PHYSICAL EXAMINATION AND HISTORY TAKING
TEST BANK MULTIPLE CHOICE QUESTIONS &
ANSWERS
A 54‐year‐old diplomat working at the United Nations reports occasional chest pain and a sense of
tightness in his chest when particularly stressed over work deadlines. The patient is 6 feet 4 inches tall.
He has a temperature of 98.6ºF and blood pressure of 140/78. He has a cut over one eye that he says is
"from shaving."Which of the following represents subjective information about this patient?
a) Blood pressure of 140/78
b) Employment at the United Nations
c) Temperature of 98.6ºF
d) Cut over eye from shaving
e) Height of 6 feet 4 inches - ANS-d) Cut over eye from shaving
A physician assistant (PA) has had a long day and has seen many patients. The last patient of the day is
an 80‐year‐old woman brought to the office by her 35‐year‐old granddaughter. This is the patient's first
visit to the office. As part of the patient's past history, the PA obtains information about childhood
illnesses and adult illnesses and then moves on to inquire about the family
history. Which important area of the past history has she omitted?
a) Allergies
b) Medications
c) Immunizations
d) Chief complaint
e) Social history - ANS-c) Immunizations
A 39‐year‐old nurse who is a well‐established patient complains of irregular menstrual periods and
pelvic pain. She says that she is having trouble sleeping and asks whether she could be given a "sleeping
pill." The patient also says she is thinking of leaving her job. What is the best "next step" in caring for
this patient?
a) Ask about recent travel destinations.
b) Obtain a urine sample for testing.
c) Obtain a more complete description of problems.
d) Perform a pelvic examination.
e) Obtain blood for testing. - ANS-c) Obtain a more complete description of problems.
One important examination technique involves using the third fingers of each hand to determine the
health of internal organs. What is the name of this technique?
a) Inspection
b) Listening
,c) Auscultation
d) Percussion
e) Palpation - ANS-d) Percussion
A 59‐year‐old unemployed man complains of almost always feeling tired and hungry, despite getting
sufficient rest and having a good appetite and access to sufficient food. The patient is obese and, despite
the warm weather outside, wearing thermal socks with his sandals. He says this is because his feet are
always cold and "feel funny." With which body system should the clinician begin the examination?
a) Posterior thorax
b) Head and neck
c) Lower extremities
d) Nervous system
e) Abdomen - ANS-b) Head and neck
A 65‐year‐old retired pilot visits the clinic because of recurrent headache. The patient reports dizziness
of recent onset (previous 2 weeks) and occasional numbness on the left side. Which of the following
systems or regions should be examined in the clinician's focused assessment?
a) Gastrointestinal
b) Nervous
c) Respiratory
d) Musculoskeletal
e) Cardiovascular - ANS-b) Nervous
A 32‐year‐old office worker reports excessive stress at work and pain in the right lower quadrant. She
states that last night she vomited twice. Her blood pressure is 120/75, heart rate 93 bpm. The patient
looks pale and is sweating lightly. Which of the following is an objective finding?
a) Accelerated heart rate
b) Pain in the right lower quadrant
c) History of vomiting
d) Pale appearance
e) High stress level - ANS-a) Accelerated heart rate
A 29‐year‐old electrician complains of persistent cough and wheezing, particularly when he exercises. He
says he smokes "occasionally" but rarely so much that he needs to purchase cigarettes: "Mostly, I bum
them," he says, chuckling. Upon hearing this information, what is the best next step on the part of the
clinician?
a) Explain the relationship between smoking and cancer.
b) Determine the number of pack‐years the patient smokes.
c) Determine the patient's exercise regimen.
d) Conduct a mental status examination.
e) Determine the patient's immunization history. - ANS-b) Determine the number of pack‐years the
patient smokes.
A 47‐year‐old fitness trainer visits the physician assistant (PA) because of skin dryness, night sweats, and
irregular menstrual periods. It is the PA's first contact with this patient. The patient notes that "My sex
life has really gone downhill lately" and says that she is considering divorcing her husband of 20 years,
stating that "He's not a bad guy. I just think that I can do better." In which of the following ways should
the clinician proceed?
, a) Obtain a menstrual history for the previous 6 months.
b) Help the patient review the pros and cons of divorce.
c) Conduct a breast examination.
d) Inform the patient that menopause is a normal part of aging.
e) Determine the patient's out‐of‐country travel history. - ANS-a) Obtain a menstrual history for the
previous 6 months.
A 23‐year‐old physician assistant (PA) student found that she felt nervous when called upon to examine
men in her age group. On one occasion, she encountered a young male patient who appeared
embarrassed to see her walk into the room. What should the PA do to minimize their mutual
discomfort?
a) Adjust lighting so it is tangential to the patient's body.
b) Ask the patient where he comes from.
c) Explain that she is a PA student.
d) Provide ongoing interpretation of findings.
e) Explain how the examination will proceed. - ANS-e) Explain how the examination will proceed.
A 21‐year‐old college student experiences tachycardia following a night of heavy drinking. She is advised
to undergo a stress electrocardiogram (ECG). As she exercises, the recently calibrated pulse oximeter
records a heart rate ranging from 25 beats per minute (bpm) at rest to 50 bpm while jogging. The test is
stopped and re‐started twice, and each time the pulse oximeter yields a resting heart rate of 25 and a
jogging heart rate of 50. Which aspect of this instrument does the ECG technician question?
a) Sensitivity
b) Predictive value
c) Prevalence
d) Validity
e) Specificity - ANS-d) Validity
A 51‐year‐old moderately overweight college professor visits the clinic with a complaint of chest pain
after tennis matches. He jokes that his tennis partner "is in a lot better shape than I am" but says that he
is trying to keep up. Later in the day, a 28‐year‐old female student at the same college reports that "my
chest often feels hot and tight." She also feels stressed on the evening
before mid‐term exams. The clinician recommends an immediate evaluation for coronary artery disease
(CAD) for the professor, but not for the student. Why?
a) Negative predictive value of an observation is higher in a group with a higher prevalence of disease.
b) Positive predictive value of an observation is lower in a group with a higher
prevalence of disease.
c) Negative predictive value of an observation is lower in a group with a higher prevalence of disease.
d) Positive predictive value of an observation is greater in older peop - ANS-e) Positive predictive value
of an observation is higher in a group with a higher prevalence of disease.
A 23‐year‐old farm worker submits urine for testing. Three test strips from Container A show abnormally
low pH levels in the urine. However, three test strips from Container B, purchased more recently,
consistently indicate that the pH of this patient's urine is normal. Which of the following is a true
statement about the test strips?
a) The test strips demonstrate high specificity.
b) The test strips demonstrate high interobserver reliability.
c) The test strips demonstrate high intraobserver reliability.
TEST BANK MULTIPLE CHOICE QUESTIONS &
ANSWERS
A 54‐year‐old diplomat working at the United Nations reports occasional chest pain and a sense of
tightness in his chest when particularly stressed over work deadlines. The patient is 6 feet 4 inches tall.
He has a temperature of 98.6ºF and blood pressure of 140/78. He has a cut over one eye that he says is
"from shaving."Which of the following represents subjective information about this patient?
a) Blood pressure of 140/78
b) Employment at the United Nations
c) Temperature of 98.6ºF
d) Cut over eye from shaving
e) Height of 6 feet 4 inches - ANS-d) Cut over eye from shaving
A physician assistant (PA) has had a long day and has seen many patients. The last patient of the day is
an 80‐year‐old woman brought to the office by her 35‐year‐old granddaughter. This is the patient's first
visit to the office. As part of the patient's past history, the PA obtains information about childhood
illnesses and adult illnesses and then moves on to inquire about the family
history. Which important area of the past history has she omitted?
a) Allergies
b) Medications
c) Immunizations
d) Chief complaint
e) Social history - ANS-c) Immunizations
A 39‐year‐old nurse who is a well‐established patient complains of irregular menstrual periods and
pelvic pain. She says that she is having trouble sleeping and asks whether she could be given a "sleeping
pill." The patient also says she is thinking of leaving her job. What is the best "next step" in caring for
this patient?
a) Ask about recent travel destinations.
b) Obtain a urine sample for testing.
c) Obtain a more complete description of problems.
d) Perform a pelvic examination.
e) Obtain blood for testing. - ANS-c) Obtain a more complete description of problems.
One important examination technique involves using the third fingers of each hand to determine the
health of internal organs. What is the name of this technique?
a) Inspection
b) Listening
,c) Auscultation
d) Percussion
e) Palpation - ANS-d) Percussion
A 59‐year‐old unemployed man complains of almost always feeling tired and hungry, despite getting
sufficient rest and having a good appetite and access to sufficient food. The patient is obese and, despite
the warm weather outside, wearing thermal socks with his sandals. He says this is because his feet are
always cold and "feel funny." With which body system should the clinician begin the examination?
a) Posterior thorax
b) Head and neck
c) Lower extremities
d) Nervous system
e) Abdomen - ANS-b) Head and neck
A 65‐year‐old retired pilot visits the clinic because of recurrent headache. The patient reports dizziness
of recent onset (previous 2 weeks) and occasional numbness on the left side. Which of the following
systems or regions should be examined in the clinician's focused assessment?
a) Gastrointestinal
b) Nervous
c) Respiratory
d) Musculoskeletal
e) Cardiovascular - ANS-b) Nervous
A 32‐year‐old office worker reports excessive stress at work and pain in the right lower quadrant. She
states that last night she vomited twice. Her blood pressure is 120/75, heart rate 93 bpm. The patient
looks pale and is sweating lightly. Which of the following is an objective finding?
a) Accelerated heart rate
b) Pain in the right lower quadrant
c) History of vomiting
d) Pale appearance
e) High stress level - ANS-a) Accelerated heart rate
A 29‐year‐old electrician complains of persistent cough and wheezing, particularly when he exercises. He
says he smokes "occasionally" but rarely so much that he needs to purchase cigarettes: "Mostly, I bum
them," he says, chuckling. Upon hearing this information, what is the best next step on the part of the
clinician?
a) Explain the relationship between smoking and cancer.
b) Determine the number of pack‐years the patient smokes.
c) Determine the patient's exercise regimen.
d) Conduct a mental status examination.
e) Determine the patient's immunization history. - ANS-b) Determine the number of pack‐years the
patient smokes.
A 47‐year‐old fitness trainer visits the physician assistant (PA) because of skin dryness, night sweats, and
irregular menstrual periods. It is the PA's first contact with this patient. The patient notes that "My sex
life has really gone downhill lately" and says that she is considering divorcing her husband of 20 years,
stating that "He's not a bad guy. I just think that I can do better." In which of the following ways should
the clinician proceed?
, a) Obtain a menstrual history for the previous 6 months.
b) Help the patient review the pros and cons of divorce.
c) Conduct a breast examination.
d) Inform the patient that menopause is a normal part of aging.
e) Determine the patient's out‐of‐country travel history. - ANS-a) Obtain a menstrual history for the
previous 6 months.
A 23‐year‐old physician assistant (PA) student found that she felt nervous when called upon to examine
men in her age group. On one occasion, she encountered a young male patient who appeared
embarrassed to see her walk into the room. What should the PA do to minimize their mutual
discomfort?
a) Adjust lighting so it is tangential to the patient's body.
b) Ask the patient where he comes from.
c) Explain that she is a PA student.
d) Provide ongoing interpretation of findings.
e) Explain how the examination will proceed. - ANS-e) Explain how the examination will proceed.
A 21‐year‐old college student experiences tachycardia following a night of heavy drinking. She is advised
to undergo a stress electrocardiogram (ECG). As she exercises, the recently calibrated pulse oximeter
records a heart rate ranging from 25 beats per minute (bpm) at rest to 50 bpm while jogging. The test is
stopped and re‐started twice, and each time the pulse oximeter yields a resting heart rate of 25 and a
jogging heart rate of 50. Which aspect of this instrument does the ECG technician question?
a) Sensitivity
b) Predictive value
c) Prevalence
d) Validity
e) Specificity - ANS-d) Validity
A 51‐year‐old moderately overweight college professor visits the clinic with a complaint of chest pain
after tennis matches. He jokes that his tennis partner "is in a lot better shape than I am" but says that he
is trying to keep up. Later in the day, a 28‐year‐old female student at the same college reports that "my
chest often feels hot and tight." She also feels stressed on the evening
before mid‐term exams. The clinician recommends an immediate evaluation for coronary artery disease
(CAD) for the professor, but not for the student. Why?
a) Negative predictive value of an observation is higher in a group with a higher prevalence of disease.
b) Positive predictive value of an observation is lower in a group with a higher
prevalence of disease.
c) Negative predictive value of an observation is lower in a group with a higher prevalence of disease.
d) Positive predictive value of an observation is greater in older peop - ANS-e) Positive predictive value
of an observation is higher in a group with a higher prevalence of disease.
A 23‐year‐old farm worker submits urine for testing. Three test strips from Container A show abnormally
low pH levels in the urine. However, three test strips from Container B, purchased more recently,
consistently indicate that the pH of this patient's urine is normal. Which of the following is a true
statement about the test strips?
a) The test strips demonstrate high specificity.
b) The test strips demonstrate high interobserver reliability.
c) The test strips demonstrate high intraobserver reliability.
