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A 40-year-old woman reports a change in mole size, accompanied by color changes, itching, burning, and bleeding over the past month. She has a dark complexion and has no family history of skin cancer, but she has had many blistering sunburns in the past. The nurse would:
- A. Tell the patient to watch the lesion and report back in 2 months.
- B. Refer the patient because of the suggestion of melanoma on the basis of her symptoms.
- C. Ask additional questions regarding environmental irritants that may have caused this condition.
- D. Tell the patient that these signs suggest a compound nevus, which is very common in young to middle-aged adults.
Correct Answer: B
Rationale: The ABCD danger signs of melanoma are asymmetry, border irregularity, color variation, and diameter. In addition, individuals may report a change in size, the development of itching, burning, and bleeding, or a new-pigmented lesion. Any one of these signs raises the suggestion of melanoma and warrants immediate referral.
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The nurse is reviewing the anatomy and physiologic functioning of the heart. Which statement best describes what is meant by atrial kick?
- A. The atria contract during systole and attempt to push against closed valves.
- B. Contraction of the atria at the beginning of diastole can be felt as a palpitation.
- C. Atrial kick is the pressure exerted against the atria as the ventricles contract during systole.
- D. The atria contract toward the end of diastole and push the remaining blood into the ventricles.
Correct Answer: D
Rationale: Toward the end of diastole, the atria contract and push the last amount of blood (approximately 25% of stroke volume) into the ventricles. This active filling phase is called presystole, or atrial systole, or sometimes the atrial kick.
Which of these findings would the nurse expect to notice during a cardiac assessment on a 4-year-old child?
- A. S3 when sitting up
- B. Persistent tachycardia above 150 beats per minute
- C. Murmur at the second left intercostal space when supine
- D. Palpable apical impulse in the fifth left intercostal space lateral to midclavicular line
Correct Answer: C
Rationale: Some murmurs are common in healthy children or adolescents and are termed innocent or functional. The innocent murmur is heard at the second or third left intercostal space and disappears with sitting, and the young person has no associated signs of cardiac dysfunction.
The nurse instructor is teaching student nurses about the factors that may affect a patients blood pressure. Which statements accurately describe these factors?
- A. Blood pressure decreases with age.
- B. Blood pressure is usually lowest on arising in the morning.
- C. Women usually have lower blood pressure than men until menopause.
- D. Increased blood pressure is more prevalent in African Americans.
Correct Answer: B
Rationale: Blood pressure increases with age due to arterial stiffening, making A incorrect. Its typically lowest upon waking , reflecting circadian rhythms, making B correct. Women often have lower blood pressure than men pre-menopause due to hormonal differences, which is true. Blood pressure rises post-meal, not decreases (D replaced with original D). Its lower in prone/supine positions (E), and higher in African Americans (F), both accurate. Since the answer focuses on B, its supported by the morning dip in blood pressure, a well-documented physiological pattern. This teaches students key influences on blood pressure variability.
The nurse is assessing a patient's cranial nerve function and asks the patient to close their eyes and report whether they can feel light touch on their face. Which cranial nerve is being tested?
- A. Cranial nerve V (trigeminal nerve).
- B. Cranial nerve VII (facial nerve).
- C. Cranial nerve IX (glossopharyngeal nerve).
- D. Cranial nerve X (vagus nerve).
Correct Answer: A
Rationale: Cranial nerve V controls sensation on the face, and light touch is used to test its function.
Which of the following statements describes the chief complaint?
- A. The patient is a 52-year-old woman presenting with a 2-day history of fever and chills.
- B. The patient's symptoms are associated with nausea and vomiting.
- C. The patient states, 'I have a fever and chills.'
- D. The patient denies shortness of breath.
Correct Answer: C
Rationale: The chief complaint is the patient's primary reason for seeking care, stated in their own words.