ATI RN
Jarvis Physical Examination and Health Assessment Test Bank Questions
Question 1 of 5
A young patient presents with a left-sided mass in her abdomen. You confirm that it is present in the left upper quadrant. Which of the following would support that this represents an enlarged kidney rather than her spleen?
Correct Answer: A
Rationale: The correct answer is A: A palpable "notch" along its edge. This supports an enlarged kidney over the spleen because the kidney has a concave shape with a notch where the renal vessels enter. This notch is palpable in an enlarged kidney. Choice B is incorrect because the inability to push fingers between the mass and the costal margin is indicative of a spleen, which is a solid organ located close to the ribs. Choice C is incorrect as normal tympany over the area suggests gas-filled structures like the stomach or intestines, not a solid organ like the kidney or spleen. Choice D is incorrect as the ability to push fingers medial and deep to the mass would be more typical of an enlarged spleen, which can displace other organs medially due to its size.
Question 2 of 5
When assessing temperature of the skin, which portion of your hand should be used?
Correct Answer: A
Rationale: The correct answer is A: Fingertips. Fingertips are the most sensitive part of the hand, allowing for accurate temperature assessment. They provide better tactile discrimination and are more sensitive to changes in temperature compared to other parts of the hand. Palms have thicker skin and are less sensitive, making them less ideal for temperature assessment. Backs of fingers and ulnar aspect of the hand are also less sensitive than fingertips and lack the precision needed for accurate temperature detection.
Question 3 of 5
Which of the following is most likely benign on breast examination?
Correct Answer: B
Rationale: The correct answer is B: One breast larger than the other is most likely benign on breast examination. This is because breast asymmetry is a common and typically benign finding in women. It is important to note that a significant difference in breast size may warrant further evaluation, but in general, slight variations in size are normal. Now, let's discuss why the other choices are incorrect: A: Dimpling of the skin resembling that of an orange is concerning for peau d'orange appearance, which can be a sign of underlying breast cancer. C: One nipple inverted can be a sign of an underlying breast issue, such as a mass or tumor. D: One breast with a dimple when the patient leans forward can be a sign of an underlying breast abnormality, such as a tumor pulling on the skin. In summary, breast asymmetry (Choice B) is the most likely benign finding, while the other choices may indicate underlying breast issues that require further evaluation.
Question 4 of 5
A 29-year-old physical therapist presents for evaluation of an eyelid problem. On observation, the right eyeball appears to be protruding forward. Based on this description, what is the most likely diagnosis?
Correct Answer: B
Rationale: The correct answer is B: Exophthalmos. Exophthalmos refers to protrusion of the eyeball, which is a hallmark sign of thyroid eye disease. This condition commonly presents with forward bulging of one or both eyes due to inflammation and swelling of the eye muscles and tissues behind the eye. It is often associated with hyperthyroidism. A: Ptosis is drooping of the upper eyelid, not protrusion of the eyeball. C: Ectropion is an outward turning of the eyelid, not protrusion of the eyeball. D: Epicanthus is a vertical fold of skin on the upper eyelid near the nose, not protrusion of the eyeball.
Question 5 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.
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