Jarvis Physical Examination and Health Assessment Test Bank

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: C

Rationale: The correct answer is C: Lower dose of antibiotics. The rationale is that the patient has early renal insufficiency, which means the kidney may have difficulty clearing medications from the body. Therefore, a lower dose of antibiotics is needed to prevent potential drug toxicity. A shorter course of antibiotics (choice A) may not be effective in treating pneumonia adequately. A longer course of antibiotics (choice B) may increase the risk of drug accumulation in the body. A higher dose of antibiotics (choice D) can lead to increased toxicity in a patient with renal insufficiency. Thus, the most appropriate option is to reduce the dose to ensure safe and effective treatment.

Correct Answer: B

Rationale: The correct answer is B (Pain) because pain is a common symptom in both inflammatory and non-inflammatory joint conditions. Tenderness, warmth, and redness are more specific to inflammatory joint problems. Tenderness indicates localized inflammation, warmth suggests increased blood flow and inflammation, and redness signifies dilated blood vessels and inflammation. Therefore, pain alone is less helpful in determining if a joint problem is inflammatory compared to the other symptoms.

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: B

Rationale: The correct answer is B: A dull pain or cramp. In peripheral artery disease, calf pain is typically described as a dull ache or cramp due to inadequate blood flow to the muscles during exercise. This pain is known as claudication. Choice A is incorrect as sharp, stabbing pain is not typically associated with peripheral artery disease. Choice C, an electric shock, is more indicative of nerve-related conditions. Choice D, a pulsating pain, is more characteristic of an aneurysm rather than peripheral artery disease.