CLINICAL SKILLS EXAM I QUESTIONS
WITH COMPLETE ANSWERS
10. A 25-year-old type 1 diabetic clerk presents to the emergency room with
shortness of breath and states that his blood sugar was 605 at home. You diagnose
the patient with diabetic ketoacidosis. What is the expected pattern of breathing?
A) Normal
B) Rapid and shallow
C) Rapid and deep
D) Slow - Answer-C) Rapid and deep
Mrs. Lenzo weighs herself every day with a very accurate balance-type scale. She
has noticed that over the past 2 days she has gained 4 pounds. How would you best
explain this?
A) Attribute this to some overeating at the holidays.
B) Attribute this to wearing different clothing.
C) Attribute this to body fluid.
D) Attribute this to instrument inaccuracy - Answer-C) Attribute this to body fluid.
Mr. Curtiss has a history of obesity, diabetes, osteoarthritis of the knees, HTN, and
obstructive sleep apnea. His BMI is 43 and he has been discouraged by his difficulty
in losing weight. He is also discouraged that his goal weight is 158 pounds away.
What would you tell him?
A) "When you get down to your goal weight, you will feel so much better." B) "Some
people seem to be able to lose weight and others just can't, no matter how hard they
try."
C) "We are coming up with new medicines and methods to treat your conditions
every day."
D) "Even a weight loss of 10% can make a noticeable improvement in the problems
you mention." - Answer-D) "Even a weight loss of 10% can make a noticeable
improvement in the problems you mention."
Jenny is one of your favorite patients who usually shares a joke with you and is
nattily dressed. Today she is dressed in old jeans, lacks makeup, and avoids eye
contact. To what do you attribute these changes?
A) She is lacking sleep.
B) She is fatigued from work.
C) She is running into financial difficulty.
D) She is depressed. - Answer-D) She is depressed.
You are seeing an older patient who has not had medical care for many years. Her
vital signs taken by your office staff are: T 37.2, HR 78, BP 118/92, and RR 14, and
she denies pain. You notice that she has some hypertensive changes in her retinas
and you find mild proteinuria on a urine test in your office. You expected the BP to be
, higher. She is not on any medications. What do you think is causing this BP reading,
which doesn't correlate with the other findings?
A) It is caused by an "auscultatory gap."
B) It is caused by a cuff size error.
C) It is caused by the patient's emotional state.
D) It is caused by resolution of the process which caused her retinopathy and kidney
problems - Answer-A) It is caused by an "auscultatory gap."
Despite having high BP readings in the office, Mr. Kelly tells you that his readings at
home are much lower. He checks them twice a day at the same time of day and has
kept a log. How do you respond?
A) You diagnose "white coat hypertension."
B) You assume he is quite nervous when he comes to your office.
C) You question the accuracy of his measurements.
D) You question the accuracy of your measurements. - Answer-C) You question the
accuracy of his measurements.
You are observing a patient with heart failure and notice that there are pauses in his
breathing. On closer examination, you notice that after the pauses the patient takes
progressively deeper breaths and then progressively shallower breaths, which are
followed by another apneic spell. The patient is not in any distress. You make the
diagnosis of:
A) Ataxic (Biot's) breathing
B) Cheyne-Stokes respiration
C) Kussmaul's respiration
D) COPD with prolonged expiration - Answer-B) Cheyne-Stokes respiration
Mr. Garcia comes to your office for a rash on his chest associated with a burning
pain. Even a light touch causes this burning sensation to worsen. On examination,
you note a rash with small blisters (vesicles) on a background of reddened skin. The
rash overlies an entire rib on his right side. What type of pain is this?
A) Idiopathic pain
B) Neuropathic pain
C) Nociceptive or somatic pain
D) Psychogenic pain - Answer-B) Neuropathic pain
A 50-year-old body builder is upset by a letter of denial from his life insurance
company. He is very lean but has gained 2 pounds over the past 6 months. You
personally performed his health assessment and found no problems whatsoever. He
says he is classified as "high risk" because of obesity. What should you do next?
A) Explain that even small amounts of weight gain can classify you as obese. B)
Place him on a high-protein, low-fat diet.
C) Advise him to increase his aerobic exercise for calorie burning.
D) Measure his waist. - Answer-D) Measure his waist.
Ms. Wright comes to your office, complaining of palpitations. While checking her
pulse you notice an irregular rhythm. When you listen to her heart, every fourth beat
WITH COMPLETE ANSWERS
10. A 25-year-old type 1 diabetic clerk presents to the emergency room with
shortness of breath and states that his blood sugar was 605 at home. You diagnose
the patient with diabetic ketoacidosis. What is the expected pattern of breathing?
A) Normal
B) Rapid and shallow
C) Rapid and deep
D) Slow - Answer-C) Rapid and deep
Mrs. Lenzo weighs herself every day with a very accurate balance-type scale. She
has noticed that over the past 2 days she has gained 4 pounds. How would you best
explain this?
A) Attribute this to some overeating at the holidays.
B) Attribute this to wearing different clothing.
C) Attribute this to body fluid.
D) Attribute this to instrument inaccuracy - Answer-C) Attribute this to body fluid.
Mr. Curtiss has a history of obesity, diabetes, osteoarthritis of the knees, HTN, and
obstructive sleep apnea. His BMI is 43 and he has been discouraged by his difficulty
in losing weight. He is also discouraged that his goal weight is 158 pounds away.
What would you tell him?
A) "When you get down to your goal weight, you will feel so much better." B) "Some
people seem to be able to lose weight and others just can't, no matter how hard they
try."
C) "We are coming up with new medicines and methods to treat your conditions
every day."
D) "Even a weight loss of 10% can make a noticeable improvement in the problems
you mention." - Answer-D) "Even a weight loss of 10% can make a noticeable
improvement in the problems you mention."
Jenny is one of your favorite patients who usually shares a joke with you and is
nattily dressed. Today she is dressed in old jeans, lacks makeup, and avoids eye
contact. To what do you attribute these changes?
A) She is lacking sleep.
B) She is fatigued from work.
C) She is running into financial difficulty.
D) She is depressed. - Answer-D) She is depressed.
You are seeing an older patient who has not had medical care for many years. Her
vital signs taken by your office staff are: T 37.2, HR 78, BP 118/92, and RR 14, and
she denies pain. You notice that she has some hypertensive changes in her retinas
and you find mild proteinuria on a urine test in your office. You expected the BP to be
, higher. She is not on any medications. What do you think is causing this BP reading,
which doesn't correlate with the other findings?
A) It is caused by an "auscultatory gap."
B) It is caused by a cuff size error.
C) It is caused by the patient's emotional state.
D) It is caused by resolution of the process which caused her retinopathy and kidney
problems - Answer-A) It is caused by an "auscultatory gap."
Despite having high BP readings in the office, Mr. Kelly tells you that his readings at
home are much lower. He checks them twice a day at the same time of day and has
kept a log. How do you respond?
A) You diagnose "white coat hypertension."
B) You assume he is quite nervous when he comes to your office.
C) You question the accuracy of his measurements.
D) You question the accuracy of your measurements. - Answer-C) You question the
accuracy of his measurements.
You are observing a patient with heart failure and notice that there are pauses in his
breathing. On closer examination, you notice that after the pauses the patient takes
progressively deeper breaths and then progressively shallower breaths, which are
followed by another apneic spell. The patient is not in any distress. You make the
diagnosis of:
A) Ataxic (Biot's) breathing
B) Cheyne-Stokes respiration
C) Kussmaul's respiration
D) COPD with prolonged expiration - Answer-B) Cheyne-Stokes respiration
Mr. Garcia comes to your office for a rash on his chest associated with a burning
pain. Even a light touch causes this burning sensation to worsen. On examination,
you note a rash with small blisters (vesicles) on a background of reddened skin. The
rash overlies an entire rib on his right side. What type of pain is this?
A) Idiopathic pain
B) Neuropathic pain
C) Nociceptive or somatic pain
D) Psychogenic pain - Answer-B) Neuropathic pain
A 50-year-old body builder is upset by a letter of denial from his life insurance
company. He is very lean but has gained 2 pounds over the past 6 months. You
personally performed his health assessment and found no problems whatsoever. He
says he is classified as "high risk" because of obesity. What should you do next?
A) Explain that even small amounts of weight gain can classify you as obese. B)
Place him on a high-protein, low-fat diet.
C) Advise him to increase his aerobic exercise for calorie burning.
D) Measure his waist. - Answer-D) Measure his waist.
Ms. Wright comes to your office, complaining of palpitations. While checking her
pulse you notice an irregular rhythm. When you listen to her heart, every fourth beat
