Which of the following is the most common type of ovarian tumor in women of reproductive age?
- A. Serous cystadenoma
- B. Mucinous cystadenoma
- C. Teratoma (dermoid cyst)
- D. Endometrioma
Correct Answer: C
Rationale: Among the given options, teratoma (dermoid cyst) is the most common type of ovarian tumor in women of reproductive age. Dermoid cysts are a type of ovarian teratoma that contains tissues derived from the ectoderm (skin), mesoderm (bone, muscle), and endoderm (mucous membranes). They are usually benign and can contain a variety of elements such as hair, teeth, bone, and sebaceous material. Serous cystadenomas and mucinous cystadenomas are more commonly seen in older women, whereas endometriomas are typically associated with endometriosis rather than being the most common ovarian tumor type in women of reproductive age.
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A patient presents with a painful thyroid nodule and signs of hypothyroidism. Fine-needle aspiration biopsy reveals Hurthle 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. Hurthle cell carcinoma
Correct Answer: D
Rationale: Hurthle cell carcinoma is a subtype of thyroid cancer that arises from the follicular cells in the thyroid gland. Patients with Hurthle cell carcinoma may present with a painful thyroid nodule, which can be associated with signs of hypothyroidism due to the disruption of thyroid hormone production by the tumor. Fine-needle aspiration biopsy revealing Hurthle cells with nuclear features suggestive of malignancy is a characteristic finding in this type of carcinoma.
Which of the following interventions is most appropriate for managing a patient with acute respiratory failure and hypercapnia due to chronic obstructive pulmonary disease (COPD) exacerbation?
- A. Administration of supplemental oxygen via non-rebreather mask
- B. Initiation of non-invasive positive pressure ventilation (NIPPV)
- C. Placement of an indwelling arterial catheter for continuous monitoring
- D. Titration of inhaled bronchodilators and corticosteroids
Correct Answer: B
Rationale: In a patient with acute respiratory failure and hypercapnia due to a COPD exacerbation, the most appropriate intervention is the initiation of non-invasive positive pressure ventilation (NIPPV). NIPPV helps improve ventilation and oxygenation by providing mechanical support to the patient's breathing without the need for endotracheal intubation. It can reduce the work of breathing, decrease carbon dioxide retention, and improve respiratory muscle function. This intervention is particularly beneficial for COPD exacerbations as it can help alleviate hypercapnia and hypoxemia, leading to improved outcomes and potentially reducing the need for invasive ventilation methods. Therefore, NIPPV is the recommended management strategy in this scenario.
During the first contact of the patient with the nurse, the latter should demonstrate the following behavior, which the EXCEPTION of _______.
- A. Caring
- B. Encouraging
- C. Comforting
- D. Compelling
Correct Answer: D
Rationale: During the first contact with a patient, a nurse should demonstrate caring, encouraging, and comforting behaviors. These qualities help create a positive and supportive environment for the patient. However, compelling behavior, which implies forcing or pressuring someone to do something, is not appropriate during the initial interaction with a patient. It is essential for the nurse to build trust and rapport with the patient, and compelling behavior can be counterproductive to establishing a nurturing relationship. Thus, compelling is the exception among the given choices for the nurse's behavior during the first contact with a patient.
A patient with a history of myocardial infarction is prescribed atorvastatin for lipid-lowering therapy. Which parameter should the nurse monitor closely during atorvastatin therapy?
- A. Serum potassium levels
- B. Liver function tests
- C. Blood glucose levels
- D. Serum sodium levels
Correct Answer: B
Rationale: Atorvastatin is a medication commonly used for lipid-lowering therapy to reduce cholesterol levels and decrease the risk of cardiovascular events. However, one of the potential side effects of statin medications such as atorvastatin is liver injury. Therefore, monitoring liver function tests, including alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, is crucial during atorvastatin therapy.
A woman in active labor experiences persistent fetal malposition, with the fetus in a transverse lie presentation. What nursing intervention should be prioritized to address this abnormal labor presentation?
- A. Facilitating external cephalic version (ECV)
- B. Assisting the mother into a hands-and-knees position
- C. Preparing for immediate instrumental delivery
- D. Initiating continuous electronic fetal monitoring
Correct Answer: B
Rationale: When a woman in active labor experiences persistent fetal malposition, such as a transverse lie presentation, assisting the mother into a hands-and-knees position is a nursing intervention to prioritize. This position can help encourage the fetus to rotate into a more favorable position for delivery, such as a head-down position. By placing the mother in a hands-and-knees position, gravity can assist in shifting the fetus to the correct position. This intervention is non-invasive and can be effective in promoting the progress of labor and avoiding the need for more invasive interventions like instrumental delivery or cesarean section. However, if the fetus does not rotate or if there are signs of fetal distress, further interventions may be necessary.
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