Nokea
A patient is diagnosed with Hashimoto’s thyroiditis and asks what causes it. The nurse would respond that the destruction of the thyroid in this condition is due to which of the following?
- A. Antigen-antibody complexes
- B. Viral infection
- C. Autoantibodies
- D. Bacterial infection
Correct Answer: C
Rationale: The correct answer is C: Autoantibodies. In Hashimoto's thyroiditis, the immune system mistakenly attacks the thyroid gland by producing autoantibodies against thyroid proteins such as thyroglobulin and thyroid peroxidase. These autoantibodies lead to inflammation and destruction of thyroid tissue. Antigen-antibody complexes (choice A) are not the main mechanism in Hashimoto's thyroiditis. Viral (choice B) and bacterial infections (choice D) do not directly cause autoimmune destruction of the thyroid in this condition. Autoantibodies targeting the thyroid gland are the key pathogenic factor in Hashimoto's thyroiditis.
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A client in the final stages of terminal cancer tells the nurse: “I wish I could be just be allowed to die. I’m tired of fighting this illness. I have lived life a good life. I only continue my chemotherapy and radiation treatment because my family wants me to.” What is the best nurse’s best response?
- A. “Would you like to talk to a psychologist about your thoughts and feelings?”
- B. “Would you like to talk to your minister about the significance of death?”
- C. “Would you like to meet with your family and your physician about this matter?”
- D. “I know you are tired of fighting this illness, but death will come in due time.”
Correct Answer: A
Rationale: The correct answer is A: "Would you like to talk to a psychologist about your thoughts and feelings?" This response acknowledges the client's emotional distress and offers professional support. A psychologist can provide counseling and help the client explore their feelings and concerns about end-of-life decisions.
Choice B is incorrect because it assumes the client's spiritual beliefs are the primary concern, neglecting the emotional and psychological aspects. Choice C involves more people in the decision-making process without addressing the client's individual needs. Choice D is dismissive and does not offer any support or explore the client's feelings further.
In summary, choice A is the best response because it prioritizes the client's emotional well-being and offers appropriate support through professional counseling.
For which of the ff conditions would the use of salt tablets be considered?
- A. a. Mild deficits of serum sodium
- B. Severe deficits of serum magnesium
- C. Severe deficits of serum potassium
- D. Severe deficits of serum calcium
Correct Answer: A
Rationale: Rationale:
- Salt tablets are used for mild deficits of serum sodium to help restore electrolyte balance.
- Sodium is crucial for fluid balance, nerve function, and muscle contraction.
- Severe deficits of serum magnesium, potassium, and calcium require specific electrolyte replacement therapy, not salt tablets.
Summary:
- Choice A is correct because salt tablets are used for mild deficits of serum sodium.
- Choices B, C, and D are incorrect because they involve severe deficits of different electrolytes that require specific replacement therapy.
Pulmonary edema is characterized by:
- A. Elevated left ventricular and-diastolic
- B. Increased hydrostatic pressure
- C. All of the above alterations
- D. A rise in pulmonary venous pressure
Correct Answer: C
Rationale: Rationale:
1. Pulmonary edema is caused by increased hydrostatic pressure in the pulmonary circulation.
2. Elevated left ventricular end-diastolic pressure signifies heart failure, a common cause of pulmonary edema.
3. A rise in pulmonary venous pressure is a consequence of increased hydrostatic pressure.
Therefore, all three alterations (A, B, D) are characteristic of pulmonary edema. Option C is correct. Choices A, B, and D are incorrect because they are all individually associated with pulmonary edema and collectively represent the condition.
A client has a routine Papanicolaou (Pap) test during a yearly gynecologic examination. The result reveals a class V finding. What should the nurse tell the client about this finding?
- A. It’s normal and requires no action
- B. It calls for a repeat Pap test in 6 weeks
- C. It calls for a repeat Pap test in 3 months
- D. It calls for a biopsy as soon as possible
Correct Answer: D
Rationale: The correct answer is D because a class V Pap test finding indicates severe abnormalities, such as high-grade dysplasia or carcinoma in situ. Therefore, the nurse should instruct the client to undergo a biopsy as soon as possible to confirm the diagnosis and initiate appropriate treatment promptly. Choices A, B, and C are incorrect because a class V result is not normal and requires immediate follow-up, rather than waiting or repeating the Pap test at a later time.
Which of the following BP changes alerts the nurse to increasing ICP, and should be reported immediately?
- A. Gradual increase
- B. Widening pulse pressure
- C. Rapid drop followed by gradual increase
- D. Rapid fluctuations
Correct Answer: B
Rationale: The correct answer is B, Widening pulse pressure. This indicates increasing intracranial pressure (ICP) as it signifies a significant difference between systolic and diastolic blood pressure. A widening pulse pressure is a key sign of impending herniation and requires immediate intervention.
A: Gradual increase does not provide a clear indication of acute changes in ICP.
C: Rapid drop followed by gradual increase may suggest other conditions and is not specific to increasing ICP.
D: Rapid fluctuations may occur in various scenarios and do not specifically point to increasing ICP.
In summary, a widening pulse pressure is the most critical and specific indicator of increasing ICP among the choices provided.