1-7)
50 questions
1. Which statement belongs in the chief complaint?
A. Abdomen tender in RLQ with guarding
B. 'I've had a sharp pain in my right side since last night.'
C. Possible appendicitis
D. Order CBC and CT
Correct Answer: B. 'I've had a sharp pain in my right side since last night.'
Rationale: The CC is the reason for the visit in the patient's own words.
2. Which element of OLDCARTS is addressed by asking, 'Does the pain spread anywhere?'
A. Radiation
B. Onset
C. Timing
D. Characteristics
Correct Answer: A. Radiation
Rationale: Radiation describes spread of pain to other areas.
3. Where are review of systems findings documented?
A. In the objective section
B. In the subjective section, as symptoms the patient reports
C. In the assessment section
D. In the plan
Correct Answer: B. In the subjective section, as symptoms the patient reports
Rationale: ROS is a subjective symptom inventory.
4. A patient smoked 2 packs per day for 15 years. How many pack-years?
A. 15
B. 17
C. 7.5
D. 30
Correct Answer: D. 30
Rationale: 2 x 15 = 30 pack-years.
5. A focused (problem-oriented) assessment is most appropriate for:
A. A new patient's first comprehensive visit
B. An annual wellness exam
C. Pre-employment complete physical
D. A patient presenting with an acute sore throat
Correct Answer: D. A patient presenting with an acute sore throat
Rationale: Focused assessments target the presenting problem.
6. Which is a 'can't-miss' diagnosis for a patient with acute chest pain?
A. Costochondritis
B. Gastroesophageal reflux
C. Acute coronary syndrome
D. Muscle strain
Correct Answer: C. Acute coronary syndrome
Rationale: Life-threatening causes must be considered and ruled out first.
, 7. A pertinent negative in a patient with suspected meningitis would be:
A. Presence of fever
B. Severe headache
C. Absence of neck stiffness
D. Photophobia
Correct Answer: C. Absence of neck stiffness
Rationale: Absent findings that lower the probability are pertinent negatives.
8. Which finding is objective data?
A. Temperature 38.9 C
B. Patient reports chills
C. Patient states 'I feel weak'
D. Patient describes nausea
Correct Answer: A. Temperature 38.9 C
Rationale: Objective data are measured or observed.
9. The correct sequence for examining the abdomen is:
A. Inspection, palpation, percussion, auscultation
B. Palpation, percussion, auscultation, inspection
C. Inspection, auscultation, percussion, palpation
D. Auscultation, inspection, palpation, percussion
Correct Answer: C. Inspection, auscultation, percussion, palpation
Rationale: Auscultation comes before touching, which can alter bowel sounds.
10. Which part of the hand is best for detecting vibration such as tactile fremitus?
A. Fingertips
B. Ulnar surface or palm
C. Dorsal surface
D. Thumb only
Correct Answer: B. Ulnar surface or palm
Rationale: These areas are most sensitive to vibration.
11. The bell of the stethoscope is best for hearing:
A. Normal breath sounds
B. S3 and S4 heart sounds
C. Bowel sounds
D. S1 and S2 only
Correct Answer: B. S3 and S4 heart sounds
Rationale: The bell detects low-pitched sounds.
12. Percussion over a normal lung produces:
A. Resonance
B. Dullness
C. Flatness
D. Tympany
Correct Answer: A. Resonance
Rationale: Air-filled lung tissue is resonant.