A patient demonstrates limited active range of motion in shoulder abduction but has normal passive range of motion. The MOST likely cause of this limitation is:

Correct Answer: B

Rationale: The correct answer is B: Rotator cuff tear. Limited active range of motion with normal passive range of motion in shoulder abduction suggests a muscle-related issue, such as a rotator cuff tear. In this case, the patient can move the shoulder when someone else assists, indicating intact passive structures and a problem with the muscles. Adhesive capsulitis (choice A) typically presents with limitations in both active and passive range of motion. Glenohumeral arthritis (choice C) usually results in decreased passive range of motion as well. Shoulder impingement (choice D) may lead to pain during certain movements, but it would not explain the specific limitation described in the question.

Correct Answer: B

Rationale: The correct answer is B: Cranial nerves III, IV, and VI. These cranial nerves are responsible for controlling the extraocular muscles. Cranial nerve III (oculomotor) controls most of the eye movements, cranial nerve IV (trochlear) controls the superior oblique muscle, and cranial nerve VI (abducens) controls the lateral rectus muscle. Evaluating these cranial nerves allows the nurse to assess the full range of eye movements. Choice A (Cranial nerves II, III, and IV) includes the optic nerve (II) which is responsible for vision, not extraocular movements. Choice C (Cranial nerves V, VI, and VII) involves the trigeminal nerve (V) responsible for facial sensation, not eye movements. Choice D (Cranial nerves II, V, and VII) includes the optic nerve (II) and facial nerve (VII), which are not primarily involved in controlling extraocular movements

Correct Answer: B

Rationale: The correct answer is B: Assess the patient's ability to chew and detect light touch on the face. This is the most appropriate action for assessing cranial nerve V (trigeminal nerve) as this nerve is responsible for sensory functions of the face and motor function of the muscles of mastication. By assessing the patient's ability to chew and detecting light touch on the face, the nurse can evaluate the integrity of the trigeminal nerve. Choice A is incorrect because assessing the patient's ability to shrug their shoulders against resistance would be more indicative of assessing cranial nerve XI (accessory nerve). Choice C is incorrect because checking for gag reflex and swallowing is more related to cranial nerves IX (glossopharyngeal) and X (vagus). Choice D is incorrect because evaluating the patient's hearing ability is related to cranial nerve VIII (vestibulocochlear).

Correct Answer: B

Rationale: The correct answer is B: Steppage gait. This finding suggests a steppage gait pattern, which is characterized by foot drop and excessive hip and knee flexion to lift the foot higher to avoid dragging it on the ground. This gait pattern is often seen in patients with weakness or paralysis of the dorsiflexor muscles of the foot, typically due to conditions such as peripheral neuropathy or nerve compression. This results in a high-stepping gait with foot slap during the swing phase of walking. Ataxia (A) refers to incoordination and would manifest as unsteady and uncoordinated movements, not specifically as foot slap. Spastic hemiparesis (C) typically presents with increased muscle tone and stiffness on one side of the body, affecting arm and leg movements. Cerebellar dysfunction (D) would present with ataxic gait, intention tremors, and dysmetria, rather than the specific steppage gait pattern

Correct Answer: C

Rationale: The most likely diagnosis for the 50-year-old man with weight loss, night sweats, coughing up blood, and a mass in the left upper lobe of the lung is lung cancer (Choice C). Here's the rationale: 1. Weight loss, night sweats, and fatigue are common symptoms of advanced cancer. 2. History of smoking is a significant risk factor for developing lung cancer. 3. Coughing up blood (hemoptysis) is a classic symptom of lung cancer. 4. Chest X-ray showing a mass in the left upper lobe is indicative of a tumor. 5. Pneumonia (Choice A) typically presents with fever, productive cough, and infiltrates on imaging. 6. Tuberculosis (Choice B) usually presents with chronic cough, weight loss, night sweats, and upper lobe infiltrates. 7. Chronic obstructive pulmonary disease (Choice D) is characterized by progressive difficulty breathing, cough, and sputum production.