ATI RN
Jarvis Physical Examination and Health Assessment Practice Questions Questions
Question 1 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 2 of 9
His head, ears, nose, throat, and neck examinations are normal. His cardiac, lung, and abdominal examinations are also normal. On visualization of the anus there is no inflammation, masses, or fissures. Digital rectal examination elicits an irregular, asymmetric, hard nodule on the otherwise normal posterior surface of the prostate. Examination of the scrotum and penis are normal. Laboratory results are pending. What disorder of the anus, rectum, or prostate is mostly likely in this case?
Correct Answer: C
Rationale: The presence of an irregular, asymmetric, hard nodule on the posterior surface of the prostate detected during digital rectal examination raises suspicion for prostate cancer. Prostate cancer commonly presents with nodules or indurations on the prostate gland during physical examination. Other findings, such as no inflammation, masses, or fissures in the anus and normal examinations of the scrotum and penis, further support the likelihood of prostate cancer as the most probable diagnosis in this case. Additional laboratory results, including prostate-specific antigen (PSA) levels, can help confirm the diagnosis. Both benign prostatic hyperplasia (BPH) and prostatitis typically present with different symptoms than those described in the scenario, making prostate cancer the most likely disorder based on the provided information. Anorectal cancer is less likely given the absence of findings indicating involvement of the anus or rectum in this case.
Question 3 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 4 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 5 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 6 of 9
You are growing fatigued of performing a maneuver on examination because you have never found a positive and are usually pressed for time. How should you next approach this maneuver?
Correct Answer: A
Rationale: It is important to adjust your approach based on the clinical context and your suspicion for a certain condition. If you have never found a positive result with a particular maneuver and you are usually pressed for time during examinations, it may be more beneficial to reserve that maneuver for situations where you have a higher suspicion for a correlating condition. This allows you to use your time and resources more effectively, targeting specific tests based on the clinical scenario to increase the chances of identifying any relevant issues. By using the test selectively, you can improve the diagnostic yield without compromising the overall assessment.
Question 7 of 9
An 8-year-old girl comes with her mother for evaluation of hair loss. She denies pulling or twisting her hair, and her mother has not noted this behavior at all. She does not put her hair in braids. On physical examination, you note a clearly demarcated, round patch of hair loss without visible scaling or inflammation. There are no hair shafts visible. Based on this description, what is your most likely diagnosis?
Correct Answer: A
Rationale: The description provided, which includes a clearly demarcated, round patch of hair loss without visible scaling or inflammation and absence of hair shafts, is characteristic of alopecia areata. Alopecia areata is an autoimmune condition that causes hair loss in round or oval patches on the scalp or other parts of the body. It is not associated with pulling or twisting of hair (trichotillomania), fungal infection (tinea capitis), or hair loss due to constant pulling force (traction alopecia). In alopecia areata, the affected area usually appears smooth and without visible signs of irritation. Treatment options for alopecia areata may include corticosteroid injections, topical immunotherapy, or minoxidil.
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
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.