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

Mr. Hunter, a 69-year-old man, complains of urinary frequency and urgency that have increased over the past several months. There is no dysuria, hematuria, or sensation of incomplete voiding. He drinks 2 cups of coffee daily and diet cola multiple times a day. His International Prostate Symptom Score (IPSS) is 6, with a bother score of 1 indicating mild voiding symptoms with low impact on his quality of life. His medical history includes hypertension, coronary artery disease, and benign prostatic hyperplasia. Current medications are aspirin, metoprolol, and hydrochlorothiazide. Physical examination reveals normal sized prostate. Which of the following is the best next step?

  • A. Urinalysis
  • B. Cystoscopy
  • C. Lifestyle modifications
  • D. Tamsulosin
Correct Answer: C

Rationale: The correct next step is C: Lifestyle modifications. Given the patient's history of mild voiding symptoms and benign prostatic hyperplasia, the first approach should be conservative management. Lifestyle modifications, such as reducing caffeine intake from coffee and diet cola, can help alleviate urinary symptoms. Additionally, optimizing fluid intake and bladder habits can also improve symptoms. Urinalysis (choice A) may be considered later if symptoms persist or worsen. Cystoscopy (choice B) is invasive and not indicated at this stage. Tamsulosin (choice D) is a medication for BPH, but since the patient's symptoms are mild and bother score is low, starting with lifestyle modifications is more appropriate.

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Which of the following drugs is not contraindicated for concurrent use with warfarin (Coumadin)?

  • A. Amoxicillin (Amoxil)
  • B. Trimethoprim/sulfamethoxazole (Bactrim)
  • C. Ciprofloxacin (Cipro)
  • D. Clarithromycin (Biaxin)
Correct Answer: A

Rationale: Rationale for correct answer (A): Amoxicillin does not significantly interact with warfarin. It is an antibiotic that works through a different mechanism than warfarin and is not known to affect its anticoagulant activity.

Summary of incorrect choices:
B (Trimethoprim/sulfamethoxazole): This drug combination can enhance the effects of warfarin, increasing the risk of bleeding.
C (Ciprofloxacin): Ciprofloxacin can increase warfarin's effects, leading to a higher risk of bleeding.
D (Clarithromycin): Clarithromycin can interact with warfarin, potentially increasing the risk of bleeding.

A light is pointed at a patient's pupil, which contracts. It is also noted that the other pupil contracts as well, though it is not exposed to bright light. Which of the following terms describes this latter phenomenon?

  • A. Direct reaction
  • B. Consensual reaction
  • C. Near reaction
  • D. Accommodation
Correct Answer: B

Rationale: The correct term for the phenomenon described is "Consensual reaction" (Choice B). This occurs because the optic nerves from both eyes are connected, causing stimulation of one eye to result in a simultaneous response in the other eye due to the consensual pupillary reflex. The other choices are incorrect because:
A: Direct reaction refers to the pupil directly exposed to light contracting.
C: Near reaction refers to the pupillary response when focusing on a near object.
D: Accommodation refers to the ability of the eye to adjust focus for near and far objects, not pupil constriction.

An 84-year-old male with prostatic hypertrophy is at increased risk of:

  • A. Constipation
  • B. Fecal incontinence
  • C. Urinary tract infections
  • D. Prostate cancer
Correct Answer: C

Rationale: The correct answer is C: Urinary tract infections. Prostatic hypertrophy can cause obstruction of the urinary tract, leading to urinary retention and stasis, which increases the risk of urinary tract infections. Constipation (choice A) and fecal incontinence (choice B) are more related to issues with the gastrointestinal system rather than prostatic hypertrophy. Prostate cancer (choice D) is a separate condition that is not directly linked to prostatic hypertrophy. Therefore, the increased risk for an 84-year-old male with prostatic hypertrophy is urinary tract infections due to urinary obstruction.

A patient with bulimia is likely to be:

  • A. Very overweight
  • B. Very underweight
  • C. Of average weight
  • D. Not concerned with weight
Correct Answer: C

Rationale: The correct answer is C: Of average weight. Patients with bulimia often maintain a normal weight or fluctuate between weight extremes due to their binge-eating and compensatory behaviors. They may engage in purging to counteract the effects of binge eating, preventing significant weight gain. Choice A is incorrect as bulimia is not typically associated with being very overweight. Choice B is incorrect as individuals with bulimia can have a normal or slightly underweight body weight. Choice D is incorrect as individuals with bulimia are often preoccupied with weight and body image.

The following information is recorded in the health history: "Patient denies chest pain, palpitations, orthopnea, and paroxysmal nocturnal dyspnea." Which category does it belong to?

  • A. Chief complaint
  • B. Present illness
  • C. Personal and social history
  • D. Review of systems
Correct Answer: D

Rationale: The correct answer is D: Review of systems. In this case, the information provided pertains to specific symptoms related to the cardiovascular system. The review of systems involves asking about symptoms in various body systems to identify any potential issues. This information helps in identifying any underlying health concerns that the patient may not have mentioned as their main complaint.

Summary of why other choices are incorrect:
A: Chief complaint - This is the main reason for the patient's visit or primary concern, not a list of symptoms.
B: Present illness - Focuses on the details of the current medical issue, not a general review of symptoms.
C: Personal and social history - Pertains to the patient's lifestyle, habits, and social support, not specific symptoms related to body systems.

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