Complete Quiz Review
(Questions & Solutions)
2025
1
,1. Multiple Choice
Mrs. Kaplan, 48, presents with epigastric pain that radiates to the back
and is relieved when she leans forward. Which additional assessment
finding most strongly supports acute pancreatitis over peptic ulcer
disease? A. Board-like abdominal rigidity B. Serum amylase three times
upper limit C. Coffee-ground emesis D. Positive Murphy sign
ANS: B Rationale: A marked amylase rise is classic for pancreatitis; rigidity
suggests perforation, coffee-ground emesis implies upper GI bleed, and
Murphy sign equals cholecystitis.
2. True/False
When auscultating bowel sounds, the diaphragm should be held lightly,
because excessive pressure may distort the natural peristaltic clicks.
ANS: True Rationale: Gentle contact prevents compression of the bowel
wall and preserves acoustic fidelity.
3. Fill-in-the-Blank
Normal liver span in the right mid-clavicular line is ___ to ___ cm in a
healthy adult.
ANS: 6; 12 Rationale: Spans <6 cm suggest atrophy, >12 cm suggest
hepatomegaly.
4. Multiple Response – Select all that apply
Which bedside clues raise concern for upper motor neuron (UMN)
lesions rather than lower motor neuron injury? [ ] A. Hyperreflexia with
clonus [ ] B. Fasciculations in atrophied muscle [ ] C. Positive Babinski sign
[ ] D. Flaccid paralysis [ ] E. Pronator drift
ANSs: A, C, E Rationale: UMN damage causes spasticity, pathologic
2
, reflexes, and drift; fasciculations and flaccidity are LMN.
5. Multiple Choice
A 72-year-old develops new-onset ascites. Which percussion technique
best quantifies free fluid? A. Liver scratch test B. Fluid-wave test C.
Shifting dullness D. Traube space percussion
ANS: C Rationale: Detects >500 mL of ascites by noting movement of
dullness with position change; fluid wave needs more fluid and
cooperation.
6. True/False
Involuntary guarding that persists after the patient exhales and relaxes
suggests peritoneal irritation rather than voluntary muscle tensing.
ANS: True Rationale: Rigidity independent of respiration signals
pathologic inflammation.
7. Fill-in-the-Blank
During deep tendon testing, a 2+ patellar reflex is considered ________.
ANS: normal (or expected) Rationale: Reflex scale: 0 absent, 1+
diminished, 2+ normal, 3+ brisk, 4+ clonus.
8. Multiple Response
Which features differentiate rheumatoid arthritis (RA) from osteoarthritis
during hand inspection? [ ] A. Heberden nodes at DIP joints [ ] B. Ulnar
deviation at MCP joints [ ] C. Swan-neck deformities [ ] D. Morning
stiffness >60 min [ ] E. Single-joint involvement
ANSs: B, C, D Rationale: RA is systemic, symmetric, long stiffness, ulnar
drift, swan-neck. Heberden nodes and isolated joints imply OA.
9. Multiple Choice
Mr. Duong, 55, reports numbness in the first three fingers exacerbated at
3