ADVANCED HEALTH ASSESSMENT
AND CLINICAL DIAGNOSIS IN
PRIMARY CARE - 14TH EDITION TEST
BANK QUESTIONS AND ANSWERS
1. A 28-year-old patient presents with a sore throat, fever of 102.5°F, and anterior cervical
lymphadenopathy. She denies having a cough. According to the Modified Centor Criteria,
what is the most appropriate next step?
A. Perform a Rapid Antigen Detection Test (RADT) or throat culture.
B. Prescribe empiric antibiotics without testing.
C. Reassure the patient that the cause is likely viral and provide supportive care.
D. Order a monospot test to rule out infectious mononucleosis.
Answer: A
Conceptual Explanation: The Modified Centor Criteria score for this patient is 3 (fever, no
cough, cervical nodes). A score of 2 or 3 warrants testing for Group A Strep via RADT or
culture before initiating antibiotics.
,2. When auscultating the heart, the clinician notes a low-pitched, rumbling diastolic murmur
heard best at the apex with the bell of the stethoscope. Which condition is most likely?
A. Mitral stenosis
B. Aortic regurgitation
C. Mitral regurgitation
D. Aortic stenosis
Answer: A
Conceptual Explanation: Mitral stenosis typically presents as a low-pitched diastolic
rumble heard best at the apex in the left lateral decubitus position.
3. A 65-year-old male with a long history of smoking presents with increased dyspnea and a
productive cough. On examination, he has a barrel chest and decreased breath sounds. Which
PFT result would support a diagnosis of COPD?
A. FEV1/FVC ratio > 0.70
B. FEV1/FVC ratio < 0.70
C. Increased FEV1 after bronchodilator use
D. Normal Total Lung Capacity
Answer: B
Conceptual Explanation: A post-bronchodilator FEV1/FVC ratio of less than 0.70 is the
gold standard for diagnosing airflow obstruction consistent with COPD.
, 4. During a physical exam, a clinician performs the Lachman test on a patient’s knee. A
‘mushy’ or soft end-point is indicative of an injury to which structure?
A. Medial collateral ligament (MCL)
B. Posterior cruciate ligament (PCL)
C. Medial meniscus
D. Anterior cruciate ligament (ACL)
Answer: D
Conceptual Explanation: The Lachman test is the most sensitive clinical test for detecting
an ACL tear; a soft or absent end-point indicates ligament laxity or rupture.
5. A patient presents with sudden onset of severe eye pain, blurred vision, and seeing ‘halos’
around lights. The pupil is mid-dilated and non-reactive. What is the most likely diagnosis?
A. Open-angle glaucoma
B. Acute angle-closure glaucoma
C. Uveitis
D. Corneal abrasion
Answer: B
Conceptual Explanation: Acute angle-closure glaucoma is a medical emergency
characterized by sudden pain, visual disturbances (halos), and a fixed, mid-dilated pupil.
AND CLINICAL DIAGNOSIS IN
PRIMARY CARE - 14TH EDITION TEST
BANK QUESTIONS AND ANSWERS
1. A 28-year-old patient presents with a sore throat, fever of 102.5°F, and anterior cervical
lymphadenopathy. She denies having a cough. According to the Modified Centor Criteria,
what is the most appropriate next step?
A. Perform a Rapid Antigen Detection Test (RADT) or throat culture.
B. Prescribe empiric antibiotics without testing.
C. Reassure the patient that the cause is likely viral and provide supportive care.
D. Order a monospot test to rule out infectious mononucleosis.
Answer: A
Conceptual Explanation: The Modified Centor Criteria score for this patient is 3 (fever, no
cough, cervical nodes). A score of 2 or 3 warrants testing for Group A Strep via RADT or
culture before initiating antibiotics.
,2. When auscultating the heart, the clinician notes a low-pitched, rumbling diastolic murmur
heard best at the apex with the bell of the stethoscope. Which condition is most likely?
A. Mitral stenosis
B. Aortic regurgitation
C. Mitral regurgitation
D. Aortic stenosis
Answer: A
Conceptual Explanation: Mitral stenosis typically presents as a low-pitched diastolic
rumble heard best at the apex in the left lateral decubitus position.
3. A 65-year-old male with a long history of smoking presents with increased dyspnea and a
productive cough. On examination, he has a barrel chest and decreased breath sounds. Which
PFT result would support a diagnosis of COPD?
A. FEV1/FVC ratio > 0.70
B. FEV1/FVC ratio < 0.70
C. Increased FEV1 after bronchodilator use
D. Normal Total Lung Capacity
Answer: B
Conceptual Explanation: A post-bronchodilator FEV1/FVC ratio of less than 0.70 is the
gold standard for diagnosing airflow obstruction consistent with COPD.
, 4. During a physical exam, a clinician performs the Lachman test on a patient’s knee. A
‘mushy’ or soft end-point is indicative of an injury to which structure?
A. Medial collateral ligament (MCL)
B. Posterior cruciate ligament (PCL)
C. Medial meniscus
D. Anterior cruciate ligament (ACL)
Answer: D
Conceptual Explanation: The Lachman test is the most sensitive clinical test for detecting
an ACL tear; a soft or absent end-point indicates ligament laxity or rupture.
5. A patient presents with sudden onset of severe eye pain, blurred vision, and seeing ‘halos’
around lights. The pupil is mid-dilated and non-reactive. What is the most likely diagnosis?
A. Open-angle glaucoma
B. Acute angle-closure glaucoma
C. Uveitis
D. Corneal abrasion
Answer: B
Conceptual Explanation: Acute angle-closure glaucoma is a medical emergency
characterized by sudden pain, visual disturbances (halos), and a fixed, mid-dilated pupil.
