PHYSICAL EXAMINATION AND HEALTH
ASSESSMENT
9TH EDITION
• AUTHOR(S)CAROLYN JARVIS; ANN L.
ECKHARDT
TEST BANK
1
Reference
Ch. 1 — Evidence-Based Assessment — Family History & Three-
Generation Pedigree
Stem
A 28-year-old woman presents for a preconception visit. Her
father had early-onset coronary artery disease at 46; her
paternal aunt had breast cancer at 49. She asks whether her
family history increases her risk and what you should
document. Based on Jarvis’ guidance, which action best applies
now?
Page 1 of 985
,A. Reassure her: family history is rarely useful and no special
documentation is needed.
B. Construct a three-generation pedigree, documenting ages at
diagnosis and causes of death.
C. Order full genomic sequencing immediately to quantify her
risk.
D. Refer directly for invasive testing because family history
implies a high probability of a single gene disorder.
Correct answer
B
Rationale — Correct (B)
Jarvis emphasizes the three-generation pedigree as the
cornerstone of genetic risk assessment — it captures patterns,
ages at onset, and causes of death that stratify risk. This
targeted family history guides further testing, referral, or
screening decisions and is the evidence-based first step in
evaluation.
Rationales — Incorrect
A. Family history is often highly informative; dismissing it
contradicts Jarvis’ framework.
C. Immediate genomic sequencing without pedigree or
counseling is premature and not evidence-based.
D. A family history raises risk but does not automatically
indicate a single-gene disorder or warrant invasive testing.
Page 2 of 985
,Teaching point
Always start with a three-generation pedigree — it directs risk
stratification and next steps.
Citation
Jarvis, C., & Eckhardt, A. L. (2023). Physical Examination and
Health Assessment (9th ed.). Ch. 1.
2
Reference
Ch. 1 — Evidence-Based Assessment — Patterns of Inheritance
Stem
A 6-year-old boy is brought for evaluation because two
maternal uncles had hemophilia. The mother is asymptomatic.
The mother asks about her son’s risk. Using Jarvis’ inheritance
principles, which explanation best guides immediate nursing
action?
A. Hemophilia is autosomal dominant — the son has a 50%
chance of having the disorder.
B. Hemophilia is X-linked recessive — the son is at risk if his
mother is a carrier; assess maternal carrier status.
C. Hemophilia is mitochondrial — only boys are affected and no
further testing is needed.
D. Hemophilia transmission is random; family history is
irrelevant for male children.
Page 3 of 985
, Correct answer
B
Rationale — Correct (B)
Jarvis describes X-linked recessive patterns where carrier
mothers can transmit the affected X to sons who then manifest
the disorder. The appropriate action is to assess maternal
carrier risk and consider genetic counseling/testing to
determine the son’s risk and need for early interventions.
Rationales — Incorrect
A. Hemophilia is not autosomal dominant; this statement
misclassifies inheritance.
C. Hemophilia is not mitochondrial; mitochondrial inheritance
affects both sexes and is maternally transmitted but with
different patterns.
D. Family history is highly relevant for X-linked traits, especially
for male offspring.
Teaching point
Recognize X-linked recessive patterns: affected males often have
carrier mothers.
Citation
Jarvis, C., & Eckhardt, A. L. (2023). Physical Examination and
Health Assessment (9th ed.). Ch. 1.
3
Page 4 of 985
ASSESSMENT
9TH EDITION
• AUTHOR(S)CAROLYN JARVIS; ANN L.
ECKHARDT
TEST BANK
1
Reference
Ch. 1 — Evidence-Based Assessment — Family History & Three-
Generation Pedigree
Stem
A 28-year-old woman presents for a preconception visit. Her
father had early-onset coronary artery disease at 46; her
paternal aunt had breast cancer at 49. She asks whether her
family history increases her risk and what you should
document. Based on Jarvis’ guidance, which action best applies
now?
Page 1 of 985
,A. Reassure her: family history is rarely useful and no special
documentation is needed.
B. Construct a three-generation pedigree, documenting ages at
diagnosis and causes of death.
C. Order full genomic sequencing immediately to quantify her
risk.
D. Refer directly for invasive testing because family history
implies a high probability of a single gene disorder.
Correct answer
B
Rationale — Correct (B)
Jarvis emphasizes the three-generation pedigree as the
cornerstone of genetic risk assessment — it captures patterns,
ages at onset, and causes of death that stratify risk. This
targeted family history guides further testing, referral, or
screening decisions and is the evidence-based first step in
evaluation.
Rationales — Incorrect
A. Family history is often highly informative; dismissing it
contradicts Jarvis’ framework.
C. Immediate genomic sequencing without pedigree or
counseling is premature and not evidence-based.
D. A family history raises risk but does not automatically
indicate a single-gene disorder or warrant invasive testing.
Page 2 of 985
,Teaching point
Always start with a three-generation pedigree — it directs risk
stratification and next steps.
Citation
Jarvis, C., & Eckhardt, A. L. (2023). Physical Examination and
Health Assessment (9th ed.). Ch. 1.
2
Reference
Ch. 1 — Evidence-Based Assessment — Patterns of Inheritance
Stem
A 6-year-old boy is brought for evaluation because two
maternal uncles had hemophilia. The mother is asymptomatic.
The mother asks about her son’s risk. Using Jarvis’ inheritance
principles, which explanation best guides immediate nursing
action?
A. Hemophilia is autosomal dominant — the son has a 50%
chance of having the disorder.
B. Hemophilia is X-linked recessive — the son is at risk if his
mother is a carrier; assess maternal carrier status.
C. Hemophilia is mitochondrial — only boys are affected and no
further testing is needed.
D. Hemophilia transmission is random; family history is
irrelevant for male children.
Page 3 of 985
, Correct answer
B
Rationale — Correct (B)
Jarvis describes X-linked recessive patterns where carrier
mothers can transmit the affected X to sons who then manifest
the disorder. The appropriate action is to assess maternal
carrier risk and consider genetic counseling/testing to
determine the son’s risk and need for early interventions.
Rationales — Incorrect
A. Hemophilia is not autosomal dominant; this statement
misclassifies inheritance.
C. Hemophilia is not mitochondrial; mitochondrial inheritance
affects both sexes and is maternally transmitted but with
different patterns.
D. Family history is highly relevant for X-linked traits, especially
for male offspring.
Teaching point
Recognize X-linked recessive patterns: affected males often have
carrier mothers.
Citation
Jarvis, C., & Eckhardt, A. L. (2023). Physical Examination and
Health Assessment (9th ed.). Ch. 1.
3
Page 4 of 985
