PHYSICAL EXAMINATION AND HEALTH
ASSESSMENT
9TH EDITION
• AUTHOR(S)CAROLYN JARVIS; ANN L.
ECKHARDT
TEST BANK
Q1
Reference
Ch. 1 — Evidence-Based Assessment — Genetics and
Environment
Stem
A 28-year woman presents for a prenatal visit. She reports her
mother had early-onset Alzheimer disease in her late 50s and a
maternal uncle had late-onset Parkinson disease. The patient is
anxious and asks whether she should have genetic testing now.
Objective vitals and physical exam are normal. Which is the
most appropriate next step in the assessment and counseling
process?
Page 1 of 989
,Options
A. Order direct-to-consumer testing for APOE genotype and
report results to calm anxiety.
B. Take a three-generation family history focused on
neurological and age at onset, then provide targeted genetic
counseling referral.
C. Reassure the patient that these conditions are unrelated to
pregnancy and defer any genetic discussion until postpartum.
D. Recommend immediate MRI brain screening to detect
preclinical neurodegenerative change.
Correct answer
B
Rationale — Correct (3–4 sentences)
Jarvis emphasizes starting assessment with a focused,
structured family history to identify inheritance patterns and
age of onset. A three-generation pedigree clarifies risk and
whether testing is informative; genetic counseling is indicated
before any genetic testing. This approach addresses the
patient’s anxiety while following evidence-based, safe practice.
Rationale — Incorrect
A. Direct-to-consumer APOE testing is not recommended as first
step; APOE is a risk marker (not diagnostic), results can be
misinterpreted without counseling.
C. Deferring discussion ignores patient concern and misses
opportunity for risk stratification and informed decision-
making.
Page 2 of 989
,D. MRI is not a screening tool for preclinical neurodegeneration
and is not indicated based on family history alone.
Teaching point
Start with a three-generation pedigree and refer for genetic
counseling before testing.
Citation
Jarvis, C., & Eckhardt, A. L. (2023). Physical Examination and
Health Assessment (9th ed.). Ch. 1.
Q2
Reference
Ch. 1 — Evidence-Based Assessment — Genetics and
Environment
Stem
A 45-year man reports he was adopted and has no family
history available. He asks about his risk for a familial
cardiomyopathy after reading online. His BP is 128/78, heart
sounds normal, and BMI 27. Which assessment approach best
addresses his concern given limited family information?
Options
A. Decline further evaluation because family history is
unavailable, and reassure low immediate concern.
B. Obtain a personal cardiac risk assessment including focused
cardiac exam, ECG as indicated, and discuss genetic testing
options with counseling.
Page 3 of 989
, C. Recommend testing all first-degree relatives (siblings) despite
unknown lineage.
D. Order a full cardiomyopathy gene panel immediately without
counseling.
Correct answer
B
Rationale — Correct (3–4 sentences)
Jarvis emphasizes combining personal history and targeted
physical assessment when family history is absent. A focused
cardiac evaluation and appropriate noninvasive testing
(ECG/echo if indicated) are evidence-based first steps; discuss
genetic testing with counseling because results have
implications and require informed consent. This prioritizes
safety and practical risk stratification.
Rationale — Incorrect
A. Ignoring the concern due to absent family history misses
actionable personal risk assessment opportunities.
C. Recommending testing relatives is impossible and
inappropriate without identifying relatives and counseling.
D. Ordering a gene panel without counseling and pretest risk
assessment risks misinterpretation and violates evidence-based
practice.
Teaching point
When family history is unavailable, focus on personal risk
assessment and informed counseling before genetic testing.
Page 4 of 989
ASSESSMENT
9TH EDITION
• AUTHOR(S)CAROLYN JARVIS; ANN L.
ECKHARDT
TEST BANK
Q1
Reference
Ch. 1 — Evidence-Based Assessment — Genetics and
Environment
Stem
A 28-year woman presents for a prenatal visit. She reports her
mother had early-onset Alzheimer disease in her late 50s and a
maternal uncle had late-onset Parkinson disease. The patient is
anxious and asks whether she should have genetic testing now.
Objective vitals and physical exam are normal. Which is the
most appropriate next step in the assessment and counseling
process?
Page 1 of 989
,Options
A. Order direct-to-consumer testing for APOE genotype and
report results to calm anxiety.
B. Take a three-generation family history focused on
neurological and age at onset, then provide targeted genetic
counseling referral.
C. Reassure the patient that these conditions are unrelated to
pregnancy and defer any genetic discussion until postpartum.
D. Recommend immediate MRI brain screening to detect
preclinical neurodegenerative change.
Correct answer
B
Rationale — Correct (3–4 sentences)
Jarvis emphasizes starting assessment with a focused,
structured family history to identify inheritance patterns and
age of onset. A three-generation pedigree clarifies risk and
whether testing is informative; genetic counseling is indicated
before any genetic testing. This approach addresses the
patient’s anxiety while following evidence-based, safe practice.
Rationale — Incorrect
A. Direct-to-consumer APOE testing is not recommended as first
step; APOE is a risk marker (not diagnostic), results can be
misinterpreted without counseling.
C. Deferring discussion ignores patient concern and misses
opportunity for risk stratification and informed decision-
making.
Page 2 of 989
,D. MRI is not a screening tool for preclinical neurodegeneration
and is not indicated based on family history alone.
Teaching point
Start with a three-generation pedigree and refer for genetic
counseling before testing.
Citation
Jarvis, C., & Eckhardt, A. L. (2023). Physical Examination and
Health Assessment (9th ed.). Ch. 1.
Q2
Reference
Ch. 1 — Evidence-Based Assessment — Genetics and
Environment
Stem
A 45-year man reports he was adopted and has no family
history available. He asks about his risk for a familial
cardiomyopathy after reading online. His BP is 128/78, heart
sounds normal, and BMI 27. Which assessment approach best
addresses his concern given limited family information?
Options
A. Decline further evaluation because family history is
unavailable, and reassure low immediate concern.
B. Obtain a personal cardiac risk assessment including focused
cardiac exam, ECG as indicated, and discuss genetic testing
options with counseling.
Page 3 of 989
, C. Recommend testing all first-degree relatives (siblings) despite
unknown lineage.
D. Order a full cardiomyopathy gene panel immediately without
counseling.
Correct answer
B
Rationale — Correct (3–4 sentences)
Jarvis emphasizes combining personal history and targeted
physical assessment when family history is absent. A focused
cardiac evaluation and appropriate noninvasive testing
(ECG/echo if indicated) are evidence-based first steps; discuss
genetic testing with counseling because results have
implications and require informed consent. This prioritizes
safety and practical risk stratification.
Rationale — Incorrect
A. Ignoring the concern due to absent family history misses
actionable personal risk assessment opportunities.
C. Recommending testing relatives is impossible and
inappropriate without identifying relatives and counseling.
D. Ordering a gene panel without counseling and pretest risk
assessment risks misinterpretation and violates evidence-based
practice.
Teaching point
When family history is unavailable, focus on personal risk
assessment and informed counseling before genetic testing.
Page 4 of 989
