A patient presents with a thyroid nodule and signs of hyperthyroidism. Fine-needle aspiration biopsy reveals spindle-shaped cells and psammoma bodies. Which endocrine disorder is most likely responsible for these symptoms?

Correct Answer: C

Rationale: The presence of spindle-shaped cells and psammoma bodies on fine-needle aspiration biopsy is characteristic of follicular thyroid carcinoma. This type of thyroid cancer can present as a thyroid nodule associated with signs of hyperthyroidism due to the release of thyroid hormones from the cancerous thyroid cells. Hashimoto's thyroiditis is an autoimmune condition that typically presents with hypothyroidism, while Graves' disease is another autoimmune disorder that results in hyperthyroidism but is not associated with the presence of spindle-shaped cells and psammoma bodies in this context. Papillary thyroid carcinoma may also present with thyroid nodules, but it is more commonly associated with papillary structures and nuclear features rather than spindle-shaped cells seen in follicular thyroid carcinoma.

Correct Answer: C

Rationale: The most likely causative agent in this scenario is Borrelia burgdorferi, which is the bacterium responsible for causing Lyme disease. The classic presentation of Lyme disease includes fever, malaise, and a skin lesion resembling a "bull's eye" rash, known as erythema migrans. This rash typically appears at the site of a tick bite. If left untreated, Lyme disease can progress to involve multiple organ systems and lead to more severe complications. Plasmodium falciparum is the causative agent of malaria, which typically presents with symptoms such as fever, chills, and fatigue, but it does not cause a "bull's eye" rash. Trypanosoma cruzi is the parasite responsible for Chagas disease, which presents with symptoms such as fever, swelling at the site of entry (typically the bite wound), and enlarged lymph nodes, but it does not

Correct Answer: C

Rationale: After formulating and delimiting the research problem, the priority action would be to plan the research design of the study. This is crucial because the research design will outline the specific methods and procedures that Gloria will use to investigate the research problem and answer the research questions. Planning the research design involves determining the overall structure of the study, selecting the appropriate research methods, and outlining how data will be collected and analyzed. This step is essential for ensuring that the study is well-organized, rigorous, and will yield reliable results. Developing a solid research design early on will set a strong foundation for the rest of the research process.

Correct Answer: C

Rationale: Medico-legal charts are typically stored for a minimum of 10 years after the case is closed to ensure compliance with legal requirements and to provide a comprehensive record of the medical care provided. This duration allows for potential future reference, follow-up treatment, or legal purposes that may arise within the specified timeframe. It is important to maintain these records for an extended period to protect both the patient's rights and the healthcare provider's accountability. Additionally, storing medico-legal charts for 10 years aligns with standard retention practices in the healthcare industry.

Correct Answer: C

Rationale: Uterine rupture is the most likely cause of these symptoms in a pregnant woman presenting with sudden onset of severe abdominal pain, vaginal bleeding, rigidity of the abdomen, and palpable fetal parts abdominally. Uterine rupture is a rare but serious complication of pregnancy, typically occurring during labor in women with a previous cesarean delivery or other uterine scars. The sudden onset of severe abdominal pain can be associated with vaginal bleeding due to the tearing of the uterine wall, causing fetal parts to be palpable abdominally. This is a life-threatening emergency that requires immediate medical intervention. Ectopic pregnancy, pelvic inflammatory disease, and ovarian torsion may present with abdominal pain and vaginal bleeding but would not typically present with palpable fetal parts abdominally in a pregnant woman.

Correct Answer: A

Rationale: Myxedema is a severe form of hypothyroidism that is characterized by the accumulation of mucopolysaccharides in subcutaneous and other interstitial tissues. This condition leads to puffiness, swelling, and thickening of the skin, giving it a waxy appearance. Other symptoms of myxedema include fatigue, weight gain, cold intolerance, and hair loss. It is important to recognize and treat myxedema promptly as it can lead to serious complications such as myxedema coma, which is a life-threatening condition requiring immediate medical attention.

Correct Answer: C

Rationale: A living will is a legal document that outlines a person's preferences and wishes regarding medical treatment, including resuscitation, in the event they become unable to communicate or make decisions. In this scenario, the client being admitted to the oncology unit wants to convey his wishes regarding resuscitation in case of cardiopulmonary arrest. A living will helps ensure that these wishes are known and respected by healthcare providers and loved ones. While a will addresses how a person's assets should be distributed after death and a health care power of attorney designates someone to make medical decisions on the person's behalf, a living will specifically focuses on healthcare preferences and treatment decisions. A proxy directive is similar to a health care power of attorney, designating someone to make healthcare decisions for the person if they are unable to do so themselves.

Correct Answer: C

Rationale: The correct response would be "Absorption of iron is enhanced with Vitamin C." Iron absorption is increased in the presence of Vitamin C. Therefore, recommending Evelyn to take her iron supplement with a source of Vitamin C such as orange juice or a Vitamin C tablet would optimize the absorption of iron in her body and help prevent maternal anemia more effectively. Taking iron with other vitamins separately, after a full meal, or with milk would not have the same beneficial effect on iron absorption as combining it with Vitamin C.

Correct Answer: D

Rationale: A trimalleolar fracture is characterized by fractures involving the lateral malleolus (distal fibula), medial malleolus (distal tibia), and the posterior tubercle of the distal tibia. This fracture pattern results in instability of the ankle joint and is often associated with widening of the ankle mortise on X-ray. The deformity and swelling seen in this patient are indicative of a trimalleolar fracture and are typically caused by a high-energy injury, such as a forceful twisting motion. Treatment for trimalleolar fractures often involves surgical intervention to stabilize the ankle joint and restore normal function.