The electrical stimulus of the cardiac cycle follows which sequence?

Correct Answer: C

Rationale: The correct sequence of the electrical stimulus in the cardiac cycle is SA node → AV node → bundle of His → bundle branches. The rationale is as follows: 1. The SA node initiates the electrical impulse in the heart. 2. The impulse travels to the AV node, which serves as a delay mechanism to ensure proper coordination of atrial and ventricular contractions. 3. From the AV node, the impulse then travels to the bundle of His, which conducts the impulse to the bundle branches. 4. Finally, the impulse is transmitted through the bundle branches to the Purkinje fibers, which then distribute the impulse throughout the ventricles for coordinated contraction. Therefore, choice C is correct as it accurately represents the sequential pathway of the electrical stimulus in the cardiac cycle. Choices A, B, and D are incorrect as they do not follow the physiologically accurate sequence of the cardiac conduction system.

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.

Correct Answer: D

Rationale: The correct answer is D: To screen for depression. Susanne's symptoms of headaches, muscle aches, and fatigue for an extended period may indicate underlying depression. Screening for depression is important as it is a common cause of somatic symptoms. It is crucial to address mental health concerns that could be contributing to her physical symptoms. Referral to a neurologist (Choice A) or rheumatologist (Choice B) may not be necessary if there are no specific findings to suggest neurological or rheumatologic conditions. Telling the patient you can't find anything (Choice C) without exploring all possibilities is not appropriate. Screening for depression is the most appropriate next step to consider in this case.