Physical Examination and Health Assessment 8th Edition Test Bank

Correct Answer: C

Rationale: The clinical presentation described in the scenario is classic for bacterial vaginosis (BV). BV is the most common cause of vaginal discharge in women of childbearing age. Key features of BV include a thin gray-white discharge with a fishy odor, which typically worsens after sexual intercourse and during menstruation. The discharge characteristically has a pH over 4.5, and the presence of clue cells on wet prep is diagnostic. Clue cells are vaginal epithelial cells covered with bacteria, giving them a stippled appearance when viewed under the microscope. These features are consistent with the findings in this patient.

Correct Answer: D

Rationale: The scenario described with a strong pulse followed by a weak pulse is characteristic of pulsus paradoxus, a finding often associated with cardiac tamponade. Cardiac tamponade is a medical emergency where there is an accumulation of fluid (such as blood) in the pericardial sac that exerts pressure on the heart, limiting its ability to pump effectively. As a result, patients may exhibit this pulsus paradoxus, where the pulse strength varies with respiration. The other conditions listed (emphysema, asthma exacerbation, severe left heart failure) are not typically associated with this specific pulsatile pattern.

Correct Answer: C

Rationale: The symptoms described, including decreased air movement, high-pitched whistling (wheezing) on expiration in all lobes, and resonant lungs on percussion, are characteristic findings of asthma. Asthma is a chronic respiratory condition characterized by airway inflammation, bronchoconstriction, and increased mucus production, leading to symptoms like wheezing, shortness of breath, chest tightness, and cough. The presence of wheezing, particularly on expiration, is a classic sign of asthma. In contrast, spontaneous pneumothorax would typically present with sudden chest pain and shortness of breath, accompanied by hyperresonant percussion notes due to trapped air in the pleural space. COPD, a chronic lung condition characterized by progressive airflow limitation, would often present with symptoms such as chronic cough, sputum production, and dyspnea on exertion. Pneumonia is an infection of the lung tissue,

Correct Answer: B

Rationale: Given the information provided about Jim's recent separation from his wife after a long marriage, coupled with the fact that he still experiences early morning erections, the likely cause for his sexual function difficulties is psychological issues. Separation, divorce, or relationship problems can have a significant impact on a person's sexual function due to emotional stress, anxiety, depression, or other mental health issues. In Jim's case, the presence of early morning erections suggests that there may not be a physiological issue like decreased testosterone levels, abnormal circulation, or impaired neural innervation. Instead, the situation seems more related to his emotional state and psychological well-being following the separation. It would be advisable for Jim to seek counseling or therapy to address these psychological factors affecting his sexual function.

Correct Answer: C

Rationale: By connecting the patient's presenting symptoms (wheezing when exposed to cats) and family history of asthma, you have identified asthma as the most likely diagnosis for the 5-year-old girl. This initial conclusion, based on the available information, is known as a working diagnosis. Further evaluation and testing may be required to confirm the diagnosis, but at this stage, you have established a preliminary understanding of the likely condition affecting the patient.