Nokea
A patient presents with a small, painless, well-defined nodule on the lateral aspect of the neck, just above the clavicle. Fine-needle aspiration cytology reveals clusters of polygonal cells with abundant granular cytoplasm. Which of the following conditions is most likely responsible for this presentation?
- A. Thyroglossal duct cyst
- B. Branchial cleft cyst
- C. Lymphadenopathy
- D. Parathyroid adenoma
Correct Answer: D
Rationale: The presentation described is characteristic of a parathyroid adenoma. Parathyroid adenomas are benign neoplasms that can present as painless, well-defined nodules usually located in the lower pole of the thyroid gland or in close proximity, such as the lateral aspect of the neck above the clavicle. Fine-needle aspiration cytology of a parathyroid adenoma typically reveals polygonal cells with abundant granular cytoplasm, often referred to as chief cells. This is key in differentiating it from other conditions mentioned in the question.
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A patient appears confused and disoriented during a consultation. What is the nurse's priority?
- A. Assume the patient is not capable of understanding and proceed with the consultation.
- B. Provide clear and simple explanations and assess for any underlying causes of confusion.
- C. Ignore the patient's confusion and proceed with the consultation.
- D. Dismiss the patient's confusion as insignificant and focus solely on the medical information.
Correct Answer: B
Rationale: The nurse's priority when a patient appears confused and disoriented during a consultation is to provide clear and simple explanations and assess for any underlying causes of confusion. It is essential to ensure that the patient understands the information being provided and to address any potential reasons for the confusion, such as medication side effects, medical conditions, or cognitive impairment. Ignoring the patient's confusion or assuming they cannot understand can lead to misunderstandings, errors in care, and ultimately jeopardize the patient's well-being. It is crucial to approach the situation with empathy, patience, and a focus on ensuring effective communication and understanding between the nurse and the patient.
For this patient who is to undergo surgery (closure of the sac), what would be the PRIORITY nursing diagnosis? It is risk for __________.
- A. Activity intolerance
- B. Infection
- C. Respiration
- D. Altered growth and development
Correct Answer: B
Rationale: The priority nursing diagnosis for a patient undergoing surgery (closure of the sac) would be risk for infection. This is because surgical procedures increase the risk of infection due to the breach in the skin and introduction of microorganisms. Infection can lead to serious complications, delay healing, and prolong recovery time. Therefore, prevention, early detection, and prompt treatment of infections are essential in the perioperative period to ensure the best possible outcomes for the patient.
Patient Sienna who seems to be irritated with the nurse said "I don't want to talk with you because you're only a nurse. I will wait for my doctor. " Which of the following should the nurse say I'm response to the patient?
- A. Your doctor prescribed this for us to do nursing care.
- B. I understand. I should call your doctor.
- C. I' m angry with the way you dismiss me.
- D. So then you would prefer to speak with your doctor?
Correct Answer: D
Rationale: It is important for the nurse to acknowledge the patient's preference and respect their choice. By responding with "So then you would prefer to speak with your doctor?" the nurse is showing understanding and willingness to accommodate the patient's request. This response helps to maintain a positive and respectful interaction with the patient.
The client has been "pesky," seeking the attention of nurses in the nurses' station much of the day. Now the nurse escorts the client to the room and tells the client to stay there or be put into seclusion. The nurse is threatening to give the client an injection in order to restrain the client for inappropriate behavior. This is an example of
- A. Abuse
- B. Assault
- C. False imprisonment
- D. Battery
Correct Answer: C
Rationale: False imprisonment is the act of improperly restraining another individual against their will. In this scenario, the nurse's threat of putting the client into seclusion and administering an injection to restrain them for inappropriate behavior constitutes false imprisonment. The client is being restricted in their movement without valid reason or proper procedure. This type of action is not acceptable in healthcare settings and violates the client's rights. It is important for healthcare professionals to use appropriate de-escalation techniques and interventions to manage challenging behaviors without resorting to threats of physical restraint.
A 28-year-old woman presents with cyclic pelvic pain, dysmenorrhea, and infertility. On pelvic examination, tender nodules are palpated along the uterosacral ligaments. Which of the following conditions is most likely to be responsible for these findings?
- A. Polycystic ovary syndrome (PCOS)
- B. Endometriosis
- C. Adenomyosis
- D. Leiomyomas (uterine fibroids)
Correct Answer: B
Rationale: Endometriosis is a chronic gynecologic condition characterized by the presence of endometrial-like tissue outside the uterus, commonly on structures within the pelvis. The classic symptoms of endometriosis include cyclic pelvic pain, dysmenorrhea (painful periods), and infertility. On pelvic examination, tender nodules or masses may be palpated along the uterosacral ligaments. These nodules are often referred to as "endometriotic implants" or "chocolate cysts." Endometriosis can cause inflammation, scarring, and adhesions in the pelvis, leading to symptoms such as pain and infertility. Polycystic ovary syndrome (PCOS) is characterized by ovarian dysfunction and hormonal imbalances, often leading to irregular periods and symptoms related to excess androgens. Adenomyosis is the presence of endometrial tissue within the myometrium of the uterus, leading