ATI RN
Jarvis Physical Examination and Health Assessment Test Bank Questions
Question 1 of 9
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 9
An 86-year-old female comes to your office for a wellness visit. Her blood pressure is 125/70 mmHg, pulse 69 beats per minute, and respiratory rate 18 breaths per minute. She is well-appearing and reports she is up to date on her routine vaccinations. She introduces her partner of 35 years, whom she would like to make medical decisions for her in case she becomes unable to make decisions for herself. She reports that she and her partner are not married. She asks if she needs any further documentation to ensure her goals of care are followed.
Correct Answer: C
Rationale: The correct answer is C: Advise them to file an advanced directive. An advanced directive is a legal document that allows individuals to specify their healthcare preferences in advance, including who they want to make medical decisions for them if they are unable to do so. In this scenario, since the patient and her partner are not married, it is important for her to have an advanced directive in place to ensure that her partner is legally recognized as the decision-maker. This documentation will help ensure her goals of care are followed in case she becomes incapacitated. Choice A (Advise them to complete a POLST) is incorrect because a POLST (Physician Orders for Life-Sustaining Treatment) form is used to specify a patient's wishes for end-of-life care, not for designating a medical decision-maker. Choice B (Advise them that they have adequate documentation to be recognized legally) is incorrect because without an advanced directive, there may be legal challenges to the partner's authority to make medical decisions
Question 3 of 9
Which one of the following statements is true of Munchausen syndrome by proxy?
Correct Answer: B
Rationale: The correct answer is B because in Munchausen syndrome by proxy, the patient only exhibits symptoms under the direct care or supervision of the abuser. This is because the abuser intentionally causes or fabricates symptoms in the victim to gain attention or sympathy. In contrast, the other choices are incorrect. A is incorrect because the injury is inflicted by the abuser, not self-inflicted by the patient. C is incorrect as the caregiver is the one perpetrating the abuse. D is incorrect because the abuser is often overly involved and manipulative, rather than inattentive and uncaring.
Question 4 of 9
A 19-year-old-college student presents to the emergency room with fever, headache, and neck pain/stiffness. She is concerned about the possibility of meningococcal meningitis. Several of her dorm mates have been vaccinated, but she hasn't been. Which of the following physical examination descriptions is most consistent with meningitis?
Correct Answer: C
Rationale: The correct answer is C. Meningitis typically presents with neck stiffness due to meningeal irritation. In choice C, the patient has a tender neck to palpation and is unable to perform range of motion, indicating meningeal inflammation. Choices A, B, and D all describe a normal head and fundi exam, which is not consistent with meningitis. Choice B mentions muscle spasm and limited range of motion to the right, but this is more suggestive of a musculoskeletal issue rather than meningitis. Choice D describes a normal neck exam, which is not in line with the presentation of meningitis.
Question 5 of 9
A 16-year-old high school junior is brought to your clinic by his father. The teenager was taught in his health class at school to do monthly testicular self-examinations. Yesterday when he felt his left testicle it was enlarged and tender. He isn't sure if he has had burning with urination and he says he has never had sexual intercourse. He has had a sore throat, cough, and runny nose for the last 3 days. His past medical history is significant for a tonsillectomy as a small child. His father has high blood pressure and his mother is healthy. On examination you see a teenager in no acute distress. His temperature is 8 and his blood pressure and pulse are unremarkable. On visualization of his penis, he is uncircumcised and has no lesions or discharge. His scrotum is red and tense on the left and normal appearing on the right. Palpating his left testicle reveals a mildly sore swollen testicle. The right testicle is unremarkable. An examining finger is put through both inguinal rings, and there are no bulges with bearing down. His prostate examination is unremarkable. Urine analysis is also unremarkable. What abnormality of the testes does this teenager most likely have?
Correct Answer: A
Rationale: The correct answer is A: Acute orchitis. Orchitis is inflammation of the testicle that can cause testicular enlargement and tenderness. In this case, the teenager presents with a swollen and sore left testicle, which aligns with the symptoms of orchitis. The patient's history of upper respiratory symptoms suggests a viral infection, which can lead to orchitis. The normal prostate exam and urine analysis rule out prostatitis. Acute epididymitis typically presents with pain and swelling in the epididymis, not the testicle itself. Torsion of the spermatic cord would present with sudden, severe testicular pain and is an emergency requiring immediate surgical intervention.
Question 6 of 9
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 7 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 8 of 9
Which one of the following is most true about the staffing of a typical nursing home?
Correct Answer: C
Rationale: The correct answer is C because Certified Nursing Assistants (CNAs) typically provide the majority of direct patient care in nursing homes. CNAs assist with activities of daily living, monitoring patients' health, and providing emotional support. This is true in most nursing homes as they play a crucial role in patient care. Rationale: - A: Most nurses in nursing homes are not necessarily Registered Nurses (RNs), as there are also Licensed Practical Nurses (LPNs) and Certified Nursing Assistants (CNAs) who provide care. - B: LPNs or LVNs may assist with the patient care plan under the supervision of an RN, but they do not typically develop the plan themselves. - D: Staff turnover is a major issue in nursing homes due to various factors such as workload, stress, and burnout among healthcare workers.
Question 9 of 9
A 78-year-old man with multi-infarct dementia, chronic kidney disease, congestive heart failure, and uncontrolled hypertension develops confusion, restlessness, and combativeness. Which of the pharmacologic agents would be the best choice for treating the agitation associated with his delirium?
Correct Answer: B
Rationale: The correct answer is B: Haloperidol. Haloperidol is a first-line antipsychotic commonly used to manage agitation in delirium due to its rapid onset and minimal sedative effects. It acts by blocking dopamine receptors in the brain, which helps to reduce agitation and combativeness. Melatonin (A) is not effective for acute agitation. Diazepam (C) can worsen confusion in elderly patients and is not recommended for delirium. Gabapentin (D) is not indicated for managing agitation in delirium and may not be effective in this scenario.