nclex practice questions 2023 health assessment

Correct Answer: C

Rationale: Step 1: Dark skin may not show cyanosis well, making choice A less reliable. Step 2: Erythema refers to redness, which may not be easily visible in dark skin, making choice B less suitable. Step 3: Palpating for edema and increased warmth allows for a more reliable assessment of inflammation in dark skin, making choice C the correct answer. Step 4: Palpating for tenderness and ecchymosis may be useful but not specific to inflammation assessment in dark skin, making choice D less relevant.

Correct Answer: A

Rationale: The correct answer is A: Teeth that appear shorter. As people age, teeth naturally wear down and may appear shorter due to years of use. This is a normal part of the aging process. B: A smoother tongue is not a typical age-related change. C: Beefy red buccal mucosa may be indicative of an underlying health issue, not solely related to aging. D: A painless lump on the tongue could be a sign of a more serious condition and should be investigated further.

Correct Answer: C

Rationale: Step 1: The nurse notices an enlarged and thick skull, which are common signs of acromegaly. Step 2: Acromegaly results from excess growth hormone, leading to changes in facial features. Step 3: Coarse facial features such as enlarged nose, lips, and jaw are classic signs of acromegaly. Step 4: Therefore, assessing for coarse facial features is crucial in confirming acromegaly. Summary: A: Exophthalmos is associated with hyperthyroidism, not acromegaly. B: Bowed long bones are seen in conditions like rickets, not acromegaly. D: An acorn-shaped cranium is not a typical feature of acromegaly.

Correct Answer: C

Rationale: The correct answer is C: "This is a fungal infection caused by all the antibiotics you've received." The black, hairy tongue is a known side effect of prolonged antibiotic use, which disrupts the balance of normal oral flora and predisposes to fungal overgrowth, specifically of the yeast Candida. Antibiotics can eliminate the competing bacteria that normally keep Candida in check. Therefore, the patient's symptoms are most likely due to a fungal infection related to antibiotic therapy, rather than a bacterial issue or temporary overgrowth of hair. Biopsy is not necessary as the condition is commonly seen in this context and can be managed with appropriate treatment for fungal overgrowth.

Correct Answer: B

Rationale: The bright cherry-red coloring in a semiconscious woman found on the floor in her kitchen indicates carbon monoxide poisoning. Carbon monoxide binds to hemoglobin with a higher affinity than oxygen, leading to tissue hypoxia and the characteristic cherry-red coloration. Polycythemia would result in a purplish-red color, carotenemia in a yellow-orange hue, and uremia in a pale or yellowish complexion. Therefore, the correct answer is B, as it aligns with the clinical presentation and pathophysiology of carbon monoxide poisoning.