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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.
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A patient admitted to the ICU develops delirium characterized by acute onset confusion and agitation. What intervention should the healthcare team prioritize to manage the patient's delirium?
- A. Administer antipsychotic medications to reduce agitation.
- B. Implement environmental modifications to promote orientation.
- C. Refer the patient to a psychiatrist for further evaluation.
- D. Prescribe benzodiazepines for sedation and calming effect.
Correct Answer: B
Rationale: The healthcare team should prioritize implementing environmental modifications to promote orientation in a patient with delirium. Delirium is a state of acute confusion and agitation that can be triggered by various factors such as medications, infections, or metabolic disturbances. Environmental modifications involve creating a calm, quiet, and well-lit environment for the patient. Promoting proper orientation through the use of clocks, calendars, and familiar objects can help reduce confusion and improve the patient's understanding of their surroundings. These interventions are non-pharmacological and aim to address the underlying causes of delirium while minimizing the need for additional medications that may have potential side effects. Antipsychotic medications and benzodiazepines should be used judiciously and under close supervision due to the risk of adverse effects in older adults and critically ill patients. Referring the patient to a psychiatrist may be considered if the delirium is complex or if there are underlying psychiatric issues contributing to the presentation.
A woman in active labor is experiencing meconium-stained amniotic fluid. What is the nurse's priority action?
- A. Administer oxygen to the mother.
- B. Prepare for immediate delivery.
- C. Insert a urinary catheter to monitor urine output.
- D. Notify the neonatal resuscitation team.
Correct Answer: B
Rationale: Meconium-stained amniotic fluid indicates that the fetus may have passed stool in utero, which can lead to potential respiratory problems once born due to meconium aspiration. The priority action for the nurse in this situation is to prepare for immediate delivery to expedite the removal of the fetus from the contaminated environment and provide necessary interventions such as suctioning of the airway to prevent aspiration of meconium. Prompt delivery is crucial to minimize the risk of complications related to meconium aspiration syndrome. Administering oxygen, inserting a urinary catheter, and notifying the neonatal resuscitation team can be important subsequent actions, but the immediate focus should be on delivering the baby.
As a nurse you are guided that pain is usually described BEST as a phenomenon which is a ________.
- A. Neurologic activation nociceptors
- B. Subjective unpleasant experience
- C. Adaptive mechanism to a stimulus
- D. Creation of one's imagination
Correct Answer: B
Rationale: Pain is best described as a subjective unpleasant experience because it is unique to each individual and is influenced by a variety of factors including emotional, psychological, and cultural elements. Pain cannot be objectively measured or quantified, and therefore it is considered a subjective experience that is reported by the person experiencing it. This is why pain is often assessed using self-report scales and tools to capture the individual's perception of their pain intensity and quality.
A patient expresses concerns about the potential side effects of a prescribed medication. What is the nurse's best approach to address these concerns?
- A. Dismiss the patient's concerns and reassure them that side effects are unlikely.
- B. Provide the patient with accurate information about potential side effects and management strategies.
- C. Ignore the patient's concerns and focus solely on administering the medication.
- D. Tell the patient that side effects are common and unavoidable.
Correct Answer: B
Rationale: The nurse's best approach to address a patient's concerns about the potential side effects of a prescribed medication is to provide the patient with accurate information about potential side effects and management strategies. It is important for the nurse to acknowledge the patient's concerns, listen attentively, and offer clear explanations to help alleviate any fears or uncertainties. Providing accurate information can empower the patient to make informed decisions about their healthcare and feel more confident in taking the prescribed medication. Dismissing or ignoring the patient's concerns can lead to mistrust and non-adherence to the treatment plan. It is essential for the nurse to prioritize open communication and patient education to ensure the patient's well-being and compliance with the prescribed medication regimen.
times. II before removing from the shelf. III before measuring actual dose. IV before opening a unit dose-container.
- A. II & III
- B. I, II & III
- C. I & II
- D. I, II, III, & IV
Correct Answer: D
Rationale: It is important to check the medication label against the medication order before administering any medication to ensure accuracy.