NR 509 Week 3 Quiz - All Correct
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Correct answer: C Step-by-step explanation: • The patient’s symptoms (daytime fatigue, loud snoring, mood changes) are classic for obstructive sleep apnea (OSA). • First, the NP should perform targeted screening in the history: ask about apneas witnessed by a bed partner, choking/gasping at night, nonrestorative sleep, morning headaches, nocturia, and driving sleepiness; use validated tools such as STOP-BANG or the Epworth Sleepiness Scale. • If screening is positive or suspicion remains high, refer for definitive diagnostic testing (overnight polysomnography or home sleep apnea testing per guidelines). That is reflected in option C. Why others are incorrect: • A: Overnight pulse oximetry is only a screening adjunct and cannot confirm OSA; polysomnography/home sleep testing is needed. • B: Exercise/hydration advice alone delays appropriate evaluation of a potentially serious condition. • D: Attributing fatigue to stress without assessment risks missing OSA. Correct answer: B Step-by-step explanation: • A: A smooth, symmetric thyroid that rises with swallowing is a normal finding. • B: A firm nodule larger than 1–1.5 cm that is fixed (non-mobile) to surrounding tissues is worrisome for malignancy and warrants urgent further evaluation with ultrasound ± FNA and endocrinology/ENT referral. • C: In thin adults, a nonpalpable thyroid without symptoms can be normal. • D: A small (1 cm), soft, mobile nodule that moves with swallowing is more consistent with a benign lesion (e.g., colloid cyst) and is less concerning than a fixed, hard mass. Correct answer: A — Grade 4 Step-by-step explanation: • Standard tonsil grading (Brodsky scale): • Grade 0: Tonsils absent • Grade 1: 75% (“kissing” tonsils, nearly touching at midline) • The question states the tonsils occupy more than 75% of the oropharyngeal airway and are nearly touching at the midline. • That fits Grade 4 enlargement. Correct answer: C Step-by-step explanation: • A thorough scalp and hair exam requires visualizing the skin beneath the hair. Pathology (e.g., tinea capitis, psoriasis plaques, lice/nits, nevi, masses) can be hidden under hair. • The best technique is to part the hair in multiple areas to inspect the entire scalp surface. • Option A is incomplete—focusing only on visible areas misses hidden lesions. • Option B sacrifices diagnostic accuracy; wigs/hairpieces should be removed with consent for proper inspection. • Option D (percussion) is not a standard assessment for the scalp; palpation may be used for tenderness or masses, but visualization by parting the hair is key. Therefore, parting the hair in multiple areas is the most appropriate action to ensure a thorough assessment. Correct answer: B — Chest expansion Step-by-step explanation: • Technique described: The examiner places both thumbs at the costal margins with hands along the lateral rib cage and asks the patient to take a deep breath. The thumbs should move apart symmetrically as the chest expands. • Purpose: To assess thoracic (chest) expansion and detect asymmetry that may suggest conditions such as lobar pneumonia, pneumothorax, pleural effusion, or rib fracture. • Why others are incorrect: • A Adventitious breath sounds are evaluated by auscultation with a
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