The papule on the nose of a 52-year-old woman has rounded, pearly borders and a central red ulcer. She tells the nurse that it has been present for several months and is slowly growing larger. Which of the following conditions does the nurse suspect?

Correct Answer: B

Rationale: The correct answer is B: Basal cell carcinoma. The clinical presentation of a papule with rounded, pearly borders, central red ulcer, slow growth, and location on the nose is highly indicative of basal cell carcinoma. Basal cell carcinoma commonly presents with these characteristics and is the most common type of skin cancer. It is locally invasive but rarely metastasizes. A: Acne is a common skin condition characterized by comedones, papules, and pustules, not typically presenting with the described features. C: Malignant melanoma usually presents as an asymmetric, irregularly bordered, multicolored lesion with rapid growth and potential for metastasis. D: Squamous cell carcinoma typically presents as a scaly, crusted lesion with potential for metastasis, not showing the described features.

Correct Answer: B

Rationale: The correct answer is B: assess for middle ear infection as a possible cause. Sensorineural hearing loss is usually caused by damage to the inner ear or the nerve pathway to the brain. Middle ear infection can sometimes lead to conductive hearing loss, but it's important to rule out this possibility during assessment. Speaking loudly (A) is not effective for sensorineural hearing loss. Asking about medications (C) may be relevant but not as crucial as assessing for a possible cause. Looking for external ear obstruction (D) is more relevant for conductive hearing loss, not sensorineural.

Correct Answer: C

Rationale: The correct answer is C because the frontal sinuses are indeed fairly well developed at birth. This is true as the frontal sinuses start developing around the age of 7-8 years but are present in a rudimentary form at birth. This is because the frontal bone grows rapidly in the first few years of life, allowing for the development of the frontal sinuses. Choice A is incorrect because the sphenoid sinuses are not at full size at birth; they continue to develop throughout childhood. Choice B is incorrect as the maxillary sinuses reach full size around the teenage years, not after puberty. Choice D is incorrect as the frontal sinuses are also present at birth, along with the maxillary and ethmoid sinuses.

Correct Answer: D

Rationale: The correct answer is D because testing for strabismus by performing the corneal light reflex test is crucial in diagnosing "lazy eye" or amblyopia in children. Strabismus is a condition where the eyes are misaligned, leading to poor vision in one eye. By performing the corneal light reflex test, the nurse can assess if the child's eyes are aligned or if there is deviation, which could indicate lazy eye. Options A, B, and C are incorrect as they do not specifically address the assessment of strabismus, which is the key indicator for lazy eye in this scenario.

Correct Answer: B

Rationale: The correct answer is B: Use a bath blanket for warmth and privacy. This is important when making an occupied bed to ensure the comfort and dignity of the patient. The bath blanket provides warmth and privacy during the bed-making process, maintaining the patient's comfort and respecting their privacy. Keeping the bed in a low position (choice A) is important for safety but not directly related to the patient's comfort during bed-making. Constantly raising side rails (choice C) is unnecessary and may cause discomfort to the patient. Moving back and forth between sides (choice D) is not essential for making an occupied bed and may disrupt the process.

Correct Answer: B

Rationale: The correct answer is B: It is the most common type of glaucoma. Open-angle glaucoma is indeed the most common type, accounting for about 90% of all glaucoma cases. In open-angle glaucoma, the drainage angle of the eye remains open, but the trabecular meshwork becomes blocked over time. This leads to increased intraocular pressure, which can damage the optic nerve and result in vision loss. A, C, and D are incorrect: A: The symptoms mentioned (sensitivity to light, nausea, halos around lights) are more commonly associated with acute angle-closure glaucoma, not open-angle glaucoma. C: Immediate treatment is not necessarily needed for open-angle glaucoma as it progresses slowly, and treatment can vary based on the severity of the condition. D: Vision loss in open-angle glaucoma typically starts with the loss of peripheral vision, not central vision.

Correct Answer: D

Rationale: The correct answer is D because all choices (A, B, and C) can increase the risk of STDs. Alcohol use can impair judgment leading to risky sexual behavior. Certain sexual practices (such as unprotected sex or having multiple partners) can directly increase the risk of STD transmission. Oral contraception does not protect against STDs, so individuals relying solely on it may still be at risk. Therefore, all of the above factors can contribute to an increased risk of contracting STDs.

Correct Answer: D

Rationale: The correct answer is D: discuss how the patient's food choices may affect her health and that of her baby. This is the most appropriate response because it addresses the potential impact of the patient's current diet on her health and the health of her baby during pregnancy. By discussing the implications of her food choices, the nurse can educate the patient on the importance of a balanced and nutritious diet for a healthy pregnancy. This approach promotes awareness and empowers the patient to make informed decisions for her and her baby's well-being. Incorrect choices: A: This option does not provide guidance or education on improving the patient's diet, which is crucial for a healthy pregnancy. B: Focusing on weight gain rather than nutritional content may not address the underlying issue of poor dietary choices. C: Assuming the patient's ability to cook or go grocery shopping may not address the immediate need for dietary education and guidance.

Correct Answer: A

Rationale: The correct answer is A: Administer bronchodilators. During an acute asthma attack, the priority is to open the airways quickly to improve breathing. Bronchodilators work rapidly to dilate the constricted airways, providing immediate relief. Corticosteroids are used for long-term management and take time to be effective. Administering morphine is not recommended as it can depress the respiratory system. Performing an ECG is not necessary in the acute management of an asthma attack.