A 70-year-old woman who loves to garden has small, flat, brown macules over her arms and hands. She asks, "What causes these liver spots?' The nurse tells her:

Correct Answer: C

Rationale: The correct answer is C because the small, flat, brown macules described are consistent with lentigines (commonly known as age or liver spots), which are clusters of melanocytes that appear after prolonged sun exposure. This explanation directly addresses the patient's question about the cause of the spots and is supported by the clinical presentation. Choice A is incorrect because decreased hematocrit related to anemia would not cause these specific skin changes. Choice B is incorrect as destruction of melanin due to sun exposure would result in lighter spots, not dark brown macules. Choice D is incorrect because hyperpigmentation related to decreased perfusion and vasoconstriction would present differently and not primarily on sun-exposed areas like the arms and hands.

Correct Answer: A

Rationale: The correct answer is A. A blood pressure reading of 160/100 mm Hg is most concerning because it falls within the hypertensive crisis range, indicating severely elevated blood pressure that requires immediate medical attention to prevent complications like stroke or heart attack. Choices B, C, and D are within the prehypertension or mild hypertension ranges and are not as immediately concerning.

Correct Answer: D

Rationale: The correct answer is D because a proficient nurse should have a holistic view of the patient's situation, focusing on long-term goals rather than just completing tasks. This approach ensures comprehensive care and better outcomes. Choice A is incorrect as it implies reliance on rules over experience. Choice B is incorrect because intuition alone may not always lead to the best solution. Choice C is incorrect as it emphasizes daily plans rather than long-term goals.

Correct Answer: A

Rationale: The correct answer is A: Severe headaches and blurred vision. These symptoms can indicate a hypertensive crisis, a severe complication of hypertension. Headaches and blurred vision are signs of potentially dangerous high blood pressure levels. Weight loss and fatigue (B), increased appetite and tremors (C), and nausea and vomiting (D) are not typical complications of hypertension and do not directly relate to the cardiovascular effects of high blood pressure. Monitoring for severe headaches and blurred vision is crucial for early detection and management of hypertensive crises.

Correct Answer: A

Rationale: The correct answer is A: "Do you perform testicular self-examinations?" This question is appropriate as it addresses health promotion activities specific to the patient's age and gender, promoting early detection of testicular cancer. Explanation: 1. Testicular self-examination is a key health promotion activity for men in their 20s and 30s. 2. It encourages self-awareness and early detection of abnormalities in the testicles. 3. Testicular cancer is most common in younger men, making this question relevant. 4. Options B, C, and D are not directly related to health promotion activities for a 30-year-old male.

Correct Answer: A

Rationale: Step-by-step rationale for the correct answer (A): 1. A critical cultural perspective recognizes that culture is dynamic and contextual. 2. It acknowledges that culture is not static but evolves over time. 3. Understanding culture as relational highlights the interconnectedness of people and their environment. 4. This perspective emphasizes the importance of considering historical, social, and political factors in analyzing culture. Summary of why other choices are incorrect: B: This choice assumes cultural homogeneity, which does not account for diversity and variation within cultures. C: While language and behavior are aspects of culture, they do not encompass the entirety of cultural expressions. D: This choice oversimplifies culture by suggesting it is solely influenced by environmental factors, neglecting social and historical dimensions.

Correct Answer: C

Rationale: The correct answer is C: Pneumonia. The patient's symptoms of shortness of breath and cough with thick, green sputum suggest an acute infection in the lungs. Pneumonia is characterized by inflammation and infection of the lung tissue, leading to symptoms such as productive cough, shortness of breath, and sputum production. It is a serious condition that requires prompt treatment with antibiotics. A: Asthma typically presents with wheezing, chest tightness, and shortness of breath triggered by certain stimuli, but not usually with thick, green sputum. B: Bronchitis is inflammation of the bronchial tubes, characterized by cough with clear or slightly discolored sputum, not typically thick and green. D: Pulmonary embolism is a blockage in the arteries of the lungs, causing sudden shortness of breath and chest pain, but not usually associated with green sputum production.

Correct Answer: A

Rationale: The correct answer is A: Inspecting feet daily for signs of injury. This is crucial for patients with diabetic neuropathy to prevent complications like foot ulcers. Daily foot inspections can catch any signs of injury early, allowing for prompt treatment. It helps in preventing infections and serious complications. Summary of why other choices are incorrect: B: Exercising to improve circulation - While exercise is beneficial for overall health, it may not directly address the risk of injury due to neuropathy. C: Eating more protein-rich foods - While a balanced diet is important for managing diabetes, protein-rich foods do not specifically address the risk of foot injuries in diabetic neuropathy. D: Using tight-fitting shoes to prevent blisters - Tight-fitting shoes can actually increase the risk of blisters and injuries, especially in patients with diabetic neuropathy.

Correct Answer: A

Rationale: The correct answer is A: Crossing the legs at the knees. This position can cause hip dislocation due to the twisting motion it creates on the hip joint. When the legs are crossed at the knees, it puts stress on the hip joint, potentially leading to dislocation. Choice B: Sitting with the feet flat on the floor is a safe position that does not put undue stress on the hip joint. Choice C: Sleeping on the affected side can also increase the risk of hip dislocation due to the pressure and weight placed on the hip joint in this position. Choice D: Using assistive devices for ambulation is important for stability and support, and it does not directly contribute to hip dislocation if used correctly.