High School

Read this excerpt from a patient's physical exam:

**Physical Exam:**
- Temperature: 98.6°F
- Heart Rate: 100 bpm
- Respiratory Rate: 32 breaths/min
- BP: 84/60 mmHg

**General:**
- Thin
- Lethargic

**Head:**
- Normocephalic atraumatic
- Very dry mucous membranes
- Ketotic breath
- Pupils equal, round, and reactive to light
- TMs normal

**Neck:**
- Supple

**Cardiovascular:**
- Mild tachycardia
- No murmur, gallop, or rub

**Respiratory:**
- Deep, rapid breathing
- Clear to auscultation
- No retractions

**Abdomen:**
- Soft, nontender, nondistended
- Spleen and liver edge not palpable

**Neurologic:**
- DTRs: patellar and brachial present and equal

**Skin:**
- Dry
- Capillary refill > 3 seconds

**Extremities:**
- No cyanosis, clubbing, or edema

Which statement is a correct reflection of the physical exam?

A. The patient is febrile, has a normal heart rate and respiratory rate, and is overweight.

B. The patient is afebrile, has a normal heart and respiratory rate, PERRLA, and therefore looks healthy.

C. The patient is afebrile, has a fast heart and respiratory rate, fruity-smelling breath, and PERRLA.

D. The patient is febrile, has a fast heart and respiratory rate, and her eyes are not reacting to light.

Answer :

Final answer:

The correct interpretation of the physical exam is that the patient is not feverish, has elevated heart rate and rapid breathing, fruity smelling breath, and normal pupil reactivity. Other signs of illness are also present.

Explanation:

The correct answer is C - 'The patient is afebrile, has a fast heart and respiratory rate, fruity-smelling breath, and PERRLA.' The physical exam shows that the patient's temperature (98.6) is within the normal range (afebrile), and the heart rate (100) is somewhat elevated (tachycardia). The respiratory rate (32) is also high, indicating rapid breathing. The mention of ketotic breath is consistent with a fruity smell, often a symptom of metabolic conditions like diabetes. 'PERRLA' stands for 'Pupils Equal, Round, and Reactive to Light,' a standard part of a neurological exam, which is normal in this patient. It's important to note that despite the presence of PERRLA this patient shows other signs of potential illness including lethargy, dry skin and mucous membranes, and prolonged capillary refill time.

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Answer:

B

Explanation:

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