ATI RN
Jarvis Physical Examination and Health Assessment Test Bank Questions
Question 1 of 5
A 22-year-old architecture major comes to your office, complaining of severe burning with urination, a fever of 101 degrees, and aching all over. She denies any upper respiratory, gastrointestinal, cardiac, or pulmonary symptoms. Her past medical history consists of severe acne. She is currently on an oral contraceptive. She has had no pregnancies or surgeries. She reports one new partner within the last month. She does not smoke but does drink occasionally. Her parents are both in good health. On examination you see a young woman appearing slightly ill. Her temperature is 3 and her pulse and blood pressure are unremarkable. Her head, ears, eyes, nose, throat, cardiac, pulmonary, and abdominal examinations are unremarkable. Palpation of the inguinal nodes shows lymphadenopathy bilaterally. On visualization of the perineum there are more than 10 shallow ulcers along each side of the vulva. Speculum and bimanual examination are unremarkable for findings, although she is very tender at the introitus. Urine analysis has some white blood cells but no red blood cells or bacteria. Her urine pregnancy test is negative. Which disorder of the vulva is most likely in this case?
Correct Answer: A
Rationale: The correct answer is A: Genital herpes. The patient's symptoms of severe burning with urination, fever, lymphadenopathy, and multiple shallow ulcers along the vulva are classic for genital herpes. The new sexual partner and absence of red blood cells or bacteria in the urine support a sexually transmitted infection. The presence of white blood cells in urine and absence of other systemic symptoms help differentiate it from other choices. Condylomata acuminata (choice B) present as warty lesions and do not cause the systemic symptoms described. Syphilitic chancre (choice C) would typically present as a single painless ulcer and is unlikely given the multiple shallow ulcers described. Epidermoid cyst (choice D) does not match the clinical presentation of fever, burning with urination, and lymphadenopathy.
Question 2 of 5
A patient with alcoholism is brought in with confusion. You ask him to "stop traffic" with his palms and notice that every few seconds his palms suddenly move toward the floor. What does this indicate?
Correct Answer: B
Rationale: The correct answer is B: Metabolic problems. The patient's inability to maintain sustained upward hand posture indicates asterixis, a sign of metabolic encephalopathy commonly seen in patients with liver failure due to alcoholism. This is caused by metabolic disturbances affecting the brain's function, leading to confusion and motor abnormalities. It is not indicative of a stroke (A), carpal tunnel syndrome (C), or severe fatigue and weakness (D), as they do not typically present with asterixis or the described palm movements.
Question 3 of 5
A 32-year-old warehouse worker presents for evaluation of low back pain. He notes a sudden onset of pain after lifting a set of boxes that were heavier than usual. He also states that he has numbness and tingling in the left leg. He wants to know if he needs to be off of work. What test should you perform to assess for a herniated disc?
Correct Answer: B
Rationale: The correct answer is B: Straight-leg raise. This test is used to assess for herniated disc by stretching the sciatic nerve. A positive test is indicated by reproduction of leg pain when the leg is raised between 30 to 70 degrees. This suggests nerve root irritation, common in herniated disc. A: Leg-length test - This test is used to assess for leg length discrepancy, not herniated disc. C: Tinel's test - This test is used to assess for nerve compression, typically in carpal tunnel syndrome, not specifically for herniated disc. D: Phalen's test - This test is used to assess for carpal tunnel syndrome, not herniated disc.
Question 4 of 5
Bill, a 55-year-old man, presents with pain in his epigastrium which lasts for 30 minutes or more at a time and has started recently. Which of the following should be considered?
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.
Question 5 of 5
What term describes the rhythmic, involuntary contractions of a muscle that can occur in patients with neurological conditions, such as cerebral palsy?
Correct Answer: B
Rationale: The correct answer is B: Clonus. Clonus is a series of rhythmic, involuntary muscle contractions and relaxations that occur due to an abnormal response in the stretch reflex. In patients with neurological conditions like cerebral palsy, clonus is often observed due to increased muscle tone. Tremor (A) is a rhythmic shaking movement, not specifically associated with muscle contractions. Spasm (C) is a sudden, involuntary muscle contraction that is not typically rhythmic. Fasciculation (D) is a brief, spontaneous contraction of a small number of muscle fibers, not the rhythmic pattern seen in clonus.
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