D444 Adult Health I - Set 4 - Part 1

Correct Answer: Cirrhosis development

Option c is correct because skin pigmentation and arthralgia indicate cirrhosis development with metabolic changes requiring close monitoring for progression.
Option a is incorrect because liver cancer typically presents with weight loss and abdominal mass rather than skin changes and joint pain.
Option b is incorrect because portal hypertension causes varices and ascites, not the skin pigmentation and arthralgia described in this presentation.
Option d is incorrect because bile obstruction causes jaundice and clay stools rather than darkened pigmentation with joint pain symptoms occurring.

Correct Answer: Dry mouth developing

Option b is correct because dry mouth from anticholinergic effects is manageable with sugar-free candy and fluids without stopping medication.
Option a is incorrect because palpitations may indicate systemic absorption requiring medical evaluation rather than simple comfort measures for management typically.
Option c is incorrect because vision changes could indicate angle-closure glaucoma requiring immediate evaluation not just comfort measures for safety.
Option d is incorrect because urinary retention is serious anticholinergic effect requiring medical intervention rather than simple comfort measures alone sufficiently.

Correct Answer: Grating leather sound

Option b is correct because pleural friction rub creates distinctive grating or leather-rubbing sound from inflamed pleural surfaces rubbing together.
Option a is incorrect because wet crackling describes rales or crackles from fluid in alveoli, not pleural friction rub characteristics specifically.
Option c is incorrect because high-pitched whistling describes wheezing from narrowed airways rather than pleural surface friction sounds heard typically.
Option d is incorrect because low rumbling describes rhonchi from secretions in large airways, not pleural friction rub sounds characteristically present.

Correct Answer: Productive purulent sputum

Option b is correct because purulent sputum suggests bacterial infection requiring antibiotics while viral pneumonia typically produces clear or minimal sputum.
Option a is incorrect because both bacterial and viral pneumonia cause fever, making this nonspecific for determining antibiotic therapy needs appropriately.
Option c is incorrect because chest pain occurs in both types of pneumonia from coughing and pleuritic irritation, not distinguishing etiology.
Option d is incorrect because dyspnea occurs with any pneumonia type affecting gas exchange regardless of bacterial or viral cause present.

Correct Answer: Rests inflamed pancreas

Option b is correct because NPO status prevents food-stimulated enzyme release allowing the inflamed pancreas to heal without further autodigestion.
Option a is incorrect because while NPO prevents vomiting, the primary purpose is pancreatic rest not symptom management alone in treatment.
Option c is incorrect because NPO status doesn't directly prevent infection; it specifically reduces pancreatic stimulation and enzyme production during inflammation.
Option d is incorrect because pain medication needs relate to inflammation severity not oral intake status, though pain may decrease with rest.

Correct Answer: Expected color change

Option b is correct because rifampin normally causes harmless red-orange discoloration of all body fluids including urine as expected effect.
Option a is incorrect because red urine from rifampin doesn't indicate kidney damage; it's a harmless discoloration effect of medication metabolism.
Option c is incorrect because rifampin's orange-red color differs from blood in urine which would indicate bleeding requiring immediate evaluation instead.
Option d is incorrect because color change occurs at therapeutic doses and doesn't indicate overdose or need for dose adjustment typically.

Correct Answer: Abdominal distention with fever

Option b is correct because severe distention with systemic toxicity indicates toxic megacolon, a life-threatening complication requiring immediate intervention urgently.
Option a is incorrect because toxic megacolon causes decreased or absent bowel sounds from ileus, not increased intestinal activity sounds typically.
Option c is incorrect because toxic megacolon causes severe diarrhea or obstipation, not formed stools which indicate less severe disease activity.
Option d is incorrect because toxic megacolon causes severe pain with peritoneal signs, not mild cramping suggesting less serious exacerbation occurring.

Correct Answer: Hand hygiene consistently

Option b is correct because consistent hand hygiene prevents most opportunistic infections by eliminating pathogens before they enter the body systemically.
Option a is incorrect because masks protect against respiratory pathogens but don't prevent the broader range of opportunistic infections possible overall.
Option c is incorrect because complete crowd avoidance is impractical and unnecessary with proper precautions including hand hygiene and immunization appropriately.
Option d is incorrect because while vitamins support immunity, they don't directly prevent pathogen transmission like hand hygiene does effectively always.

Correct Answer: Seek emergency care

Option c is correct because forty percent indicates red zone emergency status requiring immediate medical attention to prevent respiratory failure.
Option a is incorrect because forty percent is dangerously low requiring emergency intervention not continuation of normal activities risking respiratory arrest.
Option b is incorrect because while rescue inhaler should be used, emergency care is needed immediately when peak flow reaches forty percent.
Option d is incorrect because documentation alone without emergency action could result in respiratory failure when peak flow critically low presently.

Correct Answer: Fluid wave test

Option b is correct because fluid wave test specifically detects free fluid in peritoneal cavity characteristic of ascites in cirrhosis.
Option a is incorrect because deep palpation may be difficult with tense ascites and doesn't specifically confirm fluid presence versus other causes.
Option c is incorrect because rebound tenderness indicates peritoneal irritation or inflammation rather than specifically detecting ascites fluid present in abdomen.
Option d is incorrect because Murphy's sign tests for cholecystitis by palpating gallbladder area, not for detecting ascitic fluid accumulation present.

Correct Answer: Cover mouth when coughing

Option c is correct because tuberculosis spreads through airborne droplets when coughing, making respiratory hygiene the primary prevention method needed.
Option a is incorrect because tuberculosis doesn't spread through saliva on utensils but through airborne particles requiring respiratory precautions instead primarily.
Option b is incorrect because while helpful, covering coughs is more important than sleeping arrangements for preventing airborne transmission to others.
Option d is incorrect because tuberculosis doesn't spread through clothing contact but through inhaled droplet nuclei from coughing and sneezing.

Correct Answer: Accessory respiratory muscles

Option b is correct because tripod position fixes shoulder girdle allowing accessory muscles like scalenes and sternocleidomastoid to aid breathing.
Option a is incorrect because tripod position doesn't directly assist flattened diaphragm function but rather recruits additional muscle groups for breathing.
Option c is incorrect because while abdominal muscles aid exhalation, tripod specifically facilitates accessory muscle use for inspiration in emphysema.
Option d is incorrect because intercostal muscles work regardless of position; tripod specifically optimizes accessory muscle mechanical advantage for breathing effectively.

Correct Answer: Protein

Option b is correct because protein metabolism produces ammonia which accumulates in liver failure causing encephalopathy and confusion symptoms progressively.
Option a is incorrect because carbohydrates are safe energy sources that don't produce ammonia contributing to hepatic encephalopathy development in patients.
Option c is incorrect because fat restriction isn't specifically required for encephalopathy though may help with steatorrhea in liver disease generally.
Option d is incorrect because fiber doesn't affect ammonia production; protein restriction is key dietary modification for encephalopathy management specifically required.

Correct Answer: Every five minutes

Option b is correct because epinephrine can be repeated every five to fifteen minutes for persistent anaphylaxis symptoms requiring additional doses.
Option a is incorrect because two minutes is too frequent and doesn't allow time to assess initial epinephrine response before repeating unnecessarily.
Option c is incorrect because while acceptable, five minutes allows faster intervention for life-threatening symptoms than waiting ten minutes between doses.
Option d is incorrect because thirty minutes is too long to wait when anaphylaxis symptoms persist, risking cardiovascular collapse without treatment given.

Correct Answer: Relieved by antacids

Option b is correct because GERD pain responds to antacids neutralizing stomach acid while cardiac pain requires different interventions typically needed.
Option a is incorrect because radiation to arm suggests cardiac origin rather than the esophageal pain of GERD typically experienced by patients.
Option c is incorrect because exertional chest pain suggests cardiac origin while GERD pain occurs after meals or when lying down.
Option d is incorrect because diaphoresis accompanies cardiac events rather than the isolated burning sensation of acid reflux in GERD.

Correct Answer: Decreasing creatinine

Option b is correct because falling creatinine levels indicate improving glomerular filtration as kidneys recover ability to clear waste products.
Option a is incorrect because rising BUN suggests worsening not improving kidney function, though BUN is less specific than creatinine levels.
Option c is incorrect because increasing potassium indicates worsening kidney function with decreased excretion rather than improvement in filtration occurring.
Option d is incorrect because calcium changes are complex in kidney disease and don't directly indicate improving or worsening function specifically.

Correct Answer: Cerebellum

Option c is correct because scanning speech with irregular rhythm and emphasis results from cerebellar demyelination affecting coordination of speech.
Option a is incorrect because optic nerve demyelination causes vision problems like optic neuritis, not speech pattern changes in MS patients.
Option b is incorrect because spinal cord lesions cause motor and sensory deficits in extremities rather than speech coordination problems specifically occurring.
Option d is incorrect because cerebral cortex lesions cause cognitive changes rather than the coordination problems producing scanning speech patterns characteristically.

Correct Answer: Increase oxygen delivery

Option a is correct because tachypnea compensates for impaired gas exchange by increasing minute ventilation to deliver more oxygen systemically needed.
Option b is incorrect because while hyperventilation reduces CO2, the primary drive for tachypnea in pneumonia is hypoxemia not hypercapnia initially.
Option c is incorrect because rapid shallow breathing actually increases work of breathing rather than reducing energy expenditure in pneumonia typically.
Option d is incorrect because tachypnea doesn't prevent atelectasis; deep breathing and coughing are needed for alveolar expansion and secretion clearance.

Correct Answer: Take before breakfast

Option b is correct because proton pump inhibitors work best when taken before first meal to inhibit acid pumps maximally.
Option a is incorrect because taking with food decreases absorption; PPIs should be taken on empty stomach before meals for effectiveness.
Option c is incorrect because bedtime dosing misses the opportunity to suppress daytime acid production when most ulcer damage occurs typically.
Option d is incorrect because antacids aren't needed with PPIs and may interfere with absorption if taken simultaneously rather than separately.

Correct Answer: Trendelenburg

Option c is correct because Trendelenburg position increases blood flow to varices and aspiration risk, worsening hemorrhage and complications significantly.
Option a is incorrect because High Fowler's position helps prevent aspiration and is appropriate during variceal bleeding episodes requiring positioning considerations.
Option b is incorrect because left lateral position may help prevent aspiration if consciousness impaired while managing active variceal hemorrhage appropriately positioned.
Option d is incorrect because Semi-Fowler's position is acceptable for conscious patients, helping prevent aspiration while managing variceal bleeding emergencies effectively.