What is the best method for the nurse to assess for cyanosis in a dark-skinned patient?

Correct Answer: B

Rationale: The correct answer is B: Examine the lips and oral mucosa. In dark-skinned patients, cyanosis may not be easily visible on the skin. Lips and oral mucosa are more sensitive areas where cyanosis can be detected early. Inspecting the sclera (choice A) may not show cyanosis accurately. Palpating the skin for coolness (choice C) is not a specific method for detecting cyanosis. Assessing capillary refill in the fingers (choice D) is more related to circulation status rather than directly assessing for cyanosis.

Correct Answer: B

Rationale: The primary purpose of performing percussion over the costovertebral angle is to assess kidney tenderness. This technique, known as CVA tenderness, helps identify potential kidney issues such as infections or kidney stones. By tapping over this area, any tenderness or pain indicates underlying kidney pathology. This is crucial in diagnosing conditions like pyelonephritis or renal stones. The other choices are incorrect because: A: Liver enlargement is typically detected through palpation and imaging studies, not percussion over the costovertebral angle. C: Evaluating diaphragmatic excursion involves assessing the movement of the diaphragm during respiration, which is not related to percussion in the CVA region. D: Detecting fluid in the lungs is usually done through auscultation and imaging studies, not percussion over the costovertebral angle.

Correct Answer: C

Rationale: The correct answer is C: Absent dorsalis pedis pulse. This finding is most concerning as it indicates a significant impairment in arterial blood flow to the foot, potentially leading to severe complications such as tissue necrosis or limb ischemia. Absence of the dorsalis pedis pulse suggests a severe blockage or narrowing in the arteries supplying the foot, which requires immediate medical attention to prevent further complications. Capillary refill of 2 seconds (choice A) is within the normal range and indicates adequate peripheral circulation. Bilateral pitting edema (choice B) can be a sign of venous insufficiency but is not as urgent as an absent dorsalis pedis pulse. Warm and pink extremities (choice D) indicate good tissue perfusion and are positive findings in a vascular assessment.

Correct Answer: A

Rationale: The correct answer is A: Osteoarthritis. In a 60-year-old woman with joint pain worsened with activity, improved with rest, decreased range of motion, and crepitus, osteoarthritis is the most likely diagnosis due to its characteristic presentation in weight-bearing joints. Osteoarthritis is a degenerative joint disease characterized by cartilage breakdown, leading to pain and stiffness. Rheumatoid arthritis (B) typically presents with symmetric joint involvement, morning stiffness, and systemic symptoms. Gout (C) manifests as sudden onset of severe joint pain, redness, and swelling, commonly affecting the big toe. Psoriatic arthritis (D) is associated with skin psoriasis and may involve asymmetric joint inflammation.

Correct Answer: A

Rationale: The most likely diagnosis for the 30-year-old woman with shortness of breath, dry cough, and a history of frequent sinus infections is Sarcoidosis. This is because Sarcoidosis commonly presents with respiratory symptoms such as cough and dyspnea, and can be associated with sinus involvement. Sarcoidosis is more common in younger individuals, like the patient in this case, compared to lung cancer or COPD. Pneumonia typically presents with fever and productive cough, which are not mentioned in the patient's symptoms. Chronic obstructive pulmonary disease (COPD) is more commonly seen in older individuals with a history of smoking, which is not indicated in this case. Therefore, the most likely diagnosis is Sarcoidosis based on the patient's age, symptoms, and medical history.