Download Physical Examination Techniques: Multiple Choice Questions for Medical Students and more Quizzes Nursing in PDF only on Docsity!
- Which statement is TRUE regarding barriers to performing a physical examination? Physical exams are no longer necessary with modern tests. Physical exams are not accurate. Patients do not want physical exams. Insurance does not pay for physical exams. Physical exams may not be done due to lack of training and lack of time on the clinician's part.
- A patient with bulging cheeks often described as “chipmunk” facies likely has which of the following diseases? Adenovirus Measles German measles Roseola infantum Mumps
- On physical examination, a patient's sclerae can clearly be seen above their irides. What condition does this patient most likely have? Hypothyroidism Hyperthyroidism Wilson disease Addison's disease Cirrhosis
- When using an otoscope, what does the green line represent? Maximum intensity light The otoscope is fully charged. Minimum intensity light The otoscope has recently been calibrated. The appropriate setting for a user with 20/20 vision
- What physical exam finding is most suggestive of otitis externa? Bulging tympanic membrane Pain when pulling on the ear Erythema of the tympanic membrane Nonerythematous external acoustic meatus
Absence of the light reflex
- Palatal petechiae suggests a diagnosis of what condition? Herpes zoster Hypertrophy of adenoids Measles Coxsackievirus infection Adenovirus infection
- Ludwig's angina indicates which of the following? Ear infection Sinus infection Coronary artery disease Submandibular infection Peripheral artery disease
- What does a "hairy tongue" with increased hyperkeratinization suggest? The patient has poor dental hygiene. The patient is a smoker. The patient has a fungal infection. The patient is immunocompromised. The patient has an oral malignancy.
- What internal cause of eye pain is an ophthalmological emergency? Uveitis Hordeolum Open-angle glaucoma Corneal abrasion Closed-angle glaucoma
- What physical examination findings suggest hypovolemia? Jaundice Exophthalmos Sunken eyes Diplopia Pterygium
- What does a bruit heard on auscultation over the thyroid suggest? Nontoxic goiter Medullary carcinoma Graves' disease Hashimoto's disease Subacute thyroiditis
- A diffusely enlarged and firm thyroid is most suggestive of what diagnosis? Toxic multinodular goiter Medullary carcinoma Toxic adenoma Graves' disease Hashimoto's disease
- What is one of the signs of hypothyroidism found on physical examination? Weight loss Tachycardia Excessive sweating Diffuse hair loss Hyperreflexia
- What sign associated with hyperthyroidism is found on physical examination? Brittle nails Nasal voice Lid lag Dry, cool skin Hyporeflexia
- What is a characteristic finding in a patient with Graves' disease? Decreased sympathetic tone Bradycardia Pretibial myxedema Weight gain
- What physical exam finding is most suggestive of otitis externa?
Erythema of the tympanic membrane Nonerythematous external acoustic meatus Absence of the light reflex Bulging tympanic membrane Pain when pulling on the ear
- Which part of the body has a high incidence of incidental findings on imaging? Eyes Thyroid gland Lungs Skin Heart
- What is an adverse reaction of undergoing CT imaging studies? Depression Radiation exposure Joint pain Lack of accuracy Diarrhea
- What is the risk of future cancers associated with > 100 mSv of radiation exposure during imaging tests? o < 0.2% o 10% o 2% o < 0.5% o 5%
- Which of the following statements is TRUE regarding rashes? Psoriasis is more of an acute than a chronic skin condition. Atopic dermatitis is characterized by acute vesicles on the skin. Cellulitis and impetigo are acute skin infections. Atopic dermatitis has an asymmetric random distribution on the body. Psoriasis is characterized by inflammatory erythema.
- Which condition is also known as male-pattern baldness? Alopecia androgenetica Alopecia totalis Seborrheic dermatitis Telogen effluvium Alopecia areata
- What are the 4 abdominal quadrants called on examination? Right upper quadrant, left upper quadrant, right lower quadrant, and left lower quadrant Right hypochondriac quadrant, left hypochondriac quadrant, right iliac quadrant, and left iliac quadrant Epigastric quadrant, umbilical quadrant, right lumbar quadrant, and left lumbar quadrant Right upper quadrant, left upper quadrant, epigastric quadrant, and pelvic quadrant Epigastric quadrant, umbilical quadrant, hypogastric quadrant, and pelvic quadrant
- What are 3 examples of common conditions associated with pain in the abdominal right upper quadrant (RUQ)? Cholecystitis, prostatitis, and pelvic inflammatory disease Hepatitis, ovarian torsion, and appendicitis Diverticulitis, ovarian torsion, and splenic infarct Appendicitis, peptic ulcer disease, and diverticulitis Cholecystitis, hepatitis, and peptic ulcer disease
- Which of the following is a possible finding on inspection of the abdomen? Striae due to Cushing disease Renal mass Abdominal bruits due to aneurysm Tenderness in the right upper quadrant Pain in the epigastric region
- Which statement is TRUE regarding percussion of the abdomen? Dullness is noted over solid organs and tympani is noted over air in the bowels. Dullness is noted over air in the bowels.
Castell point is useful in assessing liver size. Tympani or resonance is found with percussion over the liver. Diffuse tympani of the abdomen is normal.
- During palpation of the abdomen, which maneuver may be part of an appropriate exam? Avoid looking at the patient's face during the abdominal examination Start with deep palpation before percussion Start with the area of pain first Expose the entire abdomen and chest before performing an abdominal exam Flex at the hips and bend the knees slightly to relax the abdominal musculature
- Which area of palpation is most important to assess the liver size? Left upper quadrant Right upper quadrant Epigastric area Left lower quadrant Right lower quadrant
- Which area of palpation is most important to assess the spleen? Right lower quadrant Left lower quadrant Epigastric area Right upper quadrant Left upper quadrant
- Which area(s) of palpation is/are most important to assess for possible aortic aneurysm? Chest wall Right lower quadrant Periumbilical and epigastric areas Left lower quadrant Abdominal aneurysm unable to be assessed for on palpation
- Where is a Sister Mary Joseph node found? A palpable lymph node in the neck A palpable lymph node in the axilla
Gynecomastia, conjunctivitis, and intention tremor Spider angiomas, dermatitis, and deep vein thrombosis Ascites, gynecomastia, and spider angiomas Asterixis, facial erythema, and wheezing Ascites, Sister Mary Joseph node, and Beau's lines in the nails
- Which of the following describes "guarding" in a patient with acute abdominal pain? The patient is reluctant to discuss their pain. The patient has contraction of the abdominal wall muscles to prevent increased pain on palpation. The clinician observes relaxation of the abdomen upon palpation. The patient appears defensive when asking them about their abdominal pain. The clinician observes pain relief upon abdominal percussion.
- A positive Murphy's sign is related to what clinical condition? Acute appendicitis Acute cholecystitis Nephrolithiasis Acute diverticulitis Pelvic inflammatory disease
- A positive psoas sign is related to what clinical condition? Pelvic inflammatory disease Acute cholecystitis Nephrolithiasis Acute diverticulitis Acute appendicitis
- What does a positive Carnett sign signify? The patient has abdominal pain due to a urinary tract infection. The patient has abdominal pain due to acute appendicitis. The patient has abdominal pain due to acute cholecystitis. The patient has abdominal pain due to an abdominal wall musculature issue. The patient has abdominal pain due to a kidney stone.
50. Stigmata of cirrhosis include each of the following except? Positive Carnett’s sign Bulging flanks Pedal edema Terry’s nails Palmar erythema
- Findings associated with acute appendicitis include each of the following except? Castell’s sign Psoas sign Obturator sign Mcburney’s sign Rebound tenderness
- A 30-year-old obese woman is brought to the emergency department with sudden- onset abdominal pain in the right-upper quadrant for 5 hours. She has nausea and vomiting. Physical examination shows right upper quadrant tenderness. Which of the following is the most appropriate initial imaging option? Computed tomography scan Esophagogastroduodenoscopy Ultrasound Colonoscopy X-ray
- A patient comes in with the complaint, "My stomach hurts." Which of the following is the best next thing to ask or say to the patient to obtain an accurate and efficient history? "Does the pain radiate?" "That's usually no big deal. Don't worry." "Tell me more about your stomach pain." "Is the pain in your left lower quadrant?" "You haven't had any new strange foods, have you?"
- Which of the following recommendations is the most appropriate when starting to take a new patient's history? Introduce yourself positively and confidently. Always give a gentle pat on the knee or hug to the patient so they feel welcomed.
Internal bleeding Bone marrow disorders Which of the following represent critical white blood cell (WBC) values for leukopenia and leukocytosis? < 500 and > 30, 500 and < 30, < 2000 and > 50, < 4000 and > 10, Which cause of shortness of breath is primarily due to a pulmonary etiology? Arrhythmia Cardiac tamponade Pneumothorax Valvular disease Guillain-Barré syndrome Which statement demonstrates the correct path of cardiac blood flow? Blood flows from the right atrium to the right ventricle through the mitral valve. Blood flows from the left atrium to the left ventricle through the mitral valve. Blood flows from the left atrium to the left ventricle through the tricuspid valve. Blood flows from the right ventricle to the aorta through the aortic valve. Blood flows from the left atrium to the left ventricle through the pulmonary valve. How can an examiner assess a patient's cardiovascular status even before using their stethoscope? By looking in the chart to check if the patient has a history of cardiovascular disease By asking the nurse who took their vital signs It is not possible to evaluate a patient's cardiovascular status without using a stethoscope. By asking the patient's companion if they are having distress By observing the patient's general signs of discomfort such as respiratory distress or diaphoresis.
What cardiac physiology does the S2 heart sound represent? Ventricular contraction Closure of the aortic valve and pulmonic valves Increased ventricular filling pressures, such as in heart failure Closure of the mitral and tricuspid valves Atrial contraction against a stiff ventricle, as seen in left ventricular hypertrophy What cardiac physiology does the S4 heart sound represent? Closure of the mitral and tricuspid valves Closure of the aortic valve and pulmonic valves Increased ventricular filling pressures, such as in heart failure Ventricular contraction Atrial contraction against a stiff ventricle, as seen in left ventricular hypertrophy What cardiac physiology does the S3 heart sound represent? Closure of the aortic valve and pulmonic valves Closure of the mitral and tricuspid valves Atrial contraction against a stiff ventricle, as seen in left ventricular hypertrophy Increased ventricular filling pressures, such as in heart failure Ventricular contraction What cardiac physiology does the S1 heart sound represent? Atrial contraction against a stiff ventricle, as seen in left ventricular hypertrophy Closure of the aortic and pulmonic valves Ventricular contraction Closure of the mitral and tricuspid valves Increased ventricular filling pressures, such as in heart failure What is TRUE regarding the physiologic splitting of the second heart sound (S2)? It is an abnormal finding when splitting gets more pronounced with inspiration. The splitting gets more pronounced with inspiration, as it takes longer for the aortic valve to close. The splitting gets more pronounced with inspiration, as it takes longer for the pulmonic valve to close. The splitting gets more pronounced with inspiration, as it takes longer for the mitral valve to close. Physiologic splitting is not heard in a patient with a left bundle branch block. What are the five qualities of a heart murmur that are important to describe? Loudness, intensity, slope, point, and timing
Located at the left lower sternal border, heard during diastole, the intensity of murmur does not correlate with the degree of stenosis Located anywhere in the chest, heard during systole, the intensity of murmur correlates with the degree of valvular disease Located at the apex of the heart, heard during systole, the intensity of the murmur predicts the extent of valvular disease How does the handgrip maneuver affect a heart murmur due to mitral regurgitation? The intensity of the murmur gets louder due to increased afterload. The intensity of the murmur gets louder due to increased contractility. The intensity of the murmur gets softer due to increased afterload. The intensity of the murmur gets louder due to increased preload. The intensity of the murmur gets louder due to decreased afterload. Which features are the MOST accurate descriptions of a tricuspid regurgitation murmur? Located at the apex of the heart, crescendo/decrescendo, the intensity of the murmur predicts the extent of valvular disease Located at the left lower sternal border, heard during diastole, the intensity of murmur does not correlate with the degree of stenosis Located anywhere in the chest, heard during systole, the intensity of murmur correlates with the degree of valvular disease Located at the right upper sternal border, diastolic, high pitched Located at the tricuspid area, holosystolic, high-pitched What is pulse pressure? It is the pressure of peripheral vascular resistance during diastole. It is the pressure of blood ejected during systole. It is the pressure of blood ejected during diastole. It is the pressure of peripheral vascular resistance during systole. It is the difference between systolic and diastolic blood pressure. What are the cardinal features of a murmur related to mitral stenosis? Located at the apex, heard during diastole, described as a low-pitched rumble Located at the right upper sternal border, holosystolic, may radiate to the right carotid area Located at the left sternal border, diastolic decrescendo murmur, sometimes associated with an S3 sound Located at the left sternal border, associated with an S4 sound and decreased pulse pressure Located at the apex, heard during systole, causes increased pulse pressure
Which valvular heart disease is associated with rhythmic head bobbing, pulsation in the uvula, and Quincke's pulse? Mitral regurgitation Aortic stenosis Aortic regurgitation Tricuspid regurgitation Mitral stenosis What are the cardinal features of a murmur related to aortic insufficiency? Located anywhere in the chest, heard during diastole between S1 and S Located at the left sternal border, diastolic decrescendo murmur, sometimes associated with an S3 sound Located at the apex, heard during systole, causes increased pulse pressure Located at the left sternal border, associated with an S4 sound and decreased pulse pressure Located at the right upper sternal border, holosystolic, may radiate to the right carotid area Which valvular heart disease is associated with increased pulse pressure? Mitral stenosis Aortic regurgitation Tricuspid regurgitation Mitral regurgitation Aortic stenosis What is TRUE regarding the point of maximal impulse (PMI)? In patients with severe COPD, the PMI is may be found at the subxiphoid area. Percussion of the heart is the most accurate method to locate the PMI in all patients. The PMI is usually found at the center of the chest, regardless of any underlying heart conditions. The PMI is always easiest to palpate in patients with COPD due to the diaphragm being pushed down. The PMI is typically located in the mid-axillary line in a healthy individual. What is TRUE regarding abdominojugular reflux? Abdominojugular reflux is a physical examination test useful in diagnosing emphysema.
...due to hyperlipidemia. What is TRUE regarding the arterial pulses in the lower extremities? The femoral pulse is located behind the knee. The popliteal pulse is located on top of the foot lateral to the first MTP joint. The posterior tibial pulse is located on top of the foot lateral to the first metatarsophalangeal (MTP) joint. The posterior tibial pulse is located behind the medial malleolus of the ankle. The dorsalis pedis pulse is located behind the medial malleolus of the ankle. Pulsus paradoxus refers to... ...unequal pulses on the right arm and left arm. ...a drop in systolic pressure > 10 mm Hg during inspiration. ...pulses felt in the arms but not in the feet. ...a rapid, bounding pulse. ...feeling the radial pulse at the same time as hearing the S1 heart sound. A patient with viral pericarditis... ...will have elevated blood pressure. ...is more comfortable lying flat. ...has louder heart sounds than usual. ...is most comfortable sitting upright and forward. ...will not have a pulsus paradoxus. What are the components of Beck's triad seen with pericarditis? Muffled heart sounds, HYPOtension, and Kussmaul's sign Friction rub, HYPERtension, and Kussmaul's sign Loud heart sounds, HYPOtension, and pitting edema Muffled heart sounds, HYPERtension, and Kussmaul's sign Loud heart sounds, HYPERtension, and Kussmaul's sign What causes an increased pulsus paradoxus in a patient with pericarditis and cardiac tamponade? Pericarditis causes heart failure, which, in turn, causes an increased pulsus paradoxus. The left ventricle contracts more forcefully due to fluid overload. The left ventricle is hyperdynamic with pericarditis, causing louder heart sounds. Blood in the right heart starts to compromise the left ventricular outflow tract due to increased volume in the pericardium. The blood pressure is too low for the first Korotkoff sound to be heard. What is a pericardial friction rub? The fluid around the heart makes a splashing sound that can be heard on auscultation.
The visceral pericardium and the parietal pericardium audibly rub against each other. Inflammation due to pericarditis causes the patient to rub their chest for pain relief. Inflammation of the parietal pleura causes a rubbing sound. A low-pitched continuous sound heard at the right upper sternal border in patients with pericarditis is called a rub. What are splinter hemorrhages seen with bacterial endocarditis? Circumscribed painful erythematous swelling in the skin and subcutaneous tissues of the hands They are also known as Osler nodes. They are also known as Janeway lesions. Microthrombi in the nail bed Small hemorrhages seen in the retina What physical exam finding is more indicative of peripheral artery disease than normal peripheral arterial circulation? Warm to palpation Pink color Hair growth on feet Strong pedal pulses Pallor after light pressure applied to the foot What is the primary indication for performing an ankle-brachial index test? Hypertension Hyperlipidemia Diabetes Claudication Chest pain Which result indicates the most severe peripheral artery disease? ABI > 1 Ankle-brachial index (ABI) < 0. ABI > 2 ABI < 0. ABI < 1
