Test Bank Physical Examination and Health Assessment

Correct Answer: A

Rationale: Anisocoria refers to a condition where the pupils are of unequal size. Pathologic causes of anisocoria can include conditions such as Horner's syndrome. Horner's syndrome is a rare disorder caused by damage to the sympathetic nerves of the face and eye. Symptoms can include a constricted pupil (miosis), drooping of the upper eyelid (ptosis), and decreased sweating in the affected area. This results in anisocoria, where the affected pupil is smaller than the unaffected pupil. Other options listed (B-D) do not typically lead to pathologic anisocoria.

Correct Answer: C

Rationale: The patient's history of frequent loose stools with cramping, occurring since high school and worsening during periods of nervousness, along with occasional constipation, is characteristic of irritable bowel syndrome (IBS). IBS is a functional gastrointestinal disorder that presents with symptoms such as abdominal pain or discomfort, bloating, and altered bowel habits (diarrhea, constipation, or both) without any evidence of organic disease. The absence of systemic symptoms like fever, weight loss, or blood in the stool, as well as normal physical examination findings, also support the diagnosis of IBS in this case. This condition is often triggered or exacerbated by stress or anxiety. Monitoring stress levels, dietary modifications, and possibly prescription medications may help manage IBS symptoms in this patient.

Correct Answer: C

Rationale: A "red flag" regarding patients presenting with a headache is their age being over 50. This is because new-onset or persistent headaches in individuals over 50 may raise concerns about underlying serious conditions such as temporal arteritis, brain tumor, or other vascular issues. It is important to thoroughly evaluate and consider these possibilities in older patients with headaches to ensure appropriate management and timely intervention.

Correct Answer: C

Rationale: Peyronie's disease is a condition characterized by the formation of fibrous scar tissue in the penis, leading to the development of plaques or indurations along the shaft of the penis, typically on the ventral surface. These plaques can cause penile curvature, pain, and erectile dysfunction. Urethral stricture, testicular carcinoma, and epidermoid cysts are not typically associated with indurations along the ventral surface of the penis.

Correct Answer: D

Rationale: Weight loss can have a significant impact on the health problems associated with obesity. Even a modest weight loss of around 10% can lead to noticeable improvements in conditions such as diabetes, hypertension, osteoarthritis, and obstructive sleep apnea. Encouraging Mr. Curtiss to focus on achieving a meaningful but achievable goal, such as a 10% weight loss, can help him experience positive changes in his health and overall wellbeing, even if his ultimate goal weight seems far away. This approach can also help to boost his motivation and confidence in his ability to make progress towards better health.