Assessment Final
Review of material for final exam in Assessment class. Abdomen, Respiratory, male & female genitalia.
- 1.
A 42 year old waitress presents to your office for evaluation of shortness of breath. She has had a fever as high as 103F for the last few days and has a cough productive of green sputum. On physical examination, you hear crackles in her lungs. A chest radiograph reveals a consolidation in the left lower lobe. You diagnose her with lobar pneumonia. When you perform tactile fremitus of the left lower thorax, you would expect the fremitus to be:
- A.
Increased
- B.
Decreased
- C.
Unchanged
- D.
Displaced
Correct Answer
A. Increased -
- 2.
What would you expect to hear when percussing the left lower throax of a pt with lobar pneumonia?
- A.
Dull
- B.
Resonant
- C.
Flat
- D.
Hyperresonant
Correct Answer
A. Dull -
- 3.
When performing a test for Egophony on a pt with lobar pneumonia, what would you expect to hear?
- A.
Eeeee
- B.
Aaay
- C.
Ooooo
- D.
Whisper Petriloquoy
Correct Answer
B. Aaay -
- 4.
In a patient with lobar pneumonia, you would expect breath sounds on auscultation to reveal:
- A.
Rhonchi
- B.
Egophany
- C.
Decreased Resonance
- D.
Increased Air Movement
Correct Answer
B. Egophany -
- 5.
A 65 year old smoker presents for evaluation of dyspnea. He has a 100-pack/year history of tobacco use. The dyspnea is exacerbated by exertion. He denies fever or chills; he has not had recent contact with anyone who is sick. You diagnose chronic obstructive pulmonary disease (COPD). On physical examination of the thorax, you would expect to find:
- A.
Increased AP diameter
- B.
Decreased AP diameter
- C.
No change in AP diameter
Correct Answer
A. Increased AP diameter -
- 6.
Upon auscultation in a patient with COPD, you would expect to hear:
- A.
Stridor
- B.
Delayed Expiratory Phase
- C.
Pleural Rub
- D.
Late Inspiratory Crackles
Correct Answer
B. Delayed Expiratory Phase -
- 7.
A 19 year old college student presents to the emergency room for sudden onset of dyspnea. The general survey reveals that she is 6 feet 2 inches tall and weighs 135 pounds. She denies fever, chills, cough, and sore throat. She is a nonsmoker. You suspect that she has a pneumothorax. What findings would you expect with percussion of the thorax?
- A.
Decreased resonance on the affected side
- B.
Increased resonance (hyperresonance) on the affected side
- C.
Increased resonance on the nonaffected side
- D.
Dullness
Correct Answer
B. Increased resonance (hyperresonance) on the affected side -
- 8.
In a patient with pneumothorax, what findings would you expect with auscultation of the thorax on the affected side?
- A.
Wheezes
- B.
Rhonchi
- C.
Absence of Breath Sounds
- D.
Hyperresonance
Correct Answer
C. Absence of Breath Sounds -
- 9.
In a healthy adult, the expected measurement of descent of the diaphragm is:
- A.
1-2 cm
- B.
5-6 cm
- C.
7-8 cm
- D.
10-12 cm
Correct Answer
B. 5-6 cm -
- 10.
In a healthy adult, the respiratory rate is:
- A.
4 to 14 breaths per minute
- B.
14-16 breaths per minute
- C.
14 - 20 breaths per minute
- D.
26-40 breaths per minute
Correct Answer
C. 14 - 20 breaths per minute -
- 11.
What is the preferred order for examination of the abdomen?
- A.
Inspection, auscultation, percussion, palpation
- B.
Percussion, auscultation, palpation, inspection
- C.
Auscultation, inspection, palpation, percussion
- D.
Inspection, palpation, auscultation, percussion
Correct Answer
A. Inspection, auscultation, percussion, palpation -
- 12.
You are in the emergency room assessing a patient with abdominal pain and fever. You are performing an abdominal examination to assess for peritoneal signs. Which one of the following is NOT a peritoneal sign?
- A.
Rebound tenderness
- B.
Involuntary guarding
- C.
Rigidity of the abdomen
- D.
Voluntary guarding
Correct Answer
D. Voluntary guarding -
- 13.
A 15 year old high school student presents to the clinic with a 1 day history of nausea and anorexia. He describes the pain as generalized yesterday, but today it has localized to his right lower quadrant. You palpate the left lower quadrant and the patient experiences pain in the right lower quadrant. What is the name of this sign?
- A.
Psoas sign
- B.
Obturator sign
- C.
Rovsing’s sign
- D.
Cuteaneuos hyperesthesia
Correct Answer
C. Rovsing’s sign -
- 14.
A 25 year old veterinarian presents to the clinic for evaluation of flank pain, dysuria, nausea and fever. A urine pregnancy test is negative. A urine dipstick is positive for leukocyte esterase. On physical examination, what would be the most likely sign?
- A.
Psoas sign
- B.
CVA (costovertebral angle) tenderness
- C.
Rosving’s sign
- D.
Murphy’s sign
Correct Answer
B. CVA (costovertebral angle) tenderness -
- 15.
A 40 year old flight attendant presents to your office for evaluation of abdominal pain. It is worse after eating, especially if she has a meal that is spicy or high in fat. She has tried over the counter antacids, but they have not helped the pain. After examining her abdomen, you strongly suspect cholecystitis. Which sign on examination increases your suspicion for this diagnosis?
- A.
Psoas sign
- B.
Rovsing’s sign
- C.
Murphy’s sign
- D.
Grey Turner’s sign
Correct Answer
C. Murphy’s sign -
- 16.
A 22 year old celebrity with a known history of intravenous drug use presents to the emergency room for evaluation of a 5 day history of nausea, emesis, and right upper quadrant abdominal pain. On general survey, he appears ill and his skin is distinctly yellow. He has a temperature of 102.5 F and a heart rate of 112 bpm. You provisionally diagnose him with acute hepatitis. What would you expect to find on abdominal examination?
- A.
Liver edge is tender and 4 to 5 finger breadths below RCM
- B.
Liver edge is nonpalpable
- C.
Liver edge is tender and 1 finger breadth below the RCM
- D.
Liver edge is non tender and 4 to 5 finger breadths below the RCM
Correct Answer
A. Liver edge is tender and 4 to 5 finger breadths below RCM -
- 17.
What is Rovsings sign?
- A.
Pain in the right lower quadrant during palpation of the left lower quadrant
- B.
Pain is elicited by gently picking up a fold of abdominal skin anteriorly without pinching it
- C.
Rebound tenderness
- D.
Pain elicited when the patient’s right thigh is flexed at the hip with the knee bent, and the leg is internally rotated at the hip
Correct Answer
A. Pain in the right lower quadrant during palpation of the left lower quadrant -
- 18.
A 25 year old truck driver presents to the ER for evaluation of pain in his left groin. He has noticed that the pain increases after lifting several boxes, each weighing more than 100 lbs, to fill up his truck. He has had this pain intermittently over the past 5 years, but it has gone away on its own. He is here because the pain has not gone away, and he is becoming nauseated. He denies fever, chills, constipation, or diarrhea. He denis urethral discharge; he is married and states he is faithful to his wife. On physical examination of the left testicular area, you note there is a buldge when you palpate the inguinal canal as you ask the patient to strain. You listen to the left testicular area and hear bowel sounds. Your most likely diagnosis is:
- A.
Appendicitis
- B.
Testicular torsion
- C.
Hernia
- D.
Pelvic inflammatory disease
Correct Answer
C. Hernia -
- 19.
A 19 year old college athlete presents to the student health center for evaluation of penile pain. He is sexually active and his last sexual encounter was one week ago. He has had more than 5 partners in his lifetime to date. You inspect his penis and see a cluster of small vesicles and a few swallow ulcerated areas. Your diagnosis based on this history and the physical examination is:
- A.
Carcinoma of the penis
- B.
Venereal Wart
- C.
Syphilitic chancre
- D.
Genital herpes
Correct Answer
D. Genital herpes -
- 20.
A 15 year old high school student wishing to join the school’s football and basketball teams presents to your office for a sports physical. As a part of the physical, you perform a hernia check. You notice that his right scrotum is markedly larger than his left. He denies pain or tenderness, as well as fever, night sweats, and weight loss. On palpitation, you feel a fluid filled mass in the scrotum but can’t get above the mass with your fingers. What is your most likely diagnosis?
- A.
Hydrocele
- B.
Testicular tumor
- C.
Varicocele
- D.
Epidermoid inclusion cyst
Correct Answer
A. Hydrocele -
- 21.
A 18 year old high school student presents to his family doctor’s office for evaluation of acute onset of pain in the left testicle. He has had no problems until this morning. The pain has been intermittent, sharp, and radiates into the left groin. On physical examination, the testicle feels swollen and is tender to palpation. What is your most likely diagnosis
- A.
Epididymytis
- B.
Testicular torsion
- C.
Acute orchitis
- D.
Testicular cancer
Correct Answer
B. Testicular torsion -
- 22.
What is Phimosis?
- A.
Undescended testicle
- B.
Ventral displacement of the urethral meatus on the penis
- C.
Tight prepuce; once retracted, cannot be returned
- D.
Tight prepuce that cannot be retracted over the glans
- E.
Inflammation of the glans
Correct Answer
D. Tight prepuce that cannot be retracted over the glans -
- 23.
What is Paraphimosis?
- A.
Undescended testicle
- B.
Ventral displacement of the urethral meatus on the penis
- C.
Tight prepuce; once retracted, cannot be returned
- D.
Tight prepuce that cannot be retracted over the glans
- E.
Inflammation of the glans
Correct Answer
C. Tight prepuce; once retracted, cannot be returned -
- 24.
What is Balanitis?
- A.
Undescended testicle
- B.
Ventral displacement of the urethral meatus on the penis
- C.
Tight prepuce; once retracted, cannot be returned
- D.
Tight prepuce that cannot be retracted over the glans
- E.
Inflammation of the glans
Correct Answer
E. Inflammation of the glans -
- 25.
What is Cryptorchidism?
- A.
Undescended testicle
- B.
Ventral displacement of the urethral meatus on the penis
- C.
Tight prepuce; once retracted, cannot be returned
- D.
Tight prepuce that cannot be retracted over the glans
- E.
Inflammation of the glans
Correct Answer
A. Undescended testicle -
- 26.
What is hypospadius?
- A.
Undescended testicle
- B.
Ventral displacement of the urethral meatus on the penis
- C.
Tight prepuce; once retracted, cannot be returned
- D.
Tight prepuce that cannot be retracted over the glans
- E.
Inflammation of the glans
Correct Answer
B. Ventral displacement of the urethral meatus on the penis -
- 27.
A 19 y/o sexually active college student presents for evaluation of a vaginal discharge. She has been in a monogamous relationship since becoming sexually active and is married to her partner. She denies that he has been unfaithful. She denies fever or shills. She states that the discharge is thick, white, and curd like and although there is no bad odor, she does experience some itching. Upon physical examination of the vagina, you see an inflamed vulva, with a slightly red vaginal mucosa. The discharge is thick and white. There is no cervical motion tenderness. The uterus is normal in size without adnexal masses. Based on this information, what is your most likely diagnosis?
- A.
Bacterial vaginosis
- B.
Trichomonas vaginalis infection
- C.
Candida vaginitis
- D.
Pelvic inflammatory disease
Correct Answer
C. Candida vaginitis -
- 28.
A 35 y/o woman presents for evaluation of several new lesions on her vagina. She denies any previous medical problems. She is sexually active. She has had four pregnancies and has given birth to two children. She has had more than ten sexual partners in her lifetime. She is currently divorced but involved in a new relationship with a man whose past sexual history is unknown. On physical examination of the external vagina, you see cauliflower-like lesions scattered on the labia. These are nontender to palpation; the largest is 1 cm in diameter. The remainder of the pelvic exam is unremarkable, and there is no vaginal discharge. Based on this information, what is your most likely diagnosis?
- A.
Epidermoid inclusion cysts
- B.
Venereal warts
- C.
Genital herpes
- D.
Syphilitic chancre
Correct Answer
B. Venereal warts -
- 29.
A 28 y/o housewife presents for an annual checkup. When queried, she mentions that she has noticed bleeding in between her periods for the past several months. She has been pregnant five times and has given birth to five infants. She is sexually active in a monogamous relationship with her husband. On physical exam of the uterus, you palpate an irregular nodule that is approximately 3 cm in diameter. Based on this information, what is your most likely diagnosis?
- A.
Leiomyoma or fibroid
- B.
Cervical cancer
- C.
Uterine cancer
- D.
Cystocele
Correct Answer
A. Leiomyoma or fibroid -
- 30.
A 23 y/o sex worker presents to the ER for evaluation of pelvic pain and fever. You obtain a pregnancy test, which is negative. Her last menstrual period was 1 week ago and was normal. You obtain a complete blood count, and the white blood cell count is elevated. On pelvic exam, she has cervical motion tenderness and a right adnexal mass that is larger than 5 cm in diameter and is extremely tender to palpation. What is the most likely cause of this adnexal mass?
- A.
Ovarian tumor
- B.
Ruptured ovarian cyst
- C.
Ruptured tubal pregnancy
- D.
Tubo-ovarian abscess
Correct Answer
D. Tubo-ovarian abscess -
- 31.
Which one of the following positions is acceptable for examining the anus and rectum?
- A.
Patient lying down on his or her side on the examining table
- B.
Patient sitting down with arms forward, leaning over the examining table
- C.
Patient standing upright with feet together and arms extended
- D.
Patient sitting upright with arms braced backward
Correct Answer
A. Patient lying down on his or her side on the examining table -
- 32.
As part of a routine checkup, you are examining the prostate of a 55 y/o man. He denies nocturia and urinary hesitancy. On physical exam, you palpate the prostate gland and feel a mass. Which of the following descriptors would you use to characterize this mass?
- A.
Color
- B.
Size
- C.
Presence of Discharge
- D.
Presence of Rash
Correct Answer
B. Size -
- 33.
You are performaing a routine physical exam on a 70 y/o retired banker. On exam of the prostate, you palpate a mass that is 1 cm in diameter, hard and non tender. The pt has had a 6 mo history of fatigue. He denies weight loss and night sweats. What is your most likely diagnosis?
- A.
Benign prostatic hyperplasia
- B.
Internal hemmorrhoid
- C.
Prostatitis
- D.
Prostate cancer
Correct Answer
D. Prostate cancer -
- 34.
An 18 y/o college student presents to your office for evaluation of rectal bleeding. You obtain a more thorough history and find that the blood was seen when she wiped after having a bowel movement; she has been constipated and has needed to strain to move her bowels. She denies a family history of colon cancer of inflammatory bowel disease. On physical examination, you note a 1 cm round mass at the 10 o’clock position at the rectum externally. What is your most likely diagnosis?
- A.
External hemorrhoids
- B.
Rectal prolapse
- C.
Uterine prolapse
- D.
Crohn’s disease
Correct Answer
A. External hemorrhoids -
- 35.
An 80 y/o retired secretary presents to the emergency room because of difficulty having a bowel movement, stating that “it feels like something is coming out.” She denies fever or chills and weight loss. She has had constipation and has used an over-the-counter stool softener and increased her water intake. She denies pain with defecation. On physical examination of the anus, you see a doughnut of red tissue, with concentrically circular folds where the anus should be. What is your most likely diagnosis?
- A.
Thrombosed external hemorrhoid
- B.
Anal fissure
- C.
Rectal prolapse
- D.
Rectal cancer
Correct Answer
C. Rectal prolapse -
- 36.
According to our notes, which of the following pts would qualify as abusing alcohol?
- A.
44 yr old Male who has 12 drinks per week, 2 per ocassion
- B.
17 yr old patient who drinks 3 drinks per week.
- C.
32 yr old female who drinks 10 drinks per week, 4-5 per ocassion
- D.
67 yr old female who drinks 6 drinks per week, but feels very ashamed of it because her religious convictions do not look kindly on this.
Correct Answer
C. 32 yr old female who drinks 10 drinks per week, 4-5 per ocassion -
- 37.
You are doing a visual inspection on the abdomen of a patient with an abdominal Aortic aneurysm, what might you expect to see.
- A.
Swollen stomach, dull to percussion
- B.
Increased pulsations in the stomach
- C.
Scaphoid stomach, hypoactive bowel sounds
- D.
Increased vascularity of stomach & bruits
Correct Answer
B. Increased pulsations in the stomach -
- 38.
You are visually assessing a 48 yr old Male in the ER. He came in for abdominal pain and nausea/vomitting. He states he has a lot of pain after eating and his stomach is swollen. You notice a small red circle around his belly button. What is your most likely diagnosis?
- A.
Pancreatitis
- B.
Peritonitis
- C.
Hepatitis
- D.
Stomach Flu
Correct Answer
A. Pancreatitis -
- 39.
What is the first thing we ask the client before assessing the abdomen?
- A.
If they have any pain which would prevent us from palpating.
- B.
If they emptied their bladder.
- C.
If they have any contagious diseases
- D.
If they are ticklish.
Correct Answer
B. If they emptied their bladder. -
- 40.
What areas do we auscultate for bowel sounds and for how long?
- A.
Only the RLQ for 30 seconds.
- B.
All four quadrants for 2 minutes each.
- C.
On all 4 quadrants and for 15 – 20 seconds each.
- D.
Only the RUQ and LUQ for 15 seconds each.
Correct Answer
C. On all 4 quadrants and for 15 – 20 seconds each. -
- 41.
What are normal bowel sounds?
- A.
20-55 per minutes
- B.
You should only hear them within 2 hours of eating.
- C.
< 10 per minute.
- D.
5- 34 per min
Correct Answer
D. 5- 34 per min -
- 42.
What is Ascites?
- A.
Accumulation of fluid in the peritoneal cavity.
- B.
An abnormally high level of bilirubin in the blood leading to golden brown coloration of urine.
- C.
Yellow discoloration of the sclera
- D.
An abnormally large palpable liver.
Correct Answer
A. Accumulation of fluid in the peritoneal cavity. -
- 43.
Icterus is a yellow discoloration of....
- A.
Skin
- B.
Eyes
- C.
Nails
- D.
Urine
Correct Answer
B. Eyes -
- 44.
You are performing an abdominal auscultation on a patient with gastroenteritis, what sort of bowel sounds would you expect to hear?
- A.
Hypoactive
- B.
Normal
- C.
Hyperactive
- D.
None
Correct Answer
C. Hyperactive -
- 45.
All of the following may cause dullness upon abdominal percussion EXCEPT:
- A.
Pregnancy
- B.
Ascites
- C.
Abdominal Tumor
- D.
Intestinal Obstruction
Correct Answer
D. Intestinal Obstruction -
- 46.
You are doing an abdominal assessment on a 16 yr old Male who came into the ER with severe abdominal pain. He states the pain is worst when he coughs. When palpating his stomach you notice a positive Rovsings sign and rebound tenderness. What is your most likely diagnosis?
- A.
Appendicitis
- B.
Cholecystitis
- C.
Pancreatitis
- D.
Hepatitis
Correct Answer
A. Appendicitis -
- 47.
After what age should all men start receiving yearly PSA's and colonoscopy's?
- A.
40
- B.
50
- C.
60
- D.
35
Correct Answer
B. 50 -
- 48.
A patient who suffers from a chronic cough in the AM probably has a past history of....
- A.
Cardiac Issues
- B.
Pneumonia
- C.
Smoker
- D.
Allergies
Correct Answer
C. Smoker -
- 49.
You are assessing for tactile fremitus on a patient you suspect has a pneumothorax. Which finding would help to cofirm your suspicion?
- A.
Decreased Fremitus
- B.
Increased Fremitus
- C.
Presence of Fremitus
Correct Answer
A. Decreased Fremitus -
- 50.
You are percussing the chest of a patient with emphysema, what sound would you expect to hear?
- A.
Resonant
- B.
Hyperresonant
- C.
Dull
- D.
Wheezing
Correct Answer
B. Hyperresonant -
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