Which of the following is true of a grade 4-intensity murmur?

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Jarvis Physical Examination and Health Assessment Test Bank Questions

Question 1 of 5

Which of the following is true of a grade 4-intensity murmur?

Correct Answer: A

Rationale: The correct answer is A: It is moderately loud. A grade 4-intensity murmur indicates a moderately loud murmur that is readily heard with the stethoscope lightly on the chest. This intensity suggests a significant level of turbulence in blood flow, typically indicating a more pronounced cardiac abnormality. Explanation for why other choices are incorrect: B: It can be heard with the stethoscope off the chest - This is incorrect because a murmur would not be audible without the stethoscope. C: It can be heard with the stethoscope partially off the chest - This is incorrect as a murmur would still require direct contact with the chest for auscultation. D: It is associated with a "thrill" - This is incorrect as a thrill is a palpable vibration indicating turbulent blood flow and is not directly related to murmur intensity.

Question 2 of 5

Bill, a 55-year-old man, presents with pain in his epigastrium which lasts for 30 minutes or more at a time and has started recently. Which of the following should be considered?

Correct Answer: D

Rationale: The correct answer is D, "All of the above." Bill's symptoms of epigastric pain lasting 30 minutes or more can be indicative of peptic ulcer, pancreatitis, or myocardial ischemia. Peptic ulcer can cause epigastric pain, pancreatitis presents with severe epigastric pain, and myocardial ischemia can manifest as epigastric discomfort. Considering all these possibilities is crucial for proper diagnosis and treatment. The other choices are incorrect because they do not encompass all potential causes of Bill's symptoms. It is important to consider a broad differential diagnosis to ensure comprehensive evaluation and management.

Question 3 of 5

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 4 of 5

You are assessing a patient for peripheral vascular disease in the arms, secondary to a complaint of increased weakness and a history of coronary artery disease and diabetes. You assess the brachial and radial pulses and note that they are bounding. What does that translate to on a scale of 0 to 3?

Correct Answer: B

Rationale: The correct answer is B: 3+. Bounding pulses indicate a 3+ strength on a scale of 0 to 3. This reflects increased blood flow or pressure in the arteries, which can be a sign of conditions like peripheral vascular disease. A strength of 0 indicates no palpable pulse, 1+ is weak and thready, 2+ is normal, and 3+ is bounding. In this case, the patient's history of coronary artery disease and diabetes may contribute to the increased blood flow, leading to bounding pulses. Choices A, C, and D are incorrect as they do not accurately reflect the strength of the pulses based on the given assessment findings.

Question 5 of 5

When assessing temperature of the skin, which portion of your hand should be used?

Correct Answer: A

Rationale: The correct answer is A: Fingertips. Fingertips are the most sensitive part of the hand, allowing for accurate temperature assessment. They provide better tactile discrimination and are more sensitive to changes in temperature compared to other parts of the hand. Palms have thicker skin and are less sensitive, making them less ideal for temperature assessment. Backs of fingers and ulnar aspect of the hand are also less sensitive than fingertips and lack the precision needed for accurate temperature detection.

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