Author: Anonymous

A 32-year-old woman at 28 weeks of gestation presents for a prenatal visit. On cardiac auscultation, the provider detects a Grade II systolic ejection murmur over the pulmonic area and a clearly audible S3. The patient is asymptomatic and her vital signs are within normal limits. What is the most appropriate interpretation and action?

You are examining an 80-year-old woman with 2 days of LLQ pain, mild fever, and constipation. She has a history of diverticulosis. Which statement best reflects abdominal assessment in older adults?

A 24-year-old woman presents with a 2-week history of RLQ pain, low-grade fever, diarrhea, and a 10-pound unintentional weight loss over 3 months. She has no known GI history. On exam you note RLQ tenderness, a palpable RLQ mass, and perianal skin tags with a small draining fistula. Based on the physical examination findings, which of the following best explains why this patient’s presentation is NOT consistent with ulcerative colitis?

You are seeing a 54 year old female with a history of psoriasis. She has slightly elevated erythematic rough areas that are 3 inch by 4 inch on both knees. You should describe these areas as:

A 78-year-old patient has thin, fragile skin and purple patches on the dorsal forearms. The patient denies trauma. Which explanation is most appropriate?

A nurse practitioner is evaluating a 10-year-old child who presented two months ago with fever, migratory polyarthritis, and a new holosystolic murmur following an untreated streptococcal pharyngitis infection. The parent now reports the child has developed involuntary, purposeless, jerky movements of the face and extremities that worsen with stress and disappear during sleep. Which of the following best describes this new finding and its significance within the patient’s clinical course?

A provider is conducting a focused respiratory history on a patient presenting with dyspnea. Which question best assesses the severity of the patient’s shortness of breath?

A provider is evaluating a 58-year-old male with progressive exertional dyspnea. On auscultation, a crescendo-decrescendo systolic murmur is heard, rated Grade III/VI, which radiates to the carotid arteries bilaterally. S2 is diminished. Which valvular pathology is most consistent with this presentation?

A 58-year-old man presents to the clinic for evaluation of right upper quadrant fullness and early satiety that has progressed over the past 3 months. His past medical history includes type 2 diabetes, hypertension, and obesity (BMI 34). He drinks 2–3 beers daily and has done so for 30 years. He takes metformin and lisinopril. Vital signs are within normal limits. On physical examination, you percuss along the right midclavicular line. The percussion note transitions from resonance to dullness at the 5th intercostal space. Dullness extends 15 cm inferiorly before transitioning to tympany. The splenic percussion area is normal. No fluid wave or shifting dullness is detected. Which interpretation best fits this finding?

During auscultation, a provider detects a murmur that is moderately loud and clearly audible and is accompanied by a palpable thrill over the precordium. Using the standard six-point grading scale, how should this murmur be documented?