A 45-year-old man presents with difficulty swallowing. He reports that the difficulty has been getting worse over the past few months. He also has a history of smoking and heavy alcohol use. What is the most likely diagnosis?

Correct Answer: A

Rationale: The correct answer is A: Esophageal cancer. Given the patient's age, symptoms of progressive dysphagia, and risk factors such as smoking and heavy alcohol use, esophageal cancer is the most likely diagnosis. Further evaluation with imaging studies and endoscopy is warranted to confirm the diagnosis. B: Achalasia is less likely as it typically presents with dysphagia to both solids and liquids, not just worsening dysphagia over time. C: Gastroesophageal reflux disease (GERD) may cause heartburn and regurgitation but is less likely to present with progressive dysphagia. D: Peptic ulcer disease typically presents with abdominal pain and may cause dysphagia if there is stricture formation but is less likely in this case.

Correct Answer: B

Rationale: The correct action after palpating the carotid pulse is to auscultate for bruits. Bruits are abnormal sounds caused by turbulent blood flow, which may indicate vascular disease. Auscultating for bruits specifically at the carotid arteries is important in assessing for potential arterial blockages that can lead to serious complications like stroke. Palpating the femoral pulse (Choice A) is not the next immediate step in a cardiovascular assessment after assessing the carotid pulse. Comparing the pulse rate with the apical pulse (Choice C) is important but not the immediate action required after palpating the carotid pulse. Palpating the radial pulse (Choice D) is also an important part of the assessment, but in this scenario, auscultating for bruits takes precedence for further evaluation.

Correct Answer: A

Rationale: The correct answer is A: Percussion for shifting dullness. Ascites is the accumulation of fluid in the peritoneal cavity leading to abdominal distension. By percussing the abdomen for shifting dullness, the nurse can identify fluid waves within the abdomen, confirming the presence of ascites. This technique helps differentiate ascites from other causes of abdominal distension. Auscultation for bowel sounds (B) is not directly related to assessing ascites. Palpation for tenderness (C) may be performed after confirming ascites to assess for underlying causes. Inspection for visible distension (D) can provide initial clues, but percussion for shifting dullness is needed for a definitive diagnosis of ascites.

Correct Answer: A

Rationale: The split S2 sound is typically heard during inspiration and is considered a normal finding. It occurs due to a slight delay in the closure of the aortic valve compared to the pulmonic valve. This physiological delay results in the splitting of the S2 heart sound. Aortic stenosis (B), heart failure (C), and pulmonary embolism (D) are associated with different abnormal cardiovascular conditions that would present with other characteristic auscultatory findings, such as murmurs, gallops, or wheezing, respectively.

Correct Answer: B

Rationale: Vital signs are fundamental indicators used by healthcare professionals to assess the basic physiological functions of the body, such as temperature, pulse, respiration, and blood pressure. An indication of basic body functioning, accurately captures this concept because vital signs reflect how well the body is maintaining homeostasis and performing essential tasks like circulation and oxygenation. Signs and symptoms of a disease, is incorrect because vital signs are not exclusively tied to illness; they are monitored in healthy individuals too. A part of human composition, is vague and does not specify function, while Physiology and anatomy, refers to broader scientific fields rather than the specific measurements vital signs represent. Thus, B is the most precise and appropriate definition, aligning with clinical practice where vital signs serve as a baseline for evaluating health status.