ATI RN
Jarvis Physical Examination and Health Assessment Practice Questions Questions
Question 1 of 5
An 8-year-old girl comes with her mother for evaluation of hair loss. She denies pulling or twisting her hair, and her mother has not noted this behavior at all. She does not put her hair in braids. On physical examination, you note a clearly demarcated, round patch of hair loss without visible scaling or inflammation. There are no hair shafts visible. Based on this description, what is your most likely diagnosis?
Correct Answer: A
Rationale: The description provided, which includes a clearly demarcated, round patch of hair loss without visible scaling or inflammation and absence of hair shafts, is characteristic of alopecia areata. Alopecia areata is an autoimmune condition that causes hair loss in round or oval patches on the scalp or other parts of the body. It is not associated with pulling or twisting of hair (trichotillomania), fungal infection (tinea capitis), or hair loss due to constant pulling force (traction alopecia). In alopecia areata, the affected area usually appears smooth and without visible signs of irritation. Treatment options for alopecia areata may include corticosteroid injections, topical immunotherapy, or minoxidil.
Question 2 of 5
Today her pressure is 168/94 and pressure on the other arm is similar. What would you do next?
Correct Answer: B
Rationale: In this scenario, with a blood pressure of 168/94 on both arms, it indicates poorly controlled hypertension. Hypertension can have various causes, including kidney-related issues. Referring the patient to nephrology would be the appropriate next step to evaluate and manage any potential underlying kidney conditions contributing to the uncontrolled blood pressure. The nephrologist can conduct further tests and assessments to determine the root cause and provide specialized care for the patient's condition. This approach ensures a comprehensive evaluation and targeted management plan for the patient's hypertension.
Question 3 of 5
A man's wife is upset because when she hugs him with her hands on his left shoulder blade, "it feels creepy." This came on gradually after a recent severe left-sided rotator cuff tear. How long does it usually take to develop muscular atrophy with increased prominence of the scapular spine following a rotator cuff tear?
Correct Answer: D
Rationale: Following a severe rotator cuff tear, it typically takes around 2-3 months for muscular atrophy to develop with increased prominence of the scapular spine. This is due to disuse of the affected shoulder muscles leading to muscle wasting and changes in the bony structures around the shoulder blade. Over time, the lack of muscle activity causes the shoulder blade to become more prominent and noticeable, which can result in altered sensations during activities like hugging. The gradual onset of these changes aligns with the timeline provided in the question, where the wife started to feel discomfort in her husband's left shoulder blade after the recent severe rotator cuff tear.
Question 4 of 5
A 32-year-old white male comes to your clinic, complaining of aching on the right side of his testicle. He has felt this aching for several months. He states that as the day progresses the aching increases, but when he wakes up in the morning he is pain-free. He denies any pain with urination and states that the pain doesn't change with sexual activity. He denies any fatigue, weight gain, weight loss, fever, or night sweats. His past medical history is unremarkable. He is a married hospital administrator with two children. He notes that he and his wife have been trying to have another baby this year but have so far been unsuccessful despite frequent intercourse. He denies using tobacco, alcohol, or illegal drugs. His father has high blood pressure but his mother is healthy. On examination you see a young man appearing his stated age with unremarkable vital signs. On visualization of his penis, he is circumcised with no lesions. He has no scars along his inguinal area, and palpation of the area shows no lymphadenopathy. On palpation of his scrotum you feel testes with no discrete masses. Upon placing your finger through the right inguinal ring you feel what seems like a bunch of spaghetti. Asking him to bear down, you feel no bulges. The left inguinal ring is unremarkable, with no bulges on bearing down. His prostate examination is unremarkable. What abnormality of the scrotum does he most likely have?
Correct Answer: D
Rationale: The most likely abnormality of the scrotum that the patient has is a varicocele. This is indicated by the presence of a "bag of worms" feeling upon palpation of the right scrotum through the inguinal ring. Varicoceles are enlarged, twisted veins in the scrotum, similar to varicose veins that occur in the legs. They are more common on the left side, but can occur on the right side as well.
Question 5 of 5
Which of the following percussion notes would you obtain over the gastric bubble?
Correct Answer: B
Rationale: Tympany is the percussion note you would obtain over the gastric bubble. Tympany is a drum-like sound and is typically heard over air-filled structures in the body, such as the stomach, intestines, and lungs. When percussing over the gastric bubble (air-filled stomach), you would expect to hear a tympanic note due to the presence of air in the stomach creating resonance. Resonance (choice A) is a low-pitched, hollow sound heard over normal lung tissue. Hyperresonance (choice C) is an abnormally loud, booming sound heard over hyperinflated lungs, as in conditions like emphysema. Flatness (choice D) is a dull sound heard over solid organs or areas of tissue consolidation, such as over the liver or a pleural effusion.
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