Exam 4 – Advanced Health Assessment Questions and and Answers – 100%
Solved
A 14-year-old junior high school student is brought in by his mother and father because he
seems to be developing breasts. The mother is upset because she read on the Internet that
smoking marijuana leads to breast enlargement in males. The young man adamantly denies
using any tobacco, alcohol, or drugs. He has recently noticed changes in his penis, testicles, and
pubic hair pattern. Otherwise, his past medical history is unremarkable. His parents are both in
good health. He has two older brothers who never had this problem. On examination you see a
mildly overweight teenager with enlarged breast tissue that is slightly tender on both sides.
Otherwise his examination is normal. He is agreeable to taking a drug test.
What is the most likely cause of his gynecomastia?
A) Breast cancer
B) Imbalance of hormones of puberty
C) Drug use - ✔✔✔-B) Imbalance of hormones of puberty
A 15-year-old high school football player is brought to your office by his mother. He is
complaining of severe testicular pain since exactly 8:00 this morning. He denies any sexual
activity and states that he hurts so bad he can't even urinate. He is nauseated and is throwing
up. He denies any recent illness or fever. His past medical history is unremarkable. He denies
any tobacco, alcohol, or drug use. His parents are both in good health. On examination you see
a young teenager lying on the bed with an emesis basin. He is very uncomfortable and keeps
shifting his position. His blood pressure is 150/100, his pulse is 110, and his respirations are 24.
On visualization of the penis he is circumcised and there are no lesions and no discharge from
the meatus. His scrotal skin is tense and red. Palpation of the left testicle causes severe pain and
the patient begins to cry. His prostate examination is unremarkable. His cr - ✔✔✔-C) Torsion of
the spermatic cord
A 16-year-old high school junior is brought to your clinic by his father. The teenager was taught
in his health class at school to do monthly testicular self-examinations. Yesterday when he felt
his left testicle it was enlarged and tender. He isn't sure if he has had burning with urination and
he says he has never had sexual intercourse. He has had a sore throat, cough, and runny nose
for the last 3 days. His past medical history is significant for a tonsillectomy as a small child. His
father has high blood pressure and his mother is healthy. On examination you see a teenager in
no acute distress. His temperature is 100.8 and his blood pressure and pulse are unremarkable.
On visualization of his penis, he is uncircumcised and has no lesions or discharge. His scrotum is
,Exam 4 – Advanced Health Assessment Questions and and Answers – 100%
Solved
red and tense on the left and normal appearing on the right. Palpating his left testicle reveals a
mildly sore swollen testicle. The right testicle i - ✔✔✔-A) Acute orchitis
A 19-year-old female comes to your office, complaining of a clear discharge from her right
breast for 2 months. She states that she noticed it when she and her boyfriend were "messing
around" and he squeezed her nipple. She continues to have this discharge anytime she squeezes
that nipple. She denies any trauma to her breasts. Her past medical history is unremarkable. She
denies any pregnancies. Both of her parents are healthy. She denies using tobacco or illegal
drugs and drinks three to four beers a week. On examination her breasts are symmetric with no
skin changes. You are able to express clear discharge from her right nipple. You feel no discrete
masses and her axillae are normal. The remainder of her heart, lung, abdominal, and pelvic
examinations are unremarkable. A urine pregnancy test is negative.
What cause of nipple discharge is the most likely in her circumstance?
A) Benign breast abnormality
B) Breast ca - ✔✔✔-A) Benign breast abnormality
A 20-year-old college student comes in with symptoms of fatigue, nausea, and an increase in
urination. Her last period was 3 months ago (June 20, 2008). She is sexually active and always
uses condoms. Her past medical history is unremarkable. On examination you see a young,
anxious-appearing woman. Her vital signs are unremarkable. Her head, eyes, ears, throat, neck,
thyroid, cardiac, pulmonary, and abdominal examinations are unremarkable. On pelvic
examination a soft cervix is palpated and a 14-week-sized uterus is palpated. A urine pregnancy
test is positive. You then inform the patient that she is expecting and, using Naegele's rule, give
her the estimated date of confinement (EDC, or due date).
What was the due date you gave her?
A) March 27, 2009
B) March 13, 2009
C) September 27, 2009
D) March 20, 2009 - ✔✔✔-A) March 27, 2009
,Exam 4 – Advanced Health Assessment Questions and and Answers – 100%
Solved
A 20-year-old part-time college student comes to your clinic, complaining of growths on his
penile shaft. They have been there for about 6 weeks and haven't gone away. In fact, he thinks
there may be more now. He denies any pain with intercourse or urination. He has had three
former partners and has been with his current girlfriend for 6 months. He says that because she
is on the pill they don't use condoms. He denies any fever, weight loss, or night sweats. His past
medical history is unremarkable. In addition to college, he works part-time for his father in
construction. He is engaged to be married and has no children. His father is healthy and his
mother has hypothyroidism. On examination the young man appears healthy. His vital signs are
unremarkable. On visualization of his penis you see several moist papules along all sides of his
penile shaft and even two on the corona. He has been circumcised. On palpation of - ✔✔✔-A)
Condylomata acuminata
A 21-year-old receptionist comes to your clinic, complaining of frequent diarrhea. She states
that the stools are very loose and there is some cramping beforehand. She states this has
occurred on and off since she was in high school. She denies any nausea, vomiting, or blood in
her stool. Occasionally she has periods of constipation, but that is rare. She thinks the diarrhea
is much worse when she is nervous. Her past medical history is not significant. She is single and
a junior in college majoring in accounting. She smokes when she drinks alcohol but denies using
any illegal drugs. Both of her parents are healthy. Her entire physical examination is
unremarkable.
What is most likely the etiology of her diarrhea?
A) Secretory infections
B) Inflammatory infections
C) Irritable bowel syndrome
D) Malabsorption syndrome - ✔✔✔-C) Irritable bowel syndrome
A 22-year-old architecture major comes to your office, complaining of severe burning with
urination, a fever of 101 degrees, and aching all over. She denies any upper respiratory,
gastrointestinal, cardiac, or pulmonary symptoms. Her past medical history consists of severe
acne. She is currently on an oral contraceptive. She has had no pregnancies or surgeries. She
reports one new partner within the last month. She does not smoke but does drink occasionally.
Her parents are both in good health. On examination you see a young woman appearing slightly
ill. Her temperature is 100.3 and her pulse and blood pressure are unremarkable. Her head,
, Exam 4 – Advanced Health Assessment Questions and and Answers – 100%
Solved
ears, eyes, nose, throat, cardiac, pulmonary, and abdominal examinations are unremarkable.
Palpation of the inguinal nodes shows lymphadenopathy bilaterally. On visualization of the
perineum there are more than 10 shallow ulcers along each side of the vulva. Speculum and
bimanual ex - ✔✔✔-A) Genital herpes
A 22-year-old clerk, primigravida, comes to your office for a prenatal visit. She is in her second
trimester and has had prenatal care since she was 8 weeks pregnant. Her only complaint is that
she has a new brownish line straight down her abdomen. On examination her vital signs are
unremarkable. Her urine has no protein, glucose, or leukocytes. With a Doptone the fetal heart
rate is 140, and her uterus is palpated to the umbilicus. Today you are sending her for congenital
abnormality screening and setting up an ultrasound.
What physical finding is responsible for her new "brown line"?
A) Corpus luteum
B) Linea nigra
C) Linea alba
D) Diastasis recti - ✔✔✔-B) Linea nigra
A 22-year-old law student comes to your office, complaining of severe abdominal pain radiating
to his back. He states it began last night after hours of heavy drinking. He has had abdominal
pain and vomiting in the past after drinking but never as bad as this. He cannot keep any food or
water down, and these symptoms have been going on for almost 12 hours. He has had no
recent illnesses or injuries. His past medical history is unremarkable. He denies smoking or using
illegal drugs but admits to drinking 6 to 10 beers per weekend night. He admits that last night
he drank something like 14 drinks. On examination you find a young male appearing his stated
age in some distress. He is leaning over on the examination table and holding his abdomen with
his arms. His blood pressure is 90/60 and his pulse is 120. He is afebrile. His abdominal
examination reveals normal bowel sounds, but he is very tender in the left upper qua - ✔✔✔-D)
Acute pancreatitis
A 22-year-old unemployed roofer presents to your clinic, complaining of pain in his testicle and
penis. He states the pain began last night and has steadily become worse. He states it hurts
when he urinates and he has not attempted intercourse since the pain began. He has tried
Solved
A 14-year-old junior high school student is brought in by his mother and father because he
seems to be developing breasts. The mother is upset because she read on the Internet that
smoking marijuana leads to breast enlargement in males. The young man adamantly denies
using any tobacco, alcohol, or drugs. He has recently noticed changes in his penis, testicles, and
pubic hair pattern. Otherwise, his past medical history is unremarkable. His parents are both in
good health. He has two older brothers who never had this problem. On examination you see a
mildly overweight teenager with enlarged breast tissue that is slightly tender on both sides.
Otherwise his examination is normal. He is agreeable to taking a drug test.
What is the most likely cause of his gynecomastia?
A) Breast cancer
B) Imbalance of hormones of puberty
C) Drug use - ✔✔✔-B) Imbalance of hormones of puberty
A 15-year-old high school football player is brought to your office by his mother. He is
complaining of severe testicular pain since exactly 8:00 this morning. He denies any sexual
activity and states that he hurts so bad he can't even urinate. He is nauseated and is throwing
up. He denies any recent illness or fever. His past medical history is unremarkable. He denies
any tobacco, alcohol, or drug use. His parents are both in good health. On examination you see
a young teenager lying on the bed with an emesis basin. He is very uncomfortable and keeps
shifting his position. His blood pressure is 150/100, his pulse is 110, and his respirations are 24.
On visualization of the penis he is circumcised and there are no lesions and no discharge from
the meatus. His scrotal skin is tense and red. Palpation of the left testicle causes severe pain and
the patient begins to cry. His prostate examination is unremarkable. His cr - ✔✔✔-C) Torsion of
the spermatic cord
A 16-year-old high school junior is brought to your clinic by his father. The teenager was taught
in his health class at school to do monthly testicular self-examinations. Yesterday when he felt
his left testicle it was enlarged and tender. He isn't sure if he has had burning with urination and
he says he has never had sexual intercourse. He has had a sore throat, cough, and runny nose
for the last 3 days. His past medical history is significant for a tonsillectomy as a small child. His
father has high blood pressure and his mother is healthy. On examination you see a teenager in
no acute distress. His temperature is 100.8 and his blood pressure and pulse are unremarkable.
On visualization of his penis, he is uncircumcised and has no lesions or discharge. His scrotum is
,Exam 4 – Advanced Health Assessment Questions and and Answers – 100%
Solved
red and tense on the left and normal appearing on the right. Palpating his left testicle reveals a
mildly sore swollen testicle. The right testicle i - ✔✔✔-A) Acute orchitis
A 19-year-old female comes to your office, complaining of a clear discharge from her right
breast for 2 months. She states that she noticed it when she and her boyfriend were "messing
around" and he squeezed her nipple. She continues to have this discharge anytime she squeezes
that nipple. She denies any trauma to her breasts. Her past medical history is unremarkable. She
denies any pregnancies. Both of her parents are healthy. She denies using tobacco or illegal
drugs and drinks three to four beers a week. On examination her breasts are symmetric with no
skin changes. You are able to express clear discharge from her right nipple. You feel no discrete
masses and her axillae are normal. The remainder of her heart, lung, abdominal, and pelvic
examinations are unremarkable. A urine pregnancy test is negative.
What cause of nipple discharge is the most likely in her circumstance?
A) Benign breast abnormality
B) Breast ca - ✔✔✔-A) Benign breast abnormality
A 20-year-old college student comes in with symptoms of fatigue, nausea, and an increase in
urination. Her last period was 3 months ago (June 20, 2008). She is sexually active and always
uses condoms. Her past medical history is unremarkable. On examination you see a young,
anxious-appearing woman. Her vital signs are unremarkable. Her head, eyes, ears, throat, neck,
thyroid, cardiac, pulmonary, and abdominal examinations are unremarkable. On pelvic
examination a soft cervix is palpated and a 14-week-sized uterus is palpated. A urine pregnancy
test is positive. You then inform the patient that she is expecting and, using Naegele's rule, give
her the estimated date of confinement (EDC, or due date).
What was the due date you gave her?
A) March 27, 2009
B) March 13, 2009
C) September 27, 2009
D) March 20, 2009 - ✔✔✔-A) March 27, 2009
,Exam 4 – Advanced Health Assessment Questions and and Answers – 100%
Solved
A 20-year-old part-time college student comes to your clinic, complaining of growths on his
penile shaft. They have been there for about 6 weeks and haven't gone away. In fact, he thinks
there may be more now. He denies any pain with intercourse or urination. He has had three
former partners and has been with his current girlfriend for 6 months. He says that because she
is on the pill they don't use condoms. He denies any fever, weight loss, or night sweats. His past
medical history is unremarkable. In addition to college, he works part-time for his father in
construction. He is engaged to be married and has no children. His father is healthy and his
mother has hypothyroidism. On examination the young man appears healthy. His vital signs are
unremarkable. On visualization of his penis you see several moist papules along all sides of his
penile shaft and even two on the corona. He has been circumcised. On palpation of - ✔✔✔-A)
Condylomata acuminata
A 21-year-old receptionist comes to your clinic, complaining of frequent diarrhea. She states
that the stools are very loose and there is some cramping beforehand. She states this has
occurred on and off since she was in high school. She denies any nausea, vomiting, or blood in
her stool. Occasionally she has periods of constipation, but that is rare. She thinks the diarrhea
is much worse when she is nervous. Her past medical history is not significant. She is single and
a junior in college majoring in accounting. She smokes when she drinks alcohol but denies using
any illegal drugs. Both of her parents are healthy. Her entire physical examination is
unremarkable.
What is most likely the etiology of her diarrhea?
A) Secretory infections
B) Inflammatory infections
C) Irritable bowel syndrome
D) Malabsorption syndrome - ✔✔✔-C) Irritable bowel syndrome
A 22-year-old architecture major comes to your office, complaining of severe burning with
urination, a fever of 101 degrees, and aching all over. She denies any upper respiratory,
gastrointestinal, cardiac, or pulmonary symptoms. Her past medical history consists of severe
acne. She is currently on an oral contraceptive. She has had no pregnancies or surgeries. She
reports one new partner within the last month. She does not smoke but does drink occasionally.
Her parents are both in good health. On examination you see a young woman appearing slightly
ill. Her temperature is 100.3 and her pulse and blood pressure are unremarkable. Her head,
, Exam 4 – Advanced Health Assessment Questions and and Answers – 100%
Solved
ears, eyes, nose, throat, cardiac, pulmonary, and abdominal examinations are unremarkable.
Palpation of the inguinal nodes shows lymphadenopathy bilaterally. On visualization of the
perineum there are more than 10 shallow ulcers along each side of the vulva. Speculum and
bimanual ex - ✔✔✔-A) Genital herpes
A 22-year-old clerk, primigravida, comes to your office for a prenatal visit. She is in her second
trimester and has had prenatal care since she was 8 weeks pregnant. Her only complaint is that
she has a new brownish line straight down her abdomen. On examination her vital signs are
unremarkable. Her urine has no protein, glucose, or leukocytes. With a Doptone the fetal heart
rate is 140, and her uterus is palpated to the umbilicus. Today you are sending her for congenital
abnormality screening and setting up an ultrasound.
What physical finding is responsible for her new "brown line"?
A) Corpus luteum
B) Linea nigra
C) Linea alba
D) Diastasis recti - ✔✔✔-B) Linea nigra
A 22-year-old law student comes to your office, complaining of severe abdominal pain radiating
to his back. He states it began last night after hours of heavy drinking. He has had abdominal
pain and vomiting in the past after drinking but never as bad as this. He cannot keep any food or
water down, and these symptoms have been going on for almost 12 hours. He has had no
recent illnesses or injuries. His past medical history is unremarkable. He denies smoking or using
illegal drugs but admits to drinking 6 to 10 beers per weekend night. He admits that last night
he drank something like 14 drinks. On examination you find a young male appearing his stated
age in some distress. He is leaning over on the examination table and holding his abdomen with
his arms. His blood pressure is 90/60 and his pulse is 120. He is afebrile. His abdominal
examination reveals normal bowel sounds, but he is very tender in the left upper qua - ✔✔✔-D)
Acute pancreatitis
A 22-year-old unemployed roofer presents to your clinic, complaining of pain in his testicle and
penis. He states the pain began last night and has steadily become worse. He states it hurts
when he urinates and he has not attempted intercourse since the pain began. He has tried
