Nokea
A patient presents with a painful thyroid nodule and signs of hypothyroidism. Fine-needle aspiration biopsy reveals Hurthle cells with nuclear features suggestive of malignancy. Which endocrine disorder is most likely responsible for these symptoms?
- A. Hashimoto's thyroiditis
- B. Graves' disease
- C. Diabetes mellitus
- D. Hurthle cell carcinoma
Correct Answer: D
Rationale: Hurthle cell carcinoma is a subtype of thyroid cancer that arises from the follicular cells in the thyroid gland. Patients with Hurthle cell carcinoma may present with a painful thyroid nodule, which can be associated with signs of hypothyroidism due to the disruption of thyroid hormone production by the tumor. Fine-needle aspiration biopsy revealing Hurthle cells with nuclear features suggestive of malignancy is a characteristic finding in this type of carcinoma.
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To ensure that the staff adheres to their job responsibilities which should be the appropriate toool should Nurse Mae utilize in evaluating staff performance?
- A. Memorandum
- B. Incident report
- C. Performance evaluation
- D. Anecdotal report
Correct Answer: C
Rationale: Nurse Mae should utilize performance evaluations to ensure that the staff adheres to their job responsibilities. Performance evaluations are structured assessments that provide a holistic view of an employee's performance against established standards and job responsibilities. By conducting regular performance evaluations, Nurse Mae can objectively measure staff performance, identify areas of strengths and weaknesses, provide feedback for improvement, and set goals for professional development. This tool is essential for monitoring and managing staff performance effectively in a healthcare setting.
In utilizing family coping index nurses should be knowledgeable that the focus of this tool is identifying the family's ________.
- A. strategies to deal with stressful situations
- B. Manner of interaction
- C. Ways of managing health needs and challenges
- D. Patterns of health habits
Correct Answer: A
Rationale: The Family Coping Index is a tool designed to assess the strategies that a family uses to deal with stressful situations. It focuses on how families manage and cope with stress and challenges, rather than solely on their interactions, health management, or health habits. By identifying the family's coping strategies, healthcare professionals can better understand the family dynamics and provide targeted support and interventions to help them navigate difficult circumstances.
A client is being prepared for a thoracentesis. The nurse should assist the client to which position for the procedure?
- A. Lying in bed on the affected side
- B. Lying in bed on the unaffected side
- C. Sims position with the head of the bed flat
- D. Prone with the head turned to the side and supported by a pillow
Correct Answer: B
Rationale: The client should be assisted to lie in bed on the unaffected side for a thoracentesis procedure. This position allows for better access to the pleural space for the insertion of a needle to aspirate the fluid or air. Gravity helps to separate the fluid or air, making it closer to the chest wall for easier removal. Additionally, this position reduces the risk of injury to the lung or other structures, as the needle is directed away from these vital structures. Lying on the unaffected side also helps in preventing potential complications and ensures the safety and effectiveness of the procedure.
The nurse instructs the patient that the BEST time for an incontinent patient to take his diuretics is
- A. Any time of the day
- B. In the morning
- C. After 4:00 PM
- D. At bedtime
Correct Answer: D
Rationale: The best time for an incontinent patient to take diuretics is at bedtime. This timing allows for increased urine production during the night, consequently reducing the need for frequent toileting during the day. By taking the diuretic at bedtime, the patient can manage their incontinence more effectively and have better rest without disruptions from frequent urination during the day.
A patient presents with generalized weakness, headache, and difficulty concentrating. Laboratory tests reveal normocytic normochromic anemia, normal iron studies, and elevated serum erythropoietin levels. Which of the following conditions is most likely to cause these findings?
- A. Chronic kidney disease (CKD)
- B. Iron deficiency anemia
- C. Thalassemia
- D. Aplastic anemia
Correct Answer: A
Rationale: The patient in this scenario presents with normocytic normochromic anemia, normal iron studies, and elevated serum erythropoietin levels. These findings are characteristic of anemia of chronic disease, which is commonly seen in patients with chronic kidney disease (CKD). In CKD, there is a decrease in renal production of erythropoietin, leading to reduced stimulation of erythropoiesis and subsequent anemia. The normocytic normochromic anemia pattern is typical in anemia of chronic disease, as opposed to microcytic hypochromic anemia seen in iron deficiency anemia and thalassemia. Aplastic anemia is characterized by pancytopenia, which is not described in the scenario. Therefore, the most likely cause of the patient's presentation is chronic kidney disease.