During a skin assessment, the nurse notes that the patient has petechiae. What is the primary cause of this finding?

Correct Answer: B

Rationale: The correct answer is B: Capillary bleeding. Petechiae are tiny, pinpoint, round spots that appear on the skin due to bleeding under the skin. This is caused by capillaries leaking blood into the skin, leading to the characteristic appearance of petechiae. Dilated capillaries (A) do not directly cause petechiae. Increased melanin production (C) results in skin pigmentation changes, not petechiae. Loss of collagen (D) may lead to skin changes like sagging, but it is not the primary cause of petechiae.

Correct Answer: D

Rationale: The correct answer is D, Intracranial hypertension. This condition is characterized by increased pressure within the skull, leading to symptoms such as morning headaches, nausea, vomiting, blurred vision, and papilledema. The patient's presentation of severe morning headaches with associated symptoms and papilledema is classic for intracranial hypertension. Migraine (A) typically presents with pulsating headaches without neurological signs. Cluster headache (B) is characterized by severe unilateral headaches with autonomic features but not typically associated with papilledema. Tension-type headache (C) is usually bilateral, mild to moderate in intensity, and not associated with papilledema. In summary, the patient's symptoms and signs are most consistent with intracranial hypertension due to the presence of morning headaches, nausea, vomiting, blurred vision, and papilledema.

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.