Correct Answer: B

Rationale: The description of an oval, brown, slightly elevated lesion with a flat surface and rough, wartlike texture on palpation is characteristic of a seborrheic keratosis. Seborrheic keratoses are common benign skin growths that typically occur in older adults. They can vary in color, ranging from tan to dark brown, and often have a waxy or stuck-on appearance. The lesion described does not fit the typical characteristics of actinic keratosis, basal cell carcinoma, or squamous cell carcinoma.

Correct Answer: D

Rationale: The patient's presentation is consistent with atrophic vaginitis, also known as vaginal atrophy. This condition typically occurs in postmenopausal women due to a decrease in estrogen levels, leading to thinning, drying, and inflammation of the vaginal walls. Symptoms of atrophic vaginitis include vaginal dryness, itching, discomfort with intercourse, and sometimes light bleeding after intercourse. The absence of vaginal discharge and the presence of vaginal dryness and bleeding easily upon examination suggest atrophic vaginitis as the most likely cause in this patient. Other causes of vaginitis such as Trichomonas vaginitis, Candida vaginitis, and bacterial vaginosis typically present with different symptoms and findings on examination.

Correct Answer: A

Rationale: The clinical presentation described in the scenario is consistent with benign prostatic hyperplasia (BPH). BPH is a non-cancerous enlargement of the prostate gland, typically seen in older males. The findings of a smooth, enlarged prostate on digital rectal examination without discrete masses, along with the absence of other alarming signs such as blood in the urine or on examination, make BPH the most likely diagnosis in this case.

Correct Answer: B

Rationale: In respiratory distress, the skin between the ribs moves inward with inspiration, a phenomenon known as retractions. This is a sign of increased work of breathing as the body tries to pull in more air due to difficulty in breathing. The inward movement of the skin between the ribs indicates that the individual is not able to generate enough negative pressure in the chest cavity to inhale properly. This can be seen in conditions such as asthma, pneumonia, or other respiratory issues. Skin retractions are a concerning sign and may indicate a severe respiratory compromise that requires immediate medical attention. The other options listed do not specifically describe a characteristic of respiratory distress.

Correct Answer: A

Rationale: Acknowledging and taking responsibility for any part you may have played in provoking the patient's anger is important in effectively addressing the situation. By avoiding admission of your lateness, you may come across as dismissive of the patient's feelings and not addressing the issue at hand. It is essential to validate the patient's feelings and work towards finding a solution rather than avoiding the issue.