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: B

Rationale: T cell exhaustion is a state of T cell dysfunction that arises during chronic viral infections or cancer. In the case of a chronic viral infection, the persistent exposure to viral antigens leads to continuous stimulation of CD8+ cytotoxic T cells. Over time, this sustained stimulation can lead to T cell exhaustion, characterized by the upregulation of inhibitory receptors, impaired effector functions, and reduced proliferative capacity. As a result, despite the elevated levels of CD8+ T cells in the blood, their function may be compromised, ultimately impacting the immune response against the viral infection. In contrast, activation-induced cell death (AICD) may contribute to T cell loss during chronic infections but would not explain the persistently elevated CD8+ T cell levels. Thymic involution refers to the age-related decline in thymus function, which is not directly related to the observed increase in CD8+ T cells. Antigenic

Correct Answer: B

Rationale: Loop diuretics such as furosemide are commonly prescribed for the management of heart failure to reduce fluid overload and lower blood pressure by increasing the excretion of sodium and water. These medications promote the loss of potassium through increased urinary output. Hypokalemia, or low potassium levels in the blood, is the most common electrolyte imbalance associated with loop diuretic therapy. Potassium is an essential electrolyte for proper functioning of the heart, muscles, and nerves. Low potassium levels can lead to symptoms such as muscle weakness, cramps, and potentially life-threatening cardiac arrhythmias. Patients on loop diuretics are often monitored for potassium levels, and sometimes potassium supplements may be prescribed to prevent or correct hypokalemia.

Correct Answer: D

Rationale: When administering Rilutek (riluzole), the medication should be taken with food. This is because taking Rilutek with food helps to reduce the likelihood of experiencing stomach upset as a side effect. Administering the medication on an empty stomach may increase the risk of gastrointestinal issues such as nausea, vomiting, or stomach pain. Therefore, it is recommended to administer Rilutek with food to ensure better tolerability for the patient.

Correct Answer: B

Rationale: Educating the client about the "baby blues" phenomenon should be prioritized as it is a common occurrence that happens to many women after giving birth. The "baby blues" refer to feelings of sadness, irritability, and tearfulness that many new mothers experience due to hormonal changes and the stress of adjusting to motherhood. By understanding that these feelings are a normal part of the postpartum period and that they usually resolve on their own within a few weeks, the client may feel reassured and supported. Providing information and support can help the client cope with these emotions and reduce any anxiety or distress they may be feeling. If the client's emotional state does not improve or becomes more severe, further intervention such as referring to a mental health professional may be necessary. But initially, education and reassurance about the "baby blues" can be an effective nursing intervention to address the client's emotional well-being.