CLINICAL ASSESSMENT EXAM PRACTICE QUESTIONS AND CORRECT
ANSWERS| A+ GRADED |GUARANTEED PASS!!
1) A 25-year-old optical technician comes to your clinic for evaluation of fatigue. As part of your
physical examination, you listen to her heart and hear a murmur only at the cardiac apex. Which
valve is most likely to be involved, based on the location of the murmur?
A) Mitral
B) Tricuspid
C) Aortic
D) Pulmonic - ANSWER A
Chapter: 09
Page and Header: 323, Anatomy and Physiology
Feedback: Mitral valve sounds are usually heard best at and around the cardiac apex.
2) A 58-year-old teacher presents to your clinic with a complaint of breathlessness with activity.
The patient has no chronic conditions and does not take any medications, herbs, or
supplements. Which of the following symptoms is appropriate to ask about in the cardiovascular
review of systems?
A) Abdominal pain
B) Orthopnea
C) Hematochezia
D) Tenesmus - ANSWER B
Chapter: 09
Page and Header: 337, The Health History
Feedback: Orthopnea, which is dyspnea that occurs when the patient is lying down and
improves when the patient sits up, is part of the cardiovascular review of systems and, if
positive, may indicate congestive heart failure.
3) You are screening people at the mall as part of a health fair. The first person who comes for
screening has a blood pressure of 132/85. How would you categorize this?
A) Normal
B) Prehypertension
C) Stage 1 hypertension
D) Stage 2 hypertension - ANSWER B
Chapter: 09
Page and Header: 339, Health Promotion and Counseling
Feedback: Prehypertension is considered to be a systolic blood pressure from 120 to 139 and a
diastolic BP from 80 to 89. Previously, this was considered normal. JNC 7 recommends taking
action at this point to prevent worsening hypertension. Research shows that this population is
likely to progress to more serious stages of hypertension.
,4) You are participating in a health fair and performing cholesterol screens. One person has a
cholesterol of 225. She is concerned about her risk for developing heart disease. Which of the
following factors is used to estimate the 10-year risk of developing coronary heart disease? A)
Ethnicity
B) Alcohol intake C) Gender
D) Asthma - ANSWER C
Chapter: 09
Page and Header: 339, Health Promotion and Counseling
Feedback: Gender is used in the calculation of the 10-year risk for developing coronary heart
disease, because men have a higher risk than women.
5) You are evaluating a 40-year-old banker for coronary heart disease risk factors. He has a history
of hypertension, which is well-controlled on his current medications. He does not smoke; he
does 45 minutes of aerobic exercise five times weekly. You are calculating his 10-year coronary
heart disease risk. Which of the following conditions is considered to be a coronary heart disease
risk equivalent?
A) Hypertension
B) Peripheral arterial disease
C) Systemic lupus erythematosus
D) Chronic obstructive pulmonary disease (COPD) - ANSWER B
Chapter: 09
Page and Header: 339, Health Promotion and Counseling
Feedback: Peripheral arterial disease is considered to be a coronary heart disease risk
equivalent, as are abdominal aortic aneurysm, carotid atherosclerotic disease, and diabetes
mellitus.
6) You are conducting a workshop on the measurement of jugular venous pulsation. As part of your
instruction, you tell the students to make sure that they can distinguish between the jugular
venous pulsation and the carotid pulse. Which one of the following characteristics is typical of
the carotid pulse?
A) Palpable
B) Soft, rapid, undulating quality
C) Pulsation eliminated by light pressure on the vessel
D) Level of pulsation changes with changes in position - ANSWER A
Chapter: 09
Page and Header: 348, Techniques of Examination
Feedback: The carotid pulse is palpable; the jugular venous pulsation is rarely palpable. The
carotid upstroke is normally brisk, but it may be delayed and decreased as in aortic stenosis or
bounding as in aortic insufficiency.
,7) A 68-year-old mechanic presents to the emergency room for shortness of breath. You are
concerned about a cardiac cause and measure his jugular venous pressure (JVP). It is elevated.
Which one of the following conditions is a potential cause of elevated JVP?
A) Left-sided heart failure
B) Mitral stenosis
C) Constrictive pericarditis
D) Aortic aneurysm - ANSWER C
Chapter: 09
Page and Header: 348, Techniques of Examination
Feedback: One cause of increased jugular venous pressure is constrictive pericarditis. Others
include right-sided heart failure, tricuspid stenosis, and superior vena cava syndrome. You may
wish to read about these conditions.
8) You are palpating the apical impulse in a patient with heart disease and find that the amplitude
is diffuse and increased. Which of the following conditions could be a potential cause of an
increase in the amplitude of the impulse?
A) Hypothyroidism
B) Aortic stenosis, with pressure overload of the left ventricle
C) Mitral stenosis, with volume overload of the left atrium
D) Cardiomyopathy - ANSWER B
Chapter: 09
Page and Header: 348, Techniques of Examination
Feedback: Pressure overload of the left ventricle, such as occurs in aortic stenosis, may result in
an increase in amplitude of the apical impulse. The other conditions should decrease amplitude
of the apical impulse or not be palpable at all.
9) A 36-year-old married bank teller comes to your office, complaining of pain with defecation and
occasional blood on the toilet paper. She states that last week she had food poisoning with
nausea, vomiting, and diarrhea. She had runny stools but no black or bloody stools. Ever since
her illness, she has continued to have severe pain with bowel movements. She now tries to put
off defecation as long as possible. Although she is having constipation she denies any further
diarrhea or leakage of stool. She has a past medical history of hypothyroidism and two
spontaneous vaginal deliveries. She has had no other chronic illnesses or surgeries. She does not
smoke and rarely drinks. She has two children. There is no family history of breast or colon
cancer. She has had no weight gain, weight loss, fever, or night sweats. On examination she is
afebrile, with a blood pressure of 115/70 and a pulse of 80. On abdominal examination -
ANSWER C) Anal fissure
10) Anal fissures often occur after severe diarrhea or constipation. They cause bright blood on the
toilet paper and are extremely painful during defecation. A small ulceration or fissure is
observed proximal to the anus.
, 11) A 22-year-old architecture major comes to your office, complaining of severe burning with
urination, a fever of 101 degrees, and aching all over. She denies any upper respiratory,
gastrointestinal, cardiac, or pulmonary symptoms. Her past medical history consists of severe
acne. She is currently on an oral contraceptive. She has had no pregnancies or surgeries. She
reports one new partner within the last month. She does not smoke but does drink occasionally.
Her parents are both in good health. On examination you see a young woman appearing slightly
ill. Her temperature is 100.3 and her pulse and blood pressure are unremarkable. Her head, ears,
eyes, nose, throat, cardiac, pulmonary, and abdominal examinations are unremarkable.
Palpation of the inguinal nodes shows lymphadenopathy bilaterally. On visualization of the
perineum there are more than 10 shallow ulcers along each side of the vulva. Speculum and
bimanual ex - ANSWER A) Genital herpes
Genital herpes consists of small, shallow, painful ulcers. Primary infections are often associated with
fever, malaise, and regional lymphadenopathy. The outbreak occurs generally between 1 and 3 weeks
after exposure. Herpes is contagious and the majority of transmission occurs without the presence of
obvious lesions. Transmission during passage through the birth canal can cause serious illness in affected
newborns.
12) A 42-year-old realtor comes to your clinic, complaining of "growths" in her vulvar area. She is
currently undergoing a divorce and is convinced she has a sexually transmitted disease. She
denies any vaginal discharge or pain with urination. She has had no fever, malaise, or night sweats.
Her past medical history consists of depression and hypothyroidism. She has had two spontaneous
vaginal deliveries and one cesarean section. She has had no other surgeries. She denies smoking or
drug use. She has two to three drinks weekly. Her mother also has hypothyroidism and her father
has high blood pressure and hypercholesterolemia. On examination you see a woman who is anxious
but appears otherwise healthy. Her blood pressure, pulse, and temperature are unremarkable. On
visualization of the perineum you see two 2- to 3- mm, round, yellow nodules on the left labia. On
palpation they are nontender and quite firm. What diagnosis - ANSWER D) Epidermoid cyst
These cysts are small, firm, round cystic nodules in the labia that are nonpainful. These do not
represent a sexually transmitted infection, but rather a blocked sebaceous gland.
13) A 30-year-old paralegal analyst comes to your clinic, complaining of a bad-smelling vaginal
discharge with some mild itching, present for about 3 weeks. She tried douching but it did not
help. She has had no pain with urination or with sexual intercourse. She has noticed the smell
increased after intercourse and during her period last week. She denies any upper respiratory,
gastrointestinal, cardiac, or pulmonary symptoms. Her past medical history consists of one
spontaneous vaginal delivery. She is married and has one child. She denies tobacco, alcohol, or
ANSWERS| A+ GRADED |GUARANTEED PASS!!
1) A 25-year-old optical technician comes to your clinic for evaluation of fatigue. As part of your
physical examination, you listen to her heart and hear a murmur only at the cardiac apex. Which
valve is most likely to be involved, based on the location of the murmur?
A) Mitral
B) Tricuspid
C) Aortic
D) Pulmonic - ANSWER A
Chapter: 09
Page and Header: 323, Anatomy and Physiology
Feedback: Mitral valve sounds are usually heard best at and around the cardiac apex.
2) A 58-year-old teacher presents to your clinic with a complaint of breathlessness with activity.
The patient has no chronic conditions and does not take any medications, herbs, or
supplements. Which of the following symptoms is appropriate to ask about in the cardiovascular
review of systems?
A) Abdominal pain
B) Orthopnea
C) Hematochezia
D) Tenesmus - ANSWER B
Chapter: 09
Page and Header: 337, The Health History
Feedback: Orthopnea, which is dyspnea that occurs when the patient is lying down and
improves when the patient sits up, is part of the cardiovascular review of systems and, if
positive, may indicate congestive heart failure.
3) You are screening people at the mall as part of a health fair. The first person who comes for
screening has a blood pressure of 132/85. How would you categorize this?
A) Normal
B) Prehypertension
C) Stage 1 hypertension
D) Stage 2 hypertension - ANSWER B
Chapter: 09
Page and Header: 339, Health Promotion and Counseling
Feedback: Prehypertension is considered to be a systolic blood pressure from 120 to 139 and a
diastolic BP from 80 to 89. Previously, this was considered normal. JNC 7 recommends taking
action at this point to prevent worsening hypertension. Research shows that this population is
likely to progress to more serious stages of hypertension.
,4) You are participating in a health fair and performing cholesterol screens. One person has a
cholesterol of 225. She is concerned about her risk for developing heart disease. Which of the
following factors is used to estimate the 10-year risk of developing coronary heart disease? A)
Ethnicity
B) Alcohol intake C) Gender
D) Asthma - ANSWER C
Chapter: 09
Page and Header: 339, Health Promotion and Counseling
Feedback: Gender is used in the calculation of the 10-year risk for developing coronary heart
disease, because men have a higher risk than women.
5) You are evaluating a 40-year-old banker for coronary heart disease risk factors. He has a history
of hypertension, which is well-controlled on his current medications. He does not smoke; he
does 45 minutes of aerobic exercise five times weekly. You are calculating his 10-year coronary
heart disease risk. Which of the following conditions is considered to be a coronary heart disease
risk equivalent?
A) Hypertension
B) Peripheral arterial disease
C) Systemic lupus erythematosus
D) Chronic obstructive pulmonary disease (COPD) - ANSWER B
Chapter: 09
Page and Header: 339, Health Promotion and Counseling
Feedback: Peripheral arterial disease is considered to be a coronary heart disease risk
equivalent, as are abdominal aortic aneurysm, carotid atherosclerotic disease, and diabetes
mellitus.
6) You are conducting a workshop on the measurement of jugular venous pulsation. As part of your
instruction, you tell the students to make sure that they can distinguish between the jugular
venous pulsation and the carotid pulse. Which one of the following characteristics is typical of
the carotid pulse?
A) Palpable
B) Soft, rapid, undulating quality
C) Pulsation eliminated by light pressure on the vessel
D) Level of pulsation changes with changes in position - ANSWER A
Chapter: 09
Page and Header: 348, Techniques of Examination
Feedback: The carotid pulse is palpable; the jugular venous pulsation is rarely palpable. The
carotid upstroke is normally brisk, but it may be delayed and decreased as in aortic stenosis or
bounding as in aortic insufficiency.
,7) A 68-year-old mechanic presents to the emergency room for shortness of breath. You are
concerned about a cardiac cause and measure his jugular venous pressure (JVP). It is elevated.
Which one of the following conditions is a potential cause of elevated JVP?
A) Left-sided heart failure
B) Mitral stenosis
C) Constrictive pericarditis
D) Aortic aneurysm - ANSWER C
Chapter: 09
Page and Header: 348, Techniques of Examination
Feedback: One cause of increased jugular venous pressure is constrictive pericarditis. Others
include right-sided heart failure, tricuspid stenosis, and superior vena cava syndrome. You may
wish to read about these conditions.
8) You are palpating the apical impulse in a patient with heart disease and find that the amplitude
is diffuse and increased. Which of the following conditions could be a potential cause of an
increase in the amplitude of the impulse?
A) Hypothyroidism
B) Aortic stenosis, with pressure overload of the left ventricle
C) Mitral stenosis, with volume overload of the left atrium
D) Cardiomyopathy - ANSWER B
Chapter: 09
Page and Header: 348, Techniques of Examination
Feedback: Pressure overload of the left ventricle, such as occurs in aortic stenosis, may result in
an increase in amplitude of the apical impulse. The other conditions should decrease amplitude
of the apical impulse or not be palpable at all.
9) A 36-year-old married bank teller comes to your office, complaining of pain with defecation and
occasional blood on the toilet paper. She states that last week she had food poisoning with
nausea, vomiting, and diarrhea. She had runny stools but no black or bloody stools. Ever since
her illness, she has continued to have severe pain with bowel movements. She now tries to put
off defecation as long as possible. Although she is having constipation she denies any further
diarrhea or leakage of stool. She has a past medical history of hypothyroidism and two
spontaneous vaginal deliveries. She has had no other chronic illnesses or surgeries. She does not
smoke and rarely drinks. She has two children. There is no family history of breast or colon
cancer. She has had no weight gain, weight loss, fever, or night sweats. On examination she is
afebrile, with a blood pressure of 115/70 and a pulse of 80. On abdominal examination -
ANSWER C) Anal fissure
10) Anal fissures often occur after severe diarrhea or constipation. They cause bright blood on the
toilet paper and are extremely painful during defecation. A small ulceration or fissure is
observed proximal to the anus.
, 11) A 22-year-old architecture major comes to your office, complaining of severe burning with
urination, a fever of 101 degrees, and aching all over. She denies any upper respiratory,
gastrointestinal, cardiac, or pulmonary symptoms. Her past medical history consists of severe
acne. She is currently on an oral contraceptive. She has had no pregnancies or surgeries. She
reports one new partner within the last month. She does not smoke but does drink occasionally.
Her parents are both in good health. On examination you see a young woman appearing slightly
ill. Her temperature is 100.3 and her pulse and blood pressure are unremarkable. Her head, ears,
eyes, nose, throat, cardiac, pulmonary, and abdominal examinations are unremarkable.
Palpation of the inguinal nodes shows lymphadenopathy bilaterally. On visualization of the
perineum there are more than 10 shallow ulcers along each side of the vulva. Speculum and
bimanual ex - ANSWER A) Genital herpes
Genital herpes consists of small, shallow, painful ulcers. Primary infections are often associated with
fever, malaise, and regional lymphadenopathy. The outbreak occurs generally between 1 and 3 weeks
after exposure. Herpes is contagious and the majority of transmission occurs without the presence of
obvious lesions. Transmission during passage through the birth canal can cause serious illness in affected
newborns.
12) A 42-year-old realtor comes to your clinic, complaining of "growths" in her vulvar area. She is
currently undergoing a divorce and is convinced she has a sexually transmitted disease. She
denies any vaginal discharge or pain with urination. She has had no fever, malaise, or night sweats.
Her past medical history consists of depression and hypothyroidism. She has had two spontaneous
vaginal deliveries and one cesarean section. She has had no other surgeries. She denies smoking or
drug use. She has two to three drinks weekly. Her mother also has hypothyroidism and her father
has high blood pressure and hypercholesterolemia. On examination you see a woman who is anxious
but appears otherwise healthy. Her blood pressure, pulse, and temperature are unremarkable. On
visualization of the perineum you see two 2- to 3- mm, round, yellow nodules on the left labia. On
palpation they are nontender and quite firm. What diagnosis - ANSWER D) Epidermoid cyst
These cysts are small, firm, round cystic nodules in the labia that are nonpainful. These do not
represent a sexually transmitted infection, but rather a blocked sebaceous gland.
13) A 30-year-old paralegal analyst comes to your clinic, complaining of a bad-smelling vaginal
discharge with some mild itching, present for about 3 weeks. She tried douching but it did not
help. She has had no pain with urination or with sexual intercourse. She has noticed the smell
increased after intercourse and during her period last week. She denies any upper respiratory,
gastrointestinal, cardiac, or pulmonary symptoms. Her past medical history consists of one
spontaneous vaginal delivery. She is married and has one child. She denies tobacco, alcohol, or
