Nokea
A patient presents with a thyroid nodule and signs of hyperthyroidism. Fine-needle aspiration biopsy reveals spindle-shaped cells and psammoma bodies. Which endocrine disorder is most likely responsible for these symptoms?
- A. Hashimoto's thyroiditis
- B. Graves' disease
- C. Follicular thyroid carcinoma
- D. Papillary thyroid carcinoma
Correct Answer: C
Rationale: The presence of spindle-shaped cells and psammoma bodies on fine-needle aspiration biopsy is characteristic of follicular thyroid carcinoma. This type of thyroid cancer can present as a thyroid nodule associated with signs of hyperthyroidism due to the release of thyroid hormones from the cancerous thyroid cells. Hashimoto's thyroiditis is an autoimmune condition that typically presents with hypothyroidism, while Graves' disease is another autoimmune disorder that results in hyperthyroidism but is not associated with the presence of spindle-shaped cells and psammoma bodies in this context. Papillary thyroid carcinoma may also present with thyroid nodules, but it is more commonly associated with papillary structures and nuclear features rather than spindle-shaped cells seen in follicular thyroid carcinoma.
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While preparing the surgical site, the nurse notices that the skin preparation solution has expired. What should the nurse do?
- A. Use the expired solution as it is still effective
- B. Document the expiration date in the patient's chart
- C. Discard the expired solution and obtain a new one
- D. Dilute the solution with sterile water to extend its shelf life
Correct Answer: C
Rationale: Using an expired skin preparation solution can compromise the safety and effectiveness of the surgical site cleansing. Expired solutions may have reduced efficacy or could cause adverse reactions due to chemical breakdown over time. Therefore, it is essential for the nurse to discard the expired solution and obtain a new one to ensure proper sanitation and reduce the risk of complications during the surgical procedure. It is important to adhere to proper protocols and guidelines in healthcare settings to maintain patient safety and optimal outcomes.
When communicating with a patient who speaks a different language, what is the nurse's best approach?
- A. Use a family member or friend as an interpreter to convey information.
- B. Rely solely on written instructions to avoid language barriers.
- C. Utilize professional medical interpreters to ensure accurate communication.
- D. Speak loudly and slowly to ensure the patient understands.
Correct Answer: C
Rationale: Using professional medical interpreters is the best approach when communicating with a patient who speaks a different language. This ensures accurate communication and helps prevent misunderstandings that can have serious consequences for the patient's health. Family members or friends may not be fluent in the necessary medical terminology and could unintentionally misinterpret information. Relying solely on written instructions can also be risky as the patient may have difficulty reading or comprehending the information. Speaking loudly and slowly may come across as disrespectful and does not address the root issue of the language barrier. Professional medical interpreters are trained to facilitate effective communication between healthcare providers and patients, ensuring that the patient receives the best possible care.
A patient with chronic kidney disease is prescribed erythropoietin-stimulating agents (ESAs) to manage anemia. Which laboratory parameter should be monitored closely during ESA therapy?
- A. Serum potassium
- B. Serum creatinine
- C. Hemoglobin
- D. Platelet count
Correct Answer: C
Rationale: Erythropoietin-stimulating agents (ESAs) are prescribed to manage anemia in patients with chronic kidney disease. Monitoring the hemoglobin level closely during ESA therapy is crucial to ensure that the treatment is effective in increasing red blood cell production without causing excessive elevation. Hemoglobin levels should be checked regularly to adjust the ESA dosage accordingly and prevent risks associated with high hematocrit levels, such as increasing blood viscosity and cardiovascular events. Monitoring serum potassium, creatinine, and platelet count are important in the management of chronic kidney disease for different reasons, but for ESA therapy, monitoring hemoglobin is the most essential parameter.
After five days of hospitalization, the physician said Mr. Steeve can be discharged. He ordered medications to be taken at home. The client is still weak and symptomatic, which of the following rights could be violated in this case? Right to _______.
- A. Know hospital rules
- B. Refuse treatment
- C. Privacy
- D. Continuity of care
Correct Answer: B
Rationale: The right to refuse treatment is a fundamental patient right. In this case, the physician ordering medications for the client to take at home without the client's input or agreement could possibly violate the client's right to refuse treatment. It is important for patients to have the autonomy to make decisions regarding their own treatment, especially when they are still weak and symptomatic. Patients should have the opportunity to discuss their treatment plan with their healthcare provider and express any concerns or preferences they may have.
Which of the following is NOT a step of record keeping?
- A. Structuring
- B. Securing
- C. Storing
- D. Easy Disposa l
Correct Answer: D
Rationale: Record keeping involves several key steps such as structuring, securing, and storing information. However, easy disposal is not a step in record keeping. In fact, it is important to carefully consider the disposal of records in a secure and responsible manner to protect sensitive information and comply with relevant regulations. Proper disposal methods should be followed to ensure that records are not accessible to unauthorized individuals and that any sensitive information is properly destroyed to prevent misuse or breaches of privacy. Therefore, easy disposal is not a recommended practice in effective record keeping.