A patient presents with a thyroid nodule and signs of compression such as difficulty swallowing and breathing. Fine-needle aspiration biopsy reveals lymphocytic infiltration and germinal centers. Which endocrine disorder is most likely responsible for these symptoms?

Correct Answer: A

Rationale: Hashimoto's thyroiditis is an autoimmune disorder characterized by chronic inflammation of the thyroid gland. In this condition, lymphocytic infiltration and germinal centers can be seen in the thyroid tissue. This inflammation can lead to the formation of thyroid nodules and enlargement of the thyroid gland, causing symptoms such as difficulty swallowing and breathing due to compression of surrounding structures. Additionally, Hashimoto's thyroiditis can result in hypothyroidism over time, further contributing to the symptoms. Therefore, the patient in this case is most likely experiencing these symptoms due to Hashimoto's thyroiditis. Graves' disease, on the other hand, typically presents with hyperthyroidism and is less likely to manifest as compressive symptoms of the thyroid gland.

Correct Answer: D

Rationale: If a nurse notices a discrepancy between the surgical count and the number of instruments on the sterile field during surgery, it is crucial to inform the surgical team immediately and initiate a thorough search. Patient safety is of utmost importance, and any missing instruments could potentially pose a risk to the patient. By informing the team and conducting a thorough search, the missing instrument can be located promptly to ensure it is not inadvertently left inside the patient's body. Continuing with the procedure or ignoring the discrepancy without further investigation could lead to serious consequences for the patient's well-being. It is always better to address any discrepancies or concerns during surgery proactively to maintain a high standard of patient care and safety.

Correct Answer: C

Rationale: Nonverbal communication consists of gestures, facial expressions, body language, posture, tone of voice, touch, and eye contact, among other behaviors. Option C, words representing an object, refers to verbal communication rather than nonverbal communication. Nonverbal communication is the behavior that accompanies verbal communication, providing additional layers of meaning and adding context to the spoken words. Therefore, words representing an object are not indicators of nonverbal communication.

Correct Answer: D

Rationale: In a situation where a nurse administers the wrong medication to a patient resulting in harm, both the nurse and the physician can be held liable for their respective roles in the error. The nurse is responsible for administering the incorrect medication, which is a violation of their duty to provide safe and appropriate care. However, the physician is also responsible because they failed to review the patient's documentation indicating the allergy to the medication before ordering it. As healthcare professionals, both the nurse and the physician have a duty of care to ensure patient safety, and in this case, both individuals failed in their responsibilities, leading to the harm caused to the patient. Therefore, both the nurse and the physician can be held accountable for the error.

Correct Answer: C

Rationale: Placenta previa is a condition in pregnancy where the placenta implants low in the uterus, partially or completely covering the cervix. This can lead to painless, bright red vaginal bleeding in the third trimester. However, in some cases, placenta previa can also present with sudden onset of severe lower abdominal pain and signs of shock, such as syncope, pallor, and abdominal distention due to concealed bleeding. In severe cases, the bleeding can be significant and life-threatening for both the mother and the baby. It is important to promptly diagnose and manage placenta previa to prevent complications.

Correct Answer: C

Rationale: Bruxism is the dental condition characterized by the involuntary grinding or clenching of teeth, often occurring during sleep. This habitual behavior can lead to tooth wear, muscle pain, headaches, and temporomandibular joint dysfunction. Dental caries (choice A) refers to tooth decay, while attrition (choice B) specifically refers to the wearing down of teeth due to forces like chewing. Periodontitis (choice D) is a condition involving inflammation and infection of the gums and supporting structures of the teeth. Among the choices provided, bruxism is the most fitting description for the condition characterized by tooth grinding and clenching.

Correct Answer: D

Rationale: The presentation described in the question – sudden-onset unilateral headache along with ipsilateral ptosis, miosis, and anhidrosis – is characteristic of Horner syndrome. Horner syndrome is caused by disruption of the sympathetic nerve pathway and can occur in trigeminal neuralgia. Trigeminal neuralgia is a painful condition affecting the trigeminal nerve commonly characterized by sudden and severe facial pain that can be triggered by various stimuli. The involvement of the sympathetic pathway in trigeminal neuralgia can lead to Horner syndrome symptoms such as ptosis (drooping eyelid), miosis (constricted pupil), and anhidrosis (lack of sweating) on the affected side of the face. Cluster headaches usually involve severe unilateral pain around the eye, but they do not typically present with Horner syndrome symptoms. Migraine and tension-type headaches also do not typically present with Horner syndrome symptoms.

Correct Answer: C

Rationale: The most appropriate action for a concerned nurse when nurses are projected as sex symbols in a television advertisement is to make a position paper to denounce the advertisement. This approach allows the nurse to voice their concerns in a formal and professional manner. By creating a position paper, the nurse can clearly outline why the portrayal is inappropriate and advocate for more respectful representations of nursing in the media. This action is constructive, proactive, and focuses on initiating change through advocacy and education. It is a thoughtful and strategic way to address the issue and raise awareness about the importance of respecting the nursing profession.

Correct Answer: C

Rationale: The described presentation of a yellowish-white spot on the cornea with a ring of inflammation, along with branching, filamentous opacities extending from the corneal lesion, is characteristic of fungal keratitis. Fungal keratitis typically presents with these specific features on clinical examination.