For which one of the patients would a comprehensive health history be appropriate? Correct Answer- A
new patient with the CC of "Im here to establish car... [Show More] e"
The components of a health history include all of the following except which one? Correct Answer- A.
ROS
B. Thorax and lungs
C. Present Illness
D. Personal and social items
Answer is B thorax and lungs
Is the following info subjective or objective? Mr. M has SOB that has persisted for the past 10 days; it is
worse with activity and relieved by rest Correct Answer- Subjective
Is the following info subjective or objective? Mr. M has a RR of 32 and a pulse rate of 120 Correct
Answer- objective
Health history includes- "patient has had and pain for 1 week. Pain lasts for 30min at a time; it comes
and goes. Severity is 7-9, accompanied by N&V, located in mid-epigastric area" which category does it
belong to? Correct Answer- Present Illness
This info is in the health history: "patient completed 8th grade. Currently lives with his wife and two
children. Works on cars on the weekend. Works in a glass factory during the week." Which category
does it belong to? Correct Answer- Personal and social history
The following info is recorded in the health history: "I feel really tired." which category does it belong
to? Correct Answer- Chief complaint
Recorded in health history: "patient denies chest pain, palpitation, orthopnea, and paroxysmal nocturnal
dyspnea." which category? Correct Answer- ROS
The following info is best placed in which category? "The patient had a stent placed in the LAD in 99."
Correct Answer- Adult illnesses
The following info is best placed in which category? "The patient was treated for an asthma
exacerbation in the hospital last year; the patient has never been intubated." Correct Answer- Adult
illnesses
19 yr old college student Todd...brought in by his mom for odd behavior....He tells you he has seen a
black van and computer tech workers are stealing his work through special gamma waves. "See I told
you...he's crazy. What do I do about it?" While arranging for a psychiatry consult, what psychotic
disorder do you think Todd has? Correct Answer- Schizophrenia
24 yr old secretary, complaining of difficulty sleeping, severe nightmares, and irritability. 6 months ago
she was held at gunpoint...On exam, you find a nervous woman appearing her stated age. Physical exam
is unremarkable. You recommend medication and counseling. What anxiety disorder do you think she
has? Correct Answer- PTSD
75-year old homemaker brings her 76 yr old husband to the clinic. had a stroke 4 months ago..."I will
change the Kool-aid out of the sink myself with the ludrip." She says that these sayings are becoming
frustrating. What type os aphasia does he have? Correct Answer- Wernike's aphasia
32-yr old complaining of overwhelming sadness. Last 2 months she has had crying episodes, difficulty
sleeping, and problems with overeating. On examination you see a woman appearing her stated age
who seems quite sad. Her facial expression does not change while you talk to her and she makes little
eye contact. She speaks so softly you cannot always understand her. Her though processes and content
seem unremarkable. What type of disorder do you think she has? Correct Answer- Major depressive
episode
27 yr-old woman brought to office by her mother. Mother says daughter has schizophrenic for last 8
years...Patient has been microwaving letters from mailman. Pt agrees that she does this but only bc the
mailman flipping through the envelopes and she knows he's putting anthrax on the letters. Which bus
describes the patient's abnormality of perception? Correct Answer- Illusion
22-yr old brought to office by his father to discuss mental health disorder. schizophrenia was diagnosed
6 months ago...Son has been hearing things that don't exist. You ask the young man what is going on
and he tells you that his father is just jealous bc his sister talks only to him. "Son, your sister died 2 years
ago." Son thinks she still talks to him. Which best describes the patient's abnormality of perception?
Correct Answer- Hallucination
26 yr old violinist, complains of anxiety. during performances only starts to sweat, shake, and
hyperventilate. It has gotten so bad he has thought about giving up his first chair status so he doesn't
have to play the solo during one of the movements. These symptoms don't happen during rehearsals or
when he is practicing. What type of anxiety disorder best describes his sit? Correct Answer- social
phobia
23 yr-old ticket agent is brought in by her husband bc he is concerned with her recent behavior. Stopped
showering, up all night cleaning, racking up credit cards, she states she is very happy and fulfilled.
Speaks quickly and changes the subject often. On exam she is very loud and outspoken. PE is
unremarkable. Which mood disorder does she most likely have? Correct Answer- Manic episode
72-yr old AA, after weakness in his R arm and leg...MRI showed small stroke...everyone is still having
trouble communicating with him. You ask the pt how he thinks he is doing. "well, fine, doing, okay."
Other than his weak R arm and leg his PE is unremarkable. What disorder of speech does he have?
Correct Answer- Broca's aphasia
35-yr old stockbroker, complaining of feeling tired and irritable. Also says she feels like nothing ever
goes her way and that nothing good ever happens. When you ask her how long she has felt this way she
laughs and says, "since when have I not?" She relates that she has felt pessimistic about life in general
since she was in High school. Mother has depression...What mental health disorder best describes her
symptoms? Correct Answer- Dysthymic disorder
Susanne is a 27 yr old who has had HAs, muscle aches, and fatigue for the last 2 months. thorough
history, exam, and lab workup are negative. What would be your next action? Correct Answer- To screen
for depression
You ask a patient to draw a clock. He fills in all the numbers on the R half of the circle. What do you
suspect? Correct Answer- Hemianopsia
A young woman comes to you with a cut on finger from a can she was opening. She is pacing about the
room, crying loudly, "My career as a pianist is finished!" which personality type exhibits these features?
Correct Answer- Histrionic
Adam is a successful 15 yr old student and athlete. mother brings him in bc he no longer studies, works
out, or sees his friends. Its been a month and a half, you speak to him in the room and he states "would
be better if he were not here." What would you do next? Correct Answer- Assess his suicide risk
29-yr old woman jumping from topic to topic so rapidly that you have trouble following her. You are
able to find some connections between ideas, but its difficult. Which word describes this thought
process? Correct Answer- Flight of ideas
In obtaining a health history, you note the patient uses the word "largely" repeatedly, to the point of
being a distraction to your task. Which word best describes this speech pattern? Correct AnswerPerseveration
You are performing a thorough cardiac examination. Which of the following chambers of the heart can
you assess by palpation? Correct Answer- R ventricle
what is responsible for the inspiratory splitting of S2? Correct Answer- Closure or aortic, then pulmonic
valves
A 25-yr old optical tech comes to clinic for fatigue. You listen and hear a murmur only at the cardiac
apex. Which valve is most likely to be involved, based on location of murmur? Correct Answer- Mitral
valve
a 58-yr old teacher presents to your clinic with a complaint of breathlessness with activity. Which is
appropriate to ask about in the cardiovascular ROS? Correct Answer- orthopnea
You are screening people at the mall as part of a health fair. Someone has BP 132/85, how would you
categorize this? Correct Answer- Prehypertension
You are performing cholesterol screens. One person has cholesterol of 225. She is concerned with her
risk for developing heart disease. Which of the following factors is used to estimate the 10-yr risk of
developing CAD? Correct Answer- Gender
You are evaluating a 40-yr old banker for CAD risk factors, hx of HTN, well controlled on meds. He does
not smoke, does 45 min of aerobic exercise 5 x weekly...calculating his 10-yr CAD risk...which of the
following conditions is considered to be a CAD risk equivalent? Correct Answer- Peripheral arterial
disease
You are conducting a workshop on the measurement of jugular venous pulsation....which one of the
following characteristics is typical of the carotid pulse? Correct Answer- Palpable
68-yr old mechanic in ER for SOB, concerned about JVP...it is elevated...which one of these conditions is
a potential cause of elevated JVP Correct Answer- Constrictive pericarditis
Palpating the apical impulse and find that the amplitude is diffuse and increased....what could be a
potential cause of an increase in amplitude of the impulse? Correct Answer- Aortic stenosis, with
pressure overload of the LV
You are performing a cardiac exam on a patient with SOB and palpitations...you have him turn onto his L
side in the Left lateral decubitus position...which valvular defects is best heard in this position? Correct
Answer- Mitral
You are concerned that a pt has an aortic regurgitation murmur, which is the best position to accentuate
the murmur? Correct Answer- upright, but leaning forward
A 68-yr old retired waiter comes to your clinic for eval of fatigue...cardiac exam shows pulse rate less
than 60...which could cause this? Correct Answer- Second degree A-V block
Where is the point of maximal impulse (PMI) normally located?? Correct Answer- In the left 5th
intercostal space, 7-9cm lateral to the sternum
Which of the following occurs at the start of diastole? Correct Answer- closure of the aortic valve
Which is true of a third heart sound S3? Correct Answer- It is caused by rapid deceleration of blood
against the ventricular wall
Which is true of splitting of the second heart sound? Correct Answer- It is best heard over the pulmonic
area with the bell of the stethoscope
Which of the following is true of JVP measurement? Correct Answer- The vertical height of the blood
column in centimeters, plus 5cm, is the JVP
Which of the following regarding jugular venous pulsations is a systolic phenomenon? Correct AnswerThe X descent
How much does cardiovascular risk increase for each increment of 20mm Hg systolic and 10mm Hg
diastolic in BP? Correct Answer- 100%
In healthy adults over 20, how often should BP, body mass index, waist circumference, and pulse be
assessed according to the AHA guidelines? Correct Answer- every 2 years
Which of the following is a clinical identifier of metabolic syndrome? Correct Answer- BP of 134/88 for a
male
Mrs. Adams would like to begin an exercise program ...obtain a HR 60% or greater of her maximum HR.
She is 52, what HR should she achieve? Correct Answer- 100
In measuring the JVP, which of the following is important? Correct Answer- Measure the highest visible
pressure, usually at end expiration
You find a bounding carotid pulse on a 62-yr old pt. Which murmur should you search out? Correct
Answer- Aortic insufficiency
To hear a soft murmur or bruit, which of the following may be necessary? Correct Answer- D. All of the
above....
Asking the pt to hold her breath, asking the pt in the next bed to turn down the TV, checking your
stethoscope for air leaks
Which of the following may be missed unless the pt is placed in the left lateral decubitus position and
auscultated with the bell? Correct Answer- D. All of the above....
Mitral stenosis murmur, opening snap of the mitral valve, S3 and S4 gallops
How should you determine whether a murmur is systolic or diastolic? Correct Answer- Palpate the
carotid pulse
Which of the following correlates with sustained, high-amplitude PMI? Correct Answer- Hypertension
You are examining a pt with emphysema in exacerbation and are having difficulty hearing heart
sounds...what should you do to obtain a good exam? Correct Answer- Listen in the epigastrium
You are listening carefully for S2 splitting, which of the following will help? Correct Answer- Using the
bell with light pressure over the 2nd left intercostal space
Which of the following is true of a grade 4-intenstiy murmur? Correct Answer- It is associated with a
thrill
Which valve lesion typically produces a murmur of equal intensity throughout systole? Correct AnswerMitral Insufficiency
19 yr old c/o clear discharge from her R breast for 2 months....you are able to express clear discharge
from her R nipple..no discrete masses and her axillae are normal...What cause of nipple discharge is the
most likely here? Correct Answer- Benign breast abnormality
You notice a patient has a strong pulse and then a weak pulse. This pattern continues, which of the
following is likely? Correct Answer- Severe Left heart failure
Suzanne is a 20-yr old college student who complains of CP....on exam you hear a short, high-pitched
sound in systole, followed by a murmur which increases in intensity until S2. This is heard best over the
apex. When she squats, this noise moves later in systole along with the murmur...which is the most
likely diagnosis? Correct Answer- Mitral valve prolapse
A 72-yr old retired saleswoman...complains of bloody discharge from her left breast for 3 months...no
trauma, etc...you feel no discrete masses, but her left axilla has a hard, 1-cm fixed node. The remainder
of her hears, lung, etc is unremarkable... What cause of nipple discharge is the most likely in her
circumstance? Correct Answer- Breast Cancer [Show Less]
