A physical therapist completes an examination on a five-year-old boy diagnosed with Duchenne muscular dystrophy. The referral indicates that the boy was diagnosed with the disease less than one year ago. Assuming a normal progression, which of the following would be expected?

Correct Answer: B

Rationale: The correct answer is B: Proximal muscle weakness. In Duchenne muscular dystrophy, proximal muscle weakness is typically one of the earliest signs due to the progressive degeneration of muscle fibers. This weakness starts in the pelvic girdle and lower extremities before affecting the upper extremities. Distal muscle weakness (choice A) occurs later in the disease progression. Impaired respiratory function (choice C) is also a common feature in Duchenne muscular dystrophy but usually develops later in the disease course. Inability to perform activities of daily living (choice D) may occur eventually, but proximal muscle weakness is the more immediate and expected outcome in a newly diagnosed five-year-old with Duchenne muscular dystrophy.

Correct Answer: B

Rationale: Barrel-shaped chest is most commonly associated with COPD due to chronic air trapping and hyperinflation of the lungs. In COPD, the increased residual volume leads to a more rounded appearance of the chest. Asthma typically presents with wheezing and chest tightness, not barrel chest. Pneumonia is characterized by lung consolidation and pleural effusion by fluid accumulation in the pleural space, neither of which directly causes a barrel-shaped chest.

Correct Answer: B

Rationale: The correct answer is B because a lesion that bleeds easily and does not heal could be indicative of skin cancer, such as melanoma. This finding is concerning as it suggests potential malignancy and requires immediate medical attention. A: A mole with uniform color and well-defined borders is typically considered benign and not as concerning during a skin assessment. C: A freckle that has not changed in size over several years is generally not worrisome as stable freckles are usually harmless. D: A birthmark present since infancy is usually harmless and not a cause for concern during a skin assessment.

Correct Answer: A

Rationale: The information provided in the question describes Mr. M.'s personal experience of shortness of breath, which is based on his feelings and sensations. This subjective information cannot be measured or observed by others, making it open to interpretation. Therefore, it falls under the category of subjective. In contrast, objective information is factual and verifiable, typically based on measurable data or observations made by multiple individuals. In this case, since Mr. M.'s shortness of breath is described in terms of his personal experience and feelings, it is considered subjective. Hence, choice A is correct. Choices B, C, and D are incorrect as they do not accurately reflect the nature of the information provided.

Correct Answer: D

Rationale: The correct answer is D because tenderness in the right upper quadrant is a specific clinical finding that would typically be recorded in the 'assessment' portion of the clinical record. This information is objective and related to a physical examination finding, which is crucial for assessing the patient's condition. A, B, and C are incorrect because they are subjective observations or general statements that do not provide specific clinical assessment information. Option A describes the patient's overall appearance, B relates to the patient's subjective feeling, and C provides a vital sign measurement, all of which would typically be recorded in the 'subjective' or 'objective' portions of the clinical record.