The nurse is assessing a patient's respiratory system and notes the presence of stridor. What does this finding most likely indicate?

Correct Answer: B

Rationale: The presence of stridor indicates upper airway obstruction. Stridor is a high-pitched, inspiratory sound that occurs when there is partial obstruction in the upper airway, typically in the larynx or trachea. This sound is produced as air passes through a narrowed or partially blocked airway during inhalation. Lower airway obstruction (Choice A) typically presents with wheezing, not stridor. Pleural effusion (Choice C) is the accumulation of fluid in the pleural space, which would not cause stridor. Pulmonary edema (Choice D) is the accumulation of fluid in the lungs, leading to crackles on auscultation, not stridor.

Correct Answer: D

Rationale: The correct answer is D, Cranial nerve XII (hypoglossal nerve). This nerve innervates the muscles responsible for tongue movement. When the nurse asks the patient to stick out their tongue, they are testing the function of the hypoglossal nerve. The hypoglossal nerve controls the intrinsic and extrinsic muscles of the tongue, allowing for movements such as protrusion, retraction, and side-to-side movements. Choices A, B, and C are incorrect because they do not directly relate to tongue movement. Cranial nerve IX (glossopharyngeal nerve) is involved in taste perception and swallowing, cranial nerve X (vagus nerve) is involved in various autonomic functions and cranial nerve XI (spinal accessory nerve) controls certain neck muscles.

Correct Answer: A

Rationale: The correct answer is A: Ask the patient to shrug their shoulders against resistance. This is the most appropriate action for assessing cranial nerve XI (spinal accessory nerve) because this nerve innervates the trapezius and sternocleidomastoid muscles, which are responsible for shoulder shrugging and head rotation, respectively. By asking the patient to shrug their shoulders against resistance, the nurse can assess the strength and function of the trapezius muscle, which is controlled by the spinal accessory nerve. Choices B, C, and D are incorrect: B: Having the patient stick out their tongue is used to assess cranial nerve XII (hypoglossal nerve), not cranial nerve XI. C: Testing the patient's ability to chew is used to assess cranial nerve V (trigeminal nerve), not cranial nerve XI. D: Evaluating the patient's sense of smell is used to assess cranial nerve I (olfactory nerve),

Correct Answer: B

Rationale: The most likely diagnosis for the 40-year-old man with abdominal pain, vomiting, jaundice, ascites, elevated bilirubin, and elevated AST and ALT is cirrhosis. Cirrhosis is characterized by liver dysfunction due to chronic liver injury, which can be caused by alcohol use and liver disease. The presence of jaundice, ascites, and abnormal liver function tests are classic signs of advanced liver disease like cirrhosis. Chronic pancreatitis (A) typically presents with abdominal pain radiating to the back, and may not cause jaundice or ascites. Hepatitis (C) usually presents with symptoms like fatigue, nausea, and fever, and may or may not cause jaundice. Gallstones (D) can cause abdominal pain, but are less likely to present with jaundice, ascites, and liver function test abnormalities.

Correct Answer: A

Rationale: The correct answer is A: Mammography. Mammography is the initial investigation of choice for evaluating breast lumps in women over 40 years old. It helps to identify the characteristics of the mass and determine if it is suspicious for malignancy. Fine needle aspiration (B) may be used for further evaluation if mammography is inconclusive. Excisional biopsy (C) is typically reserved for definitive diagnosis after suspicious findings on mammography. Ultrasound (D) may be used as an adjunct to mammography but is not the first-line investigation in this scenario.