You feel a small mass that you think is a lymph node. It is mobile in both the up-and- down and side-to-side directions. Which of the following is most likely?

Correct Answer: B

Rationale: The correct answer is B: Lymph node. A mobile mass that is palpable and moves in multiple directions is characteristic of a lymph node. Lymph nodes are small, bean-shaped structures that are part of the immune system and can move freely when touched. Incorrect choices: A: Cancer - A cancerous mass would typically be fixed and not mobile. C: Deep scar - Scars are usually fixed and do not move when touched. D: Muscle - Muscles are usually deeper in the body and not typically palpable as a mobile mass.

Correct Answer: C

Rationale: The correct answer is C because cultural humility emphasizes recognizing power imbalances and fostering interpersonal sensitivity through partnerships with and learning from patients. This approach encourages self-awareness, openness, and willingness to engage in respectful dialogues. Option A is incorrect because cultural humility is not solely achieved through professional development courses. Option B is incorrect as anyone, regardless of their background, can practice cultural humility. Option D is incorrect as cultural humility does consider the impacts of structural factors on health disparities, including biological, socioeconomic, and racial influences.

Correct Answer: C

Rationale: The correct answer is C: Lower dose of antibiotics. The rationale is that the patient has early renal insufficiency, which means the kidney may have difficulty clearing medications from the body. Therefore, a lower dose of antibiotics is needed to prevent potential drug toxicity. A shorter course of antibiotics (choice A) may not be effective in treating pneumonia adequately. A longer course of antibiotics (choice B) may increase the risk of drug accumulation in the body. A higher dose of antibiotics (choice D) can lead to increased toxicity in a patient with renal insufficiency. Thus, the most appropriate option is to reduce the dose to ensure safe and effective treatment.

Correct Answer: B

Rationale: The correct answer is B: Lung cancer. The patient's symptoms of chronic smoking, persistent cough, and weight loss are concerning for malignancy. Lung cancer is a common consequence of long-term smoking and can present with these symptoms. Chronic bronchitis (A) typically presents with cough and mucus production but not necessarily weight loss. Emphysema (C) is characterized by shortness of breath and is less likely to cause weight loss. Asthma (D) usually presents with wheezing and shortness of breath, not typically weight loss.

Correct Answer: B

Rationale: The correct answer is B: Present illness. The statement "I feel really tired" falls under the present illness category because it describes the current health concern the individual is experiencing. This section focuses on the details of the current symptoms, their duration, severity, and any associated factors. It helps in understanding the progression and impact of the current health issue. A: Chief complaint typically refers to the main reason for seeking medical help, usually a symptom or problem that brought the individual to the healthcare provider. C: Personal and social history covers information about the individual's lifestyle, habits, and social support system. D: Review of systems involves systematically asking about symptoms related to different body systems, which is not the case in the given statement.

Correct Answer: B

Rationale: Correct Answer: B Rationale: 1. Adaptive questioning involves tailoring the questioning style to the patient's responses and needs to gather more detailed information. 2. Reassuring the patient that the symptoms are benign and not related to cancer is not a component of adaptive questioning as it can lead to bias and may hinder the patient from providing accurate information. 3. Directed questioning (A) helps to gather specific information systematically, offering choices (C) helps clarify symptoms, and asking for specific details (D) aids in understanding the patient's experiences. 4. By reassuring the patient prematurely, you may miss important details or dismiss potential concerns that could be relevant to the patient's condition.

Correct Answer: A

Rationale: The correct answer is A: It is not effective during an acute asthma attack. Salmeterol is a long-acting beta agonist used for maintenance therapy, not for acute attacks. It does not provide immediate relief. Choices B and C are incorrect because salmeterol's onset of action is not immediate, and it may take days to weeks to achieve full effect. Choice D is incorrect because salmeterol should not be used in children under 12 years old.

Correct Answer: B

Rationale: The correct answer is B: Migraines with aura. Estrogen in contraceptives can increase the risk of stroke in patients with migraines with aura due to its effect on blood clotting. Estrogen-progestin contraceptives should be avoided in these patients to reduce the risk of adverse cardiovascular events. Choices A, C, and D do not have a direct contraindication to estrogen-progestin contraceptives based on current guidelines.

Correct Answer: B

Rationale: The correct answer is B: Small amplitude, weak. In congestive heart failure, the heart's ability to pump effectively is compromised, leading to decreased cardiac output. This results in a weakened pulse with reduced amplitude. Palpating a small, weak pulse in this patient is expected due to poor cardiac function. Choices A and C are incorrect because a large, forceful pulse is not expected in congestive heart failure, and a normal pulse may not reflect the compromised cardiac function. Choice D, bigeminal, refers to an abnormal rhythm characterized by every other heartbeat being premature and is not typically associated with congestive heart failure.