A 45-year-old farmer comes in for a skin evaluation and complains of hair loss on his head. His hair seems to be breaking off in patches, and he notices some scaling on his head. The nurse begins the examination suspecting:

Correct Answer: A

Rationale: The correct answer is A: Tinea capitis. Tinea capitis is a fungal infection of the scalp that often presents with hair loss, scaling, and broken hair in patches. In this case, the patient's symptoms of hair loss, patchy scaling, and broken hair are consistent with tinea capitis. The nurse should suspect this diagnosis based on the clinical presentation. Other choices are incorrect because: B: Folliculitis typically presents with inflamed hair follicles, pustules, and redness. It is not characterized by patchy hair loss and scaling. C: Toxic alopecia is hair loss due to exposure to toxins or chemicals, which is not suggested by the symptoms described. D: Seborrheic dermatitis presents with greasy, yellowish scaling on the scalp, but typically does not cause patchy hair loss as described in the case.

Correct Answer: C

Rationale: The correct answer is C because the presence of a crusty nodule that intermittently bleeds, does not heal, and has an ulcerated crusted appearance with an indurated base raises suspicion for potential carcinoma. This presentation is concerning for skin cancer, specifically a squamous cell carcinoma or basal cell carcinoma. Therefore, the patient should be referred for a biopsy to confirm the diagnosis and initiate appropriate treatment. Choices A, B, and D are incorrect because a benign sebaceous cyst (A) typically presents as a painless, mobile, smooth nodule, a keloid (B) is characterized by an overgrowth of scar tissue and is not associated with the described symptoms, and a tophus (D) is a deposit of uric acid crystals seen in gout, which would present differently than the described ulcerated crusted nodule.

Correct Answer: C

Rationale: The correct answer is C because tonsils that are 3+/1-4+ with large white spots are indicative of exudative tonsillitis, which commonly occurs in acute bacterial infections like streptococcal pharyngitis. Here's the rationale: 1. Tonsils 3+ indicate significant enlargement, more than the normal size. 2. 1-4+ refers to the extent of the white spots or exudate present on the tonsils. 3. Large white spots suggest a substantial amount of exudate, commonly seen in bacterial infections like streptococcal pharyngitis. Therefore, the presentation of enlarged tonsils with large white spots aligns with an acute bacterial infection. Other choices are incorrect: A: Tonsils are not significantly enlarged nor do they have white spots. B: While there is white debris, it is not extensive as indicated by the 1-4+ scale. D: Pale coloring does not indicate an

Correct Answer: A

Rationale: The correct answer is A: The spinous process of C7. The vertebra prominens is the most prominent vertebra at the base of the neck, which is C7. This is because the spinous process of C7 is longer and more palpable than other cervical vertebrae. Rationales for the incorrect choices: B: Usually nonpalpable in most individuals - This is incorrect as the vertebra prominens (C7) is usually palpable due to its prominent spinous process. C: Opposite the interior border of the scapula - This is incorrect as the vertebra prominens is located at the base of the neck, not opposite the scapula. D: Located next to the manubrium of the sternum - This is incorrect as the vertebra prominens is located higher up in the neck than the manubrium of the sternum.

Correct Answer: B

Rationale: The correct answer is B: When part of the lung is obstructed or collapsed. Unequal chest expansion can occur when there is an obstruction or collapse of a portion of the lung, leading to decreased lung expansion on that side. This can result in one side of the chest moving less during breathing. Other options are incorrect because: A: In an obese patient - obesity may affect chest wall movement but does not directly cause unequal chest expansion. C: When bulging of the intercostal spaces is present - bulging of intercostal spaces may indicate increased work of breathing but does not necessarily lead to unequal chest expansion. D: When accessory muscles are used to augment respiratory effort - while accessory muscles may be used in respiratory distress, they do not directly cause unequal chest expansion.