ATI RN
Jarvis Physical Examination and Health Assessment 9th Edition Test Bank Questions
Question 1 of 5
You are obtaining an arterial blood gas in the radial artery on a retired cab driver who has been hospitalized in the intensive care unit for a stroke. You are concerned about the possibility of arterial insufficiency. You perform the Allen test. This means that you:
Correct Answer: C
Rationale: The Allen test assesses collateral circulation by checking for patency of the ulnar artery. This is important before obtaining an arterial blood gas from the radial artery to ensure adequate blood flow and prevent ischemia. If the ulnar artery is not patent, using the radial artery could lead to arterial insufficiency. Checking the radial artery's patency (Choice A) is not the purpose of the Allen test. Checking the patency of the brachial artery (Choice B) or the femoral artery (Choice D) is not relevant in this context. The correct answer is C because ensuring ulnar artery patency is crucial for arterial blood gas sampling from the radial artery.
Question 2 of 5
A 45-year-old electrical engineer presents to your clinic, complaining of spots on his scrotum. He first noticed the spots several months ago, and they have gotten bigger. He denies any pain with urination or with sexual intercourse. He has had no fever, night sweats, weight gain, or weight loss. His past medical history consists of a vasectomy 10 years ago and mild obesity. He is on medication for hyperlipidemia. He denies any tobacco or illegal drug use and drinks alcohol socially. His mother has Alzheimer's disease and his father died of leukemia. On examination he appears relaxed and has unremarkable vital signs. On visualization of his penis, he is circumcised and has no lesions on his penis. Visualization of his scrotum shows three yellow nodules 2-3 millimeters in diameter. During palpation they are firm and nontender. What abnormality of the male genitalia is this most likely to be?
Correct Answer: D
Rationale: The correct answer is D: Epidermoid cysts. These cysts typically present as firm, non-tender nodules on the scrotum, consistent with the patient's presentation. The history of gradual growth without associated symptoms supports this diagnosis. Additionally, the lack of pain with urination or sexual intercourse rules out sexually transmitted infections like condylomata acuminata (choice A) and syphilitic chancre (choice B). Peyronie's disease (choice C) involves penile curvature and fibrous plaques, not scrotal nodules. In summary, the patient's presentation, physical examination findings, and absence of specific symptoms point towards epidermoid cysts as the most likely diagnosis.
Question 3 of 5
A 42-year-old realtor comes to your clinic, complaining of "growths" in her vulvar area. She is currently undergoing a divorce and is convinced she has a sexually transmitted disease. She denies any vaginal discharge or pain with urination. She has had no fever, malaise, or night sweats. Her past medical history consists of depression and hypothyroidism. She has had two spontaneous vaginal deliveries and one cesarean section. She has had no other surgeries. She denies smoking or drug use. She has two to three drinks weekly. Her mother also has hypothyroidism and her father has high blood pressure and hypercholesterolemia. On examination you see a woman who is anxious but appears otherwise healthy. Her blood pressure, pulse, and temperature are unremarkable. On visualization of the perineum you see two 2- to 3- mm, round, yellow nodules on the left labia. On palpation they are nontender and quite firm. What diagnosis best fits this description of her examination?
Correct Answer: D
Rationale: The correct answer is D: Epidermoid cyst. The key features in the clinical scenario that point towards an epidermoid cyst are the presence of painless, firm, non-tender, round, yellow nodules on the labia. These cysts are common in the vulvar area and often arise from blocked hair follicles. The absence of symptoms suggestive of a sexually transmitted infection (STI) such as vaginal discharge, pain with urination, fever, malaise, or night sweats, along with the patient's history of anxiety and the appearance of the nodules being consistent with an epidermoid cyst support this diagnosis. Choice A: Genital herpes typically presents with painful vesicles or ulcers, which are not described in this case. Choice B: Condylomata acuminata (genital warts) would present as soft, pink, or flesh-colored growths and are associated with HPV infection, which is not suggested in this scenario. Choice C: Sy
Question 4 of 5
On abdominal examination she has active bowel sounds, is nontender in all quadrants, and has no hepatosplenomegaly. Inspection of the anus reveals inflammation on the posterior side with erythema. Digital rectal examination is painful for the patient, but no abnormalities are palpated. Anoscopic examination reveals no inflammation or bleeding. What is the anal disorder that best describes her symptoms?
Correct Answer: C
Rationale: Rationale: The patient's symptoms of painful digital rectal examination and inflammation on the posterior side of the anus with erythema are consistent with an anal fissure. The absence of palpable abnormalities and bleeding on anoscopic examination further support this diagnosis. Anal fissures are common and typically present with these symptoms due to a tear in the anal lining. Incorrect Choices: A: Anorectal fistula typically presents with discharge, recurrent abscesses, and may have palpable tracks. B: External hemorrhoids usually present with painless bleeding, swelling, and itching, not with the described symptoms. D: Anorectal cancer would typically present with more severe symptoms like rectal bleeding, changes in bowel habits, and weight loss, which are not described in this case.
Question 5 of 5
Which is a sign of benign prostatic hyperplasia?
Correct Answer: D
Rationale: The correct answer is D: Nocturia. Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland, leading to urinary symptoms such as frequent urination at night (nocturia). This occurs due to the prostate pressing against the urethra, causing urinary flow issues. Weight loss (A) is not typically associated with BPH. Bone pain (B) is more indicative of conditions like prostate cancer or metastasis. Fever (C) is not a common symptom of BPH. Therefore, D is the most appropriate sign of BPH.