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A patient presents with a thyroid nodule and signs of compression such as difficulty swallowing and breathing. Fine-needle aspiration biopsy reveals lymphocytic infiltration and germinal centers. Which endocrine disorder is most likely responsible for these symptoms?
- A. Hashimoto's thyroiditis
- B. Graves' disease
- C. Diabetes mellitus
- D. Thyroid nodules
Correct Answer: A
Rationale: Hashimoto's thyroiditis is an autoimmune disorder characterized by chronic inflammation of the thyroid gland. In this condition, lymphocytic infiltration and germinal centers can be seen in the thyroid tissue. This inflammation can lead to the formation of thyroid nodules and enlargement of the thyroid gland, causing symptoms such as difficulty swallowing and breathing due to compression of surrounding structures. Additionally, Hashimoto's thyroiditis can result in hypothyroidism over time, further contributing to the symptoms. Therefore, the patient in this case is most likely experiencing these symptoms due to Hashimoto's thyroiditis. Graves' disease, on the other hand, typically presents with hyperthyroidism and is less likely to manifest as compressive symptoms of the thyroid gland.
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A patient is reluctant to discuss personal health issues due to embarrassment. What is the nurse's best approach to encourage open communication?
- A. Dismiss the patient's concerns and proceed with asking personal health questions.
- B. Provide the patient with privacy and assurance of confidentiality to create a safe space for discussion.
- C. Ignore the patient's reluctance and proceed with asking personal health questions regardless.
- D. Tell the patient that embarrassment is unnecessary and they should be open about their health issues.
Correct Answer: B
Rationale: Providing the patient with privacy and assurance of confidentiality is essential to create a safe and trusting environment for open communication. By assuring the patient that their information will be kept confidential, the nurse can help alleviate the patient's fears and encourage them to feel more comfortable discussing their personal health issues. Dismissing the patient's concerns (option A), ignoring their reluctance (option C), or telling them that their embarrassment is unnecessary (option D) are not effective approaches and may further hinder open communication. It is crucial for the nurse to create a supportive and nonjudgmental atmosphere to build trust with the patient and facilitate honest discussions about their health concerns.
When providing health education to a patient, what is an essential aspect of effective communication?
- A. Using complex medical terminology to convey authority.
- B. Speaking quickly to cover more information in less time.
- C. Using clear and simple language to enhance understanding.
- D. Avoiding repetition to prevent boredom.
Correct Answer: C
Rationale: When providing health education to a patient, using clear and simple language is an essential aspect of effective communication. Medical terminology can be confusing and overwhelming for individuals without a medical background. By using language that the patient can easily understand, you improve their comprehension of the information being conveyed. Speaking quickly or using complex terms can actually hinder communication and may lead to misunderstanding. Clear and simple language helps ensure that the patient fully grasps the information and can make informed decisions about their health.
The nurse who uses appropriate therapeutic listening skills will display which BEST behavior?
- A. Presume an understanding of the patient needs.
- B. Read quickly to the message.
- C. Reassure the patient that everything will be fine.
- D. Absorb both the content and the feeling which patient is conveying
Correct Answer: D
Rationale: The nurse who uses appropriate therapeutic listening skills will display the best behavior by absorbing both the content and the feeling which the patient is conveying. In the given scenario, Belle is experiencing a range of symptoms due to her mental health issues, trauma, and past experiences. By actively listening and absorbing both the content (symptoms, concerns) and the feelings (depressed mood, worry, irritability) which Belle is conveying, the nurse can demonstrate empathy, understanding, and validation of Belle's experiences. This type of therapeutic listening helps to build trust, rapport, and a supportive therapeutic relationship between the nurse and the patient, which is crucial for effective communication, assessment, and treatment in mental health care settings.
A patient with acute exacerbation of chronic obstructive pulmonary disease (COPD) demonstrates hypercapnia and respiratory acidosis on arterial blood gas analysis. Which of the following ventilatory strategies is most appropriate for managing the patient's respiratory failure?
- A. Low tidal volume ventilation
- B. High-flow nasal cannula therapy
- C. Non-invasive positive pressure ventilation (NIPPV)
- D. Invasive mechanical ventilation with lung protective strategy
Correct Answer: D
Rationale: In a patient with acute exacerbation of COPD who presents with hypercapnia and respiratory acidosis, the most appropriate ventilatory strategy is invasive mechanical ventilation with a lung protective strategy. This involves using lower tidal volumes and limiting plateau pressures to prevent ventilator-induced lung injury.
Nurse Myrna is taking care of a family chose there young children are sick with malnutrition particularly protein deficiency, which of the following behaviors is indicative of the family's positive coping index
- A. Observing erratic mealtime due to work schedule of parents
- B. Bringing children to health enter for consult only when needed.
- C. Serving foods that children like but with high in carbohydrates
- D. Cooking foods in variety that include meat, dairy products and beans.
Correct Answer: D
Rationale: Cooking foods in a variety that includes meat, dairy products, and beans demonstrates a positive coping index for the family in addressing the protein deficiency and malnutrition in their children. This behavior shows the family's understanding and effort to provide diverse sources of protein, which is essential for addressing protein deficiency. By including different protein-rich foods in their meals, the family is actively working towards improving the nutritional status of their children. This approach aligns with the goal of health education to change knowledge, attitudes, and practices to enhance individual, family, and community health.