ATI RN
jarvis physical examination and health assessment test bank Questions
Question 1 of 9
Symptoms consistent with later-stage human immunodeficiency disease (HIV) typically include all of the following except:
Correct Answer: C
Rationale: The correct answer is C: Persistent vomiting. This is because persistent vomiting is not typically associated with later-stage HIV disease. Night sweats, lymphadenopathy for more than 3 months, and persistent, unexplained fatigue are commonly seen in later-stage HIV. Vomiting may occur in earlier stages due to opportunistic infections, but it is not a hallmark symptom of advanced HIV.
Question 2 of 9
Mrs. Gloth is an 84-year-old woman whom you are admitting to the nursing home. Her son takes you aside and tells you that she has metastatic ovarian cancer but has not been told the diagnosis. He asks that you not tell her, because she would “lose all hope and die.” Which of the following is an appropriate response?
Correct Answer: C
Rationale: The correct answer is C: Suggest that you discuss this further after getting to know the patient and family a little better. This response allows the healthcare provider to gather more information about the patient's beliefs, values, and preferences before making a decision. It demonstrates respect for the autonomy of the patient and involves a collaborative approach with the family. It also allows time to assess the patient's emotional and psychological readiness to receive the diagnosis. Incorrect answers: A: This answer disregards the patient's autonomy and does not consider the emotional impact of delivering such news without proper assessment. B: While respecting the son's wishes is important, prioritizing the patient's well-being and autonomy should come first. D: Relying solely on the family's perspective without considering the patient's own wishes and understanding may lead to ethical issues and potential harm to the patient.
Question 3 of 9
When evaluating a 17-year-old girl with infrequent menstrual periods, which finding suggests probable hyperandrogenism?
Correct Answer: B
Rationale: The correct answer is B: Hirsutism. Hirsutism is the presence of excessive hair growth in a male pattern distribution in women, which is a common sign of hyperandrogenism. Elevated androgen levels can lead to hirsutism in women, especially in conditions like polycystic ovary syndrome. High pitch voice (A) and obesity (D) are not direct indicators of hyperandrogenism. While polycystic ovaries (C) can be associated with hyperandrogenism, the presence of hirsutism is a more specific and direct finding in this scenario.
Question 4 of 9
Mr. Roberts, a 72-year-old patient who has sought medical care on an intermittent basis in the past, complains of aching discomfort in his perineal area, urinary urgency, and frequency for the past few years. He also complains of insomnia and intermittent anxiety that he attributes to loneliness after his wife’s death about a year ago. Digital rectal examination (DRE) reveals a slightly enlarged, nontender prostate with no palpable nodules. Perineal examination is normal. Bladder scan is unremarkable and postvoid residual urine volume is 50 mL. Urinalysis shows no WBCs or RBCs. Urine culture is negative. Previous treatment has included dietary modifications and alpha-blocker medication. What is the most appropriate next step?
Correct Answer: D
Rationale: The correct answer is D: Screen for depression. The patient's symptoms of insomnia, anxiety, and loneliness after his wife's death suggest he may be experiencing depression, which can manifest as physical symptoms like urinary urgency and frequency. Since the patient has already received appropriate treatment for his urinary symptoms, addressing his mental health is the next crucial step. This can help improve his overall well-being and quality of life. Starting an antibiotic course (choice A) is not indicated as there are no signs of infection. Initiating a 5-alpha-reductase inhibitor (choice B) is not necessary given the absence of specific indications such as obstructive voiding symptoms. Urodynamic testing (choice C) is not warranted at this stage as the patient's history and findings do not suggest underlying bladder dysfunction.
Question 5 of 9
A 29-year-old physical therapist presents for evaluation of an eyelid problem. On observation, the right eyeball appears to be protruding forward. Based on this description, what is the most likely diagnosis?
Correct Answer: B
Rationale: The correct answer is B: Exophthalmos. Exophthalmos refers to protrusion of the eyeball, which is a hallmark sign of thyroid eye disease. This condition commonly presents with forward bulging of one or both eyes due to inflammation and swelling of the eye muscles and tissues behind the eye. It is often associated with hyperthyroidism. A: Ptosis is drooping of the upper eyelid, not protrusion of the eyeball. C: Ectropion is an outward turning of the eyelid, not protrusion of the eyeball. D: Epicanthus is a vertical fold of skin on the upper eyelid near the nose, not protrusion of the eyeball.
Question 6 of 9
A patient presents with pain in the shoulder. The nurse practitioner knows that there are four rotator cuff muscles. The muscle that initiates abduction movement at the shoulder is known as the:
Correct Answer: A
Rationale: Rationale: The correct answer is A: Supraspinatus. This muscle is responsible for initiating abduction movement at the shoulder joint. It is located on the top of the shoulder blade and assists in lifting the arm away from the body. The other choices, B: Infraspinatus, C: Levator scapulae muscle, and D: Subscapularis, are not involved in initiating abduction movement at the shoulder. Infraspinatus is responsible for external rotation, Levator scapulae muscle elevates the scapula, and Subscapularis assists in internal rotation of the shoulder joint.
Question 7 of 9
Which of the following symptoms would be a clinical manifestation noted during the secondary stage of syphilis?
Correct Answer: C
Rationale: The correct answer is C. During the secondary stage of syphilis, a rash marked by red or reddish-brown, penny-sized lesions over the palms and soles is a common clinical manifestation. This rash, known as a syphilitic rash, is a hallmark symptom of secondary syphilis. The rash can also appear on other parts of the body. It is important to note that syphilis progresses through distinct stages, and the secondary stage typically occurs a few weeks to a few months after the initial infection. Now, let's analyze why the other choices are incorrect: A: Absence of symptoms - This is incorrect as syphilis does present symptoms, especially during the secondary stage. B: Single painless lesion, chancre on the genital area - This is characteristic of the primary stage of syphilis, not the secondary stage. D: Poor muscle coordination - This symptom is associated with the late or tertiary stage of syphilis, not the secondary stage
Question 8 of 9
A 49-year-old truck driver comes to the emergency room for shortness of breath and swelling in his ankles. He is diagnosed with congestive heart failure and admitted to the hospital. You are the student assigned to do the patient's complete history and physical examination. When you palpate the pulse, what do you expect to feel?
Correct Answer: B
Rationale: The correct answer is B: Small amplitude, weak. In congestive heart failure, the heart's ability to pump effectively is compromised, leading to decreased cardiac output. This results in a weakened pulse with reduced amplitude. Palpating a small, weak pulse in this patient is expected due to poor cardiac function. Choices A and C are incorrect because a large, forceful pulse is not expected in congestive heart failure, and a normal pulse may not reflect the compromised cardiac function. Choice D, bigeminal, refers to an abnormal rhythm characterized by every other heartbeat being premature and is not typically associated with congestive heart failure.
Question 9 of 9
What term describes the rhythmic, involuntary contractions of a muscle that can occur in patients with neurological conditions, such as cerebral palsy?
Correct Answer: B
Rationale: The correct answer is B: Clonus. Clonus is a series of rhythmic, involuntary muscle contractions and relaxations that occur due to an abnormal response in the stretch reflex. In patients with neurological conditions like cerebral palsy, clonus is often observed due to increased muscle tone. Tremor (A) is a rhythmic shaking movement, not specifically associated with muscle contractions. Spasm (C) is a sudden, involuntary muscle contraction that is not typically rhythmic. Fasciculation (D) is a brief, spontaneous contraction of a small number of muscle fibers, not the rhythmic pattern seen in clonus.