Physical Examination and Health Assessment 9th Edition Test Bank

Correct Answer: B

Rationale: The clinical presentation described in the question is consistent with Candida vaginitis, also known as vaginal yeast infection. Candida vaginitis typically presents with a thick, white, curdy discharge that can be visualized on examination. The low pH of 1 is characteristic of Candida infection. The negative KOH whiff test and absence of an unusual smell help differentiate Candida vaginitis from other types of vaginitis.

Correct Answer: B

Rationale: Option B, briefy summarizing what you heard from the patient in the first 5 minutes and then trying to have her focus on one aspect of what she told you, is the best technique to facilitate a more focused and efficient interview. This approach acknowledges the patient's need to talk while also guiding the conversation towards more relevant topics. By summarizing at the beginning, you demonstrate that you are listening, and by redirecting the conversation to specific points, you can ensure that important issues are addressed within the time constraints of the appointment. It can help streamline the visit and prevent it from meandering off track due to the patient's chattiness.

Correct Answer: C

Rationale: The clinical presentation described in the question is consistent with mitral valve prolapse (MVP). MVP is characterized by the improper closure of the mitral valve leaflets during systole, leading to the prolapse of one or both leaflets into the left atrium. The classic auscultatory findings in MVP include a mid-systolic click followed by a late systolic murmur. The click is the result of sudden tensing of the chordae tendineae as the mitral valve prolapses, and the murmur occurs as blood leaks backward (mitral regurgitation) due to imperfect valve closure.

Correct Answer: A

Rationale: Inspiratory splitting of S occurs due to the normal physiological delay in the closure of the aortic and pulmonic valves during inspiration. During inspiration, the negative intrathoracic pressure leads to increased venous return to the right side of the heart, causing a slight delay in the closure of the pulmonic valve. This results in the aortic valve closing first, followed by the closure of the pulmonic valve, leading to the splitting of S during inspiration.

Correct Answer: D

Rationale: The patient's symptoms point towards pneumonia. Pneumonia is characterized by infection and inflammation in the lung tissue, leading to symptoms such as decreased air movement, crackles on auscultation, dullness on percussion, increased fremitus on palpation, and abnormal breath sounds like egophony and whispered pectoriloquy. These findings are consistent with consolidation of the lung, which occurs in pneumonia as a result of fluid, inflammatory cells, and tissue debris filling the alveoli. The presence of nasal turbinates edema indicates a possible upper respiratory tract infection that may have preceded the development of pneumonia. Spontaneous pneumothorax would typically present with sudden-onset chest pain and dyspnea but would not typically cause findings of lung consolidation. Chronic obstructive pulmonary disease (COPD) and asthma are characterized by different patterns of lung damage and symptoms, such as chronic inflammation, airflow obstruction, and hyper