Physical Assessment Practice Questions

Correct Answer: B

Rationale: The dullness in the last intercostal space in the anterior axillary line on the left side with a deep breath is suggestive of splenomegaly. However, this finding alone is not definitive for an enlarged spleen. The size of the spleen can vary, and further examination is required to confirm if the spleen is indeed enlarged. Therefore, Option B is the most appropriate choice as it indicates that the spleen is possibly enlarged, and close attention should be paid to further examination to confirm its status. Further workup, such as imaging studies or blood tests, may be necessary to evaluate the size and function of the spleen in this case.

Correct Answer: B

Rationale: In the given scenario, being a 35-year-old archaeologist with fair skin, a family history of melanoma, and many freckles scattered across her skin are all risk factors for melanoma. Age (choice A) is a relevant risk factor as melanoma incidence increases with age. Actinic lentigines (choice C), also known as sunspots, are precancerous skin lesions that can increase the risk of developing melanoma. Heavy sun exposure (choice D) is a significant risk factor as cumulative sun exposure over time can contribute to the development of melanoma.

Correct Answer: A

Rationale: The raised, dark red rash that does not blanch when pressed on, typically known as erythema nodosum, is a common skin manifestation of systemic lupus erythematosus (SLE). Given Mrs. Hill's history of SLE, it is likely that her rash is related to her autoimmune condition rather than an exposure to a chemical or an allergic reaction. It is important for her to discuss this new symptom with her healthcare provider to ensure appropriate management and monitoring of her lupus.

Correct Answer: D

Rationale: The presentation is highly suggestive of appendicitis, especially given the migration of pain from the periumbilical region to the right lower quadrant (just medial and inferior to the iliac crest). The worsening of pain with motion, along with associated symptoms such as nausea, vomiting, anorexia, and fever, are typical features of appendicitis. The classic presentation of appendicitis is pain starting around the umbilicus (due to visceral innervation) and then shifting to the right lower quadrant (due to irritation of the parietal peritoneum). Surgical intervention is usually required promptly to prevent complications like perforation, which can lead to peritonitis and sepsis.

Correct Answer: D

Rationale: The patient's presentation of new onset tremors, slow movements with shuffling steps (bradykinesia), decreased facial mobility, and blunt expression are characteristic features of Parkinson's disease. Parkinson's disease is a neurodegenerative disorder that affects movement, typically presenting with tremors, rigidity, and bradykinesia. The presence of these symptoms in this patient, along with the absence of any other medical conditions or medication use, points toward a diagnosis of Parkinson's disease. Other conditions like Cushing's syndrome, nephrotic syndrome, and myxedema are unlikely based on the patient's clinical presentation.