jarvis physical examination and health assessment test bank

Correct Answer: A

Rationale: The correct answer is A because atypical, community-acquired pneumonia often presents with subtle symptoms like a low-grade fever and malaise. Clear lung fields on auscultation are typical as atypical pneumonia affects the interstitium rather than the alveoli. Choice B is incorrect as crackles throughout the lung fields are indicative of typical pneumonia affecting the alveoli. Choice C is incorrect because a sore throat is not a typical symptom of atypical pneumonia, and diminished breath sounds are not typically associated with atypical pneumonia. Choice D is incorrect because a temperature of 102�F and dyspnea are more indicative of a more severe pneumonia, and diminished lung sounds are not typically associated with atypical pneumonia.

Correct Answer: A

Rationale: The correct answer is A: Extrapyramidal symptoms. Selective serotonin reuptake inhibitors (SSRIs) are not known to cause extrapyramidal symptoms, which are more commonly associated with antipsychotic medications. SSRIs can cause gastrointestinal bleeding, irritation, and hyponatremia in older adults due to their effects on serotonin levels and platelet function. Extrapyramidal symptoms involve movement disorders like tremors and muscle rigidity, which are not typically seen with SSRIs. Therefore, A is the correct answer.

Correct Answer: D

Rationale: The correct answer is D: Repeat PSA in 6 months. In this case, the patient's PSA levels have decreased from 12 ng/mL to 10 ng/mL after treatment with tamsulosin and removal of the Foley catheter. Given the improvement in PSA levels, it is reasonable to monitor for further changes before considering invasive procedures like transrectal ultrasound and biopsy (choice A), which may not be necessary at this time. Empiric finasteride (choice B) is not indicated as the patient is already responding well to tamsulosin. A bone scan (choice C) is not necessary at this stage as there are no indications of metastasis. Therefore, repeating the PSA in 6 months allows for continued monitoring of the patient's prostate health without subjecting him to unnecessary procedures.

Correct Answer: B

Rationale: The correct answer is B: Present illness. The statement "I feel really tired" falls under the present illness category because it describes the current health concern the individual is experiencing. This section focuses on the details of the current symptoms, their duration, severity, and any associated factors. It helps in understanding the progression and impact of the current health issue. A: Chief complaint typically refers to the main reason for seeking medical help, usually a symptom or problem that brought the individual to the healthcare provider. C: Personal and social history covers information about the individual's lifestyle, habits, and social support system. D: Review of systems involves systematically asking about symptoms related to different body systems, which is not the case in the given statement.

Correct Answer: D

Rationale: The correct answer is D, "All of the above." Bill's symptoms of epigastric pain lasting 30 minutes or more can be indicative of peptic ulcer, pancreatitis, or myocardial ischemia. Peptic ulcer can cause epigastric pain, pancreatitis presents with severe epigastric pain, and myocardial ischemia can manifest as epigastric discomfort. Considering all these possibilities is crucial for proper diagnosis and treatment. The other choices are incorrect because they do not encompass all potential causes of Bill's symptoms. It is important to consider a broad differential diagnosis to ensure comprehensive evaluation and management.