Physical Examination and Health Assessment 8th Edition Test Bank

Correct Answer: D

Rationale: The closed fist gesture over the sternum to describe chest pain is a typical characteristic of angina pectoris. Angina pectoris is chest pain or discomfort that occurs when the heart muscle does not receive enough oxygen-rich blood. The gesture of clenching a fist over the sternum is often used to describe the tight, squeezing, or pressure-like discomfort experienced with angina. This type of chest pain is typically triggered by physical or emotional stress and is relieved by rest or medications like nitroglycerin. Considering the patient's age, smoking history, and the description of the chest pain gesture, angina pectoris should be a top consideration in this case.

Correct Answer: B

Rationale: The description of dark tan patches with a reddish cast that have sharp borders and fine scales, especially more prominent on the upper back, chest, neck, and upper arms, is classic for tinea versicolor. Tinea versicolor is a superficial fungal infection caused by Malassezia species, which commonly affects individuals who sweat more, such as those working outdoors like the construction worker in this case. The rash is often pruritic (itchy) and can vary in color from tan to pink or red. The fine scales on the patches are a result of the accumulation of the yeast in the affected areas.

Correct Answer: C

Rationale: In the context of visual acuity, the numbers in the ratio 20/100 represent a comparison between the patient's vision and normal vision. Specifically, a visual acuity of 20/100 means that the patient can see at 20 feet what a person with normal vision can see at 100 feet. This indicates that the patient's vision is reduced, as she needs to be closer to see the same level of detail compared to someone with normal vision.

Correct Answer: B

Rationale: Leaning forward in the upright position increases venous return and systemic vascular resistance, which can help accentuate the intensity of aortic regurgitation murmur. This position helps to bring the heart closer to the chest wall, making the murmur easier to auscultate and potentially increasing its intensity.

Correct Answer: D

Rationale: A subconjunctival hemorrhage is a common and benign condition characterized by blood in the space between the conjunctiva and sclera of the eye. The condition often presents as a painless, sharply demarcated area of redness on the white part of the eye, typically without associated discharge or visual disturbances. In this case, the absence of eye pain, discharge, visual disturbances, and clear cornea make subconjunctival hemorrhage the most likely diagnosis. The history of forceful coughing with a recent cold is also consistent with the increased intraocular pressure leading to a rupture of a small blood vessel, resulting in the hemorrhage. Treatment is not usually required as the condition is self-limiting and resolves on its own over time.