The nurse is auscultating the lungs and hears low-pitched, soft sounds over the peripheral lung fields. How should this finding be documented?

Correct Answer: C

Rationale: The correct answer is C: Vesicular breath sounds. These are low-pitched, soft sounds heard over the peripheral lung fields during normal breathing. This finding should be documented as vesicular breath sounds because they are expected in healthy individuals. Choice A: Bronchial breath sounds are high-pitched and loud, heard over the trachea and large airways, not the peripheral lung fields. Choice B: Bronchovesicular breath sounds are a mix of bronchial and vesicular sounds, typically heard over the mainstem bronchi, not the peripheral lung fields. Choice D: Adventitious breath sounds refer to abnormal lung sounds like crackles or wheezes, not the soft, low-pitched sounds described in the scenario.

Correct Answer: B

Rationale: The correct answer is B: Myasthenia gravis. This autoimmune disorder is characterized by muscle weakness and fatigability due to antibodies attacking acetylcholine receptors at the neuromuscular junction. The presence of anti-acetylcholine receptor antibodies in this patient supports the diagnosis. Ptosis and weakness of proximal muscles are classic features. Choice A, Multiple sclerosis, is a central nervous system disorder and typically presents with sensory and motor deficits, not ptosis or fluctuating weakness. Guillain-Barré syndrome (Choice C) is characterized by ascending weakness and is typically preceded by an infection, unlike the chronic presentation in myasthenia gravis. Lambert-Eaton syndrome (Choice D) involves antibodies against presynaptic calcium channels and presents with proximal muscle weakness but often includes autonomic symptoms, which are not evident in this patient.

Correct Answer: A

Rationale: The most likely diagnosis is bronchitis because it presents with a persistent cough lasting more than 2-3 weeks without fever, chest pain, or chills. Shortness of breath can be seen in bronchitis due to airway inflammation. Asthma would typically present with wheezing and can have triggers like allergies. Pneumonia is accompanied by fever, chest pain, and productive cough with yellow or green sputum. Chronic obstructive pulmonary disease (COPD) usually occurs in older patients with a history of smoking and presents with a chronic cough and progressive shortness of breath.

Correct Answer: C

Rationale: The most likely diagnosis is breast cancer recurrence (Choice C) due to the patient's history of breast cancer and the characteristics of the mass (firm, non-tender, fixed). Recurrence is common in breast cancer survivors. Fibrocystic changes (Choice A) typically present with lumpy or tender breasts and are not usually fixed. Breast abscess (Choice B) would present with more acute symptoms like redness, warmth, and fever. Fat necrosis (Choice D) may mimic a cancerous mass but is usually not fixed to underlying tissue. In this case, the history and characteristics of the mass strongly suggest breast cancer recurrence.

Correct Answer: B

Rationale: The correct answer is B: Hypertensive crisis. The patient's symptoms of headache, blurred vision, and nausea, along with severely elevated blood pressure (200/120 mm Hg), suggest a hypertensive emergency. In this situation, the elevated blood pressure is causing end-organ damage, leading to symptoms. Treatment is urgent to prevent further complications. Choice A: Primary hypertension is unlikely as the sudden onset of severe symptoms and extremely high blood pressure indicate an acute issue rather than chronic primary hypertension. Choice C: Migraine typically presents with specific symptoms like throbbing head pain, sensitivity to light or sound, and may have an aura. The lack of these symptoms and the presence of severely elevated blood pressure make migraine less likely. Choice D: Cluster headaches are characterized by severe, unilateral head pain with associated symptoms like eye redness or tearing. The lack of these specific symptoms and the presence of markedly elevated blood pressure make cluster headache less likely.