Triangles PQR and PSR are right triangles, with both QR = SR = 5 (since these are radii of the circle R).
TR is also a radius of the circle, so TR = 5, making PR = 4 + TR = 9.
Because PQR and PSR are right triangles, we can compute the length of the missing side, which will be equal. By the Pythagorean theorem,
PQ^2 + QR^2 = PR^2
PQ^2 + 5^2 = 9^2
PQ^2 = 56
PQ = √56 = 2√14
Then the perimeter of PQRS is
PQ + QR + RS + SP = 2√14 + 5 + 5 + 2√14 = 10 + 4√14
and so the answer is B.
