A 55-year-old secretary with a recent history of breast cancer, for which she underwent surgery and radiation therapy, and a history of hypertension comes to your office for a routine checkup. Which of the following aspects of the physical are important to note when assessing the patient for peripheral vascular disease in the arms?

Correct Answer: D

Rationale: The correct answer is D: Radial pulse, brachial pulse. When assessing for peripheral vascular disease in the arms, it is important to check the radial and brachial pulses. The radial pulse is located at the wrist and is an indicator of arterial flow to the hand, while the brachial pulse is located in the upper arm and is important for assessing arterial flow to the forearm. In this patient with a history of breast cancer and hypertension, checking these pulses can provide valuable information about blood flow to the arms, especially after surgery and radiation therapy. Choices A, B, and C are incorrect because: A: Femoral and popliteal pulses are located in the lower extremities and are not relevant for assessing peripheral vascular disease in the arms. B: Dorsalis pedis and posterior tibial pulses are also located in the lower extremities and do not provide information about arterial flow to the arms. C: Carotid pulse is located in the neck and is

Correct Answer: B

Rationale: The correct answer is B: Affect is flat, with periods of emotional lability. This is because the limbic system is responsible for regulating emotions and behavior. A deficit in this area can lead to flat affect (lack of emotional expression) and emotional lability (rapid changes in emotions). A: Disorientation to person, place, and time is more indicative of a deficit in cognitive function, commonly associated with the temporal lobe rather than the limbic system. C: Difficulty recalling recent events like what was eaten for breakfast is related to memory impairment, typically associated with the hippocampus rather than the limbic system. D: Inability to perform tasks like adding and subtracting or knowing the current president is more related to executive functioning and memory, associated with the frontal lobe rather than the limbic system. In summary, the correct answer is B because it directly relates to the emotional and behavioral aspects affected by deficits in the limbic system, while the other choices are more

Correct Answer: A

Rationale: The correct answer is A: Serum albumin. Serum albumin is the most reliable indicator of long-term nutritional status because it has a longer half-life compared to other lab values, reflecting protein intake over a longer period. Low serum albumin levels indicate chronic malnutrition. B: Serum potassium is not a reliable indicator of long-term nutritional status. C: Hematocrit reflects hydration status and can be influenced by factors other than nutrition. D: Blood glucose levels can fluctuate throughout the day and are not specific to long-term nutritional status.

Correct Answer: A

Rationale: The correct answer is A. A mole with an asymmetrical shape is concerning for melanoma, a potentially deadly skin cancer. Asymmetry is a key characteristic of melanoma, warranting immediate attention for further evaluation and possible biopsy. B is incorrect as dry skin on the elbows is a common benign condition. C is incorrect as a small, round, and brown lesion is likely a benign mole or freckle. D is incorrect as faint, white striae are typically stretch marks and not urgent. In summary, the asymmetrical shape of a mole is alarming due to its association with melanoma, making it the finding requiring immediate attention.

Correct Answer: A

Rationale: The correct answer is A: Concentric. During the activity of rising from a chair, the quadriceps contract and shorten to lift the body upward, which is a concentric contraction. This type of contraction generates force while the muscle is shortening. Choice B, Eccentric, involves the muscle lengthening while generating force, which does not occur when rising from a chair. Choice C, Isometric, involves the muscle contracting without changing length, which is not the case during this activity. Choice D, Isokinetic, refers to a type of muscle contraction at a constant speed, which is not specific to the scenario of rising from a chair.