ATI RN
jarvis physical examination and health assessment test bank Questions
Question 1 of 5
Which of the following is not a side effect of selective serotonin reuptake inhibitors in older adults?
Correct Answer: A
Rationale: The correct answer is A: Extrapyramidal symptoms. Selective serotonin reuptake inhibitors (SSRIs) are not known to cause extrapyramidal symptoms, which are more commonly associated with antipsychotic medications. SSRIs can cause gastrointestinal bleeding, irritation, and hyponatremia in older adults due to their effects on serotonin levels and platelet function. Extrapyramidal symptoms involve movement disorders like tremors and muscle rigidity, which are not typically seen with SSRIs. Therefore, A is the correct answer.
Question 2 of 5
Salmeterol (Serevent) in combination with an inhaled steroid is prescribed for a patient with moderate persistent asthma. What is the most important teaching point about salmeterol?
Correct Answer: A
Rationale: The correct answer is A: It is not effective during an acute asthma attack. Salmeterol is a long-acting beta agonist used for maintenance therapy, not for acute attacks. It does not provide immediate relief. Choices B and C are incorrect because salmeterol's onset of action is not immediate, and it may take days to weeks to achieve full effect. Choice D is incorrect because salmeterol should not be used in children under 12 years old.
Question 3 of 5
A 49-year-old truck driver comes to the emergency room for shortness of breath and swelling in his ankles. He is diagnosed with congestive heart failure and admitted to the hospital. You are the student assigned to do the patient's complete history and physical examination. When you palpate the pulse, what do you expect to feel?
Correct Answer: B
Rationale: The correct answer is B: Small amplitude, weak. In congestive heart failure, the heart's ability to pump effectively is compromised, leading to decreased cardiac output. This results in a weakened pulse with reduced amplitude. Palpating a small, weak pulse in this patient is expected due to poor cardiac function. Choices A and C are incorrect because a large, forceful pulse is not expected in congestive heart failure, and a normal pulse may not reflect the compromised cardiac function. Choice D, bigeminal, refers to an abnormal rhythm characterized by every other heartbeat being premature and is not typically associated with congestive heart failure.
Question 4 of 5
A 79-year-old client is admitted with pneumonia. Which symptom would most likely indicate the need for further evaluation?
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.
Question 5 of 5
A patient with alcoholism is brought in with confusion. You ask him to "stop traffic" with his palms and notice that every few seconds his palms suddenly move toward the floor. What does this indicate?
Correct Answer: B
Rationale: The correct answer is B: Metabolic problems. The patient's inability to maintain sustained upward hand posture indicates asterixis, a sign of metabolic encephalopathy commonly seen in patients with liver failure due to alcoholism. This is caused by metabolic disturbances affecting the brain's function, leading to confusion and motor abnormalities. It is not indicative of a stroke (A), carpal tunnel syndrome (C), or severe fatigue and weakness (D), as they do not typically present with asterixis or the described palm movements.
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