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

What is the most important thing to address at today’s visit for an 81-year-old male with various health concerns, including weight loss, fatigue, and a history of falls?

  • A. His elevated blood pressure noted on today’s vitals.
  • B. Repeating his MoCA testing to assess for cognitive change.
  • C. Suggesting completion of an advance directive at visit with his goals of care in mind.
  • D. Reviewing his last colonoscopy report and discussing further screening procedures.
Correct Answer: C

Rationale: Correct Answer: C - Suggesting completion of an advance directive at the visit with his goals of care in mind.

Rationale:
1. Age and health concerns: At 81 years old with weight loss, fatigue, and a history of falls, addressing end-of-life planning becomes crucial.
2. Advance Directive: Helps the patient make decisions about the care they want if they become unable to communicate their wishes.
3. Goals of care: Understanding his wishes ensures healthcare decisions align with his values, enhancing patient autonomy and quality of care.

Summary:
- A: Blood pressure is important but not the priority compared to end-of-life planning.
- B: Cognitive testing is valuable, but addressing care preferences takes precedence.
- D: Colonoscopy report is not urgent compared to ensuring the patient's wishes are known for future care.

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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.

Which of the following medications is commonly prescribed for patients with hypertension and chronic kidney disease?

  • A. Lisinopril
  • B. Furosemide
  • C. Metoprolol
  • D. Spironolactone
Correct Answer: A

Rationale: The correct answer is A: Lisinopril. Lisinopril is an ACE inhibitor commonly prescribed for patients with hypertension and chronic kidney disease. It helps to reduce blood pressure and protect the kidneys by dilating blood vessels and improving blood flow. Furosemide (B) is a diuretic used to treat fluid retention but not specifically indicated for chronic kidney disease. Metoprolol (C) is a beta-blocker primarily used for heart conditions. Spironolactone (D) is a potassium-sparing diuretic and is not the first-line treatment for hypertension in patients with chronic kidney disease.

Which of the following medication is not indicated for the treatment of muscle spasms?

  • A. Baclofen (Lioresal)
  • B. Tizanidine (Zanaflex)
  • C. Cyclobenzaprine (Flexeril)
  • D. Carisoprodol (Soma)
Correct Answer: A

Rationale: Step-by-step rationale for why A is correct:
1. Baclofen is a muscle relaxant primarily used for treating muscle spasticity, not muscle spasms.
2. Baclofen acts on GABA receptors in the spinal cord to reduce muscle hyperactivity.
3. Tizanidine, Cyclobenzaprine, and Carisoprodol are all indicated for the treatment of muscle spasms.
4. Tizanidine acts centrally to inhibit excitatory neurotransmitter release, Cyclobenzaprine is a muscle relaxant with sedative effects, and Carisoprodol is a centrally acting skeletal muscle relaxant.
Summary: Baclofen is not indicated for the treatment of muscle spasms because it is primarily used for muscle spasticity. Tizanidine, Cyclobenzaprine, and Carisoprodol are more commonly prescribed for muscle spasms due to their mechanisms of action.

You want to start pharmacologic treatment for depression in an older patient who is taking numerous medications. Which of the following antidepressants is the least likely to cause drug-drug interactions?

  • A. Citalopram
  • B. Fluoxetine
  • C. Paroxetine
  • D. Venlafaxine
Correct Answer: E

Rationale: I believe you made a typo in listing the correct answer as "E" while there is no "E" option in the choices provided. Could you please confirm the correct answer choice so I can provide you with a detailed explanation and summary of why the correct answer is correct and why the other choices are incorrect?

You are conducting a pupillary examination on a 34-year-old man. You note that both pupils dilate slightly. Both are noted to constrict briskly when the light is placed on the right eye. What is the most likely problem?

  • A. Optic nerve damage on the right
  • B. Optic nerve damage on the left
  • C. Efferent nerve damage on the right
  • D. Efferent nerve damage on the left
Correct Answer: C

Rationale: The correct answer is C: Efferent nerve damage on the right. When both pupils dilate but only the right pupil constricts briskly in response to light, it indicates a problem with the efferent pathway controlling the right eye's pupillary constriction. This suggests damage to the parasympathetic fibers of the oculomotor nerve (CN III) that innervate the pupillary sphincter muscle. Choices A and B (optic nerve damage) do not involve pupil constriction. Choice D (efferent nerve damage on the left) would not explain the brisk constriction in the right eye.

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