The nurse is assessing a patient in the hospital who has received numerous antibiotics and notices that his tongue appears to be black and hairy. In response to his concern, what would the nurse say?

Correct Answer: C

Rationale: The correct answer is C: "Black, hairy tongue is a fungal infection caused by all the antibiotics you have received." Rationale: 1. Black, hairy tongue is a known side effect of prolonged antibiotic use, leading to fungal overgrowth. 2. Antibiotics can disrupt the natural balance of bacteria in the mouth, allowing fungi to overgrow. 3. Fungal infections can manifest as a black, hairy appearance on the tongue. 4. Biopsy is not typically needed for the diagnosis of black, hairy tongue. 5. Overgrowth of hair is not a plausible explanation for this condition. 6. The black, hairy tongue is not caused by the same bacteria the patient had in his lungs. Summary: Choice C is correct as it accurately links the patient's antibiotic use to the fungal infection causing black, hairy tongue. Choices A, B, and D are incorrect as they do not address the specific cause of this condition and provide inaccurate information.

Correct Answer: C

Rationale: The correct answer is C because in the 26th week of pregnancy, it is normal for women to experience an increased awareness of their breathing without actual shortness of breath. This is due to the growing fetus putting pressure on the diaphragm, leading to a sensation of needing to breathe more frequently. The nurse's response should reassure the woman that her experience is normal and not a cause for concern. Choice A is incorrect because the diaphragm does not become fixed during pregnancy, rather it is pushed upward by the growing uterus. Choice B is incorrect because although estrogen levels increase during pregnancy, causing changes in the rib cage, this does not directly lead to difficulty in breathing. Choice D is incorrect because the increased awareness of breathing is not solely due to the increased oxygen demand from the fetus but also from the physical changes in the body due to pregnancy.

Correct Answer: C

Rationale: The correct answer is C: "Where did the rash first appear—on the nipple, the areola, or the surrounding skin?" This question is crucial because the location of the rash can provide valuable clues about the potential cause. For example, a rash on the nipple may point towards issues like Paget's disease, while a rash on the areola could suggest eczema or contact dermatitis. On the other hand, a rash on the surrounding skin may indicate a fungal infection or allergic reaction. By identifying the precise location of the rash, the nurse can narrow down the differential diagnosis and develop an appropriate care plan. Summary: A: "Is the rash raised and red?" - This question focuses on the appearance of the rash but does not provide specific information about its location, which is more critical in determining the cause. B: "Does it appear to be cyclic?" - This question is not as directly relevant to identifying the cause of the rash compared to pinpointing its location. D

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: C

Rationale: The dull sound over the liver during percussion indicates a normal finding. The liver is a solid organ, so it produces a dull sound. Air-filled organs would produce a tympanic sound. Presence of fluid would produce a shifting dullness. Presence of a tumor may not necessarily affect the percussion sound. Therefore, the dull sound over the liver is a normal finding during abdominal percussion, indicating option C is the correct answer.