Nokea
A patient presents with a thyroid nodule and signs of hyperthyroidism. Fine-needle aspiration biopsy reveals granulomatous inflammation and multinucleated giant cells. Which endocrine disorder is most likely responsible for these symptoms?
- A. Hashimoto's thyroiditis
- B. Graves' disease
- C. Subacute thyroiditis
- D. Thyroid nodules
Correct Answer: C
Rationale: Subacute thyroiditis is an inflammatory disorder of the thyroid gland that causes gland destruction and release of pre-formed thyroid hormone leading to hyperthyroidism. The fine-needle aspiration biopsy findings of granulomatous inflammation and multinucleated giant cells are characteristic of subacute thyroiditis. This condition typically presents with a painful, tender thyroid gland and may be preceded by a viral illness. Unlike Graves' disease, which is an autoimmune disorder resulting in hyperthyroidism with diffuse goiter and positive thyroid stimulating immunoglobulins, subacute thyroiditis is typically self-limited and resolves spontaneously without the need for long-term treatment.
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Which of the following dental conditions is characterized by a localized collection of pus resulting from a bacterial infection of the tooth pulp?
- A. Dental caries
- B. Periodontitis
- C. Dental abscess
- D. Oral candidiasis
Correct Answer: C
Rationale: A dental abscess is characterized by a localized collection of pus that results from a bacterial infection of the tooth pulp, leading to swelling, pain, and inflammation. The infection typically occurs when bacteria enter the tooth through a cavity, crack, or other dental injury. The abscess can cause significant pain and discomfort and must be treated promptly by a dentist to prevent further complications. Dental caries refer to tooth decay or cavities that result from the breakdown of tooth structure by acids produced by bacteria. Periodontitis is a severe gum infection that damages the soft tissue and destroys the bone that supports the teeth. Oral candidiasis is a fungal infection that affects the mouth and throat.
The patient seems indecisive whether to breastfeed her baby or not. Which is the desired nursing action of Nurse Vera to help the pregnant patient make a decision on breastfeeding?
- A. Give pamphlets and books to read.
- B. Provide ample time for the patient to decide.
- C. Refer the patient to the nutrionist.
- D. Assist to identify breastfeeding goal and plan.
Correct Answer: D
Rationale: The desired nursing action to help the pregnant patient make a decision on breastfeeding is to assist in identifying a breastfeeding goal and plan. When patients are indecisive about breastfeeding, it is essential for the nurse to support them in setting specific goals and creating a plan that aligns with their values and circumstances. This approach can help the patient feel empowered and confident in their decision-making process. Providing pamphlets and books (choice A) may be helpful, but personalized assistance in identifying a breastfeeding goal and plan is more likely to address the patient's individual needs and concerns. Providing ample time for the patient to decide (choice B) is important, but guidance and support in setting a clear goal can facilitate the decision-making process. Referring the patient to a nutritionist (choice C) may be beneficial for dietary concerns but may not directly address the decision-making process regarding breastfeeding.
One error in record-keeping is illegible handwriting. What is the APPROPRIATE action by the nurse in this situation?
- A. Request the senior nurse to read the order for you.
- B. Let the resident-on-duty in the nurses station interpret it.
- C. Call the physician who made the order.
- D. Report the lapse to the Quality Assurance Committee
Correct Answer: A
Rationale: The appropriate action for a nurse in this situation is to request the senior nurse to read the illegible order for clarification. It is essential to ensure accurate and safe patient care by confirming the correct interpretation of the order with a colleague familiar with the handwriting. This action helps prevent errors and misunderstandings that may occur due to illegible handwriting. Consulting with the senior nurse is a common practice in healthcare settings to maintain effective communication and avoid mistakes in patient care.
Which is a common verbalization of the patient with GBS regarding the EARLY ONSET of symptoms?
- A. Acute hemiplegia
- B. Ascending motor weakness
- C. Weakness of the four lower extremities
- D. Acute hemiparesis
Correct Answer: B
Rationale: Guillain-Barré Syndrome (GBS) is characterized by ascending motor weakness, starting typically in the lower extremities and progressing upwards. Patients with GBS often verbalize the early onset of symptoms as weakness starting in the legs and potentially spreading to involve the arms and sometimes the face. Therefore, the common verbalization of the patient with GBS regarding the early onset of symptoms is ascending motor weakness. Acute hemiplegia (choice A) and acute hemiparesis (choice D) involve weakness or paralysis typically limited to one side of the body, which is not a characteristic presentation of GBS. Weakness of the four lower extremities (choice C) is also not a typical description in GBS as the weakness usually starts distally and progresses proximally.
A patient in the ICU develops acute respiratory distress syndrome (ARDS) secondary to sepsis. What intervention should the healthcare team prioritize to manage the patient's respiratory failure?
- A. Initiate lung-protective mechanical ventilation with low tidal volume.
- B. Administer inhaled nitric oxide (iNO) for pulmonary vasodilation.
- C. Perform prone positioning to improve oxygenation.
- D. Recommend high-dose corticosteroid therapy for anti-inflammatory effects.
Correct Answer: A
Rationale: ** In a patient with ARDS, the priority intervention to manage respiratory failure is to initiate lung-protective mechanical ventilation with low tidal volume. ARDS is characterized by widespread inflammation and injury to the alveoli, leading to impaired gas exchange and severe hypoxemia. Lung-protective ventilation strategies aim to minimize ventilator-induced lung injury by using lower tidal volumes (around 6 mL/kg of predicted body weight) to reduce barotrauma and volutrauma.