Physical Examination and Health Assessment 9th Edition Test Bank

Correct Answer: C

Rationale: The presence of new flat red and purple lesions that are tender on the ulnar aspect of Ms. Whiting's forearms raises concerns and warrants further investigation. Since she did not mention them, it is important to ask how she acquired them to gather more information. This will help determine the cause of the lesions and provide clues to potential underlying conditions or recent activities that could be related to their development. It is important not to dismiss these lesions as old without proper evaluation, as they could indicate a recent injury, infection, or other medical issues that may require attention.

Correct Answer: A

Rationale: It is crucial to keep the patient's torso at a 45-degree angle when measuring the jugular venous pressure (JVP). This position allows the internal jugular vein to partially collapse, ensuring accurate observation of the pulsations. Keeping the patient at a 45-degree angle provides a standardized position for JVP measurement and helps avoid errors in assessment.

Correct Answer: C

Rationale: The most likely explanation for Mrs. Lenzo noticing a 4-pound weight gain over just 2 days is fluctuations in body fluid. Our body weight can fluctuate throughout the day due to factors such as hydration levels, sodium intake, and hormonal changes. It is not physically possible to gain 4 pounds of actual body mass (e.g., fat or muscle) in such a short period of time by overeating or wearing different clothing. Additionally, if Mrs. Lenzo's scale is very accurate as mentioned, it is less likely that the weight gain is due to instrument inaccuracy. Therefore, the most plausible reason for the sudden weight gain is fluctuations in body fluid retention.

Correct Answer: C

Rationale: Epistaxis, also known as a nosebleed, should be considered in a patient complaining of coughing up blood along with a history of smoking. Epistaxis can sometimes lead to blood trickling down the throat and being coughed up. It is important to consider this differential diagnosis, especially in patients with risk factors such as smoking. Intestinal bleeding (choice A) has a different presentation and cause compared to epistaxis. Hematoma of the nasal septum (choice B) is unlikely to cause coughing up blood. Bruising of the tongue (choice D) is also less likely to be the cause of hemoptysis in this case.

Correct Answer: B

Rationale: Among the options presented, Hepatitis B (HBV) is most likely in this scenario. HBV can be transmitted through mucous membrane exposure to infectious blood or body fluids, including sexual contact. The daycare worker's history of not being sexually active for the past 10 months would not completely rule out the possibility of acquiring HBV through a past sexual encounter. Also, HBV can persist in the blood for prolonged periods, making it a likely cause of jaundice in this case. The other types of hepatitis (A, C, D) are less likely based on the information provided concerning the daycare worker's history and risk factors.