Advanced Physical Assessment
Questions and Answers (Verified Answers)
1. A young man feels something in his scrotum and comes to you for
clarifi- cation. On your examination, you note what feels like a "bag of
worms" in the left scrotum, superior to the testicles. Which of the following
is most likely?
A) Hydrocele of the spermatic cord
B) Varicocele
C) Testicular carcinoma
D) A normal vas deferens
ANS Varicocle
Varicoceles are common in normal men. They are often found in the left
scrotum or bilaterally and should normally resolve in the supine
position. This is because they represent varicosities within the scrotum.
These require further investigation if they occur only on the right side or
do not resolve in the supine position. They can contribute to infertility
because the testicles are unable to achieve a cool enough temperature
for sperm production, due to increased blood flow from the varicocele. A
hydrocele would be a painless mass on the spermatic cord and the vas
,deferens is palpated as part of the spermatic cord. You should lightly
pinch the scrotum medially and move laterally until you feel the
spermatic cord pass between your fingers.
2. Which of the following changes are expected in vision as part of the
normal aging process?
A) Cataracts
B) Glaucoma
C) Macular degeneration
D) Blurring of near vision
ANS D
The lens loses its elasticity over time as part of the normal aging
process, and the eye is less able to accommodate and focus on near
objects; therefore, the patient will be expected to have blurring of near
vision.
3. 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
ANS Constrictive pericarditis
4. Which of the following lymph node groups is most commonly involved
in breast cancer?
A) Lateral
B) Subscapular
C) Pectoral
D) Central
ANS D.) Central