A physical therapist evaluates a patient with multiple sclerosis (MS) experiencing fatigue. Which intervention is MOST appropriate to improve endurance?

Correct Answer: B

Rationale: In this case, the most appropriate intervention to improve endurance in a patient with multiple sclerosis (MS) experiencing fatigue is option B) Aquatic therapy. Aquatic therapy is a highly effective intervention for individuals with MS as it provides a supportive environment that reduces the impact of gravity, making movements easier and less fatiguing. The buoyancy of water helps to support the patient's body weight, allowing for increased mobility and endurance building without excessive strain on the muscles and joints. High-intensity interval training (option A) may not be suitable for a patient with MS experiencing fatigue, as it can be too intense and may exacerbate symptoms. Progressive resistance training (option C) focuses more on strength building rather than endurance, which may not directly address the patient's fatigue concerns. Treadmill walking at 85% HR max (option D) can be too strenuous for a patient experiencing fatigue and may not be well-tolerated. In an educational context, understanding the specific needs and limitations of patients with MS is crucial for healthcare professionals. Aquatic therapy is a valuable tool in rehabilitation for individuals with MS, as it allows for safe and effective endurance training while minimizing the risk of injury or exacerbating symptoms. Educating therapists on the benefits of aquatic therapy and its tailored approach for patients with MS can significantly improve outcomes and quality of care.

Correct Answer: D

Rationale: In assessing a patient's carotid arteries, the most appropriate technique is to palpate one carotid artery at a time. This is the correct answer because palpating one artery at a time allows the nurse to assess for any abnormalities such as pulsations, thrills, or bruits without compromising blood flow to the brain. Palpation should be gentle to avoid excessive pressure on the carotid sinus, which could lead to a dangerous drop in blood pressure. Option A, auscultating for bruits using the diaphragm of the stethoscope, is incorrect as bruits are typically auscultated over the carotid arteries, not palpated. Palpating both carotid arteries simultaneously (Option B) can obstruct blood flow and is not recommended. Option C, percussing the carotid arteries for tenderness, is not a standard or appropriate technique for assessing carotid arteries. Educationally, it's important for nurses to understand the proper techniques for assessing vital signs like carotid artery palpation to ensure accurate and safe patient evaluation. Palpating both carotid arteries simultaneously can lead to inaccurate assessments, highlighting the importance of following correct procedures for patient safety and accurate data collection.

Correct Answer: B

Rationale: In a musculoskeletal assessment, the presence of swelling and deformity suggests a possible fracture. Swelling occurs due to soft tissue inflammation from the injury, and deformity can indicate a disruption in the normal anatomical alignment of bones, characteristic of a fracture. This finding requires immediate attention to prevent further damage and ensure proper treatment. Option A, symmetrical range of motion, is incorrect because it refers to the ability to move joints equally on both sides of the body and does not specifically indicate a fracture. Option C, crepitus in the joint (a grating or grinding sensation), is more indicative of joint conditions like osteoarthritis rather than a fracture. Option D, warmth and redness over the joint, typically suggest inflammation, infection, or inflammation, which are not specific to fractures. Educationally, understanding these signs in a musculoskeletal assessment is crucial for healthcare professionals to accurately identify and manage fractures, ensuring appropriate care and promoting patient recovery and well-being.

Correct Answer: B

Rationale: The correct answer is B) Arcus senilis. This finding indicates a deposit of cholesterol in the cornea, commonly seen in older adults. Arcus senilis is a benign condition and typically does not affect vision. A) Cataracts involve clouding of the lens inside the eye, leading to vision impairment. This is not indicated by a white arc around the corneal margin. C) Glaucoma is a group of eye conditions that damage the optic nerve and can result in vision loss. It does not present as a white arc around the corneal margin. D) Macular degeneration affects the central part of the retina, leading to loss of central vision. It is unrelated to the presence of a white arc around the corneal margin. Educationally, understanding these different eye conditions is crucial for healthcare providers to accurately assess and manage patients' ocular health. Recognizing specific clinical findings, like arcus senilis, helps in making informed decisions regarding further evaluation and treatment. This knowledge contributes to providing comprehensive care for individuals with eye health concerns.

Correct Answer: A

Rationale: In this scenario, the most likely diagnosis for the 40-year-old man with bilateral hilar lymphadenopathy, shortness of breath, and a dry cough is A) Sarcoidosis. Sarcoidosis is a systemic inflammatory disease characterized by the formation of granulomas in various organs, including the lungs. Bilateral hilar lymphadenopathy is a classic finding in sarcoidosis, making it the most likely diagnosis in this case. Option B) Lung cancer is less likely in this patient as bilateral hilar lymphadenopathy is not a typical feature of lung cancer unless it has metastasized to the lymph nodes. Additionally, the patient's age and history of sinus infections do not strongly point towards lung cancer. Option C) Pneumonia is less likely since the presentation of bilateral hilar lymphadenopathy, shortness of breath, and a dry cough is not characteristic of pneumonia. Pneumonia typically presents with focal consolidation on chest X-ray and may have associated symptoms like fever and productive cough. Option D) Chronic obstructive pulmonary disease (COPD) is less likely given the patient's age and the presence of bilateral hilar lymphadenopathy, which is not a typical feature of COPD. COPD is more commonly associated with a history of smoking and progressive dyspnea. Educationally, understanding the clinical manifestations and diagnostic features of different respiratory conditions is crucial for healthcare providers to make accurate assessments and provide appropriate care. Recognizing the specific findings of sarcoidosis in this case highlights the importance of considering a broad range of differential diagnoses based on clinical presentation and diagnostic tests.