Health Assessment and Physical Examination Test Bank

Correct Answer: B

Rationale: Mrs. Fletcher's symptoms of unilateral pain during chewing, which is chronic, without facial tenderness or tenderness of the scalp are more suggestive of temporomandibular joint (TMJ) syndrome rather than other conditions listed. TMJ syndrome is characterized by pain and dysfunction of the jaw muscles and the joints that connect the jaw to the skull. The pain is often worsened by chewing or opening the mouth widely. In this case, the absence of facial tenderness or signs of temporal arteritis makes these conditions less likely. Trigeminal neuralgia typically presents with sudden, severe facial pain in the distribution of the trigeminal nerve. Tumor of the mandible would likely present with other symptoms such as swelling, bone destruction, or difficulty with mouth opening and chewing. Temporal arteritis usually presents with symptoms such as headache, scalp tenderness, and visual disturbances. Given Mrs. Fletcher's presentation,

Correct Answer: B

Rationale: While it is important to ask about recent sexual activity and whether it included sexual intercourse, using the term "intimate physical contact" is not specific enough. This question could potentially lead to misinterpretation or confusion regarding what types of activities are being referred to. It is more appropriate to directly ask about sexual intercourse when obtaining a sexual history. The other options are all appropriate questions to elicit information about the patient's sexual history.

Correct Answer: A

Rationale: The symptom described - sharp, aching chest pain that increases with breathing - is typically associated with musculoskeletal issues. The pain worsening with breathing suggests a connection to the movements of the chest wall, which could involve the muscles, bones, or joints in that area. Conditions such as costochondritis (inflammation of the cartilage that connects a rib to the breastbone) or muscle strains in the chest wall are common causes of chest pain that worsens with breathing. This localization to the musculoskeletal system is based on the characteristics of the pain and how it is affected by breathing, helping to narrow down the differential diagnosis.

Correct Answer: B

Rationale: The most likely diagnosis in this case is a scrotal hernia. The patient's history of a previous groin surgery as a baby is a key clue, as it increases the risk for developing a hernia. The lump in the left testis with aching, along with the inability to palpate above the mass through the left inguinal ring, suggests that the lump may be a hernia protruding through the inguinal canal into the scrotum. The presence of a scar in the right inguinal region also supports the likelihood of a hernia. The normal prostate on rectal examination rules out any involvement of the prostate in the presentation. Scrotal hernias may present as painless masses in the scrotum, often increasing in size with activities that increase intra-abdominal pressure, such as straining or coughing. Surgical repair is often necessary to prevent complications such as incarceration or strangulation

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.