ATI RN
jarvis physical examination and health assessment test bank Questions
Question 1 of 5
An 86-year-old man with no ADL deficits who has stopped driving because of macular degeneration is evaluated for a urinary tract infection associated with urinary retention. The consulting urologist places a Foley catheter and sends a prostate-specific antigen (PSA) level that comes back 12 ng/mL. Three months later after the Foley has been removed and he has had a good response to tamsulosin, his PSA is still 10 ng/mL. What is the appropriate next step in managing this man�s prostate problem?
Correct Answer: D
Rationale: The correct answer is D: Repeat PSA in 6 months. In this case, the patient's PSA levels have decreased from 12 ng/mL to 10 ng/mL after treatment with tamsulosin and removal of the Foley catheter. Given the improvement in PSA levels, it is reasonable to monitor for further changes before considering invasive procedures like transrectal ultrasound and biopsy (choice A), which may not be necessary at this time. Empiric finasteride (choice B) is not indicated as the patient is already responding well to tamsulosin. A bone scan (choice C) is not necessary at this stage as there are no indications of metastasis. Therefore, repeating the PSA in 6 months allows for continued monitoring of the patient's prostate health without subjecting him to unnecessary procedures.
Question 2 of 5
The nurse is caring for an older adult who is having difficulty with swallowing. Which intervention should the nurse implement to prevent aspiration?
Correct Answer: B
Rationale: The correct answer is B: Provide thickened liquids and soft foods. This intervention helps prevent aspiration by reducing the risk of food or liquids entering the airway. Thickened liquids are easier to control while swallowing, decreasing the chance of aspiration. Soft foods are also easier to chew and swallow, further reducing the risk. Choice A is incorrect because eating quickly can increase the risk of choking and aspiration. Choice C is incorrect as lying down after meals can actually increase the risk of aspiration. Choice D is incorrect as large meals can increase the likelihood of swallowing difficulties and aspiration.
Question 3 of 5
An 85-year-old man with newly diagnosed nonvalvular atrial fibrillation comes to the office for a follow-up. Which medication change would be most appropriate for reducing his stroke risk?
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.
Question 4 of 5
A patient presents with pain in the shoulder. The nurse practitioner knows that there are four rotator cuff muscles. The muscle that initiates abduction movement at the shoulder is known as the:
Correct Answer: A
Rationale: Rationale: The correct answer is A: Supraspinatus. This muscle is responsible for initiating abduction movement at the shoulder joint. It is located on the top of the shoulder blade and assists in lifting the arm away from the body. The other choices, B: Infraspinatus, C: Levator scapulae muscle, and D: Subscapularis, are not involved in initiating abduction movement at the shoulder. Infraspinatus is responsible for external rotation, Levator scapulae muscle elevates the scapula, and Subscapularis assists in internal rotation of the shoulder joint.
Question 5 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.
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