A 22-year-old woman presents with cyclic pelvic pain, dysmenorrhea, and infertility. On pelvic examination, the uterus is retroverted and enlarged. Which of the following conditions is most likely to be responsible for these findings?

Correct Answer: B

Rationale: Adenomyosis is a condition characterized by the presence of endometrial tissue within the myometrium (muscle wall) of the uterus. It can present with symptoms such as cyclic pelvic pain, dysmenorrhea (painful periods), and infertility. On pelvic examination, the uterus may be retroverted (tilted backward) and enlarged due to the presence of adenomyotic nodules within the uterine muscle. Adenomyosis can also cause heavy menstrual bleeding (menorrhagia). Endometriosis, on the other hand, involves the presence of endometrial tissue outside the uterus and can cause similar symptoms but is less likely to result in uterine enlargement or retroversion. Leiomyomas (uterine fibroids) are benign tumors of the uterine muscle and can also cause pelvic pain and abnormal uterine enlargement but are less likely to be associated with dysmenorrhea and infertility

Correct Answer: C

Rationale: The pancreas is the structure responsible for producing digestive enzymes and bicarbonate-rich pancreatic juice. These enzymes aid in the breakdown of carbohydrates, fats, and proteins in the small intestine to facilitate the absorption of nutrients. The pancreas plays a crucial role in the process of digestion, making it an essential organ in the digestive system. The liver is primarily involved in producing bile to aid in the digestion of fats, the gallbladder stores bile produced by the liver, and the spleen is involved in filtering the blood and storing blood cells.

Correct Answer: D

Rationale: An elevation of blood pressure would warrant stoppage of pills. High blood pressure, or hypertension, in a 4-year-old child is abnormal and needs prompt medical attention. Giving pills without monitoring or stopping them if blood pressure is elevated can lead to serious health complications. It is important to address the underlying cause of high blood pressure in a child, which may require further evaluation and management by a healthcare provider.

Correct Answer: B

Rationale: When a patient with chronic kidney disease is prescribed erythropoietin-stimulating agents (ESAs) for anemia management, the parameter that should be monitored closely by the nurse is the hemoglobin levels. Hemoglobin levels indicate the patient's response to ESA therapy and are essential in assessing the effectiveness of the treatment in addressing anemia. Monitoring hemoglobin levels helps ensure that the patient's anemia is controlled within the target range to avoid both the risks of under-treatment (resulting in persistent anemia) and over-treatment (increased risk of adverse outcomes such as hypertension, stroke, or cardiovascular events).

Correct Answer: D

Rationale: The patient is presenting with symptoms and laboratory findings consistent with a paraneoplastic syndrome related to Hodgkin lymphoma. In this case, the fever, chills, generalized malaise, pancytopenia, circulating Reed-Sternberg cells, and bone marrow involvement are all indicative of a paraneoplastic syndrome associated with Hodgkin lymphoma. Paraneoplastic syndromes are a group of disorders that are triggered by an abnormal immune response to a neoplasm, such as Hodgkin lymphoma, leading to various systemic manifestations.

Correct Answer: A

Rationale: In delegation, facilitating the professional growth and development of a staff is necessary because it allows team members to gain new skills and experience, leading to overall improved productivity and job satisfaction. This empowers staff and helps them feel more engaged in their work, ultimately benefiting the entire unit. Effective delegation should aim to support individuals in their roles, encourage learning, and build competence, rather than modifying standards of care or only delegating tasks without considering individual growth. Starting delegation from top management to staff-nurse level may not always be practical or efficient, as delegation should be based on competencies and responsibilities. Accountability is indeed a crucial aspect of delegation, as individuals should be held responsible for the tasks they are delegated. However, without providing opportunities for professional growth and development, delegation may not be as effective in achieving organizational goals.

Correct Answer: D

Rationale: Quantitative research is the type of research that involves collecting numerical data, which can be easily quantified and analyzed statistically. It is characterized by its structured methodology, objectivity, and the ability to control variables to a considerable extent. In the context of a study on sleep, where data related to sleep patterns, duration, quality, etc., need to be measured and analyzed in a systematic manner, quantitative research would be the most appropriate choice. This type of research allows for a more precise understanding of the relationships and patterns within the data, providing valuable insights into the sleep-related factors being studied.

Correct Answer: A

Rationale: Polycystic ovary syndrome (PCOS) is a common hormonal disorder in women of reproductive age. The classic symptoms of PCOS include irregular menstrual cycles, hirsutism (excess hair growth in a male pattern), and acne. Women with PCOS often have enlarged ovaries with multiple small cysts. Other common features include obesity, insulin resistance, and infertility. Endometriosis is characterized by the presence and growth of endometrial-like tissue outside the uterus, leading to symptoms such as pelvic pain and infertility. Ovarian cancer usually presents with nonspecific symptoms and is less likely in a young woman with these specific symptoms. Uterine fibroids are benign tumors that can cause heavy menstrual bleeding and pelvic pressure but are less likely to be associated with hirsutism and acne.

Correct Answer: B

Rationale: The nurse's best approach to address the patient's fear of pain is to provide accurate information about pain management strategies and options. In doing so, the nurse can help alleviate the patient's concerns by empowering them with knowledge and potential solutions for managing pain during and after the procedure. By acknowledging the patient's fear and addressing it with practical information, the nurse can build trust, reduce anxiety, and create a more supportive and collaborative environment for the patient. Dismissing, ignoring, or invalidating the patient's fear would not be effective in addressing the underlying concerns and could potentially lead to increased distress and resistance to the recommended procedure.