A 78-year-old male is being treated for hypertension. The nurse knows that the most appropriate first-line therapy in older adults is:

Correct Answer: A

Rationale: The correct answer is A: Diuretics. In older adults, diuretics are considered the most appropriate first-line therapy for hypertension due to their effectiveness in reducing blood pressure and preventing complications such as heart failure. Diuretics are well-tolerated, have a long history of use, and are cost-effective. They are especially beneficial in older adults with volume overload or fluid retention. Beta-blockers (B) may be less effective in older adults and can have more side effects. ACE inhibitors (C) are commonly used but may pose risks of hyperkalemia and renal dysfunction in older adults. Calcium channel blockers (D) are effective but may increase the risk of falls and fractures in older adults.

Correct Answer: C

Rationale: The correct answer is C. The patient's age (36 years) and chronic smoking are the main reasons why a combined hormonal contraceptive would be contraindicated. Age over 35 and tobacco use increase the risk of cardiovascular complications with hormonal contraceptives. Obesity (choice A), type 2 diabetes (choice B), and a sedentary lifestyle (choice D) are also risk factors, but they are not the primary reasons for contraindicating combined hormonal contraceptives in this case.

Correct Answer: B

Rationale: The correct answer is B: 3+. Bounding pulses indicate a 3+ strength on a scale of 0 to 3. This reflects increased blood flow or pressure in the arteries, which can be a sign of conditions like peripheral vascular disease. A strength of 0 indicates no palpable pulse, 1+ is weak and thready, 2+ is normal, and 3+ is bounding. In this case, the patient's history of coronary artery disease and diabetes may contribute to the increased blood flow, leading to bounding pulses. Choices A, C, and D are incorrect as they do not accurately reflect the strength of the pulses based on the given assessment findings.

Correct Answer: C

Rationale: The correct answer is C: Regularly irregular rhythm. This is the appropriate documentation for Ms. Wright's presentation as her pulse demonstrates a pattern of irregularity with every fourth beat sounding different. This indicates a regularly irregular rhythm, where there is a discernible pattern to the irregularity. Rationale: 1. Regular rate and rhythm (Choice A) is incorrect as Ms. Wright's palpitations and the irregularity in her pulse indicate an irregular rhythm. 2. Irregularly irregular rhythm (Choice B) is incorrect as this term is used to describe arrhythmias like atrial fibrillation, which do not have a discernible pattern of irregularity. 3. Bradycardia (Choice D) is incorrect as it refers to a slow heart rate, which is not the primary concern in this scenario where the focus is on the irregular rhythm. In summary, the correct choice (C) accurately describes the specific irregular pattern observed in Ms. Wright's pulse, distinguishing it from

Correct Answer: B

Rationale: Step-by-step rationale for why B is correct: Janeway lesions, petechiae, and Osler nodes are classic signs of infective endocarditis. Janeway lesions are painless erythematous macules on palms/soles, petechiae are small red/purple spots due to microemboli, and Osler nodes are tender subcutaneous nodules on fingers/toes. These findings indicate systemic embolization and immune complex deposition in infective endocarditis. Other choices are incorrect as they do not typically present with these specific dermatologic findings.

Correct Answer: B

Rationale: The correct answer is B: A dull pain or cramp. In peripheral artery disease, calf pain is typically described as a dull ache or cramp due to inadequate blood flow to the muscles during exercise. This pain is known as claudication. Choice A is incorrect as sharp, stabbing pain is not typically associated with peripheral artery disease. Choice C, an electric shock, is more indicative of nerve-related conditions. Choice D, a pulsating pain, is more characteristic of an aneurysm rather than peripheral artery disease.

Correct Answer: C

Rationale: The correct answer is C because cultural humility emphasizes recognizing power imbalances and fostering interpersonal sensitivity through partnerships with and learning from patients. This approach encourages self-awareness, openness, and willingness to engage in respectful dialogues. Option A is incorrect because cultural humility is not solely achieved through professional development courses. Option B is incorrect as anyone, regardless of their background, can practice cultural humility. Option D is incorrect as cultural humility does consider the impacts of structural factors on health disparities, including biological, socioeconomic, and racial influences.

Correct Answer: B

Rationale: The correct answer is B (Pain) because pain is a common symptom in both inflammatory and non-inflammatory joint conditions. Tenderness, warmth, and redness are more specific to inflammatory joint problems. Tenderness indicates localized inflammation, warmth suggests increased blood flow and inflammation, and redness signifies dilated blood vessels and inflammation. Therefore, pain alone is less helpful in determining if a joint problem is inflammatory compared to the other symptoms.

Correct Answer: A

Rationale: Rationale: The correct answer is A: Supraspinatus. This muscle is responsible for initiating abduction movement at the shoulder joint. It is located on the top of the shoulder blade and assists in lifting the arm away from the body. The other choices, B: Infraspinatus, C: Levator scapulae muscle, and D: Subscapularis, are not involved in initiating abduction movement at the shoulder. Infraspinatus is responsible for external rotation, Levator scapulae muscle elevates the scapula, and Subscapularis assists in internal rotation of the shoulder joint.