Physical Assessment Practice Questions

Correct Answer: C

Rationale: Constrictive pericarditis is a condition where the pericardium becomes thickened and rigid, impairing diastolic filling of the heart. This leads to an increase in venous pressure, including the jugular venous pressure (JVP). The elevated JVP in constrictive pericarditis is a result of impaired ventricular filling rather than forward failure seen in heart failure. Mitral stenosis can lead to an increased JVP due to elevated left atrial pressure, but constrictive pericarditis is a more common cause of elevated JVP in this scenario. Aortic aneurysm is not typically associated with elevated JVP.

Correct Answer: A

Rationale: When crackles, wheezes, or rhonchi clear with a cough, it is suggestive of bronchitis. Bronchitis is inflammation of the bronchial tubes, often due to a viral infection, leading to the production of excess mucus. The characteristic sounds such as crackles, wheezes, or rhonchi can be heard on auscultation due to the presence of mucus in the airways. The act of coughing helps to clear the mucus from the airways, resulting in the temporary resolution of these abnormal sounds. In contrast, asthma, cystic fibrosis, and heart failure are not typically associated with crackles, wheezes, or rhonchi that clear with a cough.

Correct Answer: C

Rationale: Diminished radial pulses may be seen in patients with arterial emboli. Arterial emboli are blood clots that travel through the bloodstream and get lodged in a blood vessel, blocking blood flow to a certain area. When an embolus affects the arteries supplying the arm, it can lead to diminished pulses in the affected arm, such as the radial pulse in the wrist. This diminished pulse is due to decreased blood flow to the area beyond the blockage caused by the embolus. This distinguishes arterial emboli from the other options listed, as aortic insufficiency, hyperthyroidism, and early "warm" septic shock typically do not cause isolated diminished radial pulses.

Correct Answer: B

Rationale: Research studies have shown that for every increment of 20 mm Hg in systolic blood pressure and 10 mm Hg in diastolic blood pressure, the cardiovascular risk approximately doubles. Therefore, the cardiovascular risk increases by 50% for each increment of 20 mm Hg systolic and 10 mm Hg diastolic in blood pressure. This underlines the importance of maintaining healthy blood pressure levels to reduce the risk of cardiovascular diseases.

Correct Answer: C

Rationale: Marion's presentation of back pain associated with constipation and urinary retention is concerning for cauda equina syndrome. Cauda equina syndrome is a rare but serious condition caused by the compression of the bundle of nerves at the bottom of the spinal cord, known as the cauda equina. This compression can result in a variety of symptoms, including back pain, sciatica, changes in bowel and bladder function (such as constipation and urinary retention), as well as lower extremity weakness or numbness.