Health Assessment and Physical Examination Test Bank

Correct Answer: B

Rationale: The description of the headache as starting a few hours ago, associated with nausea, sensitivity to light, and being severe in intensity suggests a migraine headache. Migraine headaches are often accompanied by these symptoms, known as migraine features. The fact that the patient experiences headaches like this less than once a week and typically uses over-the-counter analgesics to relieve them is also suggestive of migraines. Tension headaches typically present as a more mild to moderate, band-like pressure around the head, without the associated symptoms of nausea and sensitivity to light. Cluster headaches are characterized by excruciating pain around one eye, often accompanied by other symptoms like redness or tearing in the eye. Analgesic rebound headaches occur due to overuse of pain medications and typically present as daily headaches that improve with the same medication that caused them in the first place.

Correct Answer: B

Rationale: At the start of diastole, the ventricles relax and begin to fill with blood from the atria. As this relaxation phase begins, the pulmonic valve opens to allow blood to flow from the right ventricle to the pulmonary artery and then to the lungs for oxygenation. This marks the beginning of diastole, the period of the cardiac cycle when the heart is filling with blood. The closure of the tricuspid valve, closure of the aortic valve, and production of the first heart sound (S1) occur during systole, the phase of the cardiac cycle when the heart is contracting to pump blood out to the body.

Correct Answer: D

Rationale: To hear a soft murmur or bruit clearly, it is important to minimize any background noise or distractions that may interfere with your ability to auscultate effectively. Therefore, asking the patient to hold her breath (choice A) can help reduce noise caused by the patient's respiration. Asking the patient in the next bed to turn down the TV (choice B) can also help eliminate external noise that may disrupt your ability to hear subtle sounds. Checking your stethoscope for air leaks (choice C) is crucial to ensure that you are hearing sounds accurately and not being affected by any equipment issues. By combining these strategies, you can create an optimal environment for listening to soft murmurs or bruits.

Correct Answer: C

Rationale: The appropriate counsel for the patient during the visit would be to give information about the reduction of fat, cholesterol, and calories because he is concerned about his weight. This option addresses the patient's concern and provides guidance on making healthier choices to manage weight. Referring the patient to a nutritionist because he is anorexic (Option A) is not appropriate based on the information provided. Reassuring the patient that he has a normal body weight (Option B) may not address his concerns about weight. Giving the patient information about reducing fat and cholesterol only because he is obese (Option D) does not cover all aspects of a healthy diet such as managing calorie intake.

Correct Answer: C

Rationale: Leaving the plexor finger on the pleximeter after each strike is consistent with good percussion technique. This helps to maintain stability and precision during percussion by providing a consistent point of contact for accurate assessment of the underlying structures. This technique also helps to control the force and angle of the percussive strike, ensuring accurate interpretation of the resulting sounds produced. Maintaining this contact can enhance the effectiveness of percussion as a diagnostic tool in physical examinations.