H&P Final Bates MC Questions With 100% Correct Answers.

1. When performing a genitourinary assessment, you note that the urethral meatus is positioned ventrally. This is most likely to be: (A) A stricture (B) Hypospadius (C) The result of a circumcision (D) Related to the aging process - (B) Hypospadius Hypospadius is a congenital displacement of the urethral meatus to the inferior surface of the penis. A groove extends from the displaced urethral meatus to its normal location on the tip of the glans. There is no association between aging and displacement of the urethral meatus. 2. When performing a genitourinary assessment on an adolescent male you notice a swelling in the scrotum, which increases with increased intraabdominal pressure and decreases when lying down. The young man complains of pain when straining. This history best describes: (A) An incisional hernia (B) A direct inguinal hernia (C) An indirect inguinal hernia (D) A femoral hernia - (C) An indirect inguinal hernia An indirect hernia generally causes pain with straining and a soft swelling in the scrotum that enlarges with increased intraabdominal pressure. It originates above the inguinal ligament near the midpoint and touches the examining finger during examination. This is the most common type of hernia, found in all ages and both sexes. An incisional hernia is found in the suture line of a surgical intervention. A femoral hernia is relatively rare and occurs more often in women. It is never found in the scrotum or pressing into the inguinal canal. It is often hard to differentiate from lymph nodes. A direct hernia is more common in men over 40 and rare in women. It originates above the inguinal ligament close to the pubic tubercle and rarely enters the scrotum. It bulges anteriorly and pushes the side of the finger forward during examination. 3. The following finding is considered normal when assessing an aging male: (A) A decrease in scrotal color(B) Enlargement of the testes and scrotum (C) A decrease in the size of the penis (D) The presence of a hydrocele, or fluid in the scrotum - (C) A decrease in the size of the penis In the older male, you may note thinner, more sporadic gray pubic hair and a decrease in the size of the penis. A change in color, size, and scrotal fluid are symptoms requiring further investigation and are not associated with aging. 4. When instructing patients about how to perform a testicular self-exam, which of the following statements is most correct: (A) "A good time to examine your testicles is just before you take a shower." (B) "Perform the testicular exam at least once a week to detect the early stages of cancer." (C) "The testicle should feel firm and has a lumpy consistency, be movable, and shaped like an egg." (D) "If you notice any change from what you normally see or feel, call your health care provider." - (D) "If you notice any change from what you normally see or feel, call your health care provider." A firm painless lump, a hard area, or an enlarged testicle is each an abnormal and unexpected finding, which should be assessed by a trained clinician. Time of week and time of day are not factors men should consider relating to self-testicular examination. Regular examination should be encouraged, and changes or abnormal findings need to be reported. 5. Which of the findings is a normal finding when examining the glands? (A) The skin is wrinkled and without lesions (B) The dorsal vein may be visible (C) Smegma may be present under the foreskin of an uncircumcised male (D) There is no hair - (C) Smegma may be present under the foreskin of an uncircumcised male Some cheesy smegma may collect under the foreskin of an uncircumcised male. The glans looks smooth and without lesions. Pubic lice and nits settle in the base of the penis and excoriations or wrinkling may suggest activity. Hair distribution is variable. 6. Which of the following statements is true when performing a male genital examination? (A) Auscultate for the presence of bowel sounds over the scrotum in all males (B) Palpate for the vertical chain of lymph nodes along the groin inferior to the inguinal ligament(C) Palpate the inguinal canal only if there is a bulge present in the inguinal region during inspection (D) When palpating for a hernia on the right side, have the client shift his standing weight onto the left leg - (D) When palpating for a hernia on the right side, have the client shift his standing weight onto the left leg Positioning to the left leg allows the examiner to follow the inguinal canal and document any herniarelated bulge. 71-year-old woman is brought to the ER by her family, who state that she is not acting like herself. They say that several hours ago she began to slur her words as she started wandering around the house. They heard her calling to her husband, who has been deceased for over 10 years. After several minutes of this, she said she wasn't feeling well and laid down on the sofa; she became sleepy. When they tried to ask her what was wrong, she snapped at them. Although the woman is retired, she is very active in her church and senior citizens club. Her past medical history is significant for 3 vaginal deliveries, 10 years of hypertension, and 5 years of type-2 diabetes. She does not smoke, drink alcohol, or take drugs. Review of systems reveals that she had mentioned to her daughter the day before that urinating is painful and that her back is sore. On exam, you find an elderly woman who is lethargic. You have to speak loud - (B) Delirium The hallmark of delirium is that it occurs acutely. The course can be fluctuating, and the level of consciousness is disturbed. The patient can become somnolent, as in this case, or agitated. Illusions and hallucinations are common. Patients are often disoriented to place and time but not to person. Metabolic changes, poisonings, sepsis, and delirium tremens are causes. This episode probably began as a urinary tract infection that became uroseptic. A psychotic reaction to major depression is not a correct response. Although hallucinations are common in psychotic reactions, there is usually an underlying mental health disorder such as depression or mania. lso psychosis does not cause somnolence. Dementia is also incorrect. Dementia is a slowly progressive change in mental status over months to years. The level of consciousness is generally unaffected. Hallucinations and delusions may occur. Until late stages, patients are usually oriented to person, place, and time. The most common causes are Alzheimer's disease and multi-infarct dementia.A 13-year-old boy is brought into the urgent care clinic by his father with a complaint of swelling around his right elbow. He is in 8th grade football and has been lifting weights, despite having just started puberty. He has no significant past medical history and recalls no specific incident of trauma to the elbow. On exam, the patient has a soft swelling around the posterior of the elbow. He has no redness or warmth and minimal pain. He is nontender over the bony prominences of the ulna, radial head, and humorous. What disorder of the elbow is the most likely diagnosis? (A) Arthritis (B) Olecranon bursitis (C) Epicondylitis (D) Rheumatoid nodules - (B) Olecranon bursitis