During a cardiac assessment, the nurse notes a high-pitched, scratchy sound heard during both systole and diastole. What does this finding indicate?

Correct Answer: A

Rationale: The correct answer is A: Pericardial friction rub, as it is a high-pitched, scratchy sound heard during both systole and diastole, indicating inflammation of the pericardium. This sound is produced by the rubbing of inflamed pericardial layers during the cardiac cycle. B: Aortic stenosis produces a systolic murmur. C: Mitral valve regurgitation produces a holosystolic murmur. D: Heart murmur is a generic term and does not specifically describe the high-pitched, scratchy sound heard during both systole and diastole.

Correct Answer: C

Rationale: The most likely diagnosis for the 40-year-old man with fatigue, weight loss, chronic cough, and a mass in the left upper lobe on chest X-ray is lung cancer (Choice C). 1. Symptoms: Fatigue, weight loss, night sweats are common in lung cancer due to systemic effects. 2. History: Smoking and chronic cough are major risk factors for lung cancer. 3. Imaging: Presence of a mass in the left upper lobe on chest X-ray is highly suggestive of lung cancer. 4. Exclusion: Pneumonia (Choice A) typically presents with fever and productive cough, not weight loss. Tuberculosis (Choice B) may show upper lobe involvement but is less common in non-endemic areas without known exposure. Chronic obstructive pulmonary disease (Choice D) does not typically present with weight loss or night sweats.

Correct Answer: B

Rationale: The correct answer is B: Hypertensive emergency. The patient's symptoms of persistent headache, blurred vision, and high blood pressure indicate a hypertensive emergency, a severe increase in blood pressure requiring immediate medical attention to prevent organ damage. Primary hypertension (A) is chronic high blood pressure without acute symptoms. Cluster headache (C) is characterized by severe, unilateral head pain with associated symptoms, not necessarily elevated blood pressure. Migraine (D) is a recurrent headache disorder with specific features, not typically associated with such high blood pressure levels.

Correct Answer: A

Rationale: The correct answer is A: Postural hypotension. This is likely the cause of the man's symptoms because his blood pressure drops when standing, causing dizziness and fainting. Postural hypotension is a decrease in blood pressure upon standing, leading to inadequate blood flow to the brain. Arrhythmia (B) can cause similar symptoms but is less likely without other associated signs. Anemia (C) can cause fatigue and weakness but is less likely to result in dizziness and fainting solely based on blood pressure. Hyperthyroidism (D) can cause palpitations and weight loss, but is less likely to cause postural hypotension as the primary symptom.

Correct Answer: B

Rationale: The correct answer is B: Heart murmur. The soft, blowing sound heard over the left upper sternal border indicates the presence of turbulent blood flow within the heart, which is characteristic of a heart murmur. This finding suggests abnormal flow patterns, such as valve dysfunction or structural abnormalities. Heart failure (C) typically presents with other symptoms like edema and shortness of breath. Normal heart sounds (A) do not include blowing sounds. Aortic stenosis (D) would present with a harsh systolic ejection murmur, not a soft blowing sound.