Linda is a 29-year-old who had excruciating pain which started under her lower ribs on the right side. The pain eventually moved to her lateral abdomen and then into her right lower quadrant. Which is most likely, given this presentation?

Correct Answer: C

Rationale: The correct answer is C: Ureteral stone. The progression of pain from under the lower ribs to the lateral abdomen and then to the right lower quadrant is characteristic of a ureteral stone passing from the kidney towards the bladder. This pattern is known as "Loin to groin pain." Appendicitis typically presents with pain starting in the right lower quadrant without a gradual progression. Dysmenorrhea involves cramping pelvic pain related to menstruation. Ovarian cyst pain is usually localized to the lower abdomen and may not follow the described pattern.

Correct Answer: D

Rationale: The correct answer is D because the otoscope is a medical device specifically designed to examine the ear canal and tympanic membrane. The otoscope has a light source and a magnifying lens that allows the healthcare provider to visualize these structures. Choice A is incorrect because the otoscope is not typically used to direct light onto the sinuses. Choice B is incorrect as the otoscope uses a long, narrow speculum to visualize the ear, not a short, broad speculum. Choice C is incorrect because the otoscope is used to examine the external ear canal and tympanic membrane, not the internal ear structures.

Correct Answer: B

Rationale: The correct answer is B: Capillary refill time less than 2 seconds. This assessment is indicative of adequate peripheral circulation because it measures how quickly blood refills in the capillaries after they have been compressed. A capillary refill time of less than 2 seconds indicates normal circulation, as it demonstrates that blood is flowing efficiently to the extremities. Rationale: A: Pallor in the extremities indicates poor circulation and reduced blood flow, which is not indicative of adequate peripheral circulation. C: Cool skin temperature in the lower extremities suggests vasoconstriction and reduced blood flow, not adequate circulation. D: Diminished dorsalis pedis pulse indicates a weak or absent pulse in the foot, which is a sign of impaired circulation and not indicative of adequate peripheral circulation.

Correct Answer: B

Rationale: The correct answer is B: Nail bed pressure. This is the appropriate method to test the client's peripheral response to pain in an unconscious state. Applying pressure to the nail bed can elicit a localized pain response, indicating intact peripheral nerve function. Rationale: 1. Nail bed pressure is a sensitive area that can evoke a pain response if the client has intact peripheral nerve function. 2. Sternal rub (A) is a sternal pressure technique used to arouse a client, not specifically to test peripheral response. 3. Pressure on the orbital rim (C) is not appropriate for testing peripheral response and can be harmful. 4. Squeezing the sternocleidomastoid muscle (D) is a method to assess cranial nerve XI function, not peripheral response to pain.

Correct Answer: B

Rationale: The clinical signs of pallor, cyanosis, and cool skin are indicative of poor oxygenation and circulation, which are commonly seen in anemia. Anemia leads to reduced oxygen-carrying capacity, resulting in pallor and cyanosis. Cool skin is a result of decreased blood flow. Cor pulmonale is related to right heart failure due to lung disease, not directly related to the signs described. Hypertension typically presents with elevated blood pressure, not the signs mentioned. Diaphoresis refers to excessive sweating, which is not associated with the described clinical signs. Therefore, the correct answer is B (anemia) based on the patient's presentation.