Advanced Health Assessment
Questions With Solved Solutions.
During a routine physical exam of a 44 yo woman you note she has an inverted left nipple. You decide to
investigate because: - Answer The inversion may be a recent change
A 30 yo F is in the office c/o palpitations and some lightheadedness for the past ?, random episodes, no
detectable pattern. NP notes a mid systolic click with a late systolic murmur heard best in the apical area.
You suspect - Answer Mitral valve prolapse (MVP)
All of the following tests require the patient's voice to perform correctly except: - Answer -egophany
-tactile fremitus
-whispered pectoriloquy
auscultation
59 yo M with history of COPD presents with worsening dyspnea. Patient is afebrile, breath sounds are
decreased bilaterally, noted to have JVD and pitting edema of lower extremities. What is the most likely
cause of his dyspnea? - Answer CHF
James Jones 55 yo M smoker presents with thick sputum producing cough. Exam: +tactile fremitus,
resonant percussion, and normal voice transmission. You suspect: - Answer bronchitis
During the breast exam of a 30 year old nulliparous female. The NP palpates several rubbery areas of the
breast tissue. They are slightly tender to palpation and present in both breasts. Expecting menses in 5
days. Which intervention is best? - Answer Tell her to recheck 1 week after her menses
All of the following symptoms associated with chest pain are likely to represent CAD except? - Answer
pain with inspiration
60 yo landscaper presents to your office to establish care, history of CHF controlled with medications.
Denies cp, edema. Early diastolic ? with opening snap ___. You suspect? - Answer Mitral stenosis
, A patient states that she has had a rash on her breast for about 2 weeks. In order to determine if it is
pagets disease you would expect to have all of the following on physical exam EXCEPT - Answer
inverted nipple
You notice a medium-pitched harsh systolic murmur during a routine exam or R upper border of the
sternum. Which of the following is most likely? - Answer Aortic stenosis
Which of the following statements in NOT typical of the murmur it is describing? - Answer Grade
II/Grade VI murmur is associated with a thrill?
A 58 yo dentist presents for routine check up. He has been healthy. Non smoker, does not drink alcohol.
You hear a moderately loud murmur, no palpable thrill. What is the appropriate grade for this murmur? -
Answer Grade 3
57 yo college professor is hospitalized for SOB. As you examine her in ER, JVP of 45 degrees 8 cm above
the clavicle. finding is most consistent with which of the following diagnoses? - Answer Right sided
heart failure
What technique should be used to best auscultate the 2nd heart sounds? - Answer Diaphragm of the
stethoscope at 2nd intercostal space at the base of the heart
You hear a split s2 on auscultation of a 25 yo client. What is your best action? - Answer Tell them to
hold their breath and repeat
The client has been told he has a heart murmur. He asks you what this means. You explain - Answer It is
the rushing sound blood makes moving through narrow places. Some are harmless and others indicate
problems
Where would you expect to hear best an abnormal sound with mitral valve insufficiency? - Answer 5th
ICS at MCL
when auscultating the heart sounds of a 72 yo client with history of HTN. NP notes an S4. This finding
could indicate - Answer An increased resistance to ventricular filling
Questions With Solved Solutions.
During a routine physical exam of a 44 yo woman you note she has an inverted left nipple. You decide to
investigate because: - Answer The inversion may be a recent change
A 30 yo F is in the office c/o palpitations and some lightheadedness for the past ?, random episodes, no
detectable pattern. NP notes a mid systolic click with a late systolic murmur heard best in the apical area.
You suspect - Answer Mitral valve prolapse (MVP)
All of the following tests require the patient's voice to perform correctly except: - Answer -egophany
-tactile fremitus
-whispered pectoriloquy
auscultation
59 yo M with history of COPD presents with worsening dyspnea. Patient is afebrile, breath sounds are
decreased bilaterally, noted to have JVD and pitting edema of lower extremities. What is the most likely
cause of his dyspnea? - Answer CHF
James Jones 55 yo M smoker presents with thick sputum producing cough. Exam: +tactile fremitus,
resonant percussion, and normal voice transmission. You suspect: - Answer bronchitis
During the breast exam of a 30 year old nulliparous female. The NP palpates several rubbery areas of the
breast tissue. They are slightly tender to palpation and present in both breasts. Expecting menses in 5
days. Which intervention is best? - Answer Tell her to recheck 1 week after her menses
All of the following symptoms associated with chest pain are likely to represent CAD except? - Answer
pain with inspiration
60 yo landscaper presents to your office to establish care, history of CHF controlled with medications.
Denies cp, edema. Early diastolic ? with opening snap ___. You suspect? - Answer Mitral stenosis
, A patient states that she has had a rash on her breast for about 2 weeks. In order to determine if it is
pagets disease you would expect to have all of the following on physical exam EXCEPT - Answer
inverted nipple
You notice a medium-pitched harsh systolic murmur during a routine exam or R upper border of the
sternum. Which of the following is most likely? - Answer Aortic stenosis
Which of the following statements in NOT typical of the murmur it is describing? - Answer Grade
II/Grade VI murmur is associated with a thrill?
A 58 yo dentist presents for routine check up. He has been healthy. Non smoker, does not drink alcohol.
You hear a moderately loud murmur, no palpable thrill. What is the appropriate grade for this murmur? -
Answer Grade 3
57 yo college professor is hospitalized for SOB. As you examine her in ER, JVP of 45 degrees 8 cm above
the clavicle. finding is most consistent with which of the following diagnoses? - Answer Right sided
heart failure
What technique should be used to best auscultate the 2nd heart sounds? - Answer Diaphragm of the
stethoscope at 2nd intercostal space at the base of the heart
You hear a split s2 on auscultation of a 25 yo client. What is your best action? - Answer Tell them to
hold their breath and repeat
The client has been told he has a heart murmur. He asks you what this means. You explain - Answer It is
the rushing sound blood makes moving through narrow places. Some are harmless and others indicate
problems
Where would you expect to hear best an abnormal sound with mitral valve insufficiency? - Answer 5th
ICS at MCL
when auscultating the heart sounds of a 72 yo client with history of HTN. NP notes an S4. This finding
could indicate - Answer An increased resistance to ventricular filling
