Health Assessment and Physical Examination Test Bank

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Mrs. LaFarge is a 60-year-old who presents with urinary incontinence. She is unable to get to the bathroom quickly enough when she senses the need to urinate. She has normal mobility. Which of the following is most likely?

  • A. Stress incontinence
  • B. Urge incontinence
  • C. Overflow incontinence
  • D. Functional incontinence
Correct Answer: B

Rationale: Urge incontinence, also known as overactive bladder, is characterized by a sudden and strong urge to urinate which is difficult to control. In this case, Mrs. LaFarge is unable to get to the bathroom quickly enough when she senses the need to urinate, which indicates a lack of control over the urge to urinate. This is typically caused by involuntary contractions of the bladder muscle. Stress incontinence, on the other hand, is leakage of urine during activities that increase intra-abdominal pressure, such as coughing or exercising. Overflow incontinence is characterized by urinary retention and constant dribbling of urine due to the bladder being unable to empty properly. Functional incontinence occurs when a person has normal bladder control but is unable to reach the bathroom in time due to physical or cognitive impairments. Since Mrs. LaFarge is experiencing a sudden and strong urge to urinate that she cannot

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He is concerned about his weight. Based on this information, what is appropriate counsel for the patient during the visit?

  • A. Refer the patient to a nutritionist because he is anorexic.
  • B. Reassure the patient that he has a normal body weight.
  • C. Give the patient information about reduction of fat, cholesterol, and calories because he is overweight.
  • D. Give the patient information about reduction of fat and cholesterol because he is obese.
Correct Answer: C

Rationale: The appropriate counsel for the patient during the visit would be to give information about the reduction of fat, cholesterol, and calories because he is concerned about his weight. This option addresses the patient's concern and provides guidance on making healthier choices to manage weight. Referring the patient to a nutritionist because he is anorexic (Option A) is not appropriate based on the information provided. Reassuring the patient that he has a normal body weight (Option B) may not address his concerns about weight. Giving the patient information about reducing fat and cholesterol only because he is obese (Option D) does not cover all aspects of a healthy diet such as managing calorie intake.

A patient is examined with the ophthalmoscope and found to have red reflexes bilaterally. Which of the following have you essentially excluded from your differential?

  • A. Retinoblastoma
  • B. Cataract
  • C. Artificial eye
  • D. Hypertensive retinopathy
Correct Answer: A

Rationale: Retinoblastoma typically presents with a white reflex, known as leukocoria or a cat's eye reflex, instead of the normal red reflex seen during ophthalmoscopy. The presence of red reflexes bilaterally in this case essentially rules out retinoblastoma as a differential diagnosis.

Which of the following events occurs at the start of diastole?

  • A. Closure of the tricuspid valve
  • B. Opening of the pulmonic valve
  • C. Closure of the aortic valve
  • D. Production of the first heart sound (S )
Correct Answer: B

Rationale: At the start of diastole, the ventricles relax and begin to fill with blood from the atria. As this relaxation phase begins, the pulmonic valve opens to allow blood to flow from the right ventricle to the pulmonary artery and then to the lungs for oxygenation. This marks the beginning of diastole, the period of the cardiac cycle when the heart is filling with blood. The closure of the tricuspid valve, closure of the aortic valve, and production of the first heart sound (S1) occur during systole, the phase of the cardiac cycle when the heart is contracting to pump blood out to the body.

To hear a soft murmur or bruit, which of the following may be necessary?

  • A. Asking the patient to hold her breath
  • B. Asking the patient in the next bed to turn down the TV
  • C. Checking your stethoscope for air leaks
  • D. All of the above
Correct Answer: D

Rationale: To hear a soft murmur or bruit clearly, it is important to minimize any background noise or distractions that may interfere with your ability to auscultate effectively. Therefore, asking the patient to hold her breath (choice A) can help reduce noise caused by the patient's respiration. Asking the patient in the next bed to turn down the TV (choice B) can also help eliminate external noise that may disrupt your ability to hear subtle sounds. Checking your stethoscope for air leaks (choice C) is crucial to ensure that you are hearing sounds accurately and not being affected by any equipment issues. By combining these strategies, you can create an optimal environment for listening to soft murmurs or bruits.

A 23-year-old graduate student comes to your clinic for evaluation of a urethral discharge. As the provider, you need to get a sexual history. Which one of the following questions is inappropriate for eliciting the information?

  • A. Are you sexually active?
  • B. When was the last time you had intimate physical contact with someone, and did that contact include sexual intercourse?
  • C. Do you have sex with men, women, or both?
  • D. How many sexual partners have you had in the last 6 months?
Correct Answer: B

Rationale: While it is important to ask about recent sexual activity and whether it included sexual intercourse, using the term "intimate physical contact" is not specific enough. This question could potentially lead to misinterpretation or confusion regarding what types of activities are being referred to. It is more appropriate to directly ask about sexual intercourse when obtaining a sexual history. The other options are all appropriate questions to elicit information about the patient's sexual history.

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