Advanced physical assessment -Final
examination questions with correct answers
A |37-year-old |nurse |comes |for |evaluation |of |colicky |right |upper |quadrant |abdominal |pain. |The |
pain |is |associated |with |nausea |and |vomiting |and |occurs |1 |to |2 |hours |after |eating |greasy |foods.
|Which |one |of |the |following |physical |examination |descriptions |would |be |most |consistent |with |
the |diagnosis |of |cholecystitis?
A) |Abdomen |is |soft, |nontender, |and |nondistended, |without |hepatosplenomegaly |or |masses.
B) |Abdomen |is |soft |and |tender |to |palpation |in |the |right |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. |- |CORRECT |ANSWER✔✔-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.
When |crackles, |wheezes, |or |rhonchi |clear |with |a |cough, |which |of |the |following |is |a |likely |
etiology?
A) |Bronchitis
B) |Simple |asthma
C) |Cystic |fibrosis
D) |Heart |failure |- |CORRECT |ANSWER✔✔-A. |Bronchitis
A |patient |with |longstanding |COPD |was |told |by |another |practitioner |that |his |liver |was |enlarged |
and |this |needed |to |be |assessed. |Which |of |the |following |would |be |reasonable |to |do |next?
,A) |Percuss |the |lower |border |of |the |liver
B) |Measure |the |span |of |the |liver
C) |Order |a |hepatitis |panel
D) |Obtain |an |ultrasound |of |the |liver |- |CORRECT |ANSWER✔✔-A) |Percuss |the |lower |border |of |
the |liver
Mr. |Patel |is |a |64-year-old |man |who |was |told |by |another |care |provider |that |his |liver |is |
enlarged. |Although |he |is |a |life-long |smoker, |he |has |never |used |drugs |or |alcohol |and |has |no |
knowledge |of |liver |disease. |Indeed, |on |examination, |a |liver |edge |is |palpable |4 |centimeters |
below |the |costal |arch. |Which |of |the |following |would |you |do |next? |
A) |Check |an |ultrasound |of |the |liver
B) |Obtain |a |hepatitis |panel
C) |Determine |liver |span |by |percussion
D) |Adopt |a |"watchful |waiting" |approach |- |CORRECT |ANSWER✔✔-c. |Determine |liver |span |by |
percussion
You |are |palpating |the |abdomen |and |feel |a |small |mass. |Which |of |the |following |would |you |do |
next? |
A) |Ultrasound
B) |Examination |with |the |abdominal |muscles |tensed
C) |Surgery |referral
D) |Determine |size |by |percussion |- |CORRECT |ANSWER✔✔-B) |Examination |with |the |abdominal |
muscles |tensed
,Mr. |Kruger |is |an |84-year-old |man |who |presents |with |a |smooth |lower |abdominal |mass |in |the |
midline |which |is |minimally |tender. |There |is |dullness |to |percussion |up |to |6 |centimeters |above |
the |symphysis |pubis. |What |does |this |most |likely |represent?
A) |Sigmoid |mass
B) |Tumor |in |the |abdominal |wall
C) |Hernia
D) |Enlarged |bladder |- |CORRECT |ANSWER✔✔-D) |Enlarged |bladder
Which |of |the |following |is |consistent |with |obturator |sign?
A) |Pain |distant |from |the |site |used |to |check |rebound |tenderness
B) |Right |hypogastric |pain |with |the |right |hip |and |knee |flexed |and |the |hip |internally |rotated
C) |Pain |with |extension |of |the |right |thigh |while |the |patient |is |on |her |left |side |or |while |pressing |
her |knee |against |your |hand |with |thigh |flexion
D) |Pain |that |stops |inhalation |in |the |right |upper |quadrant |- |CORRECT |ANSWER✔✔-B) |Right |
hypogastric |pain |with |the |right |hip |and |knee |flexed |and |the |hip |internally |rotated
A |57-year-old |maintenance |worker |comes |to |your |office |for |evaluation |of |pain |in |his |legs. |He |
has |smoked |two |packs |per |day |since |the |age |of |16, |but |he |is |otherwise |healthy. |You |are |
concerned |that |he |may |have |peripheral |vascular |disease. |Which |of |the |following |is |part |of |
common |or |concerning |symptoms |for |the |peripheral |vascular |system?
A) |Intermittent |claudication
B) |Chest |pressure |with |exertion
C) |Shortness |of |breath
D) |Knee |pain |- |CORRECT |ANSWER✔✔-A) |Intermittent |claudication
, You |are |a |student |in |the |vascular |surgery |clinic. |You |are |asked |to |perform |a |physical |
examination |on |a |patient |with |known |peripheral |vascular |disease |in |the |legs. |Which |of |the |
following |aspects |is |important |to |note |when |you |perform |your |examination?
A) |Size, |symmetry, |and |skin |color
B) |Muscle |bulk |and |tone
C) |Nodules |in |joints
D) |Lower |extremity |strength |- |CORRECT |ANSWER✔✔-A) |Size, |symmetry, |and |skin |color
As |the |internal |diameter |of |a |blood |vessel |changes, |the |resistance |changes |as |well. |Which |of |
the |following |descriptions |depicts |this |relationship?
A) |Resistance |varies |linearly |with |the |diameter.
B) |Resistance |varies |proportionally |to |the |second |power |of |the |diameter.
C) |Resistance |varies |proportionally |to |the |third |power |of |the |diameter.
D) |Resistance |varies |proportionally |to |the |fourth |power |of |the |diameter. |- |CORRECT |
ANSWER✔✔-D) |Resistance |varies |proportionally |to |the |fourth |power |of |the |diameter.
A |32-year-old |warehouse |worker |presents |for |evaluation |of |low |back |pain. |He |notes |a |sudden |
onset |of |pain |after |lifting |a |set |of |boxes |that |were |heavier |than |usual. |He |also |states |that |he |
has |numbness |and |tingling |in |the |left |leg. |He |wants |to |know |if |he |needs |to |be |off |of |work. |
What |test |should |you |perform |to |assess |for |a |herniated |disc?
A) |Leg-length |test
B) |Straight-leg |raise
C) |Tinel's |test
D) |Phalen's |test |- |CORRECT |ANSWER✔✔-B) |Straight-leg |raise
examination questions with correct answers
A |37-year-old |nurse |comes |for |evaluation |of |colicky |right |upper |quadrant |abdominal |pain. |The |
pain |is |associated |with |nausea |and |vomiting |and |occurs |1 |to |2 |hours |after |eating |greasy |foods.
|Which |one |of |the |following |physical |examination |descriptions |would |be |most |consistent |with |
the |diagnosis |of |cholecystitis?
A) |Abdomen |is |soft, |nontender, |and |nondistended, |without |hepatosplenomegaly |or |masses.
B) |Abdomen |is |soft |and |tender |to |palpation |in |the |right |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. |- |CORRECT |ANSWER✔✔-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.
When |crackles, |wheezes, |or |rhonchi |clear |with |a |cough, |which |of |the |following |is |a |likely |
etiology?
A) |Bronchitis
B) |Simple |asthma
C) |Cystic |fibrosis
D) |Heart |failure |- |CORRECT |ANSWER✔✔-A. |Bronchitis
A |patient |with |longstanding |COPD |was |told |by |another |practitioner |that |his |liver |was |enlarged |
and |this |needed |to |be |assessed. |Which |of |the |following |would |be |reasonable |to |do |next?
,A) |Percuss |the |lower |border |of |the |liver
B) |Measure |the |span |of |the |liver
C) |Order |a |hepatitis |panel
D) |Obtain |an |ultrasound |of |the |liver |- |CORRECT |ANSWER✔✔-A) |Percuss |the |lower |border |of |
the |liver
Mr. |Patel |is |a |64-year-old |man |who |was |told |by |another |care |provider |that |his |liver |is |
enlarged. |Although |he |is |a |life-long |smoker, |he |has |never |used |drugs |or |alcohol |and |has |no |
knowledge |of |liver |disease. |Indeed, |on |examination, |a |liver |edge |is |palpable |4 |centimeters |
below |the |costal |arch. |Which |of |the |following |would |you |do |next? |
A) |Check |an |ultrasound |of |the |liver
B) |Obtain |a |hepatitis |panel
C) |Determine |liver |span |by |percussion
D) |Adopt |a |"watchful |waiting" |approach |- |CORRECT |ANSWER✔✔-c. |Determine |liver |span |by |
percussion
You |are |palpating |the |abdomen |and |feel |a |small |mass. |Which |of |the |following |would |you |do |
next? |
A) |Ultrasound
B) |Examination |with |the |abdominal |muscles |tensed
C) |Surgery |referral
D) |Determine |size |by |percussion |- |CORRECT |ANSWER✔✔-B) |Examination |with |the |abdominal |
muscles |tensed
,Mr. |Kruger |is |an |84-year-old |man |who |presents |with |a |smooth |lower |abdominal |mass |in |the |
midline |which |is |minimally |tender. |There |is |dullness |to |percussion |up |to |6 |centimeters |above |
the |symphysis |pubis. |What |does |this |most |likely |represent?
A) |Sigmoid |mass
B) |Tumor |in |the |abdominal |wall
C) |Hernia
D) |Enlarged |bladder |- |CORRECT |ANSWER✔✔-D) |Enlarged |bladder
Which |of |the |following |is |consistent |with |obturator |sign?
A) |Pain |distant |from |the |site |used |to |check |rebound |tenderness
B) |Right |hypogastric |pain |with |the |right |hip |and |knee |flexed |and |the |hip |internally |rotated
C) |Pain |with |extension |of |the |right |thigh |while |the |patient |is |on |her |left |side |or |while |pressing |
her |knee |against |your |hand |with |thigh |flexion
D) |Pain |that |stops |inhalation |in |the |right |upper |quadrant |- |CORRECT |ANSWER✔✔-B) |Right |
hypogastric |pain |with |the |right |hip |and |knee |flexed |and |the |hip |internally |rotated
A |57-year-old |maintenance |worker |comes |to |your |office |for |evaluation |of |pain |in |his |legs. |He |
has |smoked |two |packs |per |day |since |the |age |of |16, |but |he |is |otherwise |healthy. |You |are |
concerned |that |he |may |have |peripheral |vascular |disease. |Which |of |the |following |is |part |of |
common |or |concerning |symptoms |for |the |peripheral |vascular |system?
A) |Intermittent |claudication
B) |Chest |pressure |with |exertion
C) |Shortness |of |breath
D) |Knee |pain |- |CORRECT |ANSWER✔✔-A) |Intermittent |claudication
, You |are |a |student |in |the |vascular |surgery |clinic. |You |are |asked |to |perform |a |physical |
examination |on |a |patient |with |known |peripheral |vascular |disease |in |the |legs. |Which |of |the |
following |aspects |is |important |to |note |when |you |perform |your |examination?
A) |Size, |symmetry, |and |skin |color
B) |Muscle |bulk |and |tone
C) |Nodules |in |joints
D) |Lower |extremity |strength |- |CORRECT |ANSWER✔✔-A) |Size, |symmetry, |and |skin |color
As |the |internal |diameter |of |a |blood |vessel |changes, |the |resistance |changes |as |well. |Which |of |
the |following |descriptions |depicts |this |relationship?
A) |Resistance |varies |linearly |with |the |diameter.
B) |Resistance |varies |proportionally |to |the |second |power |of |the |diameter.
C) |Resistance |varies |proportionally |to |the |third |power |of |the |diameter.
D) |Resistance |varies |proportionally |to |the |fourth |power |of |the |diameter. |- |CORRECT |
ANSWER✔✔-D) |Resistance |varies |proportionally |to |the |fourth |power |of |the |diameter.
A |32-year-old |warehouse |worker |presents |for |evaluation |of |low |back |pain. |He |notes |a |sudden |
onset |of |pain |after |lifting |a |set |of |boxes |that |were |heavier |than |usual. |He |also |states |that |he |
has |numbness |and |tingling |in |the |left |leg. |He |wants |to |know |if |he |needs |to |be |off |of |work. |
What |test |should |you |perform |to |assess |for |a |herniated |disc?
A) |Leg-length |test
B) |Straight-leg |raise
C) |Tinel's |test
D) |Phalen's |test |- |CORRECT |ANSWER✔✔-B) |Straight-leg |raise
