https://browsegrades.net/singlePaper/416695/test-bank-for-marketing-management-16th-editi
WEEK 8 NR 509 ADVANCED HEALTH
ASSESSMENT FINAL QUESTIONS AND
ANSWERS
CHAPTERcx19:cxAbdomen
Ancxoverweightcx26-year-
oldcxpubliccxservantcxpresentscxtocxthecxEmergencycxDepartmentcxwithcx12cxhourscxofcxintense
cxabdominalcxpain,cxlight-
headedness,cxandcxacxfaintingcxepisodecxthatcxfinallycxpromptedcxhercxtocxseekcxmedicalcxatte
ntion.cxShecxhascxacxstrongcxfamilycxhistorycxofcxgallstonescxandcxiscxconcernedcxaboutcxthiscxp
ossibility.cxShecxhascxnotcxhadcxanycxvomitingcxorcxdiarrhea.cxShecxhadcxacxnormalcxbowelcxmo
vementcxthiscxmorning.cxHercxβ-humancxchorioniccxgonadotropincx(β-
hCG)cxiscxpositivecxatcxtriage.cxShecxreportscxthatcxhercxlastcxperiterm-
12odcxwascx10cxweekscxago.cxHercxvitalcxsignscxatcxtriagecxarecxpulse,cx118;cxbloodcxpressure,c
x86/68;cxrespiratorycxrate,cx20/
min;cxoxygencxsaturation,cx99%;cxandcxtemperature,cx37.3ºCcxorally.cxThecxcliniciancxperform
scxancxabdominalcxexamcxpriorcxtocxhercxpelviccxexamcxand,cxoncxpalpationcxofcxhercxabdomen,
cxfindscxinvoluntarycxrigiditycxandcxreboundcxtenderness.cxWhatcxiscxthecxmostcxlikelycxdiagnosi
s?cx-cxanswer--Rupturedcxtubalcx(orcxectopic)cxpregnancy
Rationale:cxThecxconstellationcxofcxabdominalcxpain,cxsyncope,cxtachycardia,cxhypotension,cx
positivecxβ-hCG,cxandcxfindingscxsuggestivecxofcxperitonealcxinflammation/
irritationcxstronglycxsuggestcxacxrupturedcxectopiccxpregnancycxwithcxsignificantcxintra-
abdominalcxbleedingcxleadingcxtocxperitonealcxsigns.cxThiscxcasecxiscxemergentcxandcxrequire
scximmediatecxtreatmentcxofcxhercxhypotensioncxandcxpresumedcxbloodcxlosscxascxwellcxascxgy
necologicalcxconsultcxforcxemergentcxsurgery.cxRupturedcxectopiccxpregnanciescxcancxleadcxt
ocxlife-threateningcxintra-
abdominalcxbleeding.cxAlthoughcxacutecxcholecystitis,cxrupturedcxappendix,cxbowelcxwallcxpe
rforation,cxandcxrupturedcxovariancxcystcxarecxallcxpossibilities,cxthecxpositivecxβ-
hCGcxtestingcxandcxhercxunstablecxvitalcxsignscxmakecxrupturedcxectopiccxpregnancycxmorecxli
kely.
CHAPTERcx19:cxAbdomen
Acx63-year-
oldcxjanitorcxwithcxacxhistorycxofcxadenomatouscxcoloniccxpolypscxpresentscxforcxacxwellcxvisit.cx
Basiccxlabscxarecxperformedcxtocxscreencxforcxdiabetescxmellituscxandcxdyslipidemia.cxElectrol
ytescxandcxlivercxenzymescxwerecxalsocxmeasured.cxHiscxlabscxarecxallcxnormalcxexpectcxforcxm
oderatecxelevationscxofcxaspartatecxaminotransferase,cxalaninecxaminotransferase,cxγ-
glutamylcxtransferase,cxandcxalkalinecxphosphatasecxascxwellcxascxacxmildlycxelevatedcxtotalcxb
ilirubin.cxHecxpresentscxforcxacxfollow-
upcxappointmentcxandcxthecxcliniciancxperformscxancxabdominalcxexamcxtocxassesscxhiscxliver.c
1
Copyrightcx©cx2022cxPearsoncxEducation,cx
Inc.
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Whichcxofcxthecxfollowingcxfindingscxwouldcxbecxmostcxconsistentcxwithcxhepatomegaly?cx-
x
answer--
cx
Livercxpalpablecx3cxcmcxbelowcxthecxrightcxcostalcxmargin,cxmidcxclavicularcxline,cxoncxexpiratio
n
Rationale:cxThecxlivercxbeingcxpalpablecx3cxcmcxbelowcxthecxrightcxcostalcxmargin,cxmidclavicul
arcxline,cxwouldcxbecxconsideredcxnormalcxoncxinspirationcxwhencxthecxlivercxiscxpushedcxdownc
xintocxthecxabdominalcxcavitycxoncxinspiration,cxbutcxiscxabnormalcxoncxexpiration.cxFindingscxto
cxsupportcxhepatomegalycxwouldcxbecxmorecxconvincingcxif,cxbycxpercussion,cxthecxlivercxspanc
xwascx>12cxcmcxatcxthecxmidclavicularcxline.cxForcxpatientscxwithcxobstructivecxlungcxdisease,cx
aircxtrappingcxincxthecxlungscxmaycxdisplacecxthecxlivercxdownwardscxintocxthecxabdominalcxcavi
ty.cxThecxlivercxspancxandcxdullnesscxtocxpercussioncxrefercxtocxthecxsamecxmeasurement.cxMe
asurementscxofcx6-12cxcmcxatcxthecxmid-clavicularcxlinecxandcx4-
8cxcmcxatcxthecxmidsternalcxlinecxarecxconsideredcxnormal.
CHAPTERcx19:cxAbdomen
Acx63-year-oldcxunderweightcxadministrativecxclerkcxwithcxacx50-pack-
yearcxsmokingcxhistorycxpresentscxwithcxacxseveralcxmonthcxhistorycxofcxrecurrentcxepigastriccx
abdominalcxdiscomfort.cxShecxfeelscxfairlycxwellcxotherwisecxandcxdeniescxanycxnausea,cxvomi
ting,cxdiarrhea,cxorcxconstipation.cxShecxreportscxthatcxacxfirstcxcousincxdiedcxfromcxacxrupturedc
xaneurysmcxatcxagecx68cxyears.cxHercxvitalcxsignscxarecxpulse,cx86;cxbloodcxpressure,cx148/92;c
xrespiratorycxrate,cx16;cxoxygencxsaturation,cx95%;cxandcxtemperature,cx36.2ºC.cxHercxbodycx
masscxindexcxiscx17.6.cxOncxexam,cxhercxabdominalcxaortacxiscxprominent,cxwhichcxiscxconcern
ingcxforcxancxabdominalcxaorticcxaneurysmcx(AAA).cxWhichcxofcxthecxfollowingcxiscxhercxmostcxsi
gnificantcxriskcxfactorcxforcxancxAAA?cx-cxanswer--Historycxofcxsmoking
Rationale:cxHistorycxofcxsmokingcxiscxhercxmostcxsignificantcxriskcxfactorcxforcxancxAAA.cxMalecx
gender,cxnotcxfemalecxgender,cxiscxconsideredcxascxriskcxfactor.cxUnderweightcxiscxnotcxacxriskcx
factorcxforcxAAA.cxFamilycxhistorycxofcxrupturedcxaneurysmcxiscxvaguecxandcxcouldcxbecxacxcere
bralcxaneurysm.cxFurther,cxhercxfamilycxhistorycxiscxincxacxfirst-degreecxcousincxnotcxacxfirst-
degreecxrelativecx(biologiccxparents,cxsiblings,cxandcxchildren).cxHypertensioncxcouldcxcontrib
utecxtocxatherosclerosis,cxwhichcxiscxacxriskcxfactor.cxFurther,cxacxdiagnosiscxofcxhypertensioncxi
scxnotcxbasedcxoncxonecxelevatedcxbloodcxpressurecxreading.
CHAPTERcx19:cxAbdomen
Acx76-year-
oldcxretiredcxmancxwithcxacxhistorycxofcxprostatecxcancercxandcxhypertensioncxhascxbeencxscree
nedcxannuallycxforcxcoloncxcancercxusingcxhighcxsensitivitycxfecalcxoccultcxbloodcxtestingcx(FO
BT).cxHecxpresentscxforcxfollow-
upcxofcxhiscxhypertension,cxduringcxwhichcxthecxcliniciancxscanscxhiscxchartcxtocxensurecxhecxiscx
upcxtocxdatecxwithcxhiscxpreventivecxhealthcxcare.cxHecxhascxacxpositivecxFOBTcxoncxonecxoccas
ioncxatcxagecx66cxyearscxandcxsubsequentlycxwentcxforcxacxcolonoscopy.cxInternalcxhemorrhoid
scxandcxsigmoidcxdiverticulicxwerecxfoundcxoncxcolonoscopy.cxHecxhascxnocxfirst-
degreecxrelativescxwithcxacxhistorycxofcxcolorectalcxcancercxorcxadenomatouscxpolyps.cxWhatcx
arecxthecxU.S.cxPreventivecxServicescxTaskcxForcecx(USPSTF)cxscreeningcxrecommendation
scxforcxthiscxpatient?cx-cxanswer--Docxnotcxscreencxroutinely
2
Copyrightcx©cx2022cxPearsoncxEducation,cx
Inc.
,https://browsegrades.net/singlePaper/416695/test-bank-for-marketing-management-16th-editi
Rationale:cxThecxUSPSTFcxrecommendscxnotcxscreeningcxroutinely.cxForcxmostcxadultscxage
scx76-
85cxyears,cxthecxgaincxincxlifecxyearscxiscxsmallcxcomparedcxtocxcolonoscopycxrisks.cxItcxiscxadvis
edcxtocxdiscusscxindividualizedcxriskscxandcxbenefitscxwithcxthecxpatient.cxAnnualcxFOBTcxscre
eningcxmaycxcontinuecxuntilcxagecx80-
85cxyearscxifcxbenefitscxtocxdoingcxsocxoutweighcxriskscxforcxthecxindividualcxpatient;cxhowever,cx
screeningcxshouldcxnotcxbecxroutinelycxcontinued.cxIncxgeneral,cxacxlifecxexpectancycx>7cxyear
scxiscxnecessarycxforcxscreeningcxtocxbecxpotentiallycxbeneficial.cxTherecxiscxnocxindicationcxtocx
repeatcxacxcolonoscopycxgivencxthecxabsencecxofcxanycxcancerouscxorcxprecancerouscxfinding
scxoncxhiscxcolonoscopycx10cxyearscxago.cxSigmoidoscopycxeverycx5cxyearscxwithcxFOBTcxeve
rycx3cxyearscxiscxacxvalidcxscreeningcxoption,cxbutcxagaincxscreeningcxiscxnotcxroutinelycxrecom
mendedcxforcxpatientscxagecx>75cxyears.
CHAPTERcx19:cxAbdomen
Ancxotherwisecxhealthycx31-year-
oldcxaccountantcxpresentscxtocxancxoutpatientcxcliniccxwithcxacx3-
yearcxhistorycxofcxrecurrentcxcrampycxabdominalcxpaincxthatcxlastscxforcxaboutcx1-
2cxweekscxeachcxepisodecxandcxiscxassociatedcxwithcxonsetcxofcxconstipation.cxShecxdescribes
cxinfrequent,cxsmallcxhardcxstoolcxthatcxshecxfindscxverycxdifficultcxtocxpass.cxShecxhascxtriedcxtocx
increasecxdietarycxfibercxandcxwatercxintake,cxbutcxusuallycxthiscxiscxnotcxsufficientcxandcxshecxr
esortscxtocxover-the-
countercxlaxatives,cxwhichcxshecxfindscxupsetcxhercxstomachcxbutcxdocxresolvecxthecxconstipati
on.cxSymptomscxtypicallycxgraduallycxresolvecxwithcxbowelcxmovements.cxWhichcxofcxthecxfoll
owingcxiscxthecxmostcxlikelycxphysiologicalcxmechanismcxforcxhercxconstipation?cx-cxanswer--
Functionalcxchangecxincxbowelcxmovement
Rationale:cxFunctionalcxchangecxincxbowelcxmovementcxiscxcharacteristiccxofcxirritablecxbowel
cxsyndromecx(IBS).cxIBScxiscxcharacterizedcxbycxthreecxpatterns:cxdiarrheacxpredominant,cxco
nstipationcxpredominant,cxorcxmixed.cxOthercxfunctionalcxcausescxforcxhercxconstipationcxshou
ldcxbecxexcludedcxpriorcxtocxmakingcxthiscxdiagnosis.cxAcxlargecxfirmcxfecalcxmasscxincxthecxrectu
mcxiscxcharacteristiccxofcxfecalcximpaction,cxwhichcxiscxcommoncxincxdebilitated,cxbedriddencxin
dividuals.cxDecreasedcxfecalcxbulkcxiscxcharacteristiccxofcxacxdietcxlowcxincxfiber.cxThiscxpatientcx
hadcxnotcxfoundcxthatcxincreasingcxfibercxhelpscxhercxconstipation.cxSpasmcxofcxthecxexternalcx
sphinctercxiscxassociatedcxwithcxpainfulcxanalcxlesions,cxwhichcxthiscxpatientcxdoescxnotcxreport
.cxImpairmentcxofcxautonomiccxinnervationscxiscxcharacteristiccxofcxpatientscxwithcxmultiplecxscl
erosis,cxspinalcxcordcxinjuries,cxandcxHirschsprungcxdisease.cxShecxhascxnocxknowncxdiagnosi
scxthatcxwouldcxincreasecxsuspicioncxofcxneurologicalcximpairment.
CHAPTERcx19:cxAbdomen
Acx23-year-oldcxwomancxcomescxtocxthecxrespirologycxcliniccxforcxfollow-
upcxofcxhercxchroniccxsinusitiscxandcxbronchiectasiscxthatcxiscxassociatedcxwithcxacxrarecxconge
nitalcxconditioncxcalledcxKartagenercxsyndrome.cxThecxpreceptorcxnotescxthatcxshecxhascxsitus
cxinversuscxandcxaskscxforcxacxphysicalcxexam.cxWhichcxofcxthecxfollowingcxdescriptionscxbestcxf
itscxwithcxfindingscxoncxthecxabdominalcxexam?cx-cxanswer--
Tympanycxtocxpercussioncxincxthecxrightcxuppercxquadrant,cxdullnesscxtocxpercussioncxofcxthecxl
eftcxuppercxquadrant
3
Copyrightcx©cx2022cxPearsoncxEducation,cx
Inc.
, https://browsegrades.net/singlePaper/416695/test-bank-for-marketing-management-16th-editi
Rationale:cxSituscxinversuscxiscxacxrarecxconditioncxincxwhichcxorganscxarecxreversedcxandcxiscx
associatedcxwithcxKartagenercxsyndrome.cxThus,cxthecxstomachcxandcxgastriccxaircxbubblecxar
ecxoncxthecxrightcxandcxlivercxdullnesscxiscxoncxthecxleft.cxAcxprotuberantcxabdomencxwithcxscatte
redcxareascxofcxdullnesscxandcxtympanycxandcxstoolcxoncxpalpationcxiscxlikelycxconstipation.cxN
onecxofcxthesecxfindingscxsuggestcxorgancxreversal.cxLivercxdullnesscxwillcxoccurcxincxthecxleftcxu
ppercxquadrantcxwithcxorgancxreversal.cxFindingscxgivencxincxthecxremainingcxanswercxchoices
cxarecxbothcxassociatedcxwithcxsplenomegalycxwithcxthecxspleencxlocatedcxincxthecxleftcxuppercx
quadrant,cxwhichcxwouldcxnotcxbecxthecxcasecxforcxsinuscxinversuscxtotalis.
CHAPTERcx19:cxAbdomen
Ancxotherwisecxhealthycx28-year-
oldcxlawyercxpresentscxtocxthecxEmergencycxDepartmentcxwithcxacx1-
daycxhistorycxofcxseverecxabdominalcxpain.cxThecxemergencycxphysiciancxsuspectscxappendic
itiscxandcxgeneralcxsurgerycxiscxconsulted.cxThecxresidentcxbelievescxthecxpatientcxhascxsignscx
ofcxperitonitiscxoncxexam.cxWhichcxofcxthecxfollowingcxphysicalcxexamcxfindingscxsupportscxperi
tonitis?cx-cxanswer--
Pressingcxdowncxontocxthecxabdomencxfirmlycxandcxslowlycxandcxwithdrawingcxthecxhandcxquic
klycxproducescxpain
Rationale:cxPressingcxdowncxontocxthecxabdomencxfirmlycxandcxslowlycxandcxwithdrawingcxthe
cxhandcxquicklycxproducingcxpaincxdescribescxreboundcxtenderness,cxwhich,cxalongcxwithcxgua
rdingcxandcxrigidity,cxiscxsuggestivecxofcxperitonitis.cxInvoluntarycxcontractioncxrathercxthancxvo
luntarycxcontractioncxofcxthecxabdominalcxwallcxthatcxpersistscxovercxseveralcxexaminationscxd
escribescxrigidity.cxAbdominalcxpaincxthatcxincreasescxwithcxhipcxflexioncxiscxnotcxsuggestivecxo
fcxperitonitis.cxIncxfact,cxpatientscxwithcxperitonitiscxtendcxtocxkeepcxhipscxflexedcxtocxreducecxstr
etchcxandcxirritationcxofcxthecxparietalcxperitoneum.cxTheycxoftencxwalkcxbentcxforwardcxatcxthecx
hipscxforcxthiscxreason.cxLocalizedcxpaincxovercxMcBurneycxpointcxiscxcertainlycxsuggestivecxofc
xappendicitis,cxbutcxnotcxsuggestivecxofcxperitonitis.cxSimilarlycxpaincxwithcxinternalcxrotationcxo
fcxthecxrightcxhip,cxorcxacxpositivecxobturatorcxsign,cxsuggestscxirritationcxofcxthecxpsoascxmuscle
cxduecxtocxancxinflamedcxappendix,cxbutcxnotcxperitonitis.
CHAPTERcx19:cxAbdomen
Acx58-year-
oldcxmancxwithcxacxhistorycxofcxdiabetescxandcxalcoholcxaddictioncxhascxbeencxsobercxforcxthecxl
astcx10cxmonths.cxHecxpresentscxwithcxacx4-
monthcxhistorycxofcxincreasingcxweakness,cxrecurrentcxepigastriccxpaincxradiatingcxtocxhiscxba
ck,cxchroniccxdiarrheacxwithcxstoolscx6-
8cxtimescxdaily,cxandcxweightcxlosscxofcx18cxlbcxovercx4cxmonths.cxWhatcxiscxthecxmechanismcxof
cxhiscxmostcxlikelycxdiagnosis?cx-cxanswer--Fibrosiscxofcxthecxpancreas
Rationale:cxFibrosiscxofcxthecxpancreascxiscxassociatedcxwithcxchroniccxpancreatitis.cxChronicc
xpancreatitiscxleadscxtocxfibrosiscxandcxdecreasedcxpancreaticcxfunction,cxwhichcxcausescxdiar
rheacxfromcxpancreaticcxenzymecxinsufficiencycxandcxdiabetescxmellitus.cxH.cxpyloricxinfection
cxmaycxcausecxpepticcxulcercxdiseasecxandcxdyspepsia,cxwhichcxiscxnotcxusuallycxassociatedcx
withcxdiarrhea.cxInflammationcxofcxthecxcoloniccxdiverticulumcxiscxdiverticulitiscxandcxtypicallycx
causescxleft-lower-
quadrantcxpain,cxfever,cxconstipation,cxandcxsometimescxdiarrhea.cxItcxiscxtypicallycxancxacutec
xdisease.cxReducedcxbloodcxsupplycxtocxthecxbowelcxcharacterizescxmesentericcxischemia.cxItc
4
Copyrightcx©cx2022cxPearsoncxEducation,cx
Inc.
WEEK 8 NR 509 ADVANCED HEALTH
ASSESSMENT FINAL QUESTIONS AND
ANSWERS
CHAPTERcx19:cxAbdomen
Ancxoverweightcx26-year-
oldcxpubliccxservantcxpresentscxtocxthecxEmergencycxDepartmentcxwithcx12cxhourscxofcxintense
cxabdominalcxpain,cxlight-
headedness,cxandcxacxfaintingcxepisodecxthatcxfinallycxpromptedcxhercxtocxseekcxmedicalcxatte
ntion.cxShecxhascxacxstrongcxfamilycxhistorycxofcxgallstonescxandcxiscxconcernedcxaboutcxthiscxp
ossibility.cxShecxhascxnotcxhadcxanycxvomitingcxorcxdiarrhea.cxShecxhadcxacxnormalcxbowelcxmo
vementcxthiscxmorning.cxHercxβ-humancxchorioniccxgonadotropincx(β-
hCG)cxiscxpositivecxatcxtriage.cxShecxreportscxthatcxhercxlastcxperiterm-
12odcxwascx10cxweekscxago.cxHercxvitalcxsignscxatcxtriagecxarecxpulse,cx118;cxbloodcxpressure,c
x86/68;cxrespiratorycxrate,cx20/
min;cxoxygencxsaturation,cx99%;cxandcxtemperature,cx37.3ºCcxorally.cxThecxcliniciancxperform
scxancxabdominalcxexamcxpriorcxtocxhercxpelviccxexamcxand,cxoncxpalpationcxofcxhercxabdomen,
cxfindscxinvoluntarycxrigiditycxandcxreboundcxtenderness.cxWhatcxiscxthecxmostcxlikelycxdiagnosi
s?cx-cxanswer--Rupturedcxtubalcx(orcxectopic)cxpregnancy
Rationale:cxThecxconstellationcxofcxabdominalcxpain,cxsyncope,cxtachycardia,cxhypotension,cx
positivecxβ-hCG,cxandcxfindingscxsuggestivecxofcxperitonealcxinflammation/
irritationcxstronglycxsuggestcxacxrupturedcxectopiccxpregnancycxwithcxsignificantcxintra-
abdominalcxbleedingcxleadingcxtocxperitonealcxsigns.cxThiscxcasecxiscxemergentcxandcxrequire
scximmediatecxtreatmentcxofcxhercxhypotensioncxandcxpresumedcxbloodcxlosscxascxwellcxascxgy
necologicalcxconsultcxforcxemergentcxsurgery.cxRupturedcxectopiccxpregnanciescxcancxleadcxt
ocxlife-threateningcxintra-
abdominalcxbleeding.cxAlthoughcxacutecxcholecystitis,cxrupturedcxappendix,cxbowelcxwallcxpe
rforation,cxandcxrupturedcxovariancxcystcxarecxallcxpossibilities,cxthecxpositivecxβ-
hCGcxtestingcxandcxhercxunstablecxvitalcxsignscxmakecxrupturedcxectopiccxpregnancycxmorecxli
kely.
CHAPTERcx19:cxAbdomen
Acx63-year-
oldcxjanitorcxwithcxacxhistorycxofcxadenomatouscxcoloniccxpolypscxpresentscxforcxacxwellcxvisit.cx
Basiccxlabscxarecxperformedcxtocxscreencxforcxdiabetescxmellituscxandcxdyslipidemia.cxElectrol
ytescxandcxlivercxenzymescxwerecxalsocxmeasured.cxHiscxlabscxarecxallcxnormalcxexpectcxforcxm
oderatecxelevationscxofcxaspartatecxaminotransferase,cxalaninecxaminotransferase,cxγ-
glutamylcxtransferase,cxandcxalkalinecxphosphatasecxascxwellcxascxacxmildlycxelevatedcxtotalcxb
ilirubin.cxHecxpresentscxforcxacxfollow-
upcxappointmentcxandcxthecxcliniciancxperformscxancxabdominalcxexamcxtocxassesscxhiscxliver.c
1
Copyrightcx©cx2022cxPearsoncxEducation,cx
Inc.
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Whichcxofcxthecxfollowingcxfindingscxwouldcxbecxmostcxconsistentcxwithcxhepatomegaly?cx-
x
answer--
cx
Livercxpalpablecx3cxcmcxbelowcxthecxrightcxcostalcxmargin,cxmidcxclavicularcxline,cxoncxexpiratio
n
Rationale:cxThecxlivercxbeingcxpalpablecx3cxcmcxbelowcxthecxrightcxcostalcxmargin,cxmidclavicul
arcxline,cxwouldcxbecxconsideredcxnormalcxoncxinspirationcxwhencxthecxlivercxiscxpushedcxdownc
xintocxthecxabdominalcxcavitycxoncxinspiration,cxbutcxiscxabnormalcxoncxexpiration.cxFindingscxto
cxsupportcxhepatomegalycxwouldcxbecxmorecxconvincingcxif,cxbycxpercussion,cxthecxlivercxspanc
xwascx>12cxcmcxatcxthecxmidclavicularcxline.cxForcxpatientscxwithcxobstructivecxlungcxdisease,cx
aircxtrappingcxincxthecxlungscxmaycxdisplacecxthecxlivercxdownwardscxintocxthecxabdominalcxcavi
ty.cxThecxlivercxspancxandcxdullnesscxtocxpercussioncxrefercxtocxthecxsamecxmeasurement.cxMe
asurementscxofcx6-12cxcmcxatcxthecxmid-clavicularcxlinecxandcx4-
8cxcmcxatcxthecxmidsternalcxlinecxarecxconsideredcxnormal.
CHAPTERcx19:cxAbdomen
Acx63-year-oldcxunderweightcxadministrativecxclerkcxwithcxacx50-pack-
yearcxsmokingcxhistorycxpresentscxwithcxacxseveralcxmonthcxhistorycxofcxrecurrentcxepigastriccx
abdominalcxdiscomfort.cxShecxfeelscxfairlycxwellcxotherwisecxandcxdeniescxanycxnausea,cxvomi
ting,cxdiarrhea,cxorcxconstipation.cxShecxreportscxthatcxacxfirstcxcousincxdiedcxfromcxacxrupturedc
xaneurysmcxatcxagecx68cxyears.cxHercxvitalcxsignscxarecxpulse,cx86;cxbloodcxpressure,cx148/92;c
xrespiratorycxrate,cx16;cxoxygencxsaturation,cx95%;cxandcxtemperature,cx36.2ºC.cxHercxbodycx
masscxindexcxiscx17.6.cxOncxexam,cxhercxabdominalcxaortacxiscxprominent,cxwhichcxiscxconcern
ingcxforcxancxabdominalcxaorticcxaneurysmcx(AAA).cxWhichcxofcxthecxfollowingcxiscxhercxmostcxsi
gnificantcxriskcxfactorcxforcxancxAAA?cx-cxanswer--Historycxofcxsmoking
Rationale:cxHistorycxofcxsmokingcxiscxhercxmostcxsignificantcxriskcxfactorcxforcxancxAAA.cxMalecx
gender,cxnotcxfemalecxgender,cxiscxconsideredcxascxriskcxfactor.cxUnderweightcxiscxnotcxacxriskcx
factorcxforcxAAA.cxFamilycxhistorycxofcxrupturedcxaneurysmcxiscxvaguecxandcxcouldcxbecxacxcere
bralcxaneurysm.cxFurther,cxhercxfamilycxhistorycxiscxincxacxfirst-degreecxcousincxnotcxacxfirst-
degreecxrelativecx(biologiccxparents,cxsiblings,cxandcxchildren).cxHypertensioncxcouldcxcontrib
utecxtocxatherosclerosis,cxwhichcxiscxacxriskcxfactor.cxFurther,cxacxdiagnosiscxofcxhypertensioncxi
scxnotcxbasedcxoncxonecxelevatedcxbloodcxpressurecxreading.
CHAPTERcx19:cxAbdomen
Acx76-year-
oldcxretiredcxmancxwithcxacxhistorycxofcxprostatecxcancercxandcxhypertensioncxhascxbeencxscree
nedcxannuallycxforcxcoloncxcancercxusingcxhighcxsensitivitycxfecalcxoccultcxbloodcxtestingcx(FO
BT).cxHecxpresentscxforcxfollow-
upcxofcxhiscxhypertension,cxduringcxwhichcxthecxcliniciancxscanscxhiscxchartcxtocxensurecxhecxiscx
upcxtocxdatecxwithcxhiscxpreventivecxhealthcxcare.cxHecxhascxacxpositivecxFOBTcxoncxonecxoccas
ioncxatcxagecx66cxyearscxandcxsubsequentlycxwentcxforcxacxcolonoscopy.cxInternalcxhemorrhoid
scxandcxsigmoidcxdiverticulicxwerecxfoundcxoncxcolonoscopy.cxHecxhascxnocxfirst-
degreecxrelativescxwithcxacxhistorycxofcxcolorectalcxcancercxorcxadenomatouscxpolyps.cxWhatcx
arecxthecxU.S.cxPreventivecxServicescxTaskcxForcecx(USPSTF)cxscreeningcxrecommendation
scxforcxthiscxpatient?cx-cxanswer--Docxnotcxscreencxroutinely
2
Copyrightcx©cx2022cxPearsoncxEducation,cx
Inc.
,https://browsegrades.net/singlePaper/416695/test-bank-for-marketing-management-16th-editi
Rationale:cxThecxUSPSTFcxrecommendscxnotcxscreeningcxroutinely.cxForcxmostcxadultscxage
scx76-
85cxyears,cxthecxgaincxincxlifecxyearscxiscxsmallcxcomparedcxtocxcolonoscopycxrisks.cxItcxiscxadvis
edcxtocxdiscusscxindividualizedcxriskscxandcxbenefitscxwithcxthecxpatient.cxAnnualcxFOBTcxscre
eningcxmaycxcontinuecxuntilcxagecx80-
85cxyearscxifcxbenefitscxtocxdoingcxsocxoutweighcxriskscxforcxthecxindividualcxpatient;cxhowever,cx
screeningcxshouldcxnotcxbecxroutinelycxcontinued.cxIncxgeneral,cxacxlifecxexpectancycx>7cxyear
scxiscxnecessarycxforcxscreeningcxtocxbecxpotentiallycxbeneficial.cxTherecxiscxnocxindicationcxtocx
repeatcxacxcolonoscopycxgivencxthecxabsencecxofcxanycxcancerouscxorcxprecancerouscxfinding
scxoncxhiscxcolonoscopycx10cxyearscxago.cxSigmoidoscopycxeverycx5cxyearscxwithcxFOBTcxeve
rycx3cxyearscxiscxacxvalidcxscreeningcxoption,cxbutcxagaincxscreeningcxiscxnotcxroutinelycxrecom
mendedcxforcxpatientscxagecx>75cxyears.
CHAPTERcx19:cxAbdomen
Ancxotherwisecxhealthycx31-year-
oldcxaccountantcxpresentscxtocxancxoutpatientcxcliniccxwithcxacx3-
yearcxhistorycxofcxrecurrentcxcrampycxabdominalcxpaincxthatcxlastscxforcxaboutcx1-
2cxweekscxeachcxepisodecxandcxiscxassociatedcxwithcxonsetcxofcxconstipation.cxShecxdescribes
cxinfrequent,cxsmallcxhardcxstoolcxthatcxshecxfindscxverycxdifficultcxtocxpass.cxShecxhascxtriedcxtocx
increasecxdietarycxfibercxandcxwatercxintake,cxbutcxusuallycxthiscxiscxnotcxsufficientcxandcxshecxr
esortscxtocxover-the-
countercxlaxatives,cxwhichcxshecxfindscxupsetcxhercxstomachcxbutcxdocxresolvecxthecxconstipati
on.cxSymptomscxtypicallycxgraduallycxresolvecxwithcxbowelcxmovements.cxWhichcxofcxthecxfoll
owingcxiscxthecxmostcxlikelycxphysiologicalcxmechanismcxforcxhercxconstipation?cx-cxanswer--
Functionalcxchangecxincxbowelcxmovement
Rationale:cxFunctionalcxchangecxincxbowelcxmovementcxiscxcharacteristiccxofcxirritablecxbowel
cxsyndromecx(IBS).cxIBScxiscxcharacterizedcxbycxthreecxpatterns:cxdiarrheacxpredominant,cxco
nstipationcxpredominant,cxorcxmixed.cxOthercxfunctionalcxcausescxforcxhercxconstipationcxshou
ldcxbecxexcludedcxpriorcxtocxmakingcxthiscxdiagnosis.cxAcxlargecxfirmcxfecalcxmasscxincxthecxrectu
mcxiscxcharacteristiccxofcxfecalcximpaction,cxwhichcxiscxcommoncxincxdebilitated,cxbedriddencxin
dividuals.cxDecreasedcxfecalcxbulkcxiscxcharacteristiccxofcxacxdietcxlowcxincxfiber.cxThiscxpatientcx
hadcxnotcxfoundcxthatcxincreasingcxfibercxhelpscxhercxconstipation.cxSpasmcxofcxthecxexternalcx
sphinctercxiscxassociatedcxwithcxpainfulcxanalcxlesions,cxwhichcxthiscxpatientcxdoescxnotcxreport
.cxImpairmentcxofcxautonomiccxinnervationscxiscxcharacteristiccxofcxpatientscxwithcxmultiplecxscl
erosis,cxspinalcxcordcxinjuries,cxandcxHirschsprungcxdisease.cxShecxhascxnocxknowncxdiagnosi
scxthatcxwouldcxincreasecxsuspicioncxofcxneurologicalcximpairment.
CHAPTERcx19:cxAbdomen
Acx23-year-oldcxwomancxcomescxtocxthecxrespirologycxcliniccxforcxfollow-
upcxofcxhercxchroniccxsinusitiscxandcxbronchiectasiscxthatcxiscxassociatedcxwithcxacxrarecxconge
nitalcxconditioncxcalledcxKartagenercxsyndrome.cxThecxpreceptorcxnotescxthatcxshecxhascxsitus
cxinversuscxandcxaskscxforcxacxphysicalcxexam.cxWhichcxofcxthecxfollowingcxdescriptionscxbestcxf
itscxwithcxfindingscxoncxthecxabdominalcxexam?cx-cxanswer--
Tympanycxtocxpercussioncxincxthecxrightcxuppercxquadrant,cxdullnesscxtocxpercussioncxofcxthecxl
eftcxuppercxquadrant
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, https://browsegrades.net/singlePaper/416695/test-bank-for-marketing-management-16th-editi
Rationale:cxSituscxinversuscxiscxacxrarecxconditioncxincxwhichcxorganscxarecxreversedcxandcxiscx
associatedcxwithcxKartagenercxsyndrome.cxThus,cxthecxstomachcxandcxgastriccxaircxbubblecxar
ecxoncxthecxrightcxandcxlivercxdullnesscxiscxoncxthecxleft.cxAcxprotuberantcxabdomencxwithcxscatte
redcxareascxofcxdullnesscxandcxtympanycxandcxstoolcxoncxpalpationcxiscxlikelycxconstipation.cxN
onecxofcxthesecxfindingscxsuggestcxorgancxreversal.cxLivercxdullnesscxwillcxoccurcxincxthecxleftcxu
ppercxquadrantcxwithcxorgancxreversal.cxFindingscxgivencxincxthecxremainingcxanswercxchoices
cxarecxbothcxassociatedcxwithcxsplenomegalycxwithcxthecxspleencxlocatedcxincxthecxleftcxuppercx
quadrant,cxwhichcxwouldcxnotcxbecxthecxcasecxforcxsinuscxinversuscxtotalis.
CHAPTERcx19:cxAbdomen
Ancxotherwisecxhealthycx28-year-
oldcxlawyercxpresentscxtocxthecxEmergencycxDepartmentcxwithcxacx1-
daycxhistorycxofcxseverecxabdominalcxpain.cxThecxemergencycxphysiciancxsuspectscxappendic
itiscxandcxgeneralcxsurgerycxiscxconsulted.cxThecxresidentcxbelievescxthecxpatientcxhascxsignscx
ofcxperitonitiscxoncxexam.cxWhichcxofcxthecxfollowingcxphysicalcxexamcxfindingscxsupportscxperi
tonitis?cx-cxanswer--
Pressingcxdowncxontocxthecxabdomencxfirmlycxandcxslowlycxandcxwithdrawingcxthecxhandcxquic
klycxproducescxpain
Rationale:cxPressingcxdowncxontocxthecxabdomencxfirmlycxandcxslowlycxandcxwithdrawingcxthe
cxhandcxquicklycxproducingcxpaincxdescribescxreboundcxtenderness,cxwhich,cxalongcxwithcxgua
rdingcxandcxrigidity,cxiscxsuggestivecxofcxperitonitis.cxInvoluntarycxcontractioncxrathercxthancxvo
luntarycxcontractioncxofcxthecxabdominalcxwallcxthatcxpersistscxovercxseveralcxexaminationscxd
escribescxrigidity.cxAbdominalcxpaincxthatcxincreasescxwithcxhipcxflexioncxiscxnotcxsuggestivecxo
fcxperitonitis.cxIncxfact,cxpatientscxwithcxperitonitiscxtendcxtocxkeepcxhipscxflexedcxtocxreducecxstr
etchcxandcxirritationcxofcxthecxparietalcxperitoneum.cxTheycxoftencxwalkcxbentcxforwardcxatcxthecx
hipscxforcxthiscxreason.cxLocalizedcxpaincxovercxMcBurneycxpointcxiscxcertainlycxsuggestivecxofc
xappendicitis,cxbutcxnotcxsuggestivecxofcxperitonitis.cxSimilarlycxpaincxwithcxinternalcxrotationcxo
fcxthecxrightcxhip,cxorcxacxpositivecxobturatorcxsign,cxsuggestscxirritationcxofcxthecxpsoascxmuscle
cxduecxtocxancxinflamedcxappendix,cxbutcxnotcxperitonitis.
CHAPTERcx19:cxAbdomen
Acx58-year-
oldcxmancxwithcxacxhistorycxofcxdiabetescxandcxalcoholcxaddictioncxhascxbeencxsobercxforcxthecxl
astcx10cxmonths.cxHecxpresentscxwithcxacx4-
monthcxhistorycxofcxincreasingcxweakness,cxrecurrentcxepigastriccxpaincxradiatingcxtocxhiscxba
ck,cxchroniccxdiarrheacxwithcxstoolscx6-
8cxtimescxdaily,cxandcxweightcxlosscxofcx18cxlbcxovercx4cxmonths.cxWhatcxiscxthecxmechanismcxof
cxhiscxmostcxlikelycxdiagnosis?cx-cxanswer--Fibrosiscxofcxthecxpancreas
Rationale:cxFibrosiscxofcxthecxpancreascxiscxassociatedcxwithcxchroniccxpancreatitis.cxChronicc
xpancreatitiscxleadscxtocxfibrosiscxandcxdecreasedcxpancreaticcxfunction,cxwhichcxcausescxdiar
rheacxfromcxpancreaticcxenzymecxinsufficiencycxandcxdiabetescxmellitus.cxH.cxpyloricxinfection
cxmaycxcausecxpepticcxulcercxdiseasecxandcxdyspepsia,cxwhichcxiscxnotcxusuallycxassociatedcx
withcxdiarrhea.cxInflammationcxofcxthecxcoloniccxdiverticulumcxiscxdiverticulitiscxandcxtypicallycx
causescxleft-lower-
quadrantcxpain,cxfever,cxconstipation,cxandcxsometimescxdiarrhea.cxItcxiscxtypicallycxancxacutec
xdisease.cxReducedcxbloodcxsupplycxtocxthecxbowelcxcharacterizescxmesentericcxischemia.cxItc
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