Test Bank For Advanced Assessment 4th Edition Interpreting
Findings and Formulating Differential Diagnoses by Mary Jo
Goolsby; Laurie Grubbs
Is the following information subjective or objective?
Mr. M. has shortness of breath that has persisted for the past 10 days; it is worse
with activity and relieved by rest.
A) Subjective
B) Objective - ANSWER: A) Subjective
The following information is recorded in the health history: "The patient has had
abdominal pain for 1 week. The pain lasts for 30 minutes at a time; it comes and
goes. The severity is 7 to 9 on a scale of 1 to 10. It is accompanied by nausea and
vomiting. It is located in the mid-epigastric area."
Which of these categories does it belong to?
A) Chief complaint
B) Present illness
C) Personal and social history
D) Review of systems - ANSWER: B) Present illness
The following information is recorded in the health history: "The patient completed
8th grade. He currently lives with his wife and two children. He works on old cars on
the weekend. He works in a glass factory during the week."
Which category does it belong to?
A) Chief complaint
B) Present illness
C) Personal and social history
D) Review of systems - ANSWER: C) Personal and social history
The following information is recorded in the health history: "I feel really tired."
Which category does it belong to?
A) Chief complaint
B) Present illness
C) Personal and social history
D) Review of systems - ANSWER: A) Chief complaint
The following information is recorded in the health history: "Patient denies chest
pain, palpitations, orthopnea, and paroxysmal nocturnal dyspnea."
Which category does it belong to?
A) Chief complaint
B) Present illness
C) Personal and social history
D) Review of systems - ANSWER: D) Review of systems
,Is the following information subjective or objective?
Mr. M. has a respiratory rate of 32 and a pulse rate of 120.
A) Subjective
B) Objective - ANSWER: B) Objective
Which of the following is consistent with good percussion technique?
A) Allow all of the fingers to touch the chest while performing percussion.
B) Maintain a stiff wrist and hand.
C) Leave the plexor finger on the pleximeter after each strike.
D) Strike the pleximeter over the distal interphalangeal joint - ANSWER: D) Strike the
pleximeter over the distal interphalangeal joint
Which of the following percussion notes would you obtain over the gastric bubble?
A) Resonance
B) Tympany
C) Hyperresonance
D) Flatness - ANSWER: B) Tympany
Which of the following conditions would produce a hyperresonant percussion note?
A) Large pneumothorax
B) Lobar pneumonia
C) Pleural effusion
D) Empyema - ANSWER: A) Large pneumothorax
Which lung sound possesses the characteristics of being louder and higher in pitch,
with a short silence between inspiration and expiration and with expiration being
longer than inspiration?
A) Bronchovesicular
B) Vesicular
C) Bronchial
D) Tracheal - ANSWER: C) Bronchial
When percussing the chest in a patient who has left sided heart failure, the sound
emanated would be: - ANSWER: Resonant
Alexandra is a 28-year-old editor who presents to the clinic with abdominal pain. The
pain is a dull ache, located in the right upper quadrant, that she rates as a 3 at the
least and an 8 at the worst. The pain started a few weeks ago, it lasts for 2 to 3 hours
at a time, it comes and goes, and it seems to be worse a couple of hours after eating.
She has noticed that it starts after eating greasy foods, so she has cut down on these
as much as she can. Initially it occurred once a week, but now it is occurring every
other day. Nothing makes it better. From this description, which of the seven
attributes of a symptom has been omitted?
A) Setting in which the symptom occurs
B) Associated manifestations
C) Quality
D) Timing - ANSWER: B) Associated manifestations
, Jason is a 41-year-old electrician who presents to the clinic for evaluation of
shortness of breath. The shortness of breath occurs with exertion and improves with
rest. It has been going on for several months and initially occurred only a couple of
times a day with strenuous exertion; however, it has started to occur with minimal
exertion and is happening more than a dozen times per day. The shortness of breath
lasts for less than 5 minutes at a time. He has no cough, chest pressure, chest pain,
swelling in his feet, palpitations, orthopnea, or paroxysmal nocturnal dyspnea.
Which of the following symptom attributes was not addressed in this description?
A) Severity
B) Setting in which the symptom occurs
C) Timing
D) Associated manifestations - ANSWER: A) Severity
You are interviewing an elderly woman in the ambulatory setting and trying to get
more information about her urinary symptoms. Which of the following techniques is
not a component of adaptive questioning?
A) Directed questioning: starting with the general and proceeding to the specific in a
manner that does not make the patient give a yes/no answer
B) Reassuring the patient that the urinary symptoms are benign and that she doesn't
need to worry about it being a sign of cancer
C) Offering the patient multiple choices in order to clarify the character of the
urinary symptoms that she is experiencing
D) Asking her to tell you exactly what she means when she states that she has a
urinary tract infection - ANSWER: B) Reassuring the patient that the urinary
symptoms are benign and that she doesn't need to worry about it being a sign of
cancer
For which of the following patients would a comprehensive health history be
appropriate?
A) A new patient with the chief complaint of "I sprained my ankle"
B) An established patient with the chief complaint of "I have an upper respiratory
infection"
C) A new patient with the chief complaint of "I am here to establish care"
D) A new patient with the chief complaint of "I cut my hand" - ANSWER: C) A new
patient with the chief complaint of "I am here to establish care"
Mrs. T. comes for her regular visit to the clinic. She is on your schedule because her
regular provider is on vacation and she wanted to be seen. You have heard about her
many times from your colleague and are aware that she is a very talkative person.
Which of the following is a helpful technique to improve the quality of the interview
for both the provider and the patient?
A) Allow the patient to speak uninterrupted for the duration of the appointment.
B) Briefly summarize what you heard from the patient in the first 5 minutes and then
try to have her focus on one aspect of what she told you.
C) Set the time limit at the beginning of the interview and stick with it, no matter
what occurs in the course of the interview.
Findings and Formulating Differential Diagnoses by Mary Jo
Goolsby; Laurie Grubbs
Is the following information subjective or objective?
Mr. M. has shortness of breath that has persisted for the past 10 days; it is worse
with activity and relieved by rest.
A) Subjective
B) Objective - ANSWER: A) Subjective
The following information is recorded in the health history: "The patient has had
abdominal pain for 1 week. The pain lasts for 30 minutes at a time; it comes and
goes. The severity is 7 to 9 on a scale of 1 to 10. It is accompanied by nausea and
vomiting. It is located in the mid-epigastric area."
Which of these categories does it belong to?
A) Chief complaint
B) Present illness
C) Personal and social history
D) Review of systems - ANSWER: B) Present illness
The following information is recorded in the health history: "The patient completed
8th grade. He currently lives with his wife and two children. He works on old cars on
the weekend. He works in a glass factory during the week."
Which category does it belong to?
A) Chief complaint
B) Present illness
C) Personal and social history
D) Review of systems - ANSWER: C) Personal and social history
The following information is recorded in the health history: "I feel really tired."
Which category does it belong to?
A) Chief complaint
B) Present illness
C) Personal and social history
D) Review of systems - ANSWER: A) Chief complaint
The following information is recorded in the health history: "Patient denies chest
pain, palpitations, orthopnea, and paroxysmal nocturnal dyspnea."
Which category does it belong to?
A) Chief complaint
B) Present illness
C) Personal and social history
D) Review of systems - ANSWER: D) Review of systems
,Is the following information subjective or objective?
Mr. M. has a respiratory rate of 32 and a pulse rate of 120.
A) Subjective
B) Objective - ANSWER: B) Objective
Which of the following is consistent with good percussion technique?
A) Allow all of the fingers to touch the chest while performing percussion.
B) Maintain a stiff wrist and hand.
C) Leave the plexor finger on the pleximeter after each strike.
D) Strike the pleximeter over the distal interphalangeal joint - ANSWER: D) Strike the
pleximeter over the distal interphalangeal joint
Which of the following percussion notes would you obtain over the gastric bubble?
A) Resonance
B) Tympany
C) Hyperresonance
D) Flatness - ANSWER: B) Tympany
Which of the following conditions would produce a hyperresonant percussion note?
A) Large pneumothorax
B) Lobar pneumonia
C) Pleural effusion
D) Empyema - ANSWER: A) Large pneumothorax
Which lung sound possesses the characteristics of being louder and higher in pitch,
with a short silence between inspiration and expiration and with expiration being
longer than inspiration?
A) Bronchovesicular
B) Vesicular
C) Bronchial
D) Tracheal - ANSWER: C) Bronchial
When percussing the chest in a patient who has left sided heart failure, the sound
emanated would be: - ANSWER: Resonant
Alexandra is a 28-year-old editor who presents to the clinic with abdominal pain. The
pain is a dull ache, located in the right upper quadrant, that she rates as a 3 at the
least and an 8 at the worst. The pain started a few weeks ago, it lasts for 2 to 3 hours
at a time, it comes and goes, and it seems to be worse a couple of hours after eating.
She has noticed that it starts after eating greasy foods, so she has cut down on these
as much as she can. Initially it occurred once a week, but now it is occurring every
other day. Nothing makes it better. From this description, which of the seven
attributes of a symptom has been omitted?
A) Setting in which the symptom occurs
B) Associated manifestations
C) Quality
D) Timing - ANSWER: B) Associated manifestations
, Jason is a 41-year-old electrician who presents to the clinic for evaluation of
shortness of breath. The shortness of breath occurs with exertion and improves with
rest. It has been going on for several months and initially occurred only a couple of
times a day with strenuous exertion; however, it has started to occur with minimal
exertion and is happening more than a dozen times per day. The shortness of breath
lasts for less than 5 minutes at a time. He has no cough, chest pressure, chest pain,
swelling in his feet, palpitations, orthopnea, or paroxysmal nocturnal dyspnea.
Which of the following symptom attributes was not addressed in this description?
A) Severity
B) Setting in which the symptom occurs
C) Timing
D) Associated manifestations - ANSWER: A) Severity
You are interviewing an elderly woman in the ambulatory setting and trying to get
more information about her urinary symptoms. Which of the following techniques is
not a component of adaptive questioning?
A) Directed questioning: starting with the general and proceeding to the specific in a
manner that does not make the patient give a yes/no answer
B) Reassuring the patient that the urinary symptoms are benign and that she doesn't
need to worry about it being a sign of cancer
C) Offering the patient multiple choices in order to clarify the character of the
urinary symptoms that she is experiencing
D) Asking her to tell you exactly what she means when she states that she has a
urinary tract infection - ANSWER: B) Reassuring the patient that the urinary
symptoms are benign and that she doesn't need to worry about it being a sign of
cancer
For which of the following patients would a comprehensive health history be
appropriate?
A) A new patient with the chief complaint of "I sprained my ankle"
B) An established patient with the chief complaint of "I have an upper respiratory
infection"
C) A new patient with the chief complaint of "I am here to establish care"
D) A new patient with the chief complaint of "I cut my hand" - ANSWER: C) A new
patient with the chief complaint of "I am here to establish care"
Mrs. T. comes for her regular visit to the clinic. She is on your schedule because her
regular provider is on vacation and she wanted to be seen. You have heard about her
many times from your colleague and are aware that she is a very talkative person.
Which of the following is a helpful technique to improve the quality of the interview
for both the provider and the patient?
A) Allow the patient to speak uninterrupted for the duration of the appointment.
B) Briefly summarize what you heard from the patient in the first 5 minutes and then
try to have her focus on one aspect of what she told you.
C) Set the time limit at the beginning of the interview and stick with it, no matter
what occurs in the course of the interview.
