jarvis physical examination and health assessment test bank

Correct Answer: C

Rationale: The correct answer is C: Stop aspirin and begin apixaban 5 mg twice a day. The rationale is that for stroke risk reduction in nonvalvular atrial fibrillation, anticoagulation therapy with direct oral anticoagulants (DOACs) like apixaban is preferred over antiplatelet therapy like aspirin. DOACs have been shown to be more effective in reducing stroke risk with a lower bleeding risk compared to warfarin. Choice A is incorrect as aspirin alone is not sufficient for stroke prevention in atrial fibrillation. Choice B is incorrect as warfarin has more monitoring requirements and potential drug interactions compared to DOACs like apixaban. Choice D is incorrect as aspirin and apixaban together are not recommended due to increased bleeding risk.

Correct Answer: A

Rationale: The correct answer is A: Provide positive pressure ventilation with supplemental oxygen. This is the most appropriate action as the patient is cyanotic, responsive to painful stimuli, and exhibiting stridorous respirations, indicating potential airway compromise. Providing positive pressure ventilation with supplemental oxygen can help improve oxygenation and support the patient's breathing. Summary of other choices: B: Obtaining vital signs is important, but in this urgent situation, addressing the airway and breathing takes precedence. C: Contacting medical direction may delay essential treatment. Immediate intervention is crucial in this scenario. D: Applying a pulse oximeter can provide valuable information, but administering oxygen and ensuring adequate ventilation should be the priority in a patient with compromised breathing.

Correct Answer: C

Rationale: The correct answer is C because clinical diagnosis of anxiety or depression can indeed have an effect on frailty rates. Anxiety and depression can contribute to the development and progression of frailty through various mechanisms such as decreased physical activity, poor nutrition, and social isolation. This can lead to a higher risk of frailty in individuals with mental health issues. Choices A, B, and D are incorrect because both prominent frailty models (e.g., Fried's phenotype model and Rockwood's accumulation of deficits model) do consider age as a component for defining frailty, individuals who are prefrail are at a higher risk of progressing to frailty rather than becoming robust, and frailty diagnosis has been shown to be valuable in preoperative assessment as it helps identify patients who may not do well with surgical interventions.

Correct Answer: A

Rationale: The correct answer is A because syphilis during pregnancy can lead to adverse outcomes for the fetus, such as spontaneous abortion or congenital syphilis. This is due to the ability of the Treponema pallidum bacterium to cross the placenta and infect the fetus. Testing pregnant women for syphilis helps identify and treat the infection early to prevent these complications. Choice B is incorrect because hormonal changes do not trigger activation of latent syphilis. Choice C is incorrect as syphilis can be transmitted to the fetus at any point during pregnancy, not just in the third trimester. Choice D is incorrect because while untreated syphilis can have various complications, neonatal respiratory distress is not a direct consequence of syphilis infection during pregnancy.

Correct Answer: B

Rationale: The correct answer is B: Spinal stenosis. The symptoms described suggest neurogenic claudication, which is a hallmark of spinal stenosis. Pain worsening with ambulation and improving with lumbar flexion is characteristic of spinal stenosis due to narrowing of the spinal canal leading to compression of nerves. Ankylosing spondylitis (A) presents with inflammatory back pain and stiffness, not neurogenic claudication. Bursitis (C) involves inflammation of bursae, not typically associated with leg pain and numbness. Cauda equina syndrome (D) presents with sudden-onset severe back pain, urinary retention, and saddle anesthesia, which are not consistent with the described symptoms.