Ms. Wright comes to your office, complaining of palpitations. While checking her pulse you notice an irregular rhythm. When you listen to her heart, every fourth beat sounds different. It sounds like a triplet rather than the usual "lub dup." How would you document your examination?

Correct Answer: C

Rationale: A regularly irregular rhythm, such as every fourth beat sounding different, is consistent with a pattern like a ventricular bigeminy or trigeminy.

Correct Answer: C

Rationale: Although self-examination has not been shown to reduce mortality and is not recommended by all groups making screening recommendations, many choose to teach women a systematic method in which to examine their breasts. A high proportion of breast masses are detected by breast self-examination.

Correct Answer: A

Rationale: Wheezing during expiration is a common sign of asthma, where bronchospasm causes airflow obstruction.

Correct Answer: A

Rationale: Adson's test is used to detect thoracic outlet syndrome by assessing changes in radial pulse with positional changes.

Correct Answer: A

Rationale: Orthostatic blood pressure measurements (lying, sitting, and standing) are recommended for patients experiencing dizziness, especially those on antihypertensive medications.