The nurse is assessing a patient for jaundice. Which area is the most reliable for detecting this condition?

Correct Answer: A

Rationale: The correct answer is A: Sclera. The sclera is the most reliable area for detecting jaundice due to the high concentration of bilirubin in the blood, which causes a yellowing of the sclera. The yellow discoloration is easily visible in the white part of the eye. Palms of the hands, nail beds, and dorsum of the feet are less reliable areas for detecting jaundice as the yellowing may not be as noticeable or pronounced in these areas. Thus, assessing the sclera provides a clear and direct indication of jaundice.

Correct Answer: C

Rationale: The most likely diagnosis is gout (Choice C) based on the patient's presentation of red, painful, and swollen knee, with a history of gout. Gout is a form of inflammatory arthritis caused by the deposition of uric acid crystals in the joints, leading to acute flares of pain and swelling. The characteristic features of gout include sudden onset of symptoms, typically affecting one joint at a time, with warmth, erythema, and tenderness. In this case, the patient's history of gout and the classic presentation of an acutely inflamed joint support the diagnosis. Osteoarthritis (Choice A) is a chronic degenerative joint disease characterized by gradual onset of joint pain, stiffness, and limited range of motion. It typically affects weight-bearing joints and is not associated with acute inflammation as seen in gout. Rheumatoid arthritis (Choice B) is an autoimmune disease that causes symmetrical joint pain, morning stiffness, and joint deformities

Correct Answer: A

Rationale: The most likely diagnosis for a 50-year-old man with chronic cough and a history of smoking is Chronic Obstructive Pulmonary Disease (COPD). 1) History of smoking is a major risk factor for COPD. 2) Chronic cough is a common symptom of COPD due to airway inflammation and mucus production. 3) COPD typically develops over years of smoking. Other choices are less likely: B) Pneumonia usually presents with acute symptoms; C) Lung cancer may present with cough but usually in later stages; D) Tuberculosis is less common in a chronic smoker without other risk factors. Therefore, the correct answer is A.

Correct Answer: A

Rationale: The correct answer is A: Esophageal cancer. Given the patient's age, symptoms of progressive dysphagia, and risk factors such as smoking and heavy alcohol use, esophageal cancer is the most likely diagnosis. Further evaluation with imaging studies and endoscopy is warranted to confirm the diagnosis. B: Achalasia is less likely as it typically presents with dysphagia to both solids and liquids, not just worsening dysphagia over time. C: Gastroesophageal reflux disease (GERD) may cause heartburn and regurgitation but is less likely to present with progressive dysphagia. D: Peptic ulcer disease typically presents with abdominal pain and may cause dysphagia if there is stricture formation but is less likely in this case.

Correct Answer: D

Rationale: The correct answer is D, Cranial nerve XI (spinal accessory nerve). This nerve controls the trapezius and sternocleidomastoid muscles, responsible for shoulder shrugging. Cranial nerve V (A) controls facial sensation and jaw movement. Cranial nerve VII (B) controls facial expression. Cranial nerve IX (C) controls swallowing and taste sensation. By process of elimination, D is the only nerve related to shoulder shrugging.