The nurse is assessing a patient's extraocular movements. Which cranial nerves are being evaluated?

Correct Answer: B

Rationale: The correct answer is B: Cranial nerves III, IV, and VI. These cranial nerves are responsible for controlling the extraocular muscles. Cranial nerve III (oculomotor) controls most of the eye movements, cranial nerve IV (trochlear) controls the superior oblique muscle, and cranial nerve VI (abducens) controls the lateral rectus muscle. Evaluating these cranial nerves allows the nurse to assess the full range of eye movements. Choice A (Cranial nerves II, III, and IV) includes the optic nerve (II) which is responsible for vision, not extraocular movements. Choice C (Cranial nerves V, VI, and VII) involves the trigeminal nerve (V) responsible for facial sensation, not eye movements. Choice D (Cranial nerves II, V, and VII) includes the optic nerve (II) and facial nerve (VII), which are not primarily involved in controlling extraocular movements

Correct Answer: B

Rationale: The correct answer is B: Steppage gait. This finding suggests a steppage gait pattern, which is characterized by foot drop and excessive hip and knee flexion to lift the foot higher to avoid dragging it on the ground. This gait pattern is often seen in patients with weakness or paralysis of the dorsiflexor muscles of the foot, typically due to conditions such as peripheral neuropathy or nerve compression. This results in a high-stepping gait with foot slap during the swing phase of walking. Ataxia (A) refers to incoordination and would manifest as unsteady and uncoordinated movements, not specifically as foot slap. Spastic hemiparesis (C) typically presents with increased muscle tone and stiffness on one side of the body, affecting arm and leg movements. Cerebellar dysfunction (D) would present with ataxic gait, intention tremors, and dysmetria, rather than the specific steppage gait pattern

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.