You feel a small mass that you think is a lymph node. It is mobile in both the up-and- down and side-to-side directions. Which of the following is most likely?

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Jarvis Physical Examination and Health Assessment Test Bank Questions

Question 1 of 9

You feel a small mass that you think is a lymph node. It is mobile in both the up-and- down and side-to-side directions. Which of the following is most likely?

Correct Answer: B

Rationale: The correct answer is B: Lymph node. A mobile mass that is palpable and moves in multiple directions is characteristic of a lymph node. Lymph nodes are small, bean-shaped structures that are part of the immune system and can move freely when touched. Incorrect choices: A: Cancer - A cancerous mass would typically be fixed and not mobile. C: Deep scar - Scars are usually fixed and do not move when touched. D: Muscle - Muscles are usually deeper in the body and not typically palpable as a mobile mass.

Question 2 of 9

All of the following about the Medicare Part D prescription medication benefit plan are true except:

Correct Answer: D

Rationale: The correct answer is D because beneficiaries do have out-of-pocket expenses for each prescription filled under Medicare Part D. This is typically in the form of copayments or coinsurance. A: Medicare Advantage plans often include Part D coverage, making statement A true. B: There are indeed multiple companies offering Part D plans, so statement B is true. C: The monthly premium for Part D coverage can vary, but in 2019 it was indeed around $30, making statement C true as well.

Question 3 of 9

You feel a small mass that you think is a lymph node. It is mobile in both the up-and- down and side-to-side directions. Which of the following is most likely?

Correct Answer: B

Rationale: The correct answer is B: Lymph node. A mobile mass that is palpable and moves in multiple directions is characteristic of a lymph node. Lymph nodes are small, bean-shaped structures that are part of the immune system and can move freely when touched. Incorrect choices: A: Cancer - A cancerous mass would typically be fixed and not mobile. C: Deep scar - Scars are usually fixed and do not move when touched. D: Muscle - Muscles are usually deeper in the body and not typically palpable as a mobile mass.

Question 4 of 9

A patient with longstanding COPD was told by another practitioner that his liver was enlarged and this needed to be assessed. Which of the following would be reasonable to do next?

Correct Answer: D

Rationale: The correct answer is D: Obtain an ultrasound of the liver. This is the most appropriate next step to assess the patient's enlarged liver in the context of COPD. Ultrasound can provide detailed images of the liver to identify potential causes of enlargement, such as fatty liver disease or liver cirrhosis. Percussing the lower border (Choice A) or measuring the span of the liver (Choice B) may provide some information but are less specific and may not identify the underlying cause. Ordering a hepatitis panel (Choice C) would focus only on viral hepatitis as a potential cause, while an ultrasound can provide a broader evaluation of liver structure and function.

Question 5 of 9

Salmeterol (Serevent) in combination with an inhaled steroid is prescribed for a patient with moderate persistent asthma. What is the most important teaching point about salmeterol?

Correct Answer: A

Rationale: The correct answer is A: It is not effective during an acute asthma attack. Salmeterol is a long-acting beta agonist used for maintenance therapy, not for acute attacks. It does not provide immediate relief. Choices B and C are incorrect because salmeterol's onset of action is not immediate, and it may take days to weeks to achieve full effect. Choice D is incorrect because salmeterol should not be used in children under 12 years old.

Question 6 of 9

What is the most common cause of community-acquired pneumonia in adults?

Correct Answer: B

Rationale: The correct answer is B: Streptococcus pneumoniae. This bacterium is the most common cause of community-acquired pneumonia in adults due to its prevalence and ability to cause infections in the lungs. It accounts for a significant portion of pneumonia cases worldwide. Staphylococcus aureus (A) is more commonly associated with healthcare-associated pneumonia. Mycoplasma pneumoniae (C) typically causes atypical pneumonia, which tends to be milder and more common in younger individuals. Pseudomonas aeruginosa (D) is more commonly seen in individuals with underlying health conditions or compromised immune systems, rather than in healthy adults with community-acquired pneumonia.

Question 7 of 9

When deciding on an initial treatment option for an acute flare of atopic dermatitis, unresponsive to emollient therapy, the next best choice for treatment is:

Correct Answer: B

Rationale: The correct answer is B: Betamethasone dipropionate 0.05% (Betanate). When managing an acute flare of atopic dermatitis unresponsive to emollient therapy, topical corticosteroids like betamethasone are often the first-line treatment due to their anti-inflammatory properties. Betamethasone is a potent corticosteroid that can help reduce inflammation, itching, and redness associated with atopic dermatitis. Oral corticosteroids (Choice A) are generally reserved for severe cases due to potential systemic side effects. Desonide (Choice C) is a milder topical corticosteroid suitable for maintenance therapy but may not be potent enough for acute flares. Pimecrolimus (Choice D) is a calcineurin inhibitor used for moderate to severe atopic dermatitis and is generally not the first choice for initial treatment of acute flares.

Question 8 of 9

You have arrived by the side of a cyanotic patient who is responsive to painful stimuli and exhibiting stridorous respirations. Which of the following would be most appropriate?

Correct Answer: A

Rationale: The correct answer is A: Provide positive pressure ventilation with supplemental oxygen. This is the most appropriate action as the patient is cyanotic, responsive to painful stimuli, and exhibiting stridorous respirations, indicating potential airway compromise. Providing positive pressure ventilation with supplemental oxygen can help improve oxygenation and support the patient's breathing. Summary of other choices: B: Obtaining vital signs is important, but in this urgent situation, addressing the airway and breathing takes precedence. C: Contacting medical direction may delay essential treatment. Immediate intervention is crucial in this scenario. D: Applying a pulse oximeter can provide valuable information, but administering oxygen and ensuring adequate ventilation should be the priority in a patient with compromised breathing.

Question 9 of 9

Mr. Roberts, a 72-year-old patient who has sought medical care on an intermittent basis in the past, complains of aching discomfort in his perineal area, urinary urgency, and frequency for the past few years. He also complains of insomnia and intermittent anxiety that he attributes to loneliness after his wife’s death about a year ago. Digital rectal examination (DRE) reveals a slightly enlarged, nontender prostate with no palpable nodules. Perineal examination is normal. Bladder scan is unremarkable and postvoid residual urine volume is 50 mL. Urinalysis shows no WBCs or RBCs. Urine culture is negative. Previous treatment has included dietary modifications and alpha-blocker medication. What is the most appropriate next step?

Correct Answer: D

Rationale: The correct answer is D: Screen for depression. The patient's symptoms of insomnia, anxiety, and loneliness after his wife's death suggest he may be experiencing depression, which can manifest as physical symptoms like urinary urgency and frequency. Since the patient has already received appropriate treatment for his urinary symptoms, addressing his mental health is the next crucial step. This can help improve his overall well-being and quality of life. Starting an antibiotic course (choice A) is not indicated as there are no signs of infection. Initiating a 5-alpha-reductase inhibitor (choice B) is not necessary given the absence of specific indications such as obstructive voiding symptoms. Urodynamic testing (choice C) is not warranted at this stage as the patient's history and findings do not suggest underlying bladder dysfunction.

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