Health Assessment and Physical Examination Test Bank

Correct Answer: D

Rationale: The constellation of symptoms described in the scenario, including chronic constipation, fatigue, weight gain, irregular periods, cold intolerance, and delayed deep tendon reflexes, suggests hypothyroidism as the likely cause. Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones, leading to a slowdown in bodily functions. Constipation is a common symptom of hypothyroidism due to the decreased motility of the bowel. The presence of cold intolerance, weight gain, and irregular periods further supports this diagnosis, as these are classic symptoms of hypothyroidism. The delayed deep tendon reflexes, especially in the Achilles tendons, are indicative of the myopathic changes that can occur in hypothyroidism. It is important to further investigate thyroid function through laboratory testing to confirm the diagnosis and initiate appropriate treatment. Other conditions such as large bowel obstruction, irritable bowel syndrome, and rectal cancer are less likely based

Correct Answer: C

Rationale: The most likely diagnosis in this case is prostatitis. Prostatitis is the inflammation or infection of the prostate gland, which can cause symptoms such as discomfort between the scrotum and anus (perineum), fevers, and dysuria (painful urination). The tenderness anteriorly during rectal examination is consistent with prostatitis as the prostate gland is located in front of the rectum and can be tender to touch when inflamed. Prostate cancer typically presents with symptoms such as urinary frequency, nocturia, hematuria, or bone pain, and is less likely to cause the symptoms described in this scenario. Colon cancer and colonic polyps are less likely as they would not typically cause discomfort in the perineal area or dysuria.

Correct Answer: B

Rationale: Urge incontinence, also known as overactive bladder, is characterized by a sudden and strong urge to urinate which is difficult to control. In this case, Mrs. LaFarge is unable to get to the bathroom quickly enough when she senses the need to urinate, which indicates a lack of control over the urge to urinate. This is typically caused by involuntary contractions of the bladder muscle. Stress incontinence, on the other hand, is leakage of urine during activities that increase intra-abdominal pressure, such as coughing or exercising. Overflow incontinence is characterized by urinary retention and constant dribbling of urine due to the bladder being unable to empty properly. Functional incontinence occurs when a person has normal bladder control but is unable to reach the bathroom in time due to physical or cognitive impairments. Since Mrs. LaFarge is experiencing a sudden and strong urge to urinate that she cannot

Correct Answer: B

Rationale: Orthopnea is a symptom characterized by difficulty breathing while lying flat that improves when sitting or standing upright. This symptom is specifically related to cardiovascular conditions, such as heart failure, in which fluid accumulates in the lungs when lying down. Considering the patient's complaint of breathlessness with activity and the need to assess for cardiovascular issues, asking about orthopnea would be most appropriate to gain insights into potential heart-related causes of the symptoms. Abdominal pain (A), hematochezia (C), and tenesmus (D) are not typically associated with cardiovascular conditions and are less relevant to the patient's presentation.

Correct Answer: D

Rationale: The changes in Jenny's appearance and behavior, such as wearing old jeans, lack of makeup, and avoiding eye contact, are suggestive of potential signs of depression. When a person is feeling depressed, they may lose interest in their appearance, have changes in sleep patterns leading to fatigue, and exhibit avoidance behaviors like avoiding eye contact. It is essential to approach Jenny with empathy and offer support as depression can significantly impact one's well-being and daily functioning. It would be beneficial for Jenny to seek professional help and guidance to address any underlying issues causing her to feel this way.