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: A

Rationale: The patient's symptoms of chest pain occurring during heavy lifting or physical exertion and being relieved by rest are classic characteristics of stable angina. Stable angina is caused by transient myocardial ischemia due to a fixed coronary artery obstruction. Typically, the pain is predictable and reproducible, occurring with exertion and relieved by rest. The transient ST-segment depression on ECG is also a common finding in stable angina, reflecting myocardial ischemia during episodes of chest pain.

Correct Answer: C

Rationale: The palliative nurse's most appropriate response in this scenario is to offer empathetic listening and explore the patient's concerns about the future. By providing a compassionate and supportive environment for the patient to express their fears and anxieties, the nurse can help the patient feel heard and understood. This approach allows the nurse to address the patient's emotional needs and provide appropriate support to help them cope with their feelings. Avoiding discussions or minimizing the patient's concerns may invalidate their emotions and hinder the therapeutic relationship. Encouraging distraction techniques or focusing solely on positive thoughts may not address the underlying fears and anxieties that the patient is experiencing. Therefore, offering empathetic listening and exploring the patient's concerns is the most appropriate way for the nurse to provide holistic care for the patient with advanced heart failure.

Correct Answer: A

Rationale: The most appropriate intervention for the palliative nurse to prioritize in this situation is to arrange for family members or loved ones to be present at the patient's bedside. Having loved ones nearby can provide emotional support, comfort, and reassurance to the patient during their final moments. This can help alleviate the fear and anxiety the patient is experiencing about dying alone. Additionally, it can contribute to a sense of connectedness and peace for both the patient and their loved ones during this challenging time. Offering practical solutions to address the patient's emotional needs is key in providing holistic palliative care.

Correct Answer: B

Rationale: The palliative nurse should prioritize performing thoracentesis to drain the pleural fluid and relieve dyspnea in a patient with terminal cancer experiencing pleural effusion. Pleural effusion is a common complication in patients with advanced cancer and can cause significant respiratory distress. Drainage of the pleural fluid through thoracentesis can provide immediate relief by easing the pressure on the lungs and improving the patient's ability to breathe. This intervention is essential in managing dyspnea for comfort and quality of life in palliative care settings. Administering bronchodilator medications (option A) or recommending non-invasive positive pressure ventilation (option C) may not directly address the underlying cause of dyspnea in this case. While relaxation techniques (option D) can help with anxiety and overall well-being, they may not be sufficient in managing the physical symptom of dyspnea caused by pleural effusion.