NR 509 APEA 3P EXAM WEEK 4 2024 LATEST QUESTIONS AND GUARANTEED CORRECT ANSWERS WITH RATIONALES ALREADY GRADED A+.
A 73-year-old retired salesman presents to the Emergency Department complaining of
chest pain that started about 2 hours ago. Electrocardiogram, cardiac enzymes, and
chest x-ray are normal. The nurse notes that his blood pressures in the right arm are
significantly lower than of blood pressures in his left arm. Based on history and physical
examination, which of the following will most likely explain his signs and symptoms? –
ANSWER- a. Dissecting aortic aneurysm
Rationale: Patients with dissecting aortic aneurysms typically present with chest pain,
many times described as a “tearing” type pain. They are usually elderly, and, due to the
dissection of the aorta, asymmetric pulses in blood pressures in the extremities may be
present. Coarctation of the aorta can also cause similar symptoms; however, it would be
unlikely due to the patient’s age as this is a congenital defect. MI, PE, and pericarditis
are also common causes of concerning chest pain; however, neither typically will cause
asymmetric blood pressures or pulses in the extremities.A 19-year-old carwash attendant sustained a laceration to the ulnar aspect of his mid-
forearm while at work last week. He did not have it evaluated at that time and is now
noticing purulent discharge and increasing pain from the wound along with fever and
chills. Where would the clinician expect to find the first signs of lymphadenopathy? –
ANSWER- a. Epitrochlear nodes
Rationale: The epitrochlear nodes are the first nodes in the drainage region from the
ulnar surface of the forearm and hand, little and ring fingers, and adjacent surface of the
middle finger. Axillary nodes, infraclavicular nodes, and cervical chain nodes are all
distal to this area and may show evidence of lymphadenopathy as well; however, that
would be secondary after the epitrochlear nodes.
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