protruding from the anus, which is nontender. It is soft and does not have any associated bleeding. Which of the following is most likely?
Correct Answer: A
Rationale: Rectal prolapse occurs when the rectum protrudes through the anus. It typically appears as a moist, pink mass that protrudes outside the body. The prolapse is usually painless and can be seen and felt by the patient or the examiner. It is commonly seen in elderly individuals, especially women, and those with conditions like chronic constipation, pelvic floor weakness, or dementia. On the other hand, external hemorrhoids are swollen veins located around the anus, usually painful and may cause bleeding. Perianal fistula is an abnormal tunnel-like connection between the skin near the anus and the rectum, which can cause pain and discharge. Prolapsed internal hemorrhoids are internal hemorrhoids that have descended outside the anal canal and may require manual reduction. Given the symptoms described in the scenario - a moist pink mass protruding from the anus that is nontender and soft without bleeding - the most likely diagnosis is rectal prol
Question 7 of 9
A man's wife is upset because when she hugs him with her hands on his left shoulder blade, "it feels creepy." This came on gradually after a recent severe left-sided rotator cuff tear. How long does it usually take to develop muscular atrophy with increased prominence of the scapular spine following a rotator cuff tear?
Correct Answer: D
Rationale: Following a severe rotator cuff tear, it typically takes around 2-3 months for muscular atrophy to develop with increased prominence of the scapular spine. This is due to disuse of the affected shoulder muscles leading to muscle wasting and changes in the bony structures around the shoulder blade. Over time, the lack of muscle activity causes the shoulder blade to become more prominent and noticeable, which can result in altered sensations during activities like hugging. The gradual onset of these changes aligns with the timeline provided in the question, where the wife started to feel discomfort in her husband's left shoulder blade after the recent severe rotator cuff tear.
Question 8 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 9 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.