jarvis physical examination and health assessment test bank

Correct Answer: A

Rationale: The correct answer is A: Provide positive pressure ventilation with supplemental oxygen. This is the most appropriate action as the patient is cyanotic, responsive to painful stimuli, and exhibiting stridorous respirations, indicating potential airway compromise. Providing positive pressure ventilation with supplemental oxygen can help improve oxygenation and support the patient's breathing. Summary of other choices: B: Obtaining vital signs is important, but in this urgent situation, addressing the airway and breathing takes precedence. C: Contacting medical direction may delay essential treatment. Immediate intervention is crucial in this scenario. D: Applying a pulse oximeter can provide valuable information, but administering oxygen and ensuring adequate ventilation should be the priority in a patient with compromised breathing.

Correct Answer: A

Rationale: The correct answer is A because atypical, community-acquired pneumonia often presents with subtle symptoms like a low-grade fever and malaise. Clear lung fields on auscultation are typical as atypical pneumonia affects the interstitium rather than the alveoli. Choice B is incorrect as crackles throughout the lung fields are indicative of typical pneumonia affecting the alveoli. Choice C is incorrect because a sore throat is not a typical symptom of atypical pneumonia, and diminished breath sounds are not typically associated with atypical pneumonia. Choice D is incorrect because a temperature of 102�F and dyspnea are more indicative of a more severe pneumonia, and diminished lung sounds are not typically associated with atypical pneumonia.

Correct Answer: D

Rationale: The correct answer is D: Screen for depression. The patient's symptoms of insomnia, anxiety, and loneliness after his wife's death suggest he may be experiencing depression, which can manifest as physical symptoms like urinary urgency and frequency. Since the patient has already received appropriate treatment for his urinary symptoms, addressing his mental health is the next crucial step. This can help improve his overall well-being and quality of life. Starting an antibiotic course (choice A) is not indicated as there are no signs of infection. Initiating a 5-alpha-reductase inhibitor (choice B) is not necessary given the absence of specific indications such as obstructive voiding symptoms. Urodynamic testing (choice C) is not warranted at this stage as the patient's history and findings do not suggest underlying bladder dysfunction.

Correct Answer: B

Rationale: The correct answer is B because in Munchausen syndrome by proxy, the patient only exhibits symptoms under the direct care or supervision of the abuser. This is because the abuser intentionally causes or fabricates symptoms in the victim to gain attention or sympathy. In contrast, the other choices are incorrect. A is incorrect because the injury is inflicted by the abuser, not self-inflicted by the patient. C is incorrect as the caregiver is the one perpetrating the abuse. D is incorrect because the abuser is often overly involved and manipulative, rather than inattentive and uncaring.

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.