PD Exam 3 -Bates 8, 9, 11
1. Which of the following represents age-related changes in the lungs?
A) Decrease in chest wall compliance
B) Speed of
... [Show More] expiration increases
C) Increase in respiratory muscle strength
D) Increased elastic recoil of lung tissue
- A) Decrease in chest wall compliance
2. Mr. Kelly comes to you today for a burning pain in his lower abdomen. This has
gone on for 2 months. He has received radiation for prostatic cancer for the past
quarter. What assumptions could you draw from this?
A) This represents persistent pain.
B) His pain reporting is likely to be unreliable.
C) Decrease in chest wall compliance
D) He is depressed.
- C) Decrease in chest wall compliance
3. An 89-year-old retired school principal comes for an annual check-up. She would
like to know whether or not she should undergo a screening colonoscopy. She
has never done this before. Which of the following factors should not be
considered when discussing whether she should go for this screening test?
A) Life expectancy
B) Time interval until benefit from screening accrues
C) Patient preference
D) Current age of patient
- D) Current age of patient
4. During cardiac examination you notice a new parasternal systolic murmur of 2/6
intensity. On palpation, the PMI is slightly higher than usual. What do you
suspect?
A) Mammary souffle
B) Mitral stenosis
C) Mitral regurgitation
D) Aortic insufficiency
- A) Mammary souffle
5. A 37-year-old nurse comes for evaluation of colicky right upper quadrant
abdominal pain. The pain is associated with nausea and vomiting and occurs 1 to
2 hours after eating greasy foods. Which one of the following physical
examination descriptions would be most consistent with the diagnosis of
cholecystitis?
A) Abdomen is soft, nontender, and nondistended, without
hepatosplenomegaly or masses.B) Abdomen is soft and tender to palpation in the right lower quadrant,
without rebound or guarding.
C) Abdomen is soft and tender to palpation in the right upper quadrant with
inspiration, to the point of stopping inspiration, and there is no rebound or
guarding.
D) Abdomen is soft and tender to palpation in the mid-epigastric area, without
rebound or guarding.
- C) Abdomen is soft and tender to palpation in the right upper quadrant
with inspiration, to the point of stopping inspiration, and there is no
rebound or guarding
6. You are observing a patient with heart failure and notice that there are pauses in
his breathing. On closer examination, you notice that after the pauses the patient
takes progressively deeper breaths and then progressively shallower breaths,
which are followed by another apneic spell. The patient is not in any distress.
You make the diagnosis of:
A) Ataxic (Biot's) breathing
B) Cheyne-Stokes respiration
C) Kussmaul's respiration
D) COPD with prolonged expiration
- B) Cheyne-Stokes respiration
7. Which of the following is true of assessment of the vascular system in the
elderly?
A) Fewer than one third of patients with peripheral vascular disease have
symptoms of claudication.
B) An aortic width of 2.5 cm is abnormal.
C) Bruits are commonly benign findings.
D) Orthostatic blood pressure and pulse are not useful in this population
- A) Fewer than one third of patients with peripheral vascular disease have
symptoms of claudication.
8. Mr. W. is a 51-year-old auto mechanic who comes to the emergency room
wanting to be checked out for the symptom of chest pain. As you listen to him
describe his symptom in more detail, you say "Go on," and later, "Mm-hmmm."
This is an example of which of the following skilled interviewing techniques?
A) Echoing
B) Nonverbal communication
C) Facilitation
D) Empathic response
- C) Facilitation
9. Mr. Chin is an 82-year-old man who comes to your office for a routine check. On
examination, you notice a somewhat high-pitched murmur in the second right
intercostal space during systole. It does not radiate and the rest of hisexamination is normal for his age. Which is true of the most likely cause of this
murmur?
A) It often decreases carotid upstroke.
B) It carries with it increased risk for cardiovascular disease.
C) It is usually accompanied by an S3 gallop.
D) It is found in 10% of otherwise normal elderly patients.
- B) It carries with it increased risk for cardiovascular disease.
10.A 49-year-old truck driver comes to the emergency room for shortness of breath
and swelling in his ankles. He is diagnosed with congestive heart failure and
admitted to the hospital. You are the student assigned to do the patient's
complete history and physical examination. When you palpate the pulse, what do
you expect to feel?
A) Large amplitude, forceful
B) Small amplitude, weak
C) Normal
D) Bigeminal
- B) Small amplitude, weak [Show Less]