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 34-year-old woman presents for a wellness visit. She reports
her mother had "early" heart disease and died at 52; her father
had type 2 diabetes diagnosed at 58. Vital signs are normal. You
notice she has a BMI of 31 and occasional exertional chest
tightness with brisk walking. Family history is limited to first-
degree relatives. What is the most appropriate next step in
genetic/environmental risk assessment?
Page 1 of 987
,Options
A. Reassure — family history is not strongly predictive; begin
routine care.
B. Obtain a three-generation pedigree and document age of
onset and causes of death.
C. Order comprehensive genetic sequencing for cardiomyopathy
and familial hypercholesterolemia now.
D. Schedule immediate exercise stress testing due to chest
tightness.
Correct answer
B
Rationale — Correct (3–4 sentences)
Jarvis emphasizes a focused, evidence-based family history
(three-generation pedigree) to clarify inheritance patterns and
early-onset disease. Documenting ages at diagnosis and death
distinguishes familial risk (e.g., premature coronary disease)
from sporadic events, guiding targeted screening. This step
refines risk before ordering advanced tests or interventions.
Rationale — Incorrect
A. Reassurance is premature; early parental cardiovascular
disease is a red flag for increased risk.
C. Immediate comprehensive sequencing is not indicated
without a targeted pedigree or specific clinical suspicion.
D. Stress testing may be reasonable later, but first clarify family
risk and evaluate cardiovascular risk factors.
Page 2 of 987
,Teaching point (≤20 words)
Always build a three-generation pedigree to identify patterns
and ages of onset for inherited risk.
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 28-year-old man asks about his risk for cystic fibrosis (CF). He
is healthy and reports his partner is of unknown ancestry. He
heard CF is hereditary. On exam he is well, with normal lung
sounds. What is the best evidence-based action regarding
genetic risk and screening?
Options
A. Advise no testing — CF is rare and not relevant for
asymptomatic adults.
B. Offer carrier screening to both partners, beginning with the
partner with unknown ancestry.
C. Order sweat chloride testing on the asymptomatic man.
D. Recommend chest CT to screen for early CF lung disease.
Page 3 of 987
, Correct answer
B
Rationale — Correct (3–4 sentences)
Jarvis stresses evidence-based genetic screening tailored to
reproductive planning; carrier screening for CF is appropriate
for couples planning pregnancy or with unknown partner
ancestry. Start with carrier testing (often by molecular panel)
for the partner with unknown risk and then test the other if
positive. This approach balances utility, cost, and clinical
relevance.
Rationale — Incorrect
A. Dismissing testing ignores reproductive implications and
recommended carrier screening guidelines.
C. Sweat chloride diagnoses symptomatic CF — not appropriate
for population carrier screening.
D. Chest CT is neither a screening nor preventative strategy for
asymptomatic carrier status.
Teaching point (≤20 words)
Offer targeted carrier screening for reproductive planning when
ancestry or partner status is unknown.
Citation
Jarvis, C., & Eckhardt, A. L. (2023). Physical Examination and
Health Assessment (9th ed.). Ch. 1.
3)
Page 4 of 987
ASSESSMENT
9TH EDITION
• AUTHOR(S)CAROLYN JARVIS; ANN L.
ECKHARDT
TEST BANK
1)
Reference
Ch. 1 — Evidence-Based Assessment — Genetics and
Environment
Stem
A 34-year-old woman presents for a wellness visit. She reports
her mother had "early" heart disease and died at 52; her father
had type 2 diabetes diagnosed at 58. Vital signs are normal. You
notice she has a BMI of 31 and occasional exertional chest
tightness with brisk walking. Family history is limited to first-
degree relatives. What is the most appropriate next step in
genetic/environmental risk assessment?
Page 1 of 987
,Options
A. Reassure — family history is not strongly predictive; begin
routine care.
B. Obtain a three-generation pedigree and document age of
onset and causes of death.
C. Order comprehensive genetic sequencing for cardiomyopathy
and familial hypercholesterolemia now.
D. Schedule immediate exercise stress testing due to chest
tightness.
Correct answer
B
Rationale — Correct (3–4 sentences)
Jarvis emphasizes a focused, evidence-based family history
(three-generation pedigree) to clarify inheritance patterns and
early-onset disease. Documenting ages at diagnosis and death
distinguishes familial risk (e.g., premature coronary disease)
from sporadic events, guiding targeted screening. This step
refines risk before ordering advanced tests or interventions.
Rationale — Incorrect
A. Reassurance is premature; early parental cardiovascular
disease is a red flag for increased risk.
C. Immediate comprehensive sequencing is not indicated
without a targeted pedigree or specific clinical suspicion.
D. Stress testing may be reasonable later, but first clarify family
risk and evaluate cardiovascular risk factors.
Page 2 of 987
,Teaching point (≤20 words)
Always build a three-generation pedigree to identify patterns
and ages of onset for inherited risk.
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 28-year-old man asks about his risk for cystic fibrosis (CF). He
is healthy and reports his partner is of unknown ancestry. He
heard CF is hereditary. On exam he is well, with normal lung
sounds. What is the best evidence-based action regarding
genetic risk and screening?
Options
A. Advise no testing — CF is rare and not relevant for
asymptomatic adults.
B. Offer carrier screening to both partners, beginning with the
partner with unknown ancestry.
C. Order sweat chloride testing on the asymptomatic man.
D. Recommend chest CT to screen for early CF lung disease.
Page 3 of 987
, Correct answer
B
Rationale — Correct (3–4 sentences)
Jarvis stresses evidence-based genetic screening tailored to
reproductive planning; carrier screening for CF is appropriate
for couples planning pregnancy or with unknown partner
ancestry. Start with carrier testing (often by molecular panel)
for the partner with unknown risk and then test the other if
positive. This approach balances utility, cost, and clinical
relevance.
Rationale — Incorrect
A. Dismissing testing ignores reproductive implications and
recommended carrier screening guidelines.
C. Sweat chloride diagnoses symptomatic CF — not appropriate
for population carrier screening.
D. Chest CT is neither a screening nor preventative strategy for
asymptomatic carrier status.
Teaching point (≤20 words)
Offer targeted carrier screening for reproductive planning when
ancestry or partner status is unknown.
Citation
Jarvis, C., & Eckhardt, A. L. (2023). Physical Examination and
Health Assessment (9th ed.). Ch. 1.
3)
Page 4 of 987
