Which finding during an abdominal assessment suggests the presence of ascites?

Correct Answer: B

Rationale: The correct answer is B: Shifting dullness on percussion. Ascites is the accumulation of fluid in the peritoneal cavity. When the patient is in a supine position, the fluid settles by gravity and causes dullness upon percussion in the dependent areas. Shifting dullness occurs when the patient is turned to the side, causing the fluid to shift and the dullness to move. This finding is specific to ascites. A: Hyperresonance on percussion is associated with bowel gas and is typically heard in cases of bowel obstruction. C: Borborygmi on auscultation refers to hyperactive bowel sounds and is not specific to ascites. D: Rebound tenderness on palpation indicates peritoneal irritation, often seen in cases of peritonitis, not ascites. In summary, shifting dullness on percussion is the key finding in assessing ascites due to the movement of fluid in the peritoneal cavity.

Correct Answer: B

Rationale: The correct answer is B: Surgeries. The statement 'The patient has had three cesarean sections' pertains to a surgical procedure rather than adult illnesses, obstetrics/gynecology, or psychiatric conditions. Cesarean sections are a type of surgery performed during childbirth, not related to adult illnesses or psychiatric disorders. Therefore, the information best fits under the category of Surgeries.

Correct Answer: B

Rationale: The correct answer is B: Cough. Cough is a symptom directly related to the respiratory system, indicating irritation or inflammation in the airways. Polyuria (A) is excessive urination related to the kidneys or endocrine system. Nausea (C) is associated with the gastrointestinal system. Dysphagia (D) is difficulty swallowing, which is related to the esophagus and not the respiratory system. Therefore, cough is the only symptom directly relevant to the respiratory system.

Correct Answer: A

Rationale: The correct answer is A: Sclera. The sclera is the most reliable area for detecting jaundice due to the high concentration of bilirubin in the blood, which causes a yellowing of the sclera. The yellow discoloration is easily visible in the white part of the eye. Palms of the hands, nail beds, and dorsum of the feet are less reliable areas for detecting jaundice as the yellowing may not be as noticeable or pronounced in these areas. Thus, assessing the sclera provides a clear and direct indication of jaundice.

Correct Answer: D

Rationale: The most likely diagnosis for the 45-year-old woman with chronic back pain, tenderness over the lower lumbar spine, and a history of rheumatoid arthritis is mechanical low back pain (Choice D). 1. Chronic dull, aching, constant pain with no radiation is characteristic of mechanical low back pain. 2. Presence of tenderness over the lower lumbar spine suggests a musculoskeletal origin, consistent with mechanical low back pain. 3. History of rheumatoid arthritis increases the likelihood of musculoskeletal issues like mechanical low back pain. Summary: - A: Osteoporotic fracture is less likely due to absence of acute onset, severe pain, and risk factors like advanced age or prolonged corticosteroid use. - B: Herniated disc typically presents with radicular pain (radiating pain down the leg), which is not described in this case. - C: Spinal stenosis usually presents with neurogenic claudication (pain with walking) and neurological