Correct Answer: D

Rationale: In this situation, it is important to prioritize active listening over taking detailed notes. By pushing away from the keyboard or putting down your pen, you are signaling to the patient that you are fully present and engaged in listening to their story. This will help foster trust and encourage the patient to continue sharing their personal history. Taking notes can be done later, but the immediate focus should be on providing a supportive and attentive environment for the patient to share their experiences.

Correct Answer: B

Rationale: The most likely pathologic process based on the patient's symptoms and history would be an inflammatory process. The patient's joint pain, fever, and family history of rheumatoid arthritis suggest the possibility of an autoimmune inflammatory condition like rheumatoid arthritis. Rheumatoid arthritis is a chronic inflammatory disorder that primarily affects the joints, causing pain, swelling, and stiffness. The bilateral involvement of the wrists and fingers along with a family history of rheumatoid arthritis make this diagnosis more likely than an infectious, hematologic, or traumatic process in this case.

Correct Answer: B

Rationale: A condylar joint is a type of synovial joint that allows movement in two planes, typically flexion/extension and abduction/adduction. The interphalangeal joints of the hand, which are the joints between the phalanges (finger bones), exhibit this type of movement, making them an example of a condylar joint. The hip joint (choice A) is a ball-and-socket joint, the temporomandibular joint (choice C) is a hinge joint, and the intervertebral joint (choice D) is a cartilaginous joint, none of which are examples of condylar joints.

Correct Answer: B

Rationale: Secondary amenorrhea refers to the absence of menstruation for 3-6 months in a woman who previously had regular menstrual cycles. In this case, Jean's lack of menstruation after giving birth and while breastfeeding her child for 6 months likely indicates secondary amenorrhea. This temporary suppression of ovulation and menstruation commonly occurs during breastfeeding due to the high levels of the hormone prolactin, which is responsible for milk production and can inhibit ovulation and menstruation. It is a natural phenomenon known as lactational amenorrhea. Once breastfeeding decreases or stops, menstruation usually resumes within a few months.

Correct Answer: D

Rationale: Nodules are a characteristic finding in an inflammatory joint condition such as rheumatoid arthritis. Nodules are small, firm lumps that can develop near the affected joint and are often indicative of an underlying inflammatory process. Tenderness, cool temperature, and ecchymosis can be seen in various musculoskeletal conditions, but nodules specifically point towards an inflammatory process in the joint.