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A patient presents with a palpable thyroid nodule and signs of hyperthyroidism. Fine-needle aspiration biopsy reveals follicular 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. Follicular thyroid carcinoma
Correct Answer: D
Rationale: Follicular thyroid carcinoma is a type of thyroid cancer that arises from the follicular cells of the thyroid gland. Patients with follicular thyroid carcinoma may present with a palpable thyroid nodule, which in this case is causing signs of hyperthyroidism due to the overproduction of thyroid hormones by the malignant cells. Fine-needle aspiration biopsy revealing follicular cells with nuclear features suggestive of malignancy further supports the diagnosis of follicular thyroid carcinoma in this scenario.
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A patient is prescribed a beta-adrenergic agonist for the management of asthma. Which adverse effect should the nurse monitor closely in the patient?
- A. Hypotension
- B. Hyperkalemia
- C. Tachycardia
- D. Hypoglycemia
Correct Answer: C
Rationale: Beta-adrenergic agonists stimulate beta-adrenergic receptors in the heart, leading to an increase in heart rate (tachycardia). This is a common adverse effect associated with the use of beta-adrenergic agonists in the management of conditions such as asthma. Monitoring for tachycardia is important because it can potentially lead to other complications such as palpitations, arrhythmias, and exacerbation of underlying cardiovascular conditions. It is essential for the nurse to closely monitor the patient for any signs or symptoms of tachycardia and report any abnormalities to the healthcare provider promptly to ensure appropriate management and prevent further complications.
The diagnostic examination for osteoporosis is geared towards measuring
- A. Bone density
- B. Weight
- C. Blood volume
- D. Height
Correct Answer: A
Rationale: The diagnostic examination for osteoporosis typically involves measuring bone density. This is usually done through a dual-energy x-ray absorptiometry (DEXA) scan, which is considered the gold standard for assessing bone density. Osteoporosis is characterized by decreased bone mass and deterioration of bone tissue, leading to increased bone fragility and risk of fractures. Measuring bone density helps in diagnosing osteoporosis by identifying areas of low bone density, assessing the risk of fractures, and monitoring the effectiveness of treatment. Weight, blood volume, and height are not directly used as primary indicators for diagnosing osteoporosis.
A woman in active labor is diagnosed with uterine rupture. What is the priority nursing action?
- A. Preparing for immediate cesarean section
- B. Administering intravenous oxytocin to augment contractions
- C. Assisting the mother into a hands-and-knees position
- D. Initiating cardiopulmonary resuscitation (CPR)
Correct Answer: A
Rationale: The priority nursing action for a woman diagnosed with uterine rupture during labor is to prepare for immediate cesarean section. Uterine rupture is a serious obstetric emergency that can lead to severe maternal and fetal complications, including hemorrhage, fetal distress, and injury to both mother and baby. A cesarean section is necessary to deliver the baby promptly and address any potential complications, such as controlling bleeding and ensuring the safety of both the mother and the baby. Time is critical in these situations, and prompt surgical intervention is essential to optimize outcomes. Administering intravenous oxytocin or assisting the mother into a hands-and-knees position would not address the immediate risks associated with uterine rupture. Initiating cardiopulmonary resuscitation (CPR) is only necessary if the mother's condition deteriorates to the point of cardiac or respiratory arrest, which may occur as a result of significant hemorrhage or other complications associated with uterine
A nurse is caring for a patient with limited English proficiency. What action should the nurse take to ensure effective communication with the patient?
- A. Speak loudly and slowly to help the patient understand
- B. Use medical jargon to convey information more efficiently
- C. Obtain interpreter services or language assistance as needed
- D. Ignore the patient's language barriers and focus on nonverbal communication
Correct Answer: C
Rationale: The nurse should obtain interpreter services or language assistance as needed to ensure effective communication with a patient who has limited English proficiency. Using an interpreter will facilitate clear and accurate communication between the nurse and the patient, enabling the patient to fully understand their care, treatment, and any instructions provided. Speaking loudly or slowly, using medical jargon, or ignoring the language barriers are not effective strategies for communicating with a patient who has limited English proficiency. Utilizing interpreter services demonstrates respect for the patient's language and cultural needs, which is essential for providing high-quality care.
A nurse is preparing to perform a central venous catheter (CVC) dressing change for a patient. What action should the nurse prioritize to minimize the risk of infection?
- A. Wearing sterile gloves and a mask during the dressing change
- B. Cleaning the insertion site with alcohol-based antiseptic solution
- C. Removing the old dressing and applying a new dressing using sterile technique
- D. Changing the CVC tubing along with the dressing to prevent contamination
Correct Answer: C
Rationale: The nurse should prioritize removing the old dressing and applying a new dressing using sterile technique to minimize the risk of infection during a central venous catheter (CVC) dressing change. This is because the most critical step in preventing infection is maintaining a clean and sterile environment around the CVC insertion site. By using sterile technique, the nurse can reduce the introduction of microorganisms that could potentially lead to infection. Wearing sterile gloves and cleaning the insertion site with an alcohol-based antiseptic solution are important steps as well, but the key priority lies in applying the new dressing using sterile technique to prevent contamination and reduce the risk of infection.