ADVANCED PHYSICAL ASSESSMENT : FINAL EXAM QUESTIONS
WITH ACCURATE SOLUTONS
1) Anorectal pain, tenesmus, or discharge and/or bleeding suggest -- Answer ✔✔
proctitis
2) The U.S. Preventive Task Force recommends -- Answer ✔✔ start at 55, stop at
69
3) American CA society recommends -- Answer ✔✔ starting 50 years, 40-45 for
high risk, and ending <10 years
4) American urological association recommends -- Answer ✔✔ 55 years, 40 if high
risk, <10 years, Q2 yrs
5) An overweight 26-year-old public servant presents to the Emergency Department
with 12 hours of intense abdominal pain, light-headedness, and a fainting episode
that finally prompted her to seek medical attention. She has a strong family
history of gallstones and is concerned about this possibility. She has not had any
vomiting or diarrhea. She had a normal bowel movement this morning. Her
, βhumanchorionic gonadotropin (β-hCG) is positive at triage. She reports that her
last period was 10 weeks ago. Her vital signs at triage are pulse, 118; blood
pressure, 86/68; respiratory rate, 20/min; oxygen saturation, 99%; and
temperature, 37.3ºC orally. The clinician performs an abdominal exam prior to
her pelvic exam and, on palpation of her abdomen, finds involuntary rigidity and
rebound tenderness. What is the most likely diagnosis?
a. Ruptured tubal (or ectopic) pregnancy
b. Acute cholecystitis
c. Ruptured appendix
d. Perforated -- Answer ✔✔ A
6) A 63-year-old janitor with a history of adenomatous colonic polyps presents for a
well visit. Basic labs are performed to screen for diabetes mellitus and
dyslipidemia. Electrolytes and liver enzymes were also measured. His labs are all
normal expect for moderate elevations of aspartate aminotransferase, alanine
aminotransferase, γ-glutamyl transferase, and alkaline phosphatase as well as a
mildly elevated total bilirubin. He presents for a follow-up appointment and the
clinician performs an abdominal exam to assess his liver. Which of the following
findings would be most consistent with hepatomegaly?
a. Liver span of 11 cm at the midclavicular line
b. Liver span of 8 cm at the midsternal line
c. Dullness to percussion over a span of 11 cm at the midclavicular
lined.
d. Dullness to percussion over a span of 8 cm at the midsternal line
e. Liver palpable 3 cm below the right costal margin, mid clavicular
line, on expiration -- Answer ✔✔ E
7) A 63-year-old underweight administrative clerk with a 50-pack-year smoking
history presents with a several month history of recurrent epigastric abdominal
discomfort. She feels fairly well otherwise and denies any nausea, vomiting,
diarrhea, or constipation. She reports that a first cousin died from a ruptured
aneurysm at age 68 years. Her vital signs are pulse, 86; blood pressure, 148/92;
respiratory rate, 16; oxygen saturation, 95%; and temperature, 36.2ºC. Her body
mass index is 17.6. On exam, her abdominal aorta is prominent, which is
concerning for an abdominal aortic aneurysm (AAA). Which of the following is
her most significant risk factor for an AAA?
a. Female gender
WITH ACCURATE SOLUTONS
1) Anorectal pain, tenesmus, or discharge and/or bleeding suggest -- Answer ✔✔
proctitis
2) The U.S. Preventive Task Force recommends -- Answer ✔✔ start at 55, stop at
69
3) American CA society recommends -- Answer ✔✔ starting 50 years, 40-45 for
high risk, and ending <10 years
4) American urological association recommends -- Answer ✔✔ 55 years, 40 if high
risk, <10 years, Q2 yrs
5) An overweight 26-year-old public servant presents to the Emergency Department
with 12 hours of intense abdominal pain, light-headedness, and a fainting episode
that finally prompted her to seek medical attention. She has a strong family
history of gallstones and is concerned about this possibility. She has not had any
vomiting or diarrhea. She had a normal bowel movement this morning. Her
, βhumanchorionic gonadotropin (β-hCG) is positive at triage. She reports that her
last period was 10 weeks ago. Her vital signs at triage are pulse, 118; blood
pressure, 86/68; respiratory rate, 20/min; oxygen saturation, 99%; and
temperature, 37.3ºC orally. The clinician performs an abdominal exam prior to
her pelvic exam and, on palpation of her abdomen, finds involuntary rigidity and
rebound tenderness. What is the most likely diagnosis?
a. Ruptured tubal (or ectopic) pregnancy
b. Acute cholecystitis
c. Ruptured appendix
d. Perforated -- Answer ✔✔ A
6) A 63-year-old janitor with a history of adenomatous colonic polyps presents for a
well visit. Basic labs are performed to screen for diabetes mellitus and
dyslipidemia. Electrolytes and liver enzymes were also measured. His labs are all
normal expect for moderate elevations of aspartate aminotransferase, alanine
aminotransferase, γ-glutamyl transferase, and alkaline phosphatase as well as a
mildly elevated total bilirubin. He presents for a follow-up appointment and the
clinician performs an abdominal exam to assess his liver. Which of the following
findings would be most consistent with hepatomegaly?
a. Liver span of 11 cm at the midclavicular line
b. Liver span of 8 cm at the midsternal line
c. Dullness to percussion over a span of 11 cm at the midclavicular
lined.
d. Dullness to percussion over a span of 8 cm at the midsternal line
e. Liver palpable 3 cm below the right costal margin, mid clavicular
line, on expiration -- Answer ✔✔ E
7) A 63-year-old underweight administrative clerk with a 50-pack-year smoking
history presents with a several month history of recurrent epigastric abdominal
discomfort. She feels fairly well otherwise and denies any nausea, vomiting,
diarrhea, or constipation. She reports that a first cousin died from a ruptured
aneurysm at age 68 years. Her vital signs are pulse, 86; blood pressure, 148/92;
respiratory rate, 16; oxygen saturation, 95%; and temperature, 36.2ºC. Her body
mass index is 17.6. On exam, her abdominal aorta is prominent, which is
concerning for an abdominal aortic aneurysm (AAA). Which of the following is
her most significant risk factor for an AAA?
a. Female gender
