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: D

Rationale: The correct order of priority for the problem list in this case would be chest pain, headaches, arthritis, and war injury pain. Chest pain should always be a priority as it could indicate a serious or life-threatening condition such as a heart attack. Headaches, while important, are less urgent than chest pain. Arthritis can generally be managed without immediate intervention, making it a lower priority. Finally, the pain from the old war injury, while significant, is not as urgent as the other complaints.

Correct Answer: A

Rationale: The presence of a firm and immobile mass felt against the bowel wall during a rectal examination is concerning for a potential malignancy, such as colon cancer. Other conditions such as hemorrhoids or anal fissures are typically not associated with a mass that is firm and immobile. The "Valve of Houston" is a term that does not pertain to this scenario and is not a recognized medical entity. Therefore, the most likely diagnosis based on the given information is colon cancer, and further evaluation such as a colonoscopy would be warranted for definitive diagnosis and management.

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: A

Rationale: The most significant risk factor for breast cancer in the patient's personal and family history is having a first-degree relative with premenopausal breast cancer. This is because the age at which a family member was diagnosed with breast cancer can be indicative of potential genetic predispositions that may increase the patient's own risk of developing the disease. Women with a first-degree relative who was diagnosed with breast cancer before menopause (premenopausal) are at a higher risk themselves compared to those with a family history of postmenopausal breast cancer. In this case, the patient's mother had unilateral breast cancer in her 70s, which suggests a higher risk compared to postmenopausal breast cancer. Other factors such as early age at menarche or age at first live birth are also important in assessing breast cancer risk, but having a first-degree relative with premenopausal breast cancer is the most significant