Jarvis Physical Examination and Health Assessment 9th Edition Test Bank

Jarvis Physical Examination and Health Assessment 9th Edition Test Bank Related

Review Jarvis Physical Examination and Health Assessment 9th Edition Test Bank related questions and content

A 28-year-old patient comes to the office for evaluation of a rash. At first there was only one large patch, but then more lesions erupted suddenly on the back and torso; the lesions itch. On physical examination, you note that the pattern of eruption is like a Christmas tree and that there are a variety of erythematous papules and macules on the cleavage lines of the back. Based on this description, what is the most likely diagnosis?

  • A. Pityriasis rosea
  • B. Tinea versicolor
  • C. Psoriasis
  • D. Atopic eczema
Correct Answer: A

Rationale: The correct answer is A: Pityriasis rosea. The key features that point towards this diagnosis include the sudden eruption of lesions in a Christmas tree pattern on the back and torso, along with itching. Pityriasis rosea commonly presents with a single large patch followed by smaller lesions in a distinct pattern. Other choices can be ruled out based on the description provided. Tinea versicolor typically presents with hypo- or hyperpigmented patches, not the erythematous papules and macules described. Psoriasis usually presents with thick, silvery scales, not erythematous lesions in a Christmas tree pattern. Atopic eczema may present with erythematous papules, but the Christmas tree pattern and acute onset described are not typical.

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During the breast examination of a perimenopausal woman, the NP detects a bloody spontaneous discharge from the right nipple. This indicates further evaluation:

  • A. Fibroadenoma
  • B. Polycystic breast disease
  • C. An intraductal papilloma
  • D. Pituitary prolactinoma
Correct Answer: C

Rationale: The correct answer is C: An intraductal papilloma. Bloody spontaneous discharge from the nipple in a perimenopausal woman is concerning for an intraductal papilloma, which is a benign growth in the milk ducts. Further evaluation with imaging studies and possibly a biopsy is necessary to rule out malignancy.

Choice A: Fibroadenoma is a common benign breast tumor but does not typically present with bloody discharge.

Choice B: Polycystic breast disease is not associated with bloody discharge and is characterized by multiple fluid-filled cysts in the breast tissue.

Choice D: Pituitary prolactinoma is a benign tumor of the pituitary gland that can cause elevated prolactin levels leading to nipple discharge, but it is not typically bloody and would not present with spontaneous discharge from the nipple.

You are performing a cardiac examination on a patient with shortness of breath and palpitations. You listen to the heart with the patient sitting upright, then have him change to a supine position, and finally have him turn onto his left side in the left lateral decubitus position. Which of the following valvular defects is best heard in this position?

  • A. Aortic
  • B. Pulmonic
  • C. Mitral
  • D. Tricuspid
Correct Answer: C

Rationale: The correct answer is C: Mitral valve defect. This is because the mitral valve is best heard in the left lateral decubitus position. In this position, the heart rotates, bringing the mitral valve closer to the chest wall, making it easier to auscultate any abnormalities such as murmurs. Aortic (A), pulmonic (B), and tricuspid (D) valve defects are not typically better heard in the left lateral decubitus position, so they are incorrect choices.

Which of the following drug classes is not indicated for the treatment of depression?

  • A. Buspirone (Buspar)
  • B. Selective Serotonin Reuptake Inhibitor (SSRI)
  • C. Tricyclic antidepressant (TCA)
  • D. Bupropion (Wellbutrin)
Correct Answer: A

Rationale: The correct answer is A: Buspirone (Buspar). Buspirone is not indicated for the treatment of depression; it is primarily used to treat anxiety disorders. SSRIs and TCAs are commonly prescribed for depression due to their ability to increase serotonin levels. Bupropion is an atypical antidepressant that works on norepinephrine and dopamine, making it a suitable option for depression treatment. Buspirone's mechanism of action differs from antidepressants, focusing on serotonin and dopamine receptors rather than directly targeting depression symptoms. Therefore, Buspirone is not a recommended drug class for depression treatment.

Unilateral rhinitis could be caused by all of the following except:

  • A. A foreign body in the nasal canal
  • B. A nasal polyp
  • C. Drug-induced rhinitis
  • D. A deviated septum
Correct Answer: D

Rationale: The correct answer is D: A deviated septum. Unilateral rhinitis typically refers to inflammation in one nostril. A deviated septum is a physical obstruction in the nasal passage that affects both nostrils, not just one. Choices A, B, and C can all cause unilateral rhinitis as they specifically affect one side of the nasal passage. A foreign body in the nasal canal, a nasal polyp, and drug-induced rhinitis can all lead to inflammation and symptoms in one nostril.

All of the statements about Medicare are true except:

  • A. All of the funding for Medicare comes from federal taxes.
  • B. Durable medical equipment has no out-of-pocket cost to the patient.
  • C. Part B covers outpatient services and all physician professional fees whether inpatient or outpatient.
  • D. Patients are generally responsible for 20% of Part B bills.
Correct Answer: B

Rationale: The correct answer is B because durable medical equipment under Medicare typically requires the patient to pay 20% of the Medicare-approved amount.
A is incorrect because Medicare funding also comes from payroll taxes and individual premiums.
C is incorrect as Part B covers outpatient services and physician fees only in outpatient settings.
D is incorrect as patients are generally responsible for 20% of Part B bills, not no out-of-pocket cost for durable medical equipment.

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