During a physical examination, a 45-year-old woman states that she has had a crusty, itchy rash on her breast for approximately 2 weeks. In trying to find the cause of the rash, which question would be important for the nurse to ask?

Correct Answer: C

Rationale: The correct answer is C: "Where did the rash first appear—on the nipple, the areola, or the surrounding skin?" This question is crucial because the location of the rash can provide valuable clues about the potential cause. For example, a rash on the nipple may point towards issues like Paget's disease, while a rash on the areola could suggest eczema or contact dermatitis. On the other hand, a rash on the surrounding skin may indicate a fungal infection or allergic reaction. By identifying the precise location of the rash, the nurse can narrow down the differential diagnosis and develop an appropriate care plan. Summary: A: "Is the rash raised and red?" - This question focuses on the appearance of the rash but does not provide specific information about its location, which is more critical in determining the cause. B: "Does it appear to be cyclic?" - This question is not as directly relevant to identifying the cause of the rash compared to pinpointing its location. D

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.

Correct Answer: B

Rationale: The correct answer is B: Inflammatory. The patient's symptoms of joint pain in the wrists and fingers, along with subjective fever and family history of rheumatoid arthritis, suggest an inflammatory process like rheumatoid arthritis. There is no mention of any infectious symptoms or recent activities that would suggest an infectious cause (choice A). The presentation does not point towards a hematologic issue (choice C) such as a blood disorder. Additionally, there is no history of trauma (choice D) that would explain the joint pain and fever. Therefore, based on the symptoms and family history provided, the most likely pathologic process is an inflammatory condition like rheumatoid arthritis.