Nokea
A patient presents with a painless thyroid nodule and hoarseness of voice. Fine-needle aspiration biopsy reveals papillary thyroid carcinoma. Which endocrine disorder is most likely responsible for these symptoms?
- A. Hashimoto's thyroiditis
- B. Graves' disease
- C. Diabetes mellitus
- D. Thyroid cancer
Correct Answer: D
Rationale: In this scenario, the patient's presentation of a painless thyroid nodule and hoarseness of voice is consistent with papillary thyroid carcinoma, a type of thyroid cancer. While Hashimoto's thyroiditis and Graves' disease are autoimmune thyroid conditions that can lead to thyroid nodules, they typically do not present with hoarseness of voice. Diabetes mellitus does not directly cause these symptoms. Thyroid cancer, particularly papillary thyroid carcinoma, is the most likely cause based on the patient's clinical presentation and the biopsy results.
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Which of the following strategies would prove effective in preventing more incidence of dengue infection?
- A. Healthy nutritious food
- B. Burning of leaves and garbage
- C. Destruction of breeding place of vectors
- D. Adequate rest and sleep
Correct Answer: C
Rationale: The most effective strategy in preventing more incidence of dengue infection is to target the breeding places of the Aedes mosquitoes, which are the vectors responsible for transmitting the dengue virus. By eliminating stagnant water sources where these mosquitoes breed, such as uncovered containers, flower pots, and discarded tires, the mosquito population can be significantly reduced. This, in turn, helps to lower the risk of dengue transmission to humans. While healthy nutritious food, burning of leaves and garbage, and adequate rest and sleep are important for overall health and immune function, they do not directly address the primary cause of dengue transmission, which is the Aedes mosquito population.
A patient with a history of chronic obstructive pulmonary disease (COPD) presents with increased dyspnea and cough productive of purulent sputum. On auscultation, coarse crackles are heard bilaterally. Which complication of COPD is the patient most likely experiencing?
- A. Acute exacerbation
- B. Pneumothorax
- C. Pulmonary embolism
- D. Pleural effusion
Correct Answer: A
Rationale: The patient with a history of COPD presenting with increased dyspnea, cough productive of purulent sputum, and coarse crackles on auscultation is most likely experiencing an acute exacerbation of COPD. Acute exacerbations in COPD are defined as sustained worsening of the patient's respiratory symptoms beyond normal day-to-day variations, leading to a change in medication. Common triggers for exacerbations include respiratory infections, air pollution, and non-compliance with medications.
Gloria decides to include only nurses who have a minimum three years experience as psychiatric nurses. Which of the following terms refer to this?
- A. Concept
- B. Limitation
- C. Variable
- D. Delimitation
Correct Answer: D
Rationale: A delimitation in a research study refers to setting specific boundaries or restrictions on the scope of the study. In this scenario, Gloria's decision to include only nurses with a minimum of three years experience as psychiatric nurses is a delimitation because it sets a specific criterion or boundary for the selection of participants. This helps to focus the study on a particular group of individuals who possess the required experience, ensuring the research is targeted and relevant to the topic being investigated.
A patient presents with a thyroid nodule and signs of compression such as difficulty swallowing and breathing. Fine-needle aspiration biopsy reveals a follicular pattern and colloid-filled spaces. Which endocrine disorder is most likely responsible for these symptoms?
- A. Hashimoto's thyroiditis
- B. Graves' disease
- C. Follicular adenoma
- D. Thyroid nodules
Correct Answer: C
Rationale: The patient's presentation of thyroid nodule with compression symptoms like difficulty swallowing and breathing, along with fine-needle aspiration biopsy showing a follicular pattern and colloid-filled spaces, is highly suggestive of a follicular adenoma. Follicular adenomas are benign thyroid tumors that can cause compression symptoms due to their growth and size, leading to pressure on surrounding structures in the neck area. The presence of colloid-filled spaces in the biopsy is characteristic of follicular adenomas.
A patient in the intensive care unit (ICU) develops acute respiratory distress syndrome (ARDS) characterized by hypoxemia and bilateral pulmonary infiltrates. What intervention should the healthcare team prioritize to manage the patient's condition?
- A. Initiate mechanical ventilation with low tidal volume strategy.
- B. Administer intravenous fluids to maintain hemodynamic stability.
- C. Prescribe broad-spectrum antibiotics for suspected pneumonia.
- D. Perform chest physiotherapy to promote airway clearance.
Correct Answer: A
Rationale: Acute Respiratory Distress Syndrome (ARDS) is a severe form of acute lung injury that is characterized by hypoxemia, bilateral pulmonary infiltrates, and noncardiogenic pulmonary edema. When managing a patient with ARDS in the ICU, the priority intervention is to provide adequate oxygenation and ventilation. Mechanical ventilation is often necessary to support gas exchange in these patients.