HEALTH ASSESSMENT EXAM 1 REVIEW QUESTIONS Question 1/ latest update. graded A

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HEALTH ASSESSMENT EXAM 1 REVIEW QUESTIONS Question 1 ▶ A 54 year old diplomat working at the United Nations reports occasional chest pain and a sense of tightness in his chest when particularly... stressed over work deadlines. The patient is 6 feet 4 inches tall. He has a temperature of 98.6F and blood pressure of 140/78. He has a cut over one eye that he says is ”from shaving”. Which of the following represents subjective information about this patient? ▶ A. blood pressure of 140/78 ▶ B. Employment at the United Nations ▶ C. Height of 6 feet 4 inches ▶ D. Temperature of 98.6F ▶ E. Cut over eye from shaving Answer ▶ E ▶ Subjective information is any information that the patient reports that is not observable or measurable. The cut is observable but the manner in which the cut was sustained is not. Working at the UN can be verified objectively. ▶ Bickley, page 6-7. Question 2 ▶ A physician assistant (PA) has had a long day and has seen many patients. The last patient of the day is an 80 year old woman brought to the office by her 35 year old granddaughter. This is the patient’s first visit to the office. As the part of the patient’s past history the PA obtains information about childhood illnesses and adult illnesses and then moves on to inquire about family history. Which important area of the past history has she omitted? ▶ A. medications ▶ B. social history ▶ C. chief complaint ▶ D. immunizations ▶ E. allergies Answer ▶ D. immunizations ▶ It is important to understand the three components of the past history: childhood illness, adult illness, and health maintenance behaviors including immunizations and screening tests. Allergies and medications are relevant but are part of the present illness. ▶ Bickley, page 8, 10 Question 3 ▶ A 39 year old patient who is well established complains of irregular menstrual periods and pelvic pain. She says she is having trouble sleeping and asks whether she could be given a ”sleeping pill”. The patient also says she is thinking about leaving her job. What is the best “next step” in caring for this patient? ▶ A. obtain a more complete description of problems ▶ B. obtain blood for testing ▶ C. obtain a urine sample for testing ▶ D. perform a pelvic exam ▶ E. ask about recent travel destinations Answer ▶ A : obtain a more complete description of problems ▶ It is critical to thoroughly understand the patient’s problem in order to narrow the focus of the exam. This is particularly true when symptoms are reported in multiple body systems. ▶ Bickley page 8-9 Question 4 ▶ One important examination technique involves using the third fingers of each hand to determine the health of internal organs. What is the name of this technique? ▶ A. listening ▶ B. auscultation ▶ C. palpation ▶ D. percussion ▶ E. inspection Answer ▶ D: percussion ▶ Bickley page 18-19 Question 5 ▶ A 59 year old unemployed man complains of almost always feeling tired and hungry, despite getting sufficient rest and having a good appetite and access to sufficient food. The patient is obese, and despite the warm weather outside, wearing thermal socks with his sandals. He says this is because his feet are always cold and “feel funny”. Which body system should the clinical begin the examination? Answer ▶ C :head and neck ▶ The physical exam should proceed head to toe to optimize patient comfort, minimize the number of changes in patient position, and because it is always done in the same way to ensure nothing is missed. ▶ Bickley page 19-24 Question 6 ▶ A 65 year old retired pilot visits the clinic because of recurrent headache. The patient reports dizziness of recent onset (previous 2 weeks) and occasional numbness on the left side. Which of the following systems or regions should be examined in the clinician’s focused assessment? ▶ A. gastrointestinal ▶ B. respiratory ▶ C. musculoskeletal ▶ D. nervous ▶ E. cardiovascular Answer ▶ D: nervous ▶ Bickley, page 23 Question 7 ▶ A 32 year old office worker reports excessive stress at work and pain in the right lower quadrant. She states that last night she vomited twice. Her blood pressure is 120/75, heart rate 93bpm. The patient looks pale and sweating lightly. Which of the following is an objective finding? ▶ A. history of vomiting ▶ B. accelerated heart rate ▶ C. pale appearance ▶ D. pain in the right lower quadrant ▶ E. high stress level Answer ▶ B: accelerated heart rate ▶ A resting heart rate of 93bpm is higher then normal. What appears to be pale for one person may not be considered pale to another. ▶ Bickley page 6-7 Question 8 ▶ A 29 year old electrician complains of persistent cough and wheezing, particularly when he exercises. He says he smokes ”occasionally” but rarely so much that he needs to purchase cigarettes. “mostly, I bum them,” he says chuckling. Upon hearing this information, what is the best next step on the part of the clinician? ▶ A. explain the relationship between smoking and cancer ▶ B. determine the patient’s exercise regimen ▶ C. conduct a mental status exam ▶ D. determine the patient’s immunization history ▶ E. determine the number of pack years the patient smokes Answer ▶ D: determine the number of pack years the patient smokes ▶ An accurate determination the of patient’s tobacco use is important for assessing the overall health risk due to smoking. Although the patient minimizes his smoking, it is possible the number of cigarettes smoked per day and the length of time would result in a high pack year value. ▶ Bickley page 12, 26 Question 9 ▶ A 47 year old fitness trainer visits the physician assistant because of skin dryness, night sweats, and irregular menstrual periods. It is the PA’s first contact with the patient. The patient notes that “my sex life has gone downhill lately” and says that she is considering divorcing her husband of 20 years stating that “he’s not a bad guy, I just think that I can do better”. In which of the following ways should the clinician proceed? ▶ A. determine the patient’s out of country travel history ▶ B. help the patient review the pros and cons of divorce ▶ C. conduct a breast exam ▶ D. inform the patient that menopause is a normal part of aging ▶ E. obtain a menstrual history for the previous 6 months Answer ▶ E: obtain a menstrual history for the previous 6 months ▶ It is important to review the seven attributes of a patient’s principal symptom(s), which in this case is skin dryness, night sweats, reduced interest in sex, and irregular menstrual periods. It has not been determined she is premenopausal. ▶ Bickley, page 9 Question 10 ▶ A 23 year old physician assistant student found that she felt nervous when called upon to examine men in her age group. On one occasion, she a encountered a young male patient who appeared embarrassed to see her walk into the room. What should the PA do to minimize their mutual discomfort? ▶ A. provide ongoing interpretation of the findings ▶ B. ask the patient where he comes from ▶ C. explain that she is a PA student ▶ D. explain how the examination will proceed ▶ E. adjust lighting so its is tangential to the patient’s body [Show More]

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