jarvis physical examination and health assessment test bank

Correct Answer: B

Rationale: The correct answer is B: Clonus. Clonus is a series of rhythmic, involuntary muscle contractions and relaxations that occur due to an abnormal response in the stretch reflex. In patients with neurological conditions like cerebral palsy, clonus is often observed due to increased muscle tone. Tremor (A) is a rhythmic shaking movement, not specifically associated with muscle contractions. Spasm (C) is a sudden, involuntary muscle contraction that is not typically rhythmic. Fasciculation (D) is a brief, spontaneous contraction of a small number of muscle fibers, not the rhythmic pattern seen in clonus.

Correct Answer: D

Rationale: The correct answer is D: Obtain an ultrasound of the liver. This is the most appropriate next step to assess the patient's enlarged liver in the context of COPD. Ultrasound can provide detailed images of the liver to identify potential causes of enlargement, such as fatty liver disease or liver cirrhosis. Percussing the lower border (Choice A) or measuring the span of the liver (Choice B) may provide some information but are less specific and may not identify the underlying cause. Ordering a hepatitis panel (Choice C) would focus only on viral hepatitis as a potential cause, while an ultrasound can provide a broader evaluation of liver structure and function.

Correct Answer: D

Rationale: The correct answer is D because asking the patient to describe what happened will provide crucial information about the onset, nature, and potential cause of the knee pain. This open-ended question allows the patient to share their experience freely, aiding in accurate diagnosis and appropriate treatment planning. Option A focuses solely on pain intensity, which is important but not as comprehensive as understanding the context of the pain (D). Options B and C are more specific to past injuries and onset time, respectively, which are relevant but not as immediate and all-encompassing as asking the patient to describe the current issue (D).

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.

Correct Answer: A

Rationale: The correct answer is A: A palpable "notch" along its edge. This supports an enlarged kidney over the spleen because the kidney has a concave shape with a notch where the renal vessels enter. This notch is palpable in an enlarged kidney. Choice B is incorrect because the inability to push fingers between the mass and the costal margin is indicative of a spleen, which is a solid organ located close to the ribs. Choice C is incorrect as normal tympany over the area suggests gas-filled structures like the stomach or intestines, not a solid organ like the kidney or spleen. Choice D is incorrect as the ability to push fingers medial and deep to the mass would be more typical of an enlarged spleen, which can displace other organs medially due to its size.