Chapter 4: Beginning the Physical Examination: General Survey, Vital Signs, and Pain

Chapter 4: Beginning the Physical Examination: General Survey, Vital Signs, and Pain

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Multiple Choice

1. A 15-year-old high school sophomore and her mother come to your clinic because the mother is concerned about her daughter’s weight. You measure her daughter’s height and weight and obtain a BMI of 19.5 kg/m². Based on this information, which of the following is appropriate?
2. A) Refer the patient to a nutritionist and a psychologist because the patient is anorexic.
3. B) Reassure the mother that this is a normal body weight.
4. C) Give the patient information about exercise because the patient is obese.
5. D) Give the patient information concerning reduction of fat and cholesterol in her diet because she is obese.

Ans:  B

Chapter:  04

Page and Header:  104, Health Promotion and Counseling

Feedback:  The patient has a normal BMI; the range for a normal BMI is 18.5 to 24.9 kg/m².  You may be able to give the patient and her mother the lower limit of normal in pounds for her daughter’s height, or instruct her in how to use a BMI table.

2. A 25-year-old radio announcer comes to the clinic for an annual examination. His BMI is 26.0 kg/m². He is concerned about his weight. Based on this information, what is appropriate counsel for the patient during the visit?
3. A) Refer the patient to a nutritionist because he is anorexic.
4. B) Reassure the patient that he has a normal body weight.
5. C) Give the patient information about reduction of fat, cholesterol, and calories because he is overweight.
6. D) Give the patient information about reduction of fat and cholesterol because he is obese.

Ans:  C

Chapter:  04

Page and Header:  104, Health Promotion and Counseling

Feedback:  The patient has a BMI in the overweight range, which is 25.0 to 29.9 kg/m².  It is prudent to give him information about reducing calories, fat, and cholesterol in his diet to help prevent further weight gain.

3. A 30-year-old sales clerk comes to your office wanting to lose weight; her BMI is 30.0 kg/m². What is the most appropriate amount for a weekly weight reduction goal?
4. A) .5 to 1 pound per week
5. B) 1 to 2.5 pounds per week
6. C) 5 to 3.5 pounds per week
7. D) 5 to 4.5 pounds per week

Ans:  A

Chapter:  04

Page and Header:  104, Health Promotion and Counseling

Feedback:  Based on the NIH Obesity Guidelines, this is the weekly weight loss goal to strive for to maintain long-term control of weight.  More rapid weight loss than this does not result in a better outcome at one year.

4. A 67-year-old retired janitor comes to the clinic with his wife. She brought him in because she is concerned about his weight loss. He has a history of smoking 3 packs of cigarettes a day for 30 years, for a total of 90 pack-years. He has noticed a daily cough for the past several years, which he states is productive of sputum. He came into the clinic approximately 1 year ago, and at that time his weight was 140 pounds. Today, his weight is 110 pounds.

Which one of the following questions would be the most important to ask if you suspect that he has lung cancer?

1. A) Have you tried to force yourself to vomit after eating a meal?
2. B) Do you have heartburn/indigestion and diarrhea?
3. C) Do you have enough food to eat?
4. D) Have you tried to lose weight?

Ans:  D

Chapter:  04

Page and Header:  102, The Health History

Feedback:  This is important: If the patient hasn’t tried to lose weight, then this weight loss is inadvertent and poses concern for a neoplastic process, especially given his smoking history.