NR509 Bates Test Bank - Midterm Exam
A patient presents for evaluation of a sharp, aching chest A) Musculoskeletal
pain which increases with breathing. Which anatomic area
would you localize the symptom to? Chest pain may be due to a musculoskeletal condition, such as costochondritis or
intercostal muscle cramp. This would be worsened by motion of the chest wall.
A) Musculoskeletal Pleuritic chest pain is also a sharp chest pain which increases with a deep breath.
B) Reproductive This type of pain can
C) Urinary occur with inflammation of the pleura from pneumonia or other conditions and
D) Endocrine pulmonary
embolus.
A patient comes to the emergency room for evaluation of C) Cardiac
shortness of breath. To which anatomic region would you
assign the symptom? Cardiac disorders such as congestive heart failure are the most likely on this list to
result in shortness of breath. There are cases within the other categories which may
A) Reproductive also result
B) Urinary in shortness of breath, such as anemia in the hematologic category, pregnancy in
C) Cardiac the reproductive
D) Hematologic category, or sepsis with UTI in the urinary category.
A patient presents for evaluation of a cough. Which of the C) Cardiac
following anatomic regions can be responsible for a
cough? The cardiac system can cause a cough if the patient has congestive heart failure.
This results in fluid buildup in the lungs, which in turn can cause a cough that
A) Ophthalmologic produces pink,
B) Auditory frothy sputum. A foreign body in the ear may also cause a cough by stimulating
C) Cardiac Arnold's branch of the vagus nerve, but this is less likely to be seen clinically than
D) Endocrine heart failure.
A 22-year-old advertising copywriter presents for B) Inflammatory
evaluation of joint pain. The pain is new,
located in the wrists and fingers bilaterally, with some The description is most consistent with an inflammatory process, although all the
subjective fever. The patient denies a other etiologies should be considered. Lyme disease is an infection which
rash; she also denies recent travel or camping activities. commonly causes
She has a family history significant for arthritis, hemophilia is a hematologic condition which can cause bleeding in the
rheumatoid arthritis. Based on this information, which of joints, and trauma can obviously cause joint pain.
the following pathologic processes
would be the most correct?
A) Infectious
B) Inflammatory
C) Hematologic
D) Traumatic
A 47-year-old contractor presents for evaluation of neck C) Degenerative
pain, which has been intermittent for several years. He
normally takes over-the-counter medications to ease the The description is most consistent with degenerative arthritis in the neck. The
pain, but this time they haven't worked as well and he still patient has had intermittent symptoms and the questions asked to elicit pertinent
has discomfort. He recently wallpapered the entire second negative and
floor in his house, which caused him great discomfort. The positive findings are negative for infectious, traumatic, or neoplastic disease.
pain resolved with rest. He denies fever, chills, rash, upper
respiratory symptoms, trauma, or injury to the neck. Based
on this description, what is the most likely pathologic
process?
A) Infectious
B) Neoplastic
C) Degenerative
D) Traumatic
A 15-year-old high school sophomore comes to the clinic C) Allergic
for evaluation of a 3-week history
of sneezing; itchy, watery eyes; clear nasal discharge; ear This description is most consistent with allergic rhinitis.
pain; and nonproductive cough. Which
is the most likely pathologic process?
A) Infection
B) Inflammation
C) Allergic
D) Vascular
, NR509 Bates Test Bank - Midterm Exam
A 19-year old-college student presents to the emergency C) Head is normocephalic and atraumatic, fundi with blurred disc margins, neck
room with fever, headache, and tender to
neck pain/stiffness. She is concerned about the possibility palpation, unable to perform range of motion
of meningococcal meningitis.
Several of her dorm mates have been vaccinated, but she Blurred disc margins are consistent with papilledema, and neck tenderness and lack
hasn't been. Which of the following of range of motion are consistent with neck stiffness, which in this scenario is likely
physical examination descriptions is most consistent with to be caused
meningitis? by meningeal inflammation. Kernig's and Brudzinski's signs are also helpful in
testing for meningeal irritation on exam.
A) Head is normocephalic and atraumatic, fundi with sharp
discs, neck supple with full range
of motion
B) Head is normocephalic and atraumatic, fundi with sharp
discs, neck with paraspinous
muscle spasm and limited range of motion to the right
C) Head is normocephalic and atraumatic, fundi with
blurred disc margins, neck tender to
palpation, unable to perform range of motion
D) Head is normocephalic and atraumatic, fundi with
blurred disc margins, neck supple with
full range of motion
A 37-year-old nurse comes for evaluation of colicky right C) Abdomen is soft and tender to palpation in the right upper quadrant with
upper quadrant abdominal pain. The pain is associated inspiration, to the
with nausea and vomiting and occurs 1 to 2 hours after point of stopping inspiration, and there is no rebound or guarding.
eating greasy foods. Which one of the following physical
examination descriptions would be most consistent with In cholecystitis, the pain, which originates from the gallbladder, is located in the
the diagnosis of cholecystitis? right upper quadrant. Severity of pain with inspiration that is sufficient to stop further
inhalation
A) Abdomen is soft, nontender, and nondistended, without is also known as Murphy's sign, which, if present, is further indicative of
hepatosplenomegaly or masses. inflammation of the
B) Abdomen is soft and tender to palpation in the right gallbladder.
lower quadrant, without rebound or
guarding.
C) Abdomen is soft and tender to palpation in the right
upper quadrant with inspiration, to the
point of stopping inspiration, and there is no rebound or
guarding.
D) Abdomen is soft and tender to palpation in the mid-
epigastric area, without rebound or
guarding.
A 55-year-old data entry operator comes to the clinic to B) More than one disease process
establish care. She has the following
symptoms: headache, neck pain, sinus congestion, sore The patient appears to have several possible conditions: allergic rhinitis, arthritis,
throat, ringing in ears, sharp brief chest conductive hearing loss, pleuritic chest pains, heartburn, stress urinary
pains at rest, burning abdominal pain with spicy foods, incontinence, and venous stasis, among other conditions. Although we always try, it
constipation, urinary frequency that is worse with coughing is very difficult to assign all of these
and sneezing, and swelling in legs. This cluster of symptoms to one cohesive diagnosis.
symptoms is explained
by:
A) One disease process
B) More than one disease process
A 62-year-old teacher presents to the clinic for evaluation A) One disease process
of the following symptoms: fever, headache, sinus
congestion, sore throat, green nasal discharge, and cough. This cluster of symptoms is most consistent with sinusitis. The chance that all of
This cluster of symptoms is best explained by: these symptoms are caused by multiple synchronous conditions in the same patient
is much less than the possibility of having one problem which accounts for all of
A) One disease process them.
B) More than one disease process
Steve has just seen a 5-year-old girl who wheezes when D) You have created a hypothesis.
exposed to cats. The patient's family history is positive for
asthma. You think the child most likely has asthma. What As you go through a history and examination, you will start to generate ideas to
have you just accomplished? explain the patient's symptoms. It is best to keep an open mind and make as many
hypotheses
A) You have tested your hypothesis. as you can, to avoid missing a possibility. A common mistake is to latch onto one
B) You have developed a plan. idea too early.
C) You have established a working diagnosis.
D) You have created a hypothesis.
, NR509 Bates Test Bank - Midterm Exam
Ms. Washington is a 67-year-old who had a heart attack A) Pathophysiologic problem
last month. Now she complains of shortness of breath and
not being able to sleep in a flat position (orthopnea). On This is an example of a pathophysiologic problem because Ms. Washington's
examination you note increased jugular venous pressure, symptoms are consistent with a pathophysiologic process. The heart attack reduced
an S3 gallop, crackles low in the lung fields, and swollen the ability of her heart to handle her volume status and subsequently produced the
ankles (edema). This is an example of a: many features of congestive heart failure.
A) Pathophysiologic problem
B) Psychopathologic problem
On the way to see your next patient, you glance at the B) Psychopathologic problem
calendar and make a mental note to
buy a Mother's Day card. Your patient is Ms. Hernandez, a It is not uncommon for patients to experience psychopathologic symptoms around
76-year-old widow who lost her the anniversary of a traumatic event. The time of year and the lack of an obvious
husband in May, two years ago. She comes in today with a connection
headaches, abdominal pain, and between Ms. Hernandez's symptoms would make you consider this as a possibility.
general malaise. This happened once before, about a year You will note that although this might have been an early consideration in your
ago, according to your detailed office hypothesis generation, it is
notes. You have done a thorough evaluation but are key to convince yourself that there is not a physiologic explanation for these
unable to arrive at a consistent picture to symptoms, by
tie these symptoms together. This is an example of a: performing a careful history and examination.
A) Pathophysiologic problem
B) Psychopathologic problem
Mr. Larson is a 42-year-old widowed father of two children, C) Discuss the plan with Mr. Larson.
ages 4 and 11. He works in a
sales office to support his family. Recently he has injured You should discuss your proposed plan with the patient before implementing it. In
his back and you are thinking he this case, you and Mr. Larson will need to weigh the benefit of physical therapy
would benefit from physical therapy, three times a week, against the
for an hour per session. What would ability to provide for his family. You may need to consider other ways of helping the
be your next step? patient,
perhaps through prescribed back exercises he can do at home. It is a common
A) Write the physical therapy prescription. mistake to
B) Have your office staff explain directions to the physical implement a plan without coming to an agreement with the patient first.
therapy center.
C) Discuss the plan with Mr. Larson.
D) Tell Mr. Larson that he will be going to physical therapy
three times a week.
You are seeing an elderly man with multiple complaints. D) Chest pain, headaches, arthritis, war injury pain
He has chronic arthritis, pain from an old war injury, and
headaches. Today he complains of these pains, as well as The problem list should have the most active and serious problem first. This new
dull chest pain under his sternum. What would the order of complaint of chest pain is almost certainly a higher priority than his other, more
priority be for your problem list? chronic
problems.
A) Arthritis, war injury pain, headaches, chest pain
B) War injury pain, arthritis, headaches, chest pain
C) Headaches, arthritis, war injury pain, chest pain
D) Chest pain, headaches, arthritis, war injury pain
You are excited about a positive test finding you have just C) Continue using the test, perhaps doing less laboratory work and diagnostics.
noticed on physical examination
of your patient. You go on to do more examination, This is an example of a specific test that lacks sensitivity. With this scenario,
laboratory work, and diagnostic tests, only when you finally find a positive, you might be very certain that a given condition is
to find that there is no sign of the disease you thought present.
would correlate with the finding. This We generally develop our examinations to fit our clinical experiences. Sensitive
same experience happens several times. What should you tests are
conclude? performed routinely on the screening examination, while specific tests are usually
saved for the
A) Consider not doing this test routinely. detailed or "branched" examinations. Branched examinations are further maneuvers
B) Use this test when you have a higher suspicion for a we can
certain correlating condition. perform to investigate positive findings on our screening examinations. Save this
C) Continue using the test, perhaps doing less laboratory type of
work and diagnostics. maneuver to confirm your hypothesis.
D) Omit this test from future examinations.
, NR509 Bates Test Bank - Midterm Exam
You have recently returned from a medical missions trip to A) Continue asking these questions in a more selective way.
sub-Saharan Africa, where you
learned a great deal about malaria. You decide to use The predictive value of a positive finding depends upon the prevalence of a given
some of the same questions and disease in a population. The prevalence of malaria in the Midwest is almost zero,
maneuvers in your "routine" when examining patients in except in people immigrating from areas of high prevalence. You will waste time and
the midwestern United States. You resources applying
are disappointed to find that despite getting some positive these questions and maneuvers to all patients. It would be wise to continue
answers and findings, on further applying what you
workup, none of your patients has malaria except one, learned to those who are from areas of high prevalence of a given disease. You will
who recently emigrated from Ghana. How should you next learn to tailor your examination to the population you
approach these questions and maneuvers? are serving.
A) Continue asking these questions in a more selective
way.
B) Stop asking these questions, because they are low
yield.
C) Question the validity of the questions.
D) Ask these questions of all your patients.
For which of the following patients would a comprehensive C) A new patient with the chief complaint of "I am here to establish care".
health history be appropriate?
This patient is here to establish care, and because she is new to you, a
A) A new patient with the chief complaint of "I sprained my comprehensive health history is appropriate.
ankle".
B) An established patient with the chief complaint of "I
have an upper respiratory infection".
C) A new patient with the chief complaint of "I am here to
establish care".
D) A new patient with the chief complaint of "I cut my
hand".
The components of the health history include all of the B) Thorax and lungs
following except which one?
The thorax and lungs are part of the physical examination, not part of the health
A) Review of systems history.
B) Thorax and lungs
C) Present illness
D) Personal and social items
Is the following information subjective or objective? A) Subjective
Mr. M. has shortness of breath that has persisted for the
past 10 days; it is worse with activity This is information given by the patient about the circumstances of his chief
and relieved by rest. complaint. It does not represent an objective observation by the examiner.
A) Subjective
B) Objective
Is the following information subjective or objective? B) Objective
Mr. M. has a respiratory rate of 32 and a pulse rate of 120.
This is a measurement obtained by the examiner, so it is considered objective data.
A) Subjective The patient is unlikely to be able to give this information to the examiner.
B) Objective
The following information is recorded in the health history: B) Present illness
"The patient has had abdominal
pain for 1 week. The pain lasts for 30 minutes at a time; it This information describes the problem of abdominal pain, which is the present
comes and goes. The severity is 7 to 9 illness. The interviewer has obtained the location, timing, severity, and associated
on a scale of 1 to 10. It is accompanied by nausea and manifestations
vomiting. It is located in the of the pain. The interviewer will still need to obtain information concerning the
mid-epigastric area." quality of the
Which of these categories does it belong to? pain, the setting in which it occurred, and the factors that aggravate and alleviate
the pain.
A) Chief complaint
B) Present illness
C) Personal and social history
D) Review of systems
A patient presents for evaluation of a sharp, aching chest A) Musculoskeletal
pain which increases with breathing. Which anatomic area
would you localize the symptom to? Chest pain may be due to a musculoskeletal condition, such as costochondritis or
intercostal muscle cramp. This would be worsened by motion of the chest wall.
A) Musculoskeletal Pleuritic chest pain is also a sharp chest pain which increases with a deep breath.
B) Reproductive This type of pain can
C) Urinary occur with inflammation of the pleura from pneumonia or other conditions and
D) Endocrine pulmonary
embolus.
A patient comes to the emergency room for evaluation of C) Cardiac
shortness of breath. To which anatomic region would you
assign the symptom? Cardiac disorders such as congestive heart failure are the most likely on this list to
result in shortness of breath. There are cases within the other categories which may
A) Reproductive also result
B) Urinary in shortness of breath, such as anemia in the hematologic category, pregnancy in
C) Cardiac the reproductive
D) Hematologic category, or sepsis with UTI in the urinary category.
A patient presents for evaluation of a cough. Which of the C) Cardiac
following anatomic regions can be responsible for a
cough? The cardiac system can cause a cough if the patient has congestive heart failure.
This results in fluid buildup in the lungs, which in turn can cause a cough that
A) Ophthalmologic produces pink,
B) Auditory frothy sputum. A foreign body in the ear may also cause a cough by stimulating
C) Cardiac Arnold's branch of the vagus nerve, but this is less likely to be seen clinically than
D) Endocrine heart failure.
A 22-year-old advertising copywriter presents for B) Inflammatory
evaluation of joint pain. The pain is new,
located in the wrists and fingers bilaterally, with some The description is most consistent with an inflammatory process, although all the
subjective fever. The patient denies a other etiologies should be considered. Lyme disease is an infection which
rash; she also denies recent travel or camping activities. commonly causes
She has a family history significant for arthritis, hemophilia is a hematologic condition which can cause bleeding in the
rheumatoid arthritis. Based on this information, which of joints, and trauma can obviously cause joint pain.
the following pathologic processes
would be the most correct?
A) Infectious
B) Inflammatory
C) Hematologic
D) Traumatic
A 47-year-old contractor presents for evaluation of neck C) Degenerative
pain, which has been intermittent for several years. He
normally takes over-the-counter medications to ease the The description is most consistent with degenerative arthritis in the neck. The
pain, but this time they haven't worked as well and he still patient has had intermittent symptoms and the questions asked to elicit pertinent
has discomfort. He recently wallpapered the entire second negative and
floor in his house, which caused him great discomfort. The positive findings are negative for infectious, traumatic, or neoplastic disease.
pain resolved with rest. He denies fever, chills, rash, upper
respiratory symptoms, trauma, or injury to the neck. Based
on this description, what is the most likely pathologic
process?
A) Infectious
B) Neoplastic
C) Degenerative
D) Traumatic
A 15-year-old high school sophomore comes to the clinic C) Allergic
for evaluation of a 3-week history
of sneezing; itchy, watery eyes; clear nasal discharge; ear This description is most consistent with allergic rhinitis.
pain; and nonproductive cough. Which
is the most likely pathologic process?
A) Infection
B) Inflammation
C) Allergic
D) Vascular
, NR509 Bates Test Bank - Midterm Exam
A 19-year old-college student presents to the emergency C) Head is normocephalic and atraumatic, fundi with blurred disc margins, neck
room with fever, headache, and tender to
neck pain/stiffness. She is concerned about the possibility palpation, unable to perform range of motion
of meningococcal meningitis.
Several of her dorm mates have been vaccinated, but she Blurred disc margins are consistent with papilledema, and neck tenderness and lack
hasn't been. Which of the following of range of motion are consistent with neck stiffness, which in this scenario is likely
physical examination descriptions is most consistent with to be caused
meningitis? by meningeal inflammation. Kernig's and Brudzinski's signs are also helpful in
testing for meningeal irritation on exam.
A) Head is normocephalic and atraumatic, fundi with sharp
discs, neck supple with full range
of motion
B) Head is normocephalic and atraumatic, fundi with sharp
discs, neck with paraspinous
muscle spasm and limited range of motion to the right
C) Head is normocephalic and atraumatic, fundi with
blurred disc margins, neck tender to
palpation, unable to perform range of motion
D) Head is normocephalic and atraumatic, fundi with
blurred disc margins, neck supple with
full range of motion
A 37-year-old nurse comes for evaluation of colicky right C) Abdomen is soft and tender to palpation in the right upper quadrant with
upper quadrant abdominal pain. The pain is associated inspiration, to the
with nausea and vomiting and occurs 1 to 2 hours after point of stopping inspiration, and there is no rebound or guarding.
eating greasy foods. Which one of the following physical
examination descriptions would be most consistent with In cholecystitis, the pain, which originates from the gallbladder, is located in the
the diagnosis of cholecystitis? right upper quadrant. Severity of pain with inspiration that is sufficient to stop further
inhalation
A) Abdomen is soft, nontender, and nondistended, without is also known as Murphy's sign, which, if present, is further indicative of
hepatosplenomegaly or masses. inflammation of the
B) Abdomen is soft and tender to palpation in the right gallbladder.
lower quadrant, without rebound or
guarding.
C) Abdomen is soft and tender to palpation in the right
upper quadrant with inspiration, to the
point of stopping inspiration, and there is no rebound or
guarding.
D) Abdomen is soft and tender to palpation in the mid-
epigastric area, without rebound or
guarding.
A 55-year-old data entry operator comes to the clinic to B) More than one disease process
establish care. She has the following
symptoms: headache, neck pain, sinus congestion, sore The patient appears to have several possible conditions: allergic rhinitis, arthritis,
throat, ringing in ears, sharp brief chest conductive hearing loss, pleuritic chest pains, heartburn, stress urinary
pains at rest, burning abdominal pain with spicy foods, incontinence, and venous stasis, among other conditions. Although we always try, it
constipation, urinary frequency that is worse with coughing is very difficult to assign all of these
and sneezing, and swelling in legs. This cluster of symptoms to one cohesive diagnosis.
symptoms is explained
by:
A) One disease process
B) More than one disease process
A 62-year-old teacher presents to the clinic for evaluation A) One disease process
of the following symptoms: fever, headache, sinus
congestion, sore throat, green nasal discharge, and cough. This cluster of symptoms is most consistent with sinusitis. The chance that all of
This cluster of symptoms is best explained by: these symptoms are caused by multiple synchronous conditions in the same patient
is much less than the possibility of having one problem which accounts for all of
A) One disease process them.
B) More than one disease process
Steve has just seen a 5-year-old girl who wheezes when D) You have created a hypothesis.
exposed to cats. The patient's family history is positive for
asthma. You think the child most likely has asthma. What As you go through a history and examination, you will start to generate ideas to
have you just accomplished? explain the patient's symptoms. It is best to keep an open mind and make as many
hypotheses
A) You have tested your hypothesis. as you can, to avoid missing a possibility. A common mistake is to latch onto one
B) You have developed a plan. idea too early.
C) You have established a working diagnosis.
D) You have created a hypothesis.
, NR509 Bates Test Bank - Midterm Exam
Ms. Washington is a 67-year-old who had a heart attack A) Pathophysiologic problem
last month. Now she complains of shortness of breath and
not being able to sleep in a flat position (orthopnea). On This is an example of a pathophysiologic problem because Ms. Washington's
examination you note increased jugular venous pressure, symptoms are consistent with a pathophysiologic process. The heart attack reduced
an S3 gallop, crackles low in the lung fields, and swollen the ability of her heart to handle her volume status and subsequently produced the
ankles (edema). This is an example of a: many features of congestive heart failure.
A) Pathophysiologic problem
B) Psychopathologic problem
On the way to see your next patient, you glance at the B) Psychopathologic problem
calendar and make a mental note to
buy a Mother's Day card. Your patient is Ms. Hernandez, a It is not uncommon for patients to experience psychopathologic symptoms around
76-year-old widow who lost her the anniversary of a traumatic event. The time of year and the lack of an obvious
husband in May, two years ago. She comes in today with a connection
headaches, abdominal pain, and between Ms. Hernandez's symptoms would make you consider this as a possibility.
general malaise. This happened once before, about a year You will note that although this might have been an early consideration in your
ago, according to your detailed office hypothesis generation, it is
notes. You have done a thorough evaluation but are key to convince yourself that there is not a physiologic explanation for these
unable to arrive at a consistent picture to symptoms, by
tie these symptoms together. This is an example of a: performing a careful history and examination.
A) Pathophysiologic problem
B) Psychopathologic problem
Mr. Larson is a 42-year-old widowed father of two children, C) Discuss the plan with Mr. Larson.
ages 4 and 11. He works in a
sales office to support his family. Recently he has injured You should discuss your proposed plan with the patient before implementing it. In
his back and you are thinking he this case, you and Mr. Larson will need to weigh the benefit of physical therapy
would benefit from physical therapy, three times a week, against the
for an hour per session. What would ability to provide for his family. You may need to consider other ways of helping the
be your next step? patient,
perhaps through prescribed back exercises he can do at home. It is a common
A) Write the physical therapy prescription. mistake to
B) Have your office staff explain directions to the physical implement a plan without coming to an agreement with the patient first.
therapy center.
C) Discuss the plan with Mr. Larson.
D) Tell Mr. Larson that he will be going to physical therapy
three times a week.
You are seeing an elderly man with multiple complaints. D) Chest pain, headaches, arthritis, war injury pain
He has chronic arthritis, pain from an old war injury, and
headaches. Today he complains of these pains, as well as The problem list should have the most active and serious problem first. This new
dull chest pain under his sternum. What would the order of complaint of chest pain is almost certainly a higher priority than his other, more
priority be for your problem list? chronic
problems.
A) Arthritis, war injury pain, headaches, chest pain
B) War injury pain, arthritis, headaches, chest pain
C) Headaches, arthritis, war injury pain, chest pain
D) Chest pain, headaches, arthritis, war injury pain
You are excited about a positive test finding you have just C) Continue using the test, perhaps doing less laboratory work and diagnostics.
noticed on physical examination
of your patient. You go on to do more examination, This is an example of a specific test that lacks sensitivity. With this scenario,
laboratory work, and diagnostic tests, only when you finally find a positive, you might be very certain that a given condition is
to find that there is no sign of the disease you thought present.
would correlate with the finding. This We generally develop our examinations to fit our clinical experiences. Sensitive
same experience happens several times. What should you tests are
conclude? performed routinely on the screening examination, while specific tests are usually
saved for the
A) Consider not doing this test routinely. detailed or "branched" examinations. Branched examinations are further maneuvers
B) Use this test when you have a higher suspicion for a we can
certain correlating condition. perform to investigate positive findings on our screening examinations. Save this
C) Continue using the test, perhaps doing less laboratory type of
work and diagnostics. maneuver to confirm your hypothesis.
D) Omit this test from future examinations.
, NR509 Bates Test Bank - Midterm Exam
You have recently returned from a medical missions trip to A) Continue asking these questions in a more selective way.
sub-Saharan Africa, where you
learned a great deal about malaria. You decide to use The predictive value of a positive finding depends upon the prevalence of a given
some of the same questions and disease in a population. The prevalence of malaria in the Midwest is almost zero,
maneuvers in your "routine" when examining patients in except in people immigrating from areas of high prevalence. You will waste time and
the midwestern United States. You resources applying
are disappointed to find that despite getting some positive these questions and maneuvers to all patients. It would be wise to continue
answers and findings, on further applying what you
workup, none of your patients has malaria except one, learned to those who are from areas of high prevalence of a given disease. You will
who recently emigrated from Ghana. How should you next learn to tailor your examination to the population you
approach these questions and maneuvers? are serving.
A) Continue asking these questions in a more selective
way.
B) Stop asking these questions, because they are low
yield.
C) Question the validity of the questions.
D) Ask these questions of all your patients.
For which of the following patients would a comprehensive C) A new patient with the chief complaint of "I am here to establish care".
health history be appropriate?
This patient is here to establish care, and because she is new to you, a
A) A new patient with the chief complaint of "I sprained my comprehensive health history is appropriate.
ankle".
B) An established patient with the chief complaint of "I
have an upper respiratory infection".
C) A new patient with the chief complaint of "I am here to
establish care".
D) A new patient with the chief complaint of "I cut my
hand".
The components of the health history include all of the B) Thorax and lungs
following except which one?
The thorax and lungs are part of the physical examination, not part of the health
A) Review of systems history.
B) Thorax and lungs
C) Present illness
D) Personal and social items
Is the following information subjective or objective? A) Subjective
Mr. M. has shortness of breath that has persisted for the
past 10 days; it is worse with activity This is information given by the patient about the circumstances of his chief
and relieved by rest. complaint. It does not represent an objective observation by the examiner.
A) Subjective
B) Objective
Is the following information subjective or objective? B) Objective
Mr. M. has a respiratory rate of 32 and a pulse rate of 120.
This is a measurement obtained by the examiner, so it is considered objective data.
A) Subjective The patient is unlikely to be able to give this information to the examiner.
B) Objective
The following information is recorded in the health history: B) Present illness
"The patient has had abdominal
pain for 1 week. The pain lasts for 30 minutes at a time; it This information describes the problem of abdominal pain, which is the present
comes and goes. The severity is 7 to 9 illness. The interviewer has obtained the location, timing, severity, and associated
on a scale of 1 to 10. It is accompanied by nausea and manifestations
vomiting. It is located in the of the pain. The interviewer will still need to obtain information concerning the
mid-epigastric area." quality of the
Which of these categories does it belong to? pain, the setting in which it occurred, and the factors that aggravate and alleviate
the pain.
A) Chief complaint
B) Present illness
C) Personal and social history
D) Review of systems
