During the assessment of a 20-year-old patient with a 3-day history of nausea and vomiting, the nurse notes the following: dry mucosa and deep fissures in the tongue. This finding is indicative of:

Correct Answer: A

Rationale: The dry mucosa and deep fissures in the tongue indicate dehydration in the patient. Dehydration causes decreased saliva production, leading to dry mouth and tongue fissures. This is a common symptom of dehydration. The lack of moisture in the oral cavity can result in these physical signs. The other choices are incorrect because irritation by gastric juices typically presents with other symptoms, a normal oral condition would not show these specific findings, and side effects of nausea medication would not directly cause dry mucosa and deep fissures in the tongue. Therefore, the correct answer is A: dehydration.

Correct Answer: B

Rationale: The correct answer is B: A dark retinal background. This is because individuals of African descent typically have a higher concentration of melanin in their eyes, resulting in a darker retinal background. This can affect the appearance of the fundus during eye examinations. Incorrect choices: A: Increased night vision - Night vision is not directly influenced by melanin levels in the eyes and is more related to the function of rods and cones in the retina. C: Increased photosensitivity - Melanin provides some protection against UV light, so individuals with darker retinas may have lower photosensitivity. D: Narrowed palpebral fissures - Palpebral fissures refer to the opening between the eyelids and are not typically influenced by melanin levels in the eyes.

Correct Answer: A

Rationale: The correct answer is A because one pinch of smokeless tobacco (SLT) in the mouth for 30 minutes can indeed deliver a similar amount of nicotine as smoking one cigarette. This is because the nicotine in SLT is absorbed through the oral mucosa directly into the bloodstream, providing a quick effect. This statement is accurate and reflects the pharmacokinetics of SLT use. Option B is incorrect because smoking carries a higher risk of oral cancer compared to SLT use. Option C is incorrect as pain is not always an early sign of oral cancer, and other symptoms such as non-healing sores or lumps may indicate oral cancer. Option D is incorrect as pain can sometimes be an early sign of oral cancer, especially in advanced stages.

Correct Answer: D

Rationale: The correct answer is D because it directly addresses the concern of a possible perforated eardrum by inquiring about the relationship between ear pain and discharge. This is crucial in assessing the severity of the condition. Choice A is incorrect as it focuses on subjective symptoms not specific to a perforated eardrum. Choice B is irrelevant as it doesn't pertain to the immediate concern. Choice C is also incorrect as it doesn't target the current issue of a potential perforated eardrum. Asking about ear pain and discharge helps determine the likelihood of a perforated eardrum and guides further assessment and care.

Correct Answer: B

Rationale: The correct answer is B because the patient's symptoms (change in mole size, color changes, itching, burning, bleeding) are concerning for melanoma, a type of skin cancer. Given her history of blistering sunburns, early evaluation and referral are crucial for timely intervention. Option A is incorrect as it delays necessary evaluation. Option C is irrelevant as the symptoms suggest a serious condition, not environmental irritants. Option D is incorrect as compound nevi typically do not present with the described symptoms and are not common in this age group.

Correct Answer: A

Rationale: The correct answer is A: tinea capitis. Tinea capitis is a fungal infection of the scalp that can cause hair loss, scaling, and breakage of hair. In this case, the patient's symptoms of hair loss, patchy hair breakage, and scaling on the scalp are consistent with tinea capitis. The nurse should suspect tinea capitis based on the presentation of these specific symptoms in the patient. Summary: - B: tinea corporis is a fungal infection of the skin, not the scalp, so it is not the most likely cause of the patient's symptoms. - C: toxic alopecia refers to hair loss due to exposure to toxins, which is unlikely in this case based on the symptoms described. - D: seborrheic dermatitis is a common skin condition that causes redness, scaly patches, and dandruff on the scalp, but it does not typically cause hair loss in the same way as tinea capitis

Correct Answer: C

Rationale: The correct answer is C: the presence of shadows, which may indicate glaucoma. When a light is directed across the iris from the temporal side, it helps in evaluating the presence of shadows in the anterior chamber angle, which can suggest a narrow or closed angle glaucoma. This technique is known as transillumination test and is important in detecting potential glaucoma cases. A: Drainage from dacryocystitis is incorrect as it is typically assessed by pressing on the lacrimal sac area to observe for discharge. B: Conjunctivitis over the iris is incorrect as conjunctivitis is an inflammation of the conjunctiva, not the iris. D: A scattered light reflex indicative of cataracts is incorrect as cataracts cause clouding of the lens, not scattering of light across the iris.

Correct Answer: D

Rationale: The correct answer is D: convergence of the axes of the eyes. During the accommodation response, the eyes converge to focus on a near object. This is necessary to maintain clear vision when looking at close objects. Dilation of the pupils (A) is not part of the accommodation response. A consensual light reflex (B) refers to both pupils constricting simultaneously in response to light, not specific to accommodation. Conjugate movement of the eyes (C) refers to both eyes moving together in the same direction, which is not the primary action during accommodation.

Correct Answer: A

Rationale: The correct answer is A: she may have macular degeneration. Macular degeneration is characterized by loss of central vision while peripheral vision remains intact. In this case, the woman's difficulty with tasks that require central vision, such as reading and recognizing faces, points towards macular degeneration. The other choices are incorrect because: B: Her symptoms indicate a specific vision problem, not just age-related changes. C: Cataracts typically cause blurred vision, not loss of central vision. D: Glaucoma typically affects peripheral vision first before progressing to central vision loss.