PHYSICAL EXAMINATION AND HEALTH
ASSESSMENT
9TH EDITION
• AUTHOR(S)CAROLYN JARVIS; ANN L.
ECKHARDT
TEST BANK
1)
Reference: Ch. 1 — Evidence-Based Assessment — Genetics
and Environment
Stem: A 29-year-old woman comes for a preconception visit.
She reports a family history of cystic fibrosis in a nephew and
says she is “not sure” whether she or her partner were ever
tested. Her records show no previous genetic screening. Vital
signs and exam are normal. Which action most aligns with an
evidence-based, safety-focused approach?
A. Reassure the couple because absence of personal disease
makes carrier status unlikely.
Page 1 of 982
,B. Offer carrier screening for both partners and provide
counseling about reproductive options.
C. Recommend prenatal ultrasound only if pregnancy occurs;
screening is unnecessary preconception.
D. Order a sweat chloride test on the woman to rule out cystic
fibrosis carrier status.
Correct Answer: B
Rationale — Correct (B): Jarvis emphasizes family history and
targeted genetic screening as vital components of risk
assessment. Carrier screening for both partners identifies
reproductive risk (autosomal recessive disease) and supports
informed decision-making and safety planning. Preconception
screening is evidence-based to allow options before pregnancy.
Rationale — Incorrect (A): Personal absence of disease doesn’t
exclude carrier status for autosomal recessive disorders; family
history increases risk.
Rationale — Incorrect (C): Waiting until pregnancy delays
reproductive options and reduces counseling opportunities;
preconception testing is recommended.
Rationale — Incorrect (D): Sweat chloride tests diagnose
affected individuals, not carriers; carrier screening uses genetic
testing, not diagnostic sweat testing.
Teaching point: Family history guides targeted carrier screening
before conception.
Page 2 of 982
,Citation: Jarvis, C., & Eckhardt, A. L. (2023). Physical
Examination and Health Assessment (9th ed.). Ch. 1.
2)
Reference: Ch. 1 — Evidence-Based Assessment — Genetics
and Environment
Stem: A 52-year-old man reports his mother had “heart
disease” at age 54 and his younger sister had a myocardial
infarction at 47. He smokes one pack/day and has untreated
hypertension. On examination his BP is 158/96 mmHg. Which
assessment finding or action most increases diagnostic clarity
and safety?
A. Document “family history of heart disease” and advise
lifestyle change only.
B. Elicit a three-generation pedigree and calculate his familial
cardiovascular risk.
C. Assume increased risk is solely due to his smoking and treat
hypertension only.
D. Order a routine chest x-ray to evaluate hereditary heart
disease risk.
Correct Answer: B
Rationale — Correct (B): Jarvis frames family history collected
as a pedigree (three-generation) as a “vital sign” that clarifies
inheritance patterns and familial risk. Combining pedigree with
Page 3 of 982
, modifiable risks (smoking, HTN) enables targeted prevention
and safety interventions.
Rationale — Incorrect (A): Vague documentation misses
inheritance pattern and underestimates genetic contribution;
advising lifestyle alone is incomplete.
Rationale — Incorrect (C): Smoking is important but does not
explain early-onset events in relatives; neglecting family history
risks missed high familial risk.
Rationale — Incorrect (D): Chest x-ray is not useful for assessing
hereditary cardiovascular risk; focused risk stratification and
testing (lipid profile, ECG) are appropriate.
Teaching point: Use a three-generation pedigree to quantify
familial cardiovascular risk.
Citation: Jarvis, C., & Eckhardt, A. L. (2023). Physical
Examination and Health Assessment (9th ed.). Ch. 1.
3)
Reference: Ch. 1 — Evidence-Based Assessment — Genetics
and Environment
Stem: A 40-year-old construction worker reports progressive
dyspnea and chronic cough. He mentions prolonged workplace
exposure to asbestos 20 years ago and a father who died of
lung cancer. Which interpretation most accurately prioritizes
immediate safety and next steps?
Page 4 of 982
ASSESSMENT
9TH EDITION
• AUTHOR(S)CAROLYN JARVIS; ANN L.
ECKHARDT
TEST BANK
1)
Reference: Ch. 1 — Evidence-Based Assessment — Genetics
and Environment
Stem: A 29-year-old woman comes for a preconception visit.
She reports a family history of cystic fibrosis in a nephew and
says she is “not sure” whether she or her partner were ever
tested. Her records show no previous genetic screening. Vital
signs and exam are normal. Which action most aligns with an
evidence-based, safety-focused approach?
A. Reassure the couple because absence of personal disease
makes carrier status unlikely.
Page 1 of 982
,B. Offer carrier screening for both partners and provide
counseling about reproductive options.
C. Recommend prenatal ultrasound only if pregnancy occurs;
screening is unnecessary preconception.
D. Order a sweat chloride test on the woman to rule out cystic
fibrosis carrier status.
Correct Answer: B
Rationale — Correct (B): Jarvis emphasizes family history and
targeted genetic screening as vital components of risk
assessment. Carrier screening for both partners identifies
reproductive risk (autosomal recessive disease) and supports
informed decision-making and safety planning. Preconception
screening is evidence-based to allow options before pregnancy.
Rationale — Incorrect (A): Personal absence of disease doesn’t
exclude carrier status for autosomal recessive disorders; family
history increases risk.
Rationale — Incorrect (C): Waiting until pregnancy delays
reproductive options and reduces counseling opportunities;
preconception testing is recommended.
Rationale — Incorrect (D): Sweat chloride tests diagnose
affected individuals, not carriers; carrier screening uses genetic
testing, not diagnostic sweat testing.
Teaching point: Family history guides targeted carrier screening
before conception.
Page 2 of 982
,Citation: Jarvis, C., & Eckhardt, A. L. (2023). Physical
Examination and Health Assessment (9th ed.). Ch. 1.
2)
Reference: Ch. 1 — Evidence-Based Assessment — Genetics
and Environment
Stem: A 52-year-old man reports his mother had “heart
disease” at age 54 and his younger sister had a myocardial
infarction at 47. He smokes one pack/day and has untreated
hypertension. On examination his BP is 158/96 mmHg. Which
assessment finding or action most increases diagnostic clarity
and safety?
A. Document “family history of heart disease” and advise
lifestyle change only.
B. Elicit a three-generation pedigree and calculate his familial
cardiovascular risk.
C. Assume increased risk is solely due to his smoking and treat
hypertension only.
D. Order a routine chest x-ray to evaluate hereditary heart
disease risk.
Correct Answer: B
Rationale — Correct (B): Jarvis frames family history collected
as a pedigree (three-generation) as a “vital sign” that clarifies
inheritance patterns and familial risk. Combining pedigree with
Page 3 of 982
, modifiable risks (smoking, HTN) enables targeted prevention
and safety interventions.
Rationale — Incorrect (A): Vague documentation misses
inheritance pattern and underestimates genetic contribution;
advising lifestyle alone is incomplete.
Rationale — Incorrect (C): Smoking is important but does not
explain early-onset events in relatives; neglecting family history
risks missed high familial risk.
Rationale — Incorrect (D): Chest x-ray is not useful for assessing
hereditary cardiovascular risk; focused risk stratification and
testing (lipid profile, ECG) are appropriate.
Teaching point: Use a three-generation pedigree to quantify
familial cardiovascular risk.
Citation: Jarvis, C., & Eckhardt, A. L. (2023). Physical
Examination and Health Assessment (9th ed.). Ch. 1.
3)
Reference: Ch. 1 — Evidence-Based Assessment — Genetics
and Environment
Stem: A 40-year-old construction worker reports progressive
dyspnea and chronic cough. He mentions prolonged workplace
exposure to asbestos 20 years ago and a father who died of
lung cancer. Which interpretation most accurately prioritizes
immediate safety and next steps?
Page 4 of 982
