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A patient presents with recurrent episodes of fever, sore throat, and cervical lymphadenopathy. Laboratory tests reveal leukocytosis with atypical lymphocytes on peripheral blood smear and positive heterophile antibody test (Monospot test). Which of the following conditions is most likely to cause these findings?
- A. Infectious mononucleosis (Epstein-Barr virus infection)
- B. Cytomegalovirus (CMV) infection
- C. HIV/AIDS
- D. Toxoplasmosis
Correct Answer: A
Rationale: The clinical presentation of recurrent fever, sore throat, cervical lymphadenopathy, leukocytosis with atypical lymphocytes, and positive heterophile antibody test (Monospot test) is highly indicative of infectious mononucleosis caused by the Epstein-Barr virus (EBV). EBV is a member of the herpesvirus family and is a common cause of infectious mononucleosis. The atypical lymphocytes seen on peripheral blood smear are reactive T lymphocytes responding to the EBV infection. The Monospot test detects heterophile antibodies produced in response to EBV infection.
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A patient presents with a thyroid nodule and signs of hyperthyroidism. Fine-needle aspiration biopsy reveals Hurthle cells and cellular atypia. Which endocrine disorder is most likely responsible for these symptoms?
- A. Hashimoto's thyroiditis
- B. Graves' disease
- C. Hurthle cell carcinoma
- D. Papillary thyroid carcinoma
Correct Answer: C
Rationale: Hurthle cell carcinoma is a type of thyroid cancer that arises from the Hurthle cells of the thyroid gland. Patients with Hurthle cell carcinoma may present with a thyroid nodule and signs of hyperthyroidism, which can mimic other thyroid disorders such as Graves' disease. Fine-needle aspiration biopsy revealing Hurthle cells and cellular atypia is suggestive of a Hurthle cell neoplasm, particularly Hurthle cell carcinoma. It is important to differentiate Hurthle cell carcinoma from benign Hurthle cell adenomas or other thyroid conditions to guide appropriate management and treatment.
What isotonic electrolyte solutions are COMMONLY used as fluid replacement in hypovolemic shock? I. Dextrose 5 percent in water II. 0.9 percent sodium chloride III. Lactated Ringer's solution IV. Dextrose 10 percent in water
- A. II, III, and IV
- B. II and III
- C. I, III, and IV
- D. I and IV
Correct Answer: B
Rationale: In hypovolemic shock, isotonic electrolyte solutions are commonly used for fluid replacement to restore the circulating blood volume. The commonly used isotonic electrolyte solutions for this purpose are 0.9% sodium chloride (normal saline) and lactated Ringer's solution.
Which of the following is NOT included among the factors that should be considered by the nurse or the pregnant woman in interpreting results of pregnancy test?
- A. Last menstrual period
- B. Type of pregnancy test
- C. Previous pregnancy
- D. Menstrual cycle length
Correct Answer: B
Rationale: The type of pregnancy test is not a factor that should be considered by the nurse or the pregnant woman in interpreting the results of a pregnancy test. Factors such as the last menstrual period, previous pregnancy history, and menstrual cycle length play a crucial role in determining the reliability and accuracy of the pregnancy test results.
Where should the nurse dispose used wet diaper and gloves?
- A. Green
- B. Red
- C. Black
- D. Yellow
Correct Answer: C
Rationale: Used wet diapers and gloves should be disposed of in a black waste bin. Black waste bins are designated for general waste, which includes non-infectious materials that do not pose a risk of infection to others. Wet diapers and gloves fall under this category as they are considered non-infectious waste. Proper disposal in the black bin helps in maintaining cleanliness and hygiene in the healthcare setting.
A postpartum client with a history of breast augmentation expresses concerns about breastfeeding difficulties. What nursing intervention should be prioritized to support successful breastfeeding in this situation?
- A. Providing education on techniques to promote milk production and let-down
- B. Recommending supplemental formula feedings to ensure adequate nutrition
- C. Encouraging the client to avoid breastfeeding to prevent discomfort
- D. Referring the client to a lactation consultant for specialized support
Correct Answer: D
Rationale: Referring the client to a lactation consultant for specialized support should be prioritized to support successful breastfeeding in this situation. Breast augmentation surgery may impact milk production, let-down reflex, and proper latch due to alterations in breast tissue and nerve pathways. A lactation consultant can provide individualized guidance and support to address these specific challenges. Additionally, the consultant can assist in establishing a breastfeeding plan tailored to the client's unique needs, helping to optimize the breastfeeding experience for both the mother and the baby. It is crucial to seek expert assistance in navigating any potential difficulties that may arise from breastfeeding after breast augmentation to promote successful breastfeeding outcomes.