Despite having high BP readings in the office, Mr. Kelly tells you that his readings at home are much lower. He checks them twice a day at the same time of day and has kept a log. How do you respond?

Correct Answer: A

Rationale: The correct answer is A: You diagnose "white coat hypertension." White coat hypertension refers to elevated blood pressure readings in a clinical setting due to anxiety or stress. Mr. Kelly's lower readings at home suggest this phenomenon. 1. White coat hypertension is a common occurrence, affecting about 20% of people with high office BP readings. 2. Mr. Kelly's consistent lower readings at home indicate that his true BP is likely lower than what is measured in the office. 3. Checking BP at home twice a day at the same time increases reliability and accuracy. 4. Assuming nervousness or questioning the accuracy of his measurements or yours does not address the discrepancy between office and home readings.

Correct Answer: B

Rationale: The correct answer is B: Nontherapeutic. This statement is nontherapeutic because it implies blame or judgment on the patient for waiting to see the doctor, which can make the patient feel guilty or defensive. It does not promote open communication or trust between the healthcare provider and patient. Therapeutic responses focus on understanding the patient's feelings and experiences without judgment. Choices A, C, and D are left blank as they are not relevant to the question.

Correct Answer: B

Rationale: The correct answer is B: Flexor carpi ulnaris (FCU). The median nerve innervates the flexor carpi radialis (A), palmaris longus (C), and flexor pollicis longus (D), all muscles involved in wrist and finger flexion. The FCU is innervated by the ulnar nerve, not the median nerve, making it the exception in this case. Therefore, choice B is incorrect.

Correct Answer: C

Rationale: The correct answer is C: Trigger points. Myofascial pain syndrome is characterized by localized areas of muscle tightness and tenderness called trigger points. These points can cause referred pain and muscle dysfunction. Choice A is incorrect because the tenderness in myofascial pain syndrome is typically localized, not widespread. Choice B is incorrect as tender points are different from trigger points and are not specific to myofascial pain syndrome. Choice D is incorrect as myofascial pain syndrome is associated with changes in muscle tension due to the presence of trigger points.

Correct Answer: C

Rationale: Step-by-step rationale: 1. Guyon's canal houses the ulnar nerve and ulnar artery. 2. This canal is located at the wrist, between the pisiform and hook of the hamate. 3. The correct answer, choice C, includes both the ulnar nerve and ulnar artery passing through Guyon's canal. 4. Choices A, B, and D are incorrect as they include structures that do not pass through Guyon's canal, such as the extensor carpi ulnaris and adductor pollicis.