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Explain why late inspiratory crackles in the lower third of the chest are indicative of heart failure rather than other respiratory conditions.
- A. They indicate airway obstruction typical of asthma.
- B. They suggest fluid accumulation in the alveoli due to heart failure.
- C. They are a sign of chronic bronchial inflammation.
- D. They are associated with hyperinflation of the lungs in COPD.
Correct Answer: B
Rationale: Late inspiratory crackles indicate fluid in the alveoli, a hallmark of heart failure.
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Which of the following findings could indicate a need for further evaluation of the cardiac patient?
- A. Hematocrit 42%
- B. Potassium 4.2 mg/dl
- C. Sodium 140 mEq/dl
- D. Low-density lipoprotein of 190 mg/dl
Correct Answer: D
Rationale: LDL levels over 160 mg/dl warrant further evaluation for cardiovascular risk.
Snellen chart evaluation indicated that the patient vision is 20/30. What is the proper description of this result?
- A. At 20 feet, this patient can see what a person with normal vision can see at 30 feet
- B. At 30 feet, this patient can see what a person with normal vision can see at 20 feet
- C. At 20 feet, this patient can see what few people can see at 30 feet
- D. This patient has sight abilities that are worse than a patient with 20/40 vision
Correct Answer: A
Rationale: 20/30 means that at 20 feet, the patient can see what someone with normal vision sees at 30 feet.
On examination, a patient is noted to have a "mask-like" face with decreased blinking and a characteristic stare. These features may be characteristic of:
- A. Nephrotic syndrome
- B. Myxedema
- C. Cushing’s syndrome
- D. Parkinson disease
Correct Answer: D
Rationale: A "mask-like" face is a classic feature of Parkinson’s disease.
A 40-year-old admits to multiple sex partners and presents with several lesions over his body. Findings reveal hemorrhagic vesiculopustular lesions over the hands and feet. These lesions are most likely associated with:
- A. Gonococcemia
- B. Infective endocarditis
- C. Hyperthyroidism
- D. Peripheral vascular disease
Correct Answer: A
Rationale: Hemorrhagic vesiculopustular lesions, particularly on the hands and feet, are associated with gonococcemia.
A patient calls the nurse practitioner and states that he missed his morning daily dose of warfarin, 5 mg, yesterday and today. The nurse practitioner instructs the patient to:
- A. Wait until tomorrow and resume daily dosing of warfarin 5 mg
- B. Take warfarin 10 mg now
- C. Take warfarin 5 mg now, warfarin 5 mg at 5 pm today, and resume the daily warfarin 5 mg dose in the morning as scheduled
- D. Take warfarin 5 mg now and resume the warfarin 5 mg daily dose in the morning as scheduled
Correct Answer: D
Rationale: The patient should resume the usual warfarin dose and avoid doubling it.