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
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 3 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 4 of 9
Mr. Q. is a 45-year-old salesman who comes to your office for evaluation of fatigue. He has come to the office many times in the past with a variety of injuries, and you suspect that he has a problem with alcohol. Which one of the following questions will be most helpful in diagnosing this problem?
Correct Answer: B
Rationale: Asking Mr. Q. when his last drink was is an open-ended question that can provide valuable information regarding his alcohol consumption patterns. This question allows Mr. Q. to disclose whether he has been drinking recently and can help determine the frequency and quantity of his alcohol consumption. It avoids leading or judgmental language, which can help build rapport and facilitate a more honest conversation about his alcohol use. By knowing when his last drink was, you can better assess the potential impact of alcohol on his current symptoms of fatigue and further explore any potential issues related to alcohol abuse.
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
A 29-year-old computer programmer comes to your office for evaluation of a headache. The tightening sensation is located all over the head and is of moderate intensity. It used to last minutes, but this time it has lasted for 5 days. He denies photophobia and nausea. He spends several hours each day at a computer monitor/keyboard. He has tried over-the-counter medication; it has dulled the pain but not taken it away. Based on this description, what is your most likely diagnosis?
Correct Answer: A
Rationale: The description provided fits the criteria for tension-type headache. Tension-type headaches are typically described as a mild to moderate, dull, band-like pressure or tightness around the head. They can last from minutes to days and are often triggered by stress, anxiety, poor posture, or prolonged computer use. The absence of symptoms like photophobia and nausea, along with the response to over-the-counter medication, further support the diagnosis of tension-type headache in this case. Other headache types such as migraines or cluster headaches usually present with additional symptoms like nausea, photophobia, or tearing of the eye, which are not mentioned in this scenario. Analgesic rebound headaches typically occur in individuals who overuse pain medications, leading to worsening headaches when the medication wears off, but this patient's history does not suggest such misuse.
Question 7 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 8 of 9
An elderly woman with dementia is brought in by her daughter for a "rectal mass." On examination you notice a moist pink mass protruding from the anus, which is nontender. It is soft and does not have any associated bleeding. Which of the following is most likely?
Correct Answer: A
Rationale: Rectal prolapse occurs when the rectum protrudes through the anus. It typically appears as a moist, pink mass that protrudes outside the body. The prolapse is usually painless and can be seen and felt by the patient or the examiner. It is commonly seen in elderly individuals, especially women, and those with conditions like chronic constipation, pelvic floor weakness, or dementia. On the other hand, external hemorrhoids are swollen veins located around the anus, usually painful and may cause bleeding. Perianal fistula is an abnormal tunnel-like connection between the skin near the anus and the rectum, which can cause pain and discharge. Prolapsed internal hemorrhoids are internal hemorrhoids that have descended outside the anal canal and may require manual reduction. Given the symptoms described in the scenario - a moist pink mass protruding from the anus that is nontender and soft without bleeding - the most likely diagnosis is rectal prol
Question 9 of 9
Which of the following percussion notes would you obtain over the gastric bubble?
Correct Answer: B
Rationale: Tympany is the percussion note you would obtain over the gastric bubble. Tympany is a drum-like sound and is typically heard over air-filled structures in the body, such as the stomach, intestines, and lungs. When percussing over the gastric bubble (air-filled stomach), you would expect to hear a tympanic note due to the presence of air in the stomach creating resonance. Resonance (choice A) is a low-pitched, hollow sound heard over normal lung tissue. Hyperresonance (choice C) is an abnormally loud, booming sound heard over hyperinflated lungs, as in conditions like emphysema. Flatness (choice D) is a dull sound heard over solid organs or areas of tissue consolidation, such as over the liver or a pleural effusion.