Correct Answer: A

Rationale: The raised, dark red rash that does not blanch when pressed on, typically known as erythema nodosum, is a common skin manifestation of systemic lupus erythematosus (SLE). Given Mrs. Hill's history of SLE, it is likely that her rash is related to her autoimmune condition rather than an exposure to a chemical or an allergic reaction. It is important for her to discuss this new symptom with her healthcare provider to ensure appropriate management and monitoring of her lupus.

Correct Answer: D

Rationale: Since the life insurance company is classifying the body builder as "high risk" due to obesity, it is important to assess whether his weight gain is primarily fat accumulation around the waist. Measuring his waist circumference can provide valuable information about the distribution of body fat. Abdominal obesity, indicated by an increased waist measurement, is a significant risk factor for health issues such as heart disease, diabetes, and metabolic syndrome. By measuring his waist, you can determine if his weight gain is indeed a cause for concern in terms of health risks, rather than just considering the overall weight gain. This information can help you provide more targeted advice on how to address any potential health concerns related to the weight gain.

Correct Answer: D

Rationale: Audiometric testing is a very sensitive method for detecting hearing loss. It involves a series of tests that measure a person's ability to hear sounds at various frequencies and volumes. These tests can detect even subtle changes in hearing ability and provide detailed information on the type and degree of hearing loss. The whisper test and finger rub test are basic screening tests and are not as sensitive or comprehensive as audiometric testing. The tuning fork test is also used in evaluating hearing loss, but it is not as accurate or sensitive as audiometric testing. Overall, audiometric testing is considered the gold standard for diagnosing hearing loss due to its high sensitivity and ability to provide detailed information on the individual's hearing capabilities.

Correct Answer: D

Rationale: The presentation is highly suggestive of appendicitis, especially given the migration of pain from the periumbilical region to the right lower quadrant (just medial and inferior to the iliac crest). The worsening of pain with motion, along with associated symptoms such as nausea, vomiting, anorexia, and fever, are typical features of appendicitis. The classic presentation of appendicitis is pain starting around the umbilicus (due to visceral innervation) and then shifting to the right lower quadrant (due to irritation of the parietal peritoneum). Surgical intervention is usually required promptly to prevent complications like perforation, which can lead to peritonitis and sepsis.

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.