The nurse is assessing a patient's gait and notes that the patient lifts their foot high and slaps it down while walking. What does this finding suggest?

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: 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.

Correct Answer: B

Rationale: The presence of bilateral crackles on inspiration suggests fluid in the lungs, which is characteristic of pulmonary edema. Pulmonary fibrosis is associated with fine, late inspiratory crackles. Pneumonia typically presents with focal crackles in the affected area. Asthma is characterized by wheezing rather than crackles. Therefore, the correct answer is B as it aligns with the clinical presentation of bilateral crackles on inspiration in pulmonary edema.