jarvis physical examination and health assessment test bank

Correct Answer: B

Rationale: The correct answer is B because in Munchausen syndrome by proxy, the patient only exhibits symptoms under the direct care or supervision of the abuser. This is because the abuser intentionally causes or fabricates symptoms in the victim to gain attention or sympathy. In contrast, the other choices are incorrect. A is incorrect because the injury is inflicted by the abuser, not self-inflicted by the patient. C is incorrect as the caregiver is the one perpetrating the abuse. D is incorrect because the abuser is often overly involved and manipulative, rather than inattentive and uncaring.

Correct Answer: B

Rationale: The correct answer is B because decreased tactile fremitus suggests fluid or air in the pleural space, which can occur in conditions like pleural effusion or pneumothorax. This decrease in tactile fremitus is due to the transmission of vibrations from the vocal cords being impeded by the presence of fluid or air between the lung and chest wall. Choices A, C, and D are incorrect because decreased tactile fremitus is not typically associated with increased lung density, normal lung function, or lung tumors.

Correct Answer: C

Rationale: The correct answer is C. The patient's age (36 years) and chronic smoking are the main reasons why a combined hormonal contraceptive would be contraindicated. Age over 35 and tobacco use increase the risk of cardiovascular complications with hormonal contraceptives. Obesity (choice A), type 2 diabetes (choice B), and a sedentary lifestyle (choice D) are also risk factors, but they are not the primary reasons for contraindicating combined hormonal contraceptives in this case.

Correct Answer: B

Rationale: The correct answer is B: Lung cancer. The patient's symptoms of chronic smoking, persistent cough, and weight loss are concerning for malignancy. Lung cancer is a common consequence of long-term smoking and can present with these symptoms. Chronic bronchitis (A) typically presents with cough and mucus production but not necessarily weight loss. Emphysema (C) is characterized by shortness of breath and is less likely to cause weight loss. Asthma (D) usually presents with wheezing and shortness of breath, not typically weight loss.

Correct Answer: D

Rationale: The correct answer is D, "All of the above." Bill's symptoms of epigastric pain lasting 30 minutes or more can be indicative of peptic ulcer, pancreatitis, or myocardial ischemia. Peptic ulcer can cause epigastric pain, pancreatitis presents with severe epigastric pain, and myocardial ischemia can manifest as epigastric discomfort. Considering all these possibilities is crucial for proper diagnosis and treatment. The other choices are incorrect because they do not encompass all potential causes of Bill's symptoms. It is important to consider a broad differential diagnosis to ensure comprehensive evaluation and management.