A woman in her 26th week of pregnancy states that she is 'not really short of breath' but feels that she is aware of her breathing and the need to breathe. What is the nurse's best reply?

Correct Answer: C

Rationale: The correct answer is C because in the 26th week of pregnancy, it is normal for women to experience an increased awareness of their breathing without actual shortness of breath. This is due to the growing fetus putting pressure on the diaphragm, leading to a sensation of needing to breathe more frequently. The nurse's response should reassure the woman that her experience is normal and not a cause for concern. Choice A is incorrect because the diaphragm does not become fixed during pregnancy, rather it is pushed upward by the growing uterus. Choice B is incorrect because although estrogen levels increase during pregnancy, causing changes in the rib cage, this does not directly lead to difficulty in breathing. Choice D is incorrect because the increased awareness of breathing is not solely due to the increased oxygen demand from the fetus but also from the physical changes in the body due to pregnancy.

Correct Answer: C

Rationale: The correct sequence of the electrical stimulus in the cardiac cycle is SA node → AV node → bundle of His → bundle branches. The rationale is as follows: 1. The SA node initiates the electrical impulse in the heart. 2. The impulse travels to the AV node, which serves as a delay mechanism to ensure proper coordination of atrial and ventricular contractions. 3. From the AV node, the impulse then travels to the bundle of His, which conducts the impulse to the bundle branches. 4. Finally, the impulse is transmitted through the bundle branches to the Purkinje fibers, which then distribute the impulse throughout the ventricles for coordinated contraction. Therefore, choice C is correct as it accurately represents the sequential pathway of the electrical stimulus in the cardiac cycle. Choices A, B, and D are incorrect as they do not follow the physiologically accurate sequence of the cardiac conduction system.

Correct Answer: C

Rationale: The dull sound over the liver during percussion indicates a normal finding. The liver is a solid organ, so it produces a dull sound. Air-filled organs would produce a tympanic sound. Presence of fluid would produce a shifting dullness. Presence of a tumor may not necessarily affect the percussion sound. Therefore, the dull sound over the liver is a normal finding during abdominal percussion, indicating option C is the correct answer.

Correct Answer: D

Rationale: Answer D is correct because the first step in managing an undescended testicle is to attempt to bring it down from the inguinal canal. This is important to prevent complications and improve fertility. Referring to urology (choice A) may be necessary if the testicle cannot be brought down. Rechecking in 6 months (choice B) delays necessary intervention. Telling the parent the testicle is absent (choice C) is incorrect as it may cause unnecessary worry, and the testicle could still be present in the canal.

Correct Answer: C

Rationale: The correct answer is C because the inability to palpate ulnar pulses in a patient with warm skin and normal capillary refill time is considered a normal variation. Ulnar pulses may be less prominent and harder to palpate compared to other pulses. Proceeding with the peripheral vascular evaluation is appropriate as this finding alone does not indicate any abnormalities or conditions that require immediate intervention. Checking for claudication (Choice A) is not necessary as the absence of ulnar pulses does not correlate with claudication. Referring the individual for further evaluation (Choice B) is premature and not warranted based on the information given. Asking about unusual cramping or tingling in the arm (Choice D) is not necessary at this point as the absence of ulnar pulses in this context is not indicative of any specific symptoms.