The nurse is performing a musculoskeletal assessment and notes that the patient has crepitus in the knee joint. What does this finding most likely indicate?

Correct Answer: B

Rationale: The presence of crepitus in the knee joint during a musculoskeletal assessment is most likely indicative of osteoarthritis. Crepitus is a sensation or sound that occurs when roughened joint surfaces rub together, which is a common symptom of osteoarthritis. In this condition, the cartilage between the joints wears down, leading to friction and the characteristic crepitus sound. Other choices like joint fluid accumulation (A), rheumatoid arthritis (C), and gout (D) do not typically manifest with crepitus as a prominent symptom. Therefore, choice B, osteoarthritis, is the most appropriate answer based on the given information.

Correct Answer: A

Rationale: The most likely diagnosis for a 60-year-old woman with difficulty swallowing, weight loss, and a palpable mass in the left upper abdomen is pancreatic cancer. Difficulty swallowing can be indicative of compression of the esophagus by the mass. Weight loss is common in pancreatic cancer due to malabsorption and cancer cachexia. A palpable mass in the left upper abdomen corresponds to the location of the pancreas. Pancreatic cancer commonly presents with these symptoms and signs. Gastric ulcer (B) typically presents with abdominal pain, bloating, and nausea. Cirrhosis (C) usually presents with symptoms related to liver dysfunction such as jaundice and ascites. Cholecystitis (D) presents with right upper quadrant abdominal pain, nausea, and vomiting.

Correct Answer: B

Rationale: The most likely diagnosis is Rheumatoid arthritis (RA). RA commonly presents with painful, swollen joints in the hands, particularly in the morning, along with prolonged stiffness. The autoimmune nature of RA causes inflammation, leading to these symptoms. Osteoarthritis (A) typically presents with joint pain that worsens with activity but improves with rest, not specifically in the morning. Gout (C) usually involves sudden, severe pain in a single joint, not multiple joints in the morning. Systemic lupus erythematosus (D) is characterized by a variety of symptoms beyond joint pain, such as skin rashes and fatigue, making it less likely in this case.

Correct Answer: B

Rationale: The correct answer is B: Gastrointestinal obstruction. Visible peristalsis indicates increased movement of the intestines in an attempt to overcome the obstruction. This finding is not associated with normal digestive function (choice A), ascites (choice C), or hernia (choice D). Gastrointestinal obstruction leads to visible peristalsis due to the intestines trying to push contents past the blockage. This assessment finding is crucial for prompt intervention to prevent complications.

Correct Answer: C

Rationale: The correct next step in assessing a detected abdominal mass is to palpate it for size and consistency. Palpation helps determine the characteristics of the mass, such as its shape, size, texture, and tenderness. This step provides crucial information for further evaluation and diagnosis. Auscultation for bowel sounds would not provide direct information about the mass. Percussion for tenderness may be uncomfortable and should be done after palpation. Referring the patient for imaging should come after a thorough physical examination and initial assessment of the mass.