A 45-year-old woman presents with heavy menstrual bleeding and iron deficiency anemia. On pelvic examination, the uterus is enlarged, and multiple irregularly shaped masses are palpated. Which condition is most likely to be responsible for these findings?

Correct Answer: A

Rationale: The clinical presentation of heavy menstrual bleeding, iron deficiency anemia, an enlarged uterus, and irregularly shaped masses palpated on pelvic examination is most indicative of leiomyomas, also known as uterine fibroids. Leiomyomas are benign smooth muscle tumors that commonly occur in women of reproductive age. They can lead to heavy menstrual bleeding and iron deficiency anemia due to their size and location within the uterus. On pelvic examination, leiomyomas can be felt as irregularly shaped masses within the uterine wall. This presentation is classic for leiomyomas and distinguishes them from conditions such as endometrial polyps, endometrial hyperplasia, and adenomyosis.

Correct Answer: A

Rationale: IgA is the primary immunoglobulin class involved in providing passive immunity to newborn infants through breast milk. IgA antibodies are highly concentrated in colostrum and breast milk, offering important protection to newborns against infections. IgG antibodies can also be passed from the mother to the fetus through the placenta, providing passive immunity during pregnancy, but IgA is the main immunoglobulin class transferred through breast milk for protecting the infant's gastrointestinal and respiratory tracts. IgE is mainly involved in allergies and hypersensitivity reactions, while IgM is an early responder in the immune response to infections.

Correct Answer: A

Rationale: The statement "I will have to avoid drinking nonalcoholic beer" indicates a potential misunderstanding as nonalcoholic beer is generally permitted on most diets. The client may need further teaching to clarify this misconception. The other statements indicate a good understanding of the dietary guidelines and do not raise concerns about misunderstanding.

Correct Answer: D

Rationale: The nurse should respect the patient's autonomy and collaborate on alternative treatment options. It is essential to honor the patient's cultural beliefs and preferences while also seeking to find a solution that aligns with the healthcare provider's recommendations. By working together with the patient to explore alternative treatment options that are acceptable within the patient's cultural framework, the nurse can promote patient-centered care and foster a trusting relationship with the patient.Ignoring or dismissing the patient's cultural beliefs can lead to decreased patient adherence and trust in the healthcare provider. Providing education and information to help the patient understand the treatment benefits is important, but it should be done in a way that respects the patient's autonomy and cultural perspective.

Correct Answer: A

Rationale: The patient is most likely experiencing Type 1 diabetes mellitus based on the presentation of polyuria, polydipsia, polyphagia, hyperglycemia, and glycosuria. Type 1 diabetes is characterized by autoimmune destruction of the beta cells in the pancreas, leading to absolute insulin deficiency. This results in high blood sugar levels (hyperglycemia) and glucose spilling into the urine (glycosuria). Patients with Type 1 diabetes often present with the classic symptoms of polyuria (increased urination), polydipsia (increased thirst), and polyphagia (increased hunger) due to the body's inability to utilize glucose for energy effectively. Management of Type 1 diabetes typically involves lifelong insulin therapy to maintain blood sugar levels within a target range.

Correct Answer: A

Rationale: The clinical presentation of severe lower abdominal pain and vaginal bleeding in a pregnant woman, along with cervical motion tenderness, unilateral adnexal tenderness, and an adnexal mass on the affected side, is highly concerning for an ectopic pregnancy. Ectopic pregnancy occurs when a fertilized egg implants outside the uterus, most commonly in the fallopian tube. The presence of an adnexal mass and tenderness on one side is indicative of potential tubal involvement and can mimic symptoms of pelvic inflammatory disease. Prompt evaluation and management are crucial in ectopic pregnancy to prevent life-threatening complications associated with rupture of the fallopian tube.

Correct Answer: A

Rationale: Long-term corticosteroid use in patients with rheumatoid arthritis can lead to osteoporosis, which is a common complication. Osteoporosis causes weakening of the bones, increasing the risk of fractures, particularly in weight-bearing bones such as the hip, spine, and wrist. Osteoporotic fractures are a significant concern in patients on long-term corticosteroid therapy, highlighting the importance of monitoring bone health and considering preventive measures such as calcium, Vitamin D supplementation, and regular bone density testing. While osteonecrosis of the femoral head and avascular necrosis of the talus can also occur as complications of corticosteroid use, osteoporotic fractures are more commonly associated with this type of therapy in patients with rheumatoid arthritis. Septic arthritis, on the other hand, is not directly related to corticosteroid use but can occur due to other factors such as joint infections.

Correct Answer: B

Rationale: The correct action for the nurse to ensure patient safety during a bedside bronchoscopy procedure is to obtain informed consent from the patient or their legal representative. Informed consent is a vital ethical and legal requirement before any medical procedure. It ensures that the patient understands the risks, benefits, and alternatives of the procedure, as well as gives the patient the authority to make decisions about their healthcare. By obtaining informed consent, the nurse ensures that the patient has been properly informed and agrees to undergo the bronchoscopy, which promotes patient autonomy and safety. Administering sedation, using topical anesthesia, and restricting food intake are also important aspects of bronchoscopy preparation, but obtaining informed consent is the primary action to prioritize patient safety.

Correct Answer: D

Rationale: Administering oxygen therapy is the priority nursing intervention for managing a patient with COPD experiencing respiratory distress. In COPD, the patient's lungs are less efficient at oxygen exchange, leading to hypoxemia. Oxygen therapy helps improve oxygenation in the body and alleviates respiratory distress in these patients. Positioning the patient in high Fowler's position can also help improve lung expansion, but providing supplemental oxygen takes precedence in addressing the underlying hypoxemia. Administering bronchodilators and performing chest physiotherapy aim to manage airway obstruction and promote airway clearance, but ensuring the patient has adequate oxygenation is crucial in the immediate management of respiratory distress in COPD.