A patient presents with a thyroid nodule and compressive symptoms such as difficulty swallowing and breathing. Fine-needle aspiration biopsy reveals colloid nodules. Which endocrine disorder is most likely responsible for these symptoms?

Correct Answer: D

Rationale: Thyroid nodules are abnormal growths of thyroid cells that form a lump within the thyroid gland. When a thyroid nodule becomes large enough, it can cause compressive symptoms such as difficulty swallowing and breathing. The presence of colloid nodules on fine-needle aspiration biopsy indicates a benign and common type of thyroid nodule. In this case, the symptoms are likely due to the physical pressure exerted by the thyroid nodule, rather than an underlying endocrine disorder like Hashimoto's thyroiditis, Graves' disease, or diabetes mellitus. Therefore, the most likely cause of the patient's symptoms is the thyroid nodule itself.

Correct Answer: D

Rationale: Takotsubo cardiomyopathy, also known as stress-induced cardiomyopathy or broken heart syndrome, presents with symptoms similar to acute coronary syndrome, such as chest pain and ECG changes. In Takotsubo cardiomyopathy, chest pain typically occurs during emotional stress and resolves spontaneously, similar to the scenario described in the question. The ECG may show transient ST-segment elevation. This condition is characterized by a reversible left ventricular dysfunction that can mimic a myocardial infarction. Unlike stable angina (Choice A) and unstable angina (Choice B), Takotsubo cardiomyopathy is not related to coronary artery disease. Acute myocardial infarction (Choice C) typically presents with persistent ST-segment elevation on ECG and is caused by atherosclerotic plaque rupture leading to myocardial infarction, which is not consistent with the transient ST-segment elevation seen in

Correct Answer: D

Rationale: The clinical presentation of chest pain, dyspnea, and a friction rub heard on auscultation is suggestive of pericarditis. The diffuse ST-segment elevation seen on the electrocardiogram (ECG) is a classic finding in pericarditis, known as the "universal sign." In contrast, stable angina typically presents with chest pain on exertion that is relieved by rest or nitroglycerin, while unstable angina presents with chest pain at rest or with minimal exertion. Acute myocardial infarction would typically present with ST-segment elevation in specific leads correlating with the area of myocardial ischemia/infarction. However, in the context of diffuse ST-segment elevation and symptoms suggestive of inflammation (friction rub), the most likely diagnosis is pericarditis.

Correct Answer: B

Rationale: The most appropriate intervention for a patient with difficulty swallowing due to end-stage ALS and concerns about choking is to refer the patient to a speech therapist for swallowing exercises and techniques (Choice B). Speech therapists are trained to assess and manage swallowing difficulties in patients, especially those with neurodegenerative diseases like ALS. They can provide specific exercises and strategies to help the patient swallow safely and reduce the risk of choking. This intervention focuses on addressing the underlying issue causing the difficulty swallowing and aims to improve the patient's quality of life by enhancing their ability to eat and drink. The other options are not as effective or appropriate in addressing the patient's concerns.

Correct Answer: C

Rationale: The most effective intervention to prevent pressure ulcers in bedbound patients at risk, such as those with advanced dementia, is to use pressure-relieving support surfaces like specialized mattresses or cushions. These surfaces help distribute the pressure evenly, reducing the risk of pressure ulcer formation on bony prominences. Turning the patient every 2 hours (choice A) can also help relieve pressure, but it may not be sufficient to prevent pressure ulcers in high-risk individuals. Applying barrier creams or moisture barriers (choice B) can help protect the skin but may not address the underlying issue of pressure on vulnerable areas. Administering prophylactic antibiotics (choice D) is not recommended for preventing pressure ulcers as it does not address the root cause of the problem and can lead to antibiotic resistance. Therefore, the priority intervention should be to use pressure-relieving support surfaces to minimize the risk of pressure ulcers in