The nurse is assessing a patient's cranial nerve V (trigeminal nerve). Which action is most appropriate?

Correct Answer: B

Rationale: The correct answer is B: Assess the patient's ability to chew and detect light touch on the face. This is the most appropriate action for assessing cranial nerve V (trigeminal nerve) as this nerve is responsible for sensory functions of the face and motor function of the muscles of mastication. By assessing the patient's ability to chew and detecting light touch on the face, the nurse can evaluate the integrity of the trigeminal nerve. Choice A is incorrect because assessing the patient's ability to shrug their shoulders against resistance would be more indicative of assessing cranial nerve XI (accessory nerve). Choice C is incorrect because checking for gag reflex and swallowing is more related to cranial nerves IX (glossopharyngeal) and X (vagus). Choice D is incorrect because evaluating the patient's hearing ability is related to cranial nerve VIII (vestibulocochlear).

Correct Answer: C

Rationale: The most likely diagnosis for the 50-year-old man with weight loss, night sweats, coughing up blood, and a mass in the left upper lobe of the lung is lung cancer (Choice C). Here's the rationale: 1. Weight loss, night sweats, and fatigue are common symptoms of advanced cancer. 2. History of smoking is a significant risk factor for developing lung cancer. 3. Coughing up blood (hemoptysis) is a classic symptom of lung cancer. 4. Chest X-ray showing a mass in the left upper lobe is indicative of a tumor. 5. Pneumonia (Choice A) typically presents with fever, productive cough, and infiltrates on imaging. 6. Tuberculosis (Choice B) usually presents with chronic cough, weight loss, night sweats, and upper lobe infiltrates. 7. Chronic obstructive pulmonary disease (Choice D) is characterized by progressive difficulty breathing, cough, and sputum production.

Correct Answer: B

Rationale: The most likely diagnosis is B: Cirrhosis. The patient's history of alcohol use and liver disease, along with symptoms of jaundice and ascites, strongly suggest cirrhosis. Alcohol is a common cause of cirrhosis, leading to liver damage and subsequent complications. Jaundice and ascites are classic signs of advanced liver disease. Chronic pancreatitis (choice A) typically presents with different symptoms such as persistent abdominal pain radiating to the back. Hepatitis (choice C) would present with symptoms like fatigue, nausea, and jaundice but wouldn't typically cause ascites. Gallstones (choice D) could cause abdominal pain and vomiting, but jaundice and ascites are less likely in this scenario.

Correct Answer: B

Rationale: The dull percussion note indicates fluid accumulation in the lung field, typical of pleural effusion. This fluid-filled space dampens sound transmission, resulting in a dull sound. This finding is consistent with pleural effusion, making choice B the correct answer. Normal lung tissue (Choice A) would produce a resonant percussion note. Pneumothorax (Choice C) would typically produce hyperresonant or tympanic sounds. Bronchitis (Choice D) affects airways and does not directly impact percussion notes.

Correct Answer: A

Rationale: The correct answer is A: Peripheral neuropathy. Given the patient's age, symptoms, history of diabetes mellitus, decreased sensation in lower extremities, and absent ankle reflexes, peripheral neuropathy is the most likely diagnosis. Peripheral neuropathy is a common complication of diabetes and presents with sensory symptoms like 'pins and needles,' decreased sensation, and loss of reflexes. Multiple sclerosis (B) typically presents with symptoms that involve the central nervous system and often presents with visual disturbances and muscle weakness. Spinal cord compression (C) typically presents with symptoms like weakness and sensory changes in specific dermatomal patterns, which are not consistent with the patient's presentation. Parkinson's disease (D) presents with motor symptoms such as tremors, rigidity, and bradykinesia, which are not seen in this patient.