ATI RN
jarvis physical examination and health assessment test bank Questions
Question 1 of 9
Treatment for early PD in an otherwise healthy older patient without significant functional impairment should begin with:
Correct Answer: B
Rationale: The correct answer is B: Dopamine agonist. In early PD, dopamine agonists are preferred due to their lower risk of motor complications compared to levodopa. Dopamine agonists help improve motor symptoms by directly stimulating dopamine receptors. COMT inhibitors are usually used in combination with levodopa to prolong its effects. Levodopa is effective but can lead to motor complications with long-term use. Careful observation is not a treatment strategy and delays symptom management. Therefore, starting with a dopamine agonist is the most suitable option for early PD to manage symptoms effectively with minimal risk of motor complications.
Question 2 of 9
The purpose of the expanded assessment when using the LAPSS is to:
Correct Answer: C
Rationale: The purpose of the expanded assessment when using the LAPSS is to determine whether there are other possible causes of the patient's signs and symptoms. This is because LAPSS primarily focuses on identifying stroke symptoms, so the expanded assessment helps rule out other potential conditions. Option A is incorrect because LAPSS does not primarily assess circulation. Option B is incorrect because LAPSS is not specifically designed to determine compartment syndrome. Option D is incomplete and does not provide any information to support it as the correct answer.
Question 3 of 9
Which is true of the pectinate or dentate line?
Correct Answer: C
Rationale: The pectinate or dentate line is the border between the anal canal and the rectum. This is true because it represents the transition between the endoderm-derived upper anal canal and the ectoderm-derived lower anal canal. It is an important anatomical landmark in colorectal surgery and in distinguishing different pathologies in the anal region. Choice A is incorrect because the pectinate or dentate line is not typically palpable. Choice B is incorrect as it does not demarcate areas supplied by different nervous systems. Choice D is incorrect as the pectinate or dentate line is visible on proctoscopic examination due to its distinct appearance.
Question 4 of 9
All of the following about the Medicare Part D prescription medication benefit plan are true except:
Correct Answer: D
Rationale: The correct answer is D because beneficiaries do have out-of-pocket expenses for each prescription filled under Medicare Part D. This is typically in the form of copayments or coinsurance. A: Medicare Advantage plans often include Part D coverage, making statement A true. B: There are indeed multiple companies offering Part D plans, so statement B is true. C: The monthly premium for Part D coverage can vary, but in 2019 it was indeed around $30, making statement C true as well.
Question 5 of 9
Which of the following is true about cultural humility?
Correct Answer: C
Rationale: The correct answer is C because cultural humility emphasizes recognizing power imbalances and fostering interpersonal sensitivity through partnerships with and learning from patients. This approach encourages self-awareness, openness, and willingness to engage in respectful dialogues. Option A is incorrect because cultural humility is not solely achieved through professional development courses. Option B is incorrect as anyone, regardless of their background, can practice cultural humility. Option D is incorrect as cultural humility does consider the impacts of structural factors on health disparities, including biological, socioeconomic, and racial influences.
Question 6 of 9
What is the most common cause of community-acquired pneumonia in adults?
Correct Answer: B
Rationale: The correct answer is B: Streptococcus pneumoniae. This bacterium is the most common cause of community-acquired pneumonia in adults due to its prevalence and ability to cause infections in the lungs. It accounts for a significant portion of pneumonia cases worldwide. Staphylococcus aureus (A) is more commonly associated with healthcare-associated pneumonia. Mycoplasma pneumoniae (C) typically causes atypical pneumonia, which tends to be milder and more common in younger individuals. Pseudomonas aeruginosa (D) is more commonly seen in individuals with underlying health conditions or compromised immune systems, rather than in healthy adults with community-acquired pneumonia.
Question 7 of 9
A young patient presents with a left-sided mass in her abdomen. You confirm that it is present in the left upper quadrant. Which of the following would support that this represents an enlarged kidney rather than her spleen?
Correct Answer: A
Rationale: The correct answer is A: A palpable "notch" along its edge. This supports an enlarged kidney over the spleen because the kidney has a concave shape with a notch where the renal vessels enter. This notch is palpable in an enlarged kidney. Choice B is incorrect because the inability to push fingers between the mass and the costal margin is indicative of a spleen, which is a solid organ located close to the ribs. Choice C is incorrect as normal tympany over the area suggests gas-filled structures like the stomach or intestines, not a solid organ like the kidney or spleen. Choice D is incorrect as the ability to push fingers medial and deep to the mass would be more typical of an enlarged spleen, which can displace other organs medially due to its size.
Question 8 of 9
A grandmother brings her 13-year-old grandson to you for evaluation. She noticed last week when he took off his shirt that his breastbone seemed collapsed. He seems embarrassed and tells you that it has been that way for quite a while. He states he has no symptoms from it and he just tries not to take off his shirt in front of anyone. He denies any shortness of breath, chest pain, or lightheadedness on exertion. His past medical history is unremarkable. He is in sixth grade and just moved in with his grandmother after his father was deployed to the Middle East. His mother died several years ago in a car accident. He states that he does not smoke and has never touched alcohol. On examination you see a teenage boy appearing his stated age. On visual examination of his chest, you see that the lower portion of the sternum is depressed. Auscultation of the lungs and heart are unremarkable. What disorder of the thorax best describes your findings?
Correct Answer: B
Rationale: The correct answer is B: Funnel chest (pectus excavatum). Pectus excavatum is characterized by a depressed or sunken appearance of the sternum, which matches the description provided in the case. In this condition, the chest wall is abnormally shaped inward. This can be a congenital condition or develop during growth spurts in adolescence. The lack of symptoms such as shortness of breath, chest pain, or lightheadedness on exertion is consistent with pectus excavatum, as these symptoms are not typically associated with this condition. The other choices (A: Barrel chest, C: Pigeon chest, D: Thoracic kyphoscoliosis) do not match the specific findings described in the case and are not associated with the characteristic sternal depression seen in pectus excavatum.
Question 9 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.