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A 25-year-old accountant presents with intermittent lower right-sided chest pain for several days. The pain is knifelike, lasts 3-5 seconds, worsens with deep breathing, and improves when lying on the affected side.
- A. Pericarditis
- B. Chest wall pain
- C. Pleural pain
- D. Angina pectoralis
Correct Answer: C
Rationale: The correct answer is C: Pleural pain. The key features here are the sharp, knifelike pain that worsens with deep breathing, which is typical of pleuritic pain due to inflammation of the pleura. This pain pattern is distinct from pericarditis (A) which typically worsens with lying flat and improves when sitting up. Chest wall pain (B) is usually reproducible with palpation, and angina pectoris (D) is typically described as a pressure or squeezing sensation, often triggered by exertion. Therefore, based on the pain characteristics described by the patient, pleural pain is the most likely diagnosis.
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A patient presents in the clinic with dizziness and fatigue. The nursing assistant reports a very slow radial pulse of 44. What is your priority intervention?
- A. Request that the nursing assistant repeat the pulse check
- B. Call for a stat electrocardiogram (ECG)
- C. Assess the patient's apical pulse and evidence of a pulse deficit
- D. Prepare to administer cardiac-stimulating medications
Correct Answer: C
Rationale: Bradycardia (pulse 44) with dizziness/fatigue requires apical pulse assessment to confirm rate and check for deficit, indicating cardiac output issues. Repeating radial delays RN evaluation. Stat ECG is secondary. Meds are premature. Choice C is correct, per nursing priority to verify and assess symptomatic bradycardia directly.
The nurse is preparing to perform a physical assessment. Which statement is true about the physical assessment? The inspection phase:
- A. Usually yields little information.
- B. Takes time and reveals a surprising amount of information.
- C. May be somewhat uncomfortable for the expert practitioner.
- D. Requires a quick glance at the patient's body systems before proceeding with palpation.
Correct Answer: B
Rationale: The correct answer is B: Takes time and reveals a surprising amount of information. During the inspection phase of a physical assessment, the nurse carefully observes the patient's appearance, behavior, and movements. This phase is crucial as it provides valuable visual information about the patient's overall health status, potential abnormalities, and clues for further assessment. By taking time and paying attention to detail during inspection, the nurse can gather significant data that can guide the rest of the assessment process. The other choices are incorrect because: A) Inspecting usually yields valuable information, C) Discomfort is not a typical characteristic of the inspection phase, and D) Inspection requires thorough observation, not just a quick glance before palpation.
The patient with heart failure is restless with a temperature of 102.2°F (39°C). Which action will the nurse take?
- A. Place the patient on oxygen.
- B. Encourage the patient to cough.
- C. Restrict the patient's fluid intake.
- D. Increase the patient's metabolic rate.
Correct Answer: A
Rationale: Heart failure with fever (102.2°F) and restlessness suggests increased oxygen demand. Applying oxygen addresses potential hypoxemia, a priority in heart failure exacerbation. Coughing is irrelevant without respiratory symptoms. Restricting fluids may worsen dehydration in fever. Increasing metabolic rate exacerbates stress. Choice A is correct, aligning with nursing priorities to support oxygenation in cardiac patients with fever-induced strain.
Which of the following is consistent with obturator sign?
- A. Pain distant from the site used to check rebound tenderness
- B. Right hypogastric pain with the right hip and knee flexed and the hip internally rotated
- C. Pain with extension of the right thigh while the patient is on her left side or while pressing her knee against your hand with thigh flexion
- D. Pain that stops inhalation in the right upper quadrant
Correct Answer: B
Rationale: The obturator sign is a test for appendicitis. B is correct because it describes the characteristic pain felt in the right hypogastric region when the right hip and knee are flexed and internally rotated, indicating irritation of the obturator muscle due to an inflamed appendix. A is incorrect as it describes rebound tenderness in a different location. C is incorrect as it describes pain with thigh extension or flexion, not internal rotation. D is incorrect as it describes pain that affects breathing, not related to obturator muscle irritation.
The nurse is performing a neurological assessment and observes that the patient has difficulty with rapid alternating movements. What condition does this finding suggest?
- A. Cerebellar dysfunction.
- B. Peripheral neuropathy.
- C. Motor weakness.
- D. Upper motor neuron lesion.
Correct Answer: A
Rationale: The correct answer is A: Cerebellar dysfunction. Difficulty with rapid alternating movements is a classic sign of cerebellar dysfunction due to the cerebellum's role in coordinating smooth and coordinated movements. This finding suggests impairment in the cerebellum's ability to control motor function, leading to problems with coordination and rapid movements. Peripheral neuropathy (B) primarily affects sensory and motor functions in the peripheral nervous system, not specifically rapid alternating movements. Motor weakness (C) refers to a generalized decrease in muscle strength and is not specific to rapid alternating movements. An upper motor neuron lesion (D) typically presents with spasticity and weakness but does not specifically affect rapid alternating movements as seen in cerebellar dysfunction.