Frank is a 24-year-old man who presents with multiple burning erosions on the shaft of his penis and some tender inguinal adenopathy. Which of the following is most likely?

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Physical Assessment Practice Questions Questions

Question 1 of 9

Frank is a 24-year-old man who presents with multiple burning erosions on the shaft of his penis and some tender inguinal adenopathy. Which of the following is most likely?

Correct Answer: B

Rationale: The presentation of multiple burning erosions on the shaft of the penis along with tender inguinal adenopathy is indicative of genital herpes caused by the herpes simplex virus (HSV). Primary herpes simplex infection typically presents with painful ulcers and lymphadenopathy. The ulcers are often shallow with well-defined borders and can be associated with systemic symptoms such as fever and malaise. In contrast, primary syphilis is characterized by a painless chancre at the site of infection, usually on the genitals. Chancroid can also present with painful ulcers, but it is less common in developed countries. Gonorrhea typically presents with urethral discharge, dysuria, or other symptoms of urethritis, rather than erosions on the penis shaft.

Question 2 of 9

His cardiac, lung, and abdominal examinations are normal. He has no inguinal hernia, but on his digital rectal examination you palpate a soft, smooth, nontender pedunculated mass on the posterior wall of the rectum. What anal, rectal, or prostate disorder best fits his presentation?

Correct Answer: D

Rationale: A rectal polyp is a growth that originates from the inner lining of the rectum and protrudes into the rectal canal. It may present as a soft, smooth, nontender mass on digital rectal examination. Rectal polyps are usually benign, but some may have the potential to become cancerous if left untreated. Therefore, it is important to evaluate and remove polyps to prevent complications. In this case, the description of a pedunculated mass on the posterior wall of the rectum is most suggestive of a rectal polyp.

Question 3 of 9

Jason is a 41-year-old electrician who presents to the clinic for evaluation of shortness of breath. The shortness of breath occurs with exertion and improves with rest. It has been going on for several months and initially occurred only a couple of times a day with strenuous exertion; however, it has started to occur with minimal exertion and is happening more than a dozen times per day. The shortness of breath lasts for less than 5 minutes at a time. He has no cough, chest pressure, chest pain, swelling in his feet, palpitations, orthopnea, or paroxysmal nocturnal dyspnea. Which of the following symptom attributes was not addressed in this description?

Correct Answer: A

Rationale: While the description provides information about the duration, frequency, onset, and relieving factors of Jason's shortness of breath, it does not mention the severity of the symptom. Severity refers to the intensity or degree of the symptom, such as mild, moderate, or severe. In this case, we do not have information about how Jason would rate the severity of his shortness of breath. It can be an important attribute to consider when assessing the impact of the symptom on the individual's quality of life and the potential urgency of intervention.

Question 4 of 9

A college student presents with a sore throat, fever, and fatigue for several days. You notice exudates on her enlarged tonsils. You do a careful lymphatic examination and notice some scattered small, mobile lymph nodes just behind her sternocleidomastoid muscles bilaterally. What group of nodes is this?

Correct Answer: D

Rationale: The group of lymph nodes that lie just behind the sternocleidomastoid muscles bilaterally are known as the posterior cervical lymph nodes. These lymph nodes are part of the superficial cervical lymph node chain, which is involved in draining lymph from the head and neck region. In the case described, the presence of sore throat, fever, and enlarged tonsils with exudates suggests a likely upper respiratory tract infection or tonsillitis, leading to the enlargement of the nearby lymph nodes. The posterior cervical lymph nodes are commonly examined in cases of upper respiratory infections and tonsillitis due to their proximity to the area of infection and inflammation.

Question 5 of 9

You are a student in the vascular surgery clinic. You are asked to perform a physical examination on a patient with known peripheral vascular disease in the legs. Which of the following aspects is important to note when you perform your examination?

Correct Answer: A

Rationale: When examining a patient with known peripheral vascular disease in the legs, it is important to note the size, symmetry, and skin color of the lower extremities. These aspects can provide valuable information about the circulation and potential complications related to the disease. Changes in size, such as muscle wasting or atrophy, can indicate poor circulation and muscle ischemia. Asymmetry between the two legs may point to a significant difference in blood supply to the limbs. Skin color changes, such as pallor or cyanosis, can suggest impaired blood flow. Monitoring and documenting these findings are crucial for assessing the progression or improvement of the disease and guiding treatment interventions.

Question 6 of 9

A 68-year-old mechanic presents to the emergency room for shortness of breath. You are concerned about a cardiac cause and measure his jugular venous pressure (JVP). It is elevated. Which one of the following conditions is a potential cause of elevated JVP?

Correct Answer: C

Rationale: Constrictive pericarditis is a condition where the pericardium becomes thickened and rigid, impairing diastolic filling of the heart. This leads to an increase in venous pressure, including the jugular venous pressure (JVP). The elevated JVP in constrictive pericarditis is a result of impaired ventricular filling rather than forward failure seen in heart failure. Mitral stenosis can lead to an increased JVP due to elevated left atrial pressure, but constrictive pericarditis is a more common cause of elevated JVP in this scenario. Aortic aneurysm is not typically associated with elevated JVP.

Question 7 of 9

You are listening carefully for S splitting. Which of the following will help?

Correct Answer: A

Rationale: In order to listen carefully for S splitting, one should use the diaphragm with light pressure over the 2nd right intercostal space. S splitting refers to a split of the second heart sound (S2) into its two components - A2 and P2. The A2 component is normally heard as the main heart sound when the aortic valve closes, and the P2 component is heard when the pulmonic valve closes. By placing the diaphragm lightly over the 2nd right intercostal space, one can best auscultate the aortic area and listen for the timing and splitting of the S2 components. Using the bell or applying firm pressure may not allow for optimal detection of S splitting in this specific case.

Question 8 of 9

When you enter your patient's examination room, his wife is waiting there with him. Which of the following is most appropriate?

Correct Answer: A

Rationale: The most appropriate action in this situation is to ask the patient if it's okay to carry out the visit with both people in the room. This shows respect for the patient's autonomy and privacy. Some patients may feel more comfortable discussing personal information without a family member present, while others may prefer having their spouse or family member involved in the conversation. By asking for the patient's preference, you are ensuring that they have the opportunity to control who is present during the consultation and are upholding their right to confidentiality.

Question 9 of 9

A 55-year-old bookkeeper comes to your office for a routine visit. You note that on a previous visit for treatment of contact dermatitis, her blood pressure was elevated. She does not have prior elevated readings and her family history is negative for hypertension. You measure her blood pressure in your office today. Which of the following factors can result in a false high reading?

Correct Answer: A

Rationale: A tightly fitted blood pressure cuff can result in a false high reading by compressing the underlying artery too much, causing an inaccurate measurement. It is important to ensure that the blood pressure cuff is appropriately sized for the patient's arm to obtain an accurate reading. The other factors listed, such as the patient being seated quietly, measuring on a bare arm, and supporting the patient's arm at the correct level, all contribute to obtaining an accurate measurement of blood pressure.

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