jarvis physical examination and health assessment test bank

Correct Answer: D

Rationale: The correct answer is D: Exercise and weight loss. The American College of Rheumatology recommends this intervention as first-line therapy for osteoarthritis and rheumatoid arthritis due to its proven benefits in reducing pain, improving joint function, and overall quality of life. Exercise helps strengthen muscles around the joints, improve flexibility, and reduce stiffness. Weight loss can also alleviate pressure on the joints, especially in weight-bearing joints. A: Diagnostic workup to rule out rheumatoid arthritis - This is not the first-line therapy but rather a step in the diagnostic process. B: NSAID use at the lowest effective dose - While NSAIDs may help with pain management, they are not recommended as the first-line therapy due to potential side effects. C: Acetaminophen use up to 4 grams/day - Acetaminophen can be used for pain relief, but it is not as effective as exercise and weight loss in managing osteoarthritis or rheumatoid arthritis symptoms

Correct Answer: B

Rationale: Step-by-step rationale for why B is correct: Janeway lesions, petechiae, and Osler nodes are classic signs of infective endocarditis. Janeway lesions are painless erythematous macules on palms/soles, petechiae are small red/purple spots due to microemboli, and Osler nodes are tender subcutaneous nodules on fingers/toes. These findings indicate systemic embolization and immune complex deposition in infective endocarditis. Other choices are incorrect as they do not typically present with these specific dermatologic findings.

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.

Correct Answer: C

Rationale: The correct answer is C: Regularly irregular rhythm. This is the appropriate documentation for Ms. Wright's presentation as her pulse demonstrates a pattern of irregularity with every fourth beat sounding different. This indicates a regularly irregular rhythm, where there is a discernible pattern to the irregularity. Rationale: 1. Regular rate and rhythm (Choice A) is incorrect as Ms. Wright's palpitations and the irregularity in her pulse indicate an irregular rhythm. 2. Irregularly irregular rhythm (Choice B) is incorrect as this term is used to describe arrhythmias like atrial fibrillation, which do not have a discernible pattern of irregularity. 3. Bradycardia (Choice D) is incorrect as it refers to a slow heart rate, which is not the primary concern in this scenario where the focus is on the irregular rhythm. In summary, the correct choice (C) accurately describes the specific irregular pattern observed in Ms. Wright's pulse, distinguishing it from

Correct Answer: B

Rationale: Correct Answer: B Rationale: 1. Adaptive questioning involves tailoring the questioning style to the patient's responses and needs to gather more detailed information. 2. Reassuring the patient that the symptoms are benign and not related to cancer is not a component of adaptive questioning as it can lead to bias and may hinder the patient from providing accurate information. 3. Directed questioning (A) helps to gather specific information systematically, offering choices (C) helps clarify symptoms, and asking for specific details (D) aids in understanding the patient's experiences. 4. By reassuring the patient prematurely, you may miss important details or dismiss potential concerns that could be relevant to the patient's condition.