Advanced physical assessment -Final examination questions with answers,

Advanced physical assessment - |\ |\ |\




Final examination questions |\ |\ |\




with answers |\




A 37-year-old nurse comes for evaluation of colicky right
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upper quadrant abdominal pain. The pain is associated
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with nausea and vomiting and occurs 1 to 2 hours after
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eating greasy foods. Which one of the following physical
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examination descriptions would be most consistent with |\ |\ |\ |\ |\ |\ |\



the diagnosis of cholecystitis?
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A) Abdomen is soft, nontender, and nondistended,
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without hepatosplenomegaly or masses.|\ |\ |\




B) Abdomen is soft and tender to palpation in the right
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lower quadrant, without rebound or guarding.
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C) Abdomen is soft and tender to palpation in the right
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upper quadrant with inspiration, to the point of stopping
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inspiration, and there is no rebound or guarding. |\ |\ |\ |\ |\ |\ |\




D) Abdomen is soft and tender to palpation in the mid-
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epigastric area, without rebound or guarding. - CORRECT
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ANSWERS ✔✔C) Abdomen is soft and tender to palpation|\ |\ |\ |\ |\ |\ |\ |\ |\



in the right upper quadrant with inspiration, to the point
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of stopping inspiration, and there is no rebound or
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guarding.

,When crackles, wheezes, or rhonchi clear with a cough,
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which of the following is a likely etiology?
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A) Bronchitis
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B) Simple asthma
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C) Cystic fibrosis
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D) Heart failure - CORRECT ANSWERS ✔✔A. Bronchitis
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A patient with longstanding COPD was told by another
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practitioner that his liver was enlarged and this needed to |\ |\ |\ |\ |\ |\ |\ |\ |\



be assessed. Which of the following would be reasonable
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to do next?
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A) Percuss the lower border of the liver
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B) Measure the span of the liver
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C) Order a hepatitis panel
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D) Obtain an ultrasound of the liver - CORRECT ANSWERS
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✔✔A) Percuss the lower border of the liver
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Mr. Patel is a 64-year-old man who was told by another
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care provider that his liver is enlarged. Although he is a
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life-long smoker, he has never used drugs or alcohol and
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has no knowledge of liver disease. Indeed, on
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,examination, a liver edge is palpable 4 centimeters below |\ |\ |\ |\ |\ |\ |\ |\



the costal arch. Which of the following would you do
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next? |\




A) Check an ultrasound of the liver
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B) Obtain a hepatitis panel
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C) Determine liver span by percussion
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D) Adopt a "watchful waiting" approach - CORRECT
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ANSWERS ✔✔c. Determine liver span by percussion |\ |\ |\ |\ |\ |\




You are palpating the abdomen and feel a small mass.
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Which of the following would you do next?
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A) Ultrasound
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B) Examination with the abdominal muscles tensed
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C) Surgery referral
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D) Determine size by percussion - CORRECT ANSWERS
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✔✔B) Examination with the abdominal muscles tensed
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Mr. Kruger is an 84-year-old man who presents with a
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smooth lower abdominal mass in the midline which is
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minimally tender. There is dullness to percussion up to 6
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centimeters above the symphysis pubis. What does this |\ |\ |\ |\ |\ |\ |\ |\



most likely represent?
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, A) Sigmoid mass
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B) Tumor in the abdominal wall
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C) Hernia |\




D) Enlarged bladder - CORRECT ANSWERS ✔✔D) Enlarged
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bladder
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Which of the following is consistent with obturator sign?
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A) Pain distant from the site used to check rebound
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tenderness
B) Right hypogastric pain with the right hip and knee
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flexed and the hip internally rotated
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C) Pain with extension of the right thigh while the patient
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is on her left side or while pressing her knee against your
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hand with thigh flexion
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D) Pain that stops inhalation in the right upper quadrant -
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CORRECT ANSWERS ✔✔B) Right hypogastric pain with the |\ |\ |\ |\ |\ |\ |\



right hip and knee flexed and the hip internally rotated
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A 57-year-old maintenance worker comes to your office
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for evaluation of pain in his legs. He has smoked two
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packs per day since the age of 16, but he is otherwise
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healthy. You are concerned that he may have peripheral
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vascular disease. Which of the following is part of
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