The nurse is performing an abdominal assessment and detects a bruit over the renal arteries. What does this finding suggest?

Correct Answer: B

Rationale: The correct answer is B: Renal artery stenosis. A bruit over the renal arteries indicates turbulent blood flow due to narrowed or blocked arteries, which is a classic sign of renal artery stenosis. This condition can lead to hypertension and renal dysfunction. Choices A, C, and D are incorrect: A is incorrect because a bruit is not a normal vascular sound; C is incorrect as aortic aneurysm would typically present with a pulsatile mass and not just a bruit; D is incorrect as increased peristalsis would not be detected as a bruit in the renal area.

Correct Answer: B

Rationale: The correct answer is B: Assess the patient's ability to chew and detect light touch on the face. This is the most appropriate action for assessing cranial nerve V (trigeminal nerve) as this nerve is responsible for sensory functions of the face and motor function of the muscles of mastication. By assessing the patient's ability to chew and detecting light touch on the face, the nurse can evaluate the integrity of the trigeminal nerve. Choice A is incorrect because assessing the patient's ability to shrug their shoulders against resistance would be more indicative of assessing cranial nerve XI (accessory nerve). Choice C is incorrect because checking for gag reflex and swallowing is more related to cranial nerves IX (glossopharyngeal) and X (vagus). Choice D is incorrect because evaluating the patient's hearing ability is related to cranial nerve VIII (vestibulocochlear).

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.