Jarvis Physical Examination and Health Assessment Test Bank

Correct Answer: B

Rationale: The correct answer is B: One breast larger than the other is most likely benign on breast examination. This is because breast asymmetry is a common and typically benign finding in women. It is important to note that a significant difference in breast size may warrant further evaluation, but in general, slight variations in size are normal. Now, let's discuss why the other choices are incorrect: A: Dimpling of the skin resembling that of an orange is concerning for peau d'orange appearance, which can be a sign of underlying breast cancer. C: One nipple inverted can be a sign of an underlying breast issue, such as a mass or tumor. D: One breast with a dimple when the patient leans forward can be a sign of an underlying breast abnormality, such as a tumor pulling on the skin. In summary, breast asymmetry (Choice B) is the most likely benign finding, while the other choices may indicate underlying breast issues that require further evaluation.

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: B

Rationale: The correct answer is B: Chest pain and pleuritic breathing. This indicates possible complications like pleurisy or pleural effusion, requiring further evaluation. A: Persistent cough with sputum production is common in pneumonia. C: Shortness of breath is a typical symptom of pneumonia. D: Fever and chills are also common in pneumonia. However, chest pain and pleuritic breathing are more indicative of potential complications that may require immediate attention.

Correct Answer: B

Rationale: The correct answer is B: Haloperidol. Haloperidol is a first-line antipsychotic commonly used to manage agitation in delirium due to its rapid onset and minimal sedative effects. It acts by blocking dopamine receptors in the brain, which helps to reduce agitation and combativeness. Melatonin (A) is not effective for acute agitation. Diazepam (C) can worsen confusion in elderly patients and is not recommended for delirium. Gabapentin (D) is not indicated for managing agitation in delirium and may not be effective in this scenario.

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).