Jarvis Physical Examination and Health Assessment Test Bank

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.

Correct Answer: C

Rationale: The pectinate or dentate line is the border between the anal canal and the rectum. This is true because it represents the transition between the endoderm-derived upper anal canal and the ectoderm-derived lower anal canal. It is an important anatomical landmark in colorectal surgery and in distinguishing different pathologies in the anal region. Choice A is incorrect because the pectinate or dentate line is not typically palpable. Choice B is incorrect as it does not demarcate areas supplied by different nervous systems. Choice D is incorrect as the pectinate or dentate line is visible on proctoscopic examination due to its distinct appearance.

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.

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.

Correct Answer: D

Rationale: The correct answer is D, cardiomyopathy. Cardiomyopathy is a disease of the heart muscle that can lead to an increase in the size and strength of the heart muscle, resulting in an increased amplitude of the apical impulse. This is due to the heart working harder to pump blood effectively. Hypothyroidism (choice A) typically does not cause an increase in the amplitude of the apical impulse. Aortic stenosis (choice B) and mitral stenosis (choice C) both result in pressure or volume overload on specific chambers of the heart, but they do not directly lead to diffuse and increased amplitude of the apical impulse like cardiomyopathy does. In summary, an increase in the amplitude of the apical impulse is more likely to be caused by cardiomyopathy due to the increased workload on the heart muscle, compared to the other conditions provided in the choices.