Jarvis Physical Examination and Health Assessment Practice Questions

Correct Answer: B

Rationale: A sudden, painful unilateral loss of vision is a medical emergency that may be caused by central retinal artery occlusion. This condition occurs when the main artery supplying blood to the retina becomes blocked, leading to a sudden and severe reduction in blood flow to the eye. The lack of blood flow can cause irreversible damage to the retina, resulting in a significant loss of vision. Patients with central retinal artery occlusion typically present with sudden, painless, and severe vision loss in one eye. Immediate medical attention is crucial to try to restore blood flow and minimize potential permanent vision loss in these cases. Vitreous hemorrhage, macular degeneration, and optic neuritis do not typically present with sudden, painful unilateral loss of vision as seen in central retinal artery occlusion.

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.

Correct Answer: D

Rationale: The most likely explanation for the discrepancy between the patient's relatively normal blood pressure reading (118/92) and the presence of hypertensive changes in her retinas and mild proteinuria is that the process causing her retinopathy and kidney problems has resolved. Hypertensive changes in the retinas and proteinuria are typically signs of chronic uncontrolled hypertension, but they can also be residual manifestations of previously uncontrolled hypertension that has now been effectively treated.

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.

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.