During a cardiovascular assessment, the nurse notes a patient's apical pulse is irregular. What is the next action?

Correct Answer: C

Rationale: Rationale: C is the correct answer because comparing the apical and radial pulses helps determine the regularity of the heart rate. If they are not synchronized, it may indicate an underlying cardiac issue. A is incorrect as an irregular pulse is not normal. B is unnecessary without further assessment. D is incorrect as palpating carotid arteries for thrills does not address the irregularity of the apical pulse.

Correct Answer: A

Rationale: The correct answer is A: Parkinson's disease progression. This is the most likely cause of the patient's symptoms due to his history of Parkinson's disease and the presence of typical Parkinsonian features such as rigidity, bradykinesia, and shuffling gait. Levodopa is a common medication used to manage symptoms of Parkinson's disease. The progression of Parkinson's disease can lead to worsening motor symptoms over time, including difficulty walking. Option B: Normal aging is incorrect because the patient's symptoms are not solely due to the aging process, but rather are consistent with the known condition of Parkinson's disease. Option C: Cerebellar ataxia is unlikely as the patient's symptoms align more closely with Parkinsonian features rather than cerebellar dysfunction. Option D: Spinal cord compression is not the most likely cause as the patient's symptoms are more characteristic of Parkinson's disease progression rather than symptoms typically associated with spinal cord compression.

Correct Answer: A

Rationale: The most likely diagnosis for a 60-year-old man with difficulty swallowing, weight loss, history of smoking, and heavy alcohol use is esophageal cancer. 1. Difficulty swallowing over months could indicate a progressive condition like cancer. 2. Weight loss may be due to malnutrition from impaired swallowing. 3. History of smoking and alcohol use are risk factors for esophageal cancer. 4. Symptoms are more consistent with cancer than other conditions listed. Other choices are less likely: - B: Achalasia presents with dysphagia but typically not associated with weight loss. - C: GERD can cause swallowing difficulties but is less likely to lead to significant weight loss. - D: Peptic ulcer disease usually presents with upper abdominal pain, not primarily difficulty swallowing and weight loss.

Correct Answer: A

Rationale: The correct diagnosis is A: Sarcoidosis. In this case, the key features are bilateral hilar lymphadenopathy, shortness of breath, dry cough, smoking history, and frequent sinus infections. Sarcoidosis commonly presents with these symptoms and radiographic findings. Hilar lymphadenopathy is a classic feature of sarcoidosis due to granuloma formation. Lung cancer (B) is less likely given the presentation and the absence of lung mass on imaging. Pneumonia (C) typically presents with consolidations on chest X-ray, which is not seen in this case. Chronic obstructive pulmonary disease (D) is characterized by airflow limitation and does not typically present with hilar lymphadenopathy.

Correct Answer: A

Rationale: The correct diagnosis is A: Myocardial infarction. The ST-segment elevation in leads II, III, and aVF on the ECG indicates an inferior wall myocardial infarction. This presentation, along with the patient's age, history of coronary artery disease, and diabetes mellitus, strongly suggests myocardial infarction. Angina (B) typically presents with transient chest pain that is relieved with rest or medication. Pulmonary embolism (C) presents with sudden-onset dyspnea and chest pain, often accompanied by tachycardia. Aortic dissection (D) commonly presents with severe tearing chest pain radiating to the back, not ST-segment elevation on ECG.