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1. A nurse is performing a comprehensive health assessment on a 65-yearold male patient who has a history of hypertension, diabetes, and smoking.
The nurse auscultates the patient's lungs and hears crackles in the lower
lobes bilaterally. What is the most likely cause of this finding?
a) Pneumonia
b) Asthma
c) Chronic obstructive pulmonary disease (COPD)*
d) Pulmonary edema
Rationale: Crackles are abnormal breath sounds that indicate fluid or
secretions in the alveoli. COPD is a chronic condition that causes airflow
obstruction and inflammation in the lungs, leading to mucus production
and impaired gas exchange. Smoking is a major risk factor for COPD.
Pneumonia, asthma, and pulmonary edema can also cause crackles, but
they are usually associated with other signs and symptoms, such as fever,
wheezes, and dyspnea.
2. A nurse is performing a comprehensive health assessment on a 45-yearold female patient who complains of fatigue, weight gain, and cold
intolerance. The nurse palpates the patient's thyroid gland and finds it
enlarged and firm. What is the most appropriate action for the nurse to
take next?
a) Ask the patient about her family history of thyroid disorders
b) Order a thyroid function test
c) Refer the patient to an endocrinologist*
d) Prescribe levothyroxine
Rationale: An enlarged and firm thyroid gland is a sign of goiter, which
can be caused by various thyroid disorders, such as hypothyroidism,
hyperthyroidism, or thyroid cancer. The nurse should refer the patient to
an endocrinologist for further evaluation and diagnosis, as thyroid
disorders can have serious complications if left untreated. Asking about
family history, ordering a thyroid function test, and prescribing
levothyroxine are not appropriate actions at this stage, as they do not
confirm the cause of the goiter or address the patient's symptoms.
3. A nurse is performing a comprehensive health assessment on a 25-yearold male patient who has a history of substance abuse. The nurse observesÂ
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