Jarvis Physical Examination and Health Assessment Test Bank

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.

Correct Answer: D

Rationale: The correct answer is D: A bone marrow examination. Acute lymphocytic leukemia is a type of blood cancer that affects the bone marrow's ability to produce normal blood cells. A bone marrow examination is necessary to confirm the diagnosis by analyzing the bone marrow cells for abnormality. A complete blood count (choice A) can show abnormalities in blood cell counts but cannot confirm leukemia. Magnetic resonance imaging (choice B) and nuclear bone scan (choice C) are imaging tests that can show bone abnormalities but are not specific for diagnosing leukemia.

Correct Answer: C

Rationale: The correct answer is C: Advise them to file an advanced directive. An advanced directive is a legal document that allows individuals to specify their healthcare preferences in advance, including who they want to make medical decisions for them if they are unable to do so. In this scenario, since the patient and her partner are not married, it is important for her to have an advanced directive in place to ensure that her partner is legally recognized as the decision-maker. This documentation will help ensure her goals of care are followed in case she becomes incapacitated. Choice A (Advise them to complete a POLST) is incorrect because a POLST (Physician Orders for Life-Sustaining Treatment) form is used to specify a patient's wishes for end-of-life care, not for designating a medical decision-maker. Choice B (Advise them that they have adequate documentation to be recognized legally) is incorrect because without an advanced directive, there may be legal challenges to the partner's authority to make medical decisions

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.

Correct Answer: B

Rationale: The correct answer is B: Every year. Annual assessment aligns with American Heart Association guidelines to monitor these key health indicators regularly for early detection and management of potential cardiovascular risks. More frequent assessments (A) may be unnecessary and burdensome. Less frequent assessments (C, D) increase the risk of missing important changes in health status that could lead to adverse outcomes. Regular yearly assessments allow for timely interventions and adjustments to promote optimal cardiovascular health.