ATI RN
Jarvis Physical Examination and Health Assessment Practice Questions Questions
Question 1 of 9
You are seeing an older patient who has not had medical care for many years. Her vital signs taken by your office staff are: T 2, HR 78, BP 118/92, and RR 14, and she denies pain. You notice that she has some hypertensive changes in her retinas and you find mild proteinuria on a urine test in your office. You expected the BP to be higher. She is not on any medications. What do you think is causing this BP reading, which doesn't correlate with the other findings?
Correct Answer: D
Rationale: The most likely explanation for the discrepancy between the patient's relatively normal blood pressure reading (118/92) and the presence of hypertensive changes in her retinas and mild proteinuria is that the process causing her retinopathy and kidney problems has resolved. Hypertensive changes in the retinas and proteinuria are typically signs of chronic uncontrolled hypertension, but they can also be residual manifestations of previously uncontrolled hypertension that has now been effectively treated.
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
Sudden, painful unilateral loss of vision may be caused by which of the following conditions?
Correct Answer: B
Rationale: A sudden, painful unilateral loss of vision is a medical emergency that may be caused by central retinal artery occlusion. This condition occurs when the main artery supplying blood to the retina becomes blocked, leading to a sudden and severe reduction in blood flow to the eye. The lack of blood flow can cause irreversible damage to the retina, resulting in a significant loss of vision. Patients with central retinal artery occlusion typically present with sudden, painless, and severe vision loss in one eye. Immediate medical attention is crucial to try to restore blood flow and minimize potential permanent vision loss in these cases. Vitreous hemorrhage, macular degeneration, and optic neuritis do not typically present with sudden, painful unilateral loss of vision as seen in central retinal artery occlusion.
Question 4 of 9
For which of the following patients would a comprehensive health history be appropriate?
Correct Answer: C
Rationale: For a new patient with the chief complaint of "I am here to establish care," a comprehensive health history would be appropriate. In this scenario, since the patient is new to the healthcare provider, it is important to gather detailed information about the patient's past medical history, family history, social history, medications, allergies, and specific health concerns. This comprehensive health history will help the healthcare provider establish a baseline of the patient's overall health and identify any potential risk factors or underlying conditions that may impact future care and treatment decisions. Additionally, obtaining a thorough health history is essential in building a strong patient-provider relationship and providing patient-centered care.
Question 5 of 9
A patient comes to the emergency room for evaluation of shortness of breath. To which anatomic region would you assign the symptom?
Correct Answer: C
Rationale: Shortness of breath is commonly associated with issues related to the heart and cardiovascular system. Conditions such as heart failure, coronary artery disease, or arrhythmias can lead to symptoms like shortness of breath. Therefore, the symptom of shortness of breath would be assigned to the cardiac anatomic region.
Question 6 of 9
He is afebrile. His abdominal examination reveals normal bowel sounds, but he is very tender in the left upper quadrant and epigastric area. He has no Murphy's sign or tenderness in the right lower quadrant. The remainder of his abdominal examination is normal. His rectal, prostate, penile, and testicular examinations are normal. He has no inguinal hernias or tenderness with that examination. Blood work is pending. What etiology of abdominal pain is most likely causing his symptoms?
Correct Answer: D
Rationale: The patient's presentation of tenderness in the left upper quadrant and epigastric area, along with normal bowel sounds, is suggestive of acute pancreatitis. This condition typically presents with severe, steady epigastric pain that may radiate to the back or left upper quadrant. Patients may also have tenderness on physical examination in these areas. Acute pancreatitis is commonly associated with risk factors such as gallstones or excessive alcohol consumption.
Question 7 of 9
A patient presents with ear pain. She is an avid swimmer. The history includes pain and drainage from the left ear. On examination, she has pain when the ear is manipulated, including manipulation of the tragus. The canal is narrowed and erythematous, with some white debris in the canal. The rest of the examination is normal. What diagnosis would you assign this patient?
Correct Answer: B
Rationale: The patient's history of swimming and presenting symptoms of ear pain, drainage, and manipulation tenderness are suggestive of external otitis, commonly known as swimmer's ear. External otitis is an infection of the outer ear canal, which can be caused by prolonged moisture exposure, trauma, or bacterial/fungal infections. The narrowed and erythematous canal with white debris is characteristic of this condition. Otitis media (Choice A) typically presents with deep ear pain, hearing loss, and sometimes fever, but does not involve the ear canal. Perforation of the tympanum (Choice C) would present with sudden relief of pain and possible drainage from the ear. Cholesteatoma (Choice D) is characterized by a painless cyst or mass in the middle ear, not presenting with these acute ear canal symptoms.
Question 8 of 9
A young woman comes to you with a cut on her finger caused by the lid of a can she was opening. She is pacing about the room, crying loudly, and through her sobs she says, "My career as a pianist is finished!" Which personality type exhibits these features?
Correct Answer: C
Rationale: The young woman in this scenario is exhibiting characteristics of histrionic personality disorder. Individuals with histrionic personality disorder tend to be overly dramatic, attention-seeking, and have a tendency to be excessively emotional in their reactions. The young woman's exaggerated response to a minor cut on her finger, along with her dramatic declaration that her career as a pianist is over, reflects the emotional and attention-seeking behaviors commonly associated with histrionic personality traits.
Question 9 of 9
A man's wife is upset because when she hugs him with her hands on his left shoulder blade, "it feels creepy." This came on gradually after a recent severe left-sided rotator cuff tear. How long does it usually take to develop muscular atrophy with increased prominence of the scapular spine following a rotator cuff tear?
Correct Answer: D
Rationale: Following a severe rotator cuff tear, it typically takes around 2-3 months for muscular atrophy to develop with increased prominence of the scapular spine. This is due to disuse of the affected shoulder muscles leading to muscle wasting and changes in the bony structures around the shoulder blade. Over time, the lack of muscle activity causes the shoulder blade to become more prominent and noticeable, which can result in altered sensations during activities like hugging. The gradual onset of these changes aligns with the timeline provided in the question, where the wife started to feel discomfort in her husband's left shoulder blade after the recent severe rotator cuff tear.