A patient presents with a thyroid nodule and signs of compression such as difficulty swallowing and breathing. Fine-needle aspiration biopsy reveals malignant cells with nuclear features suggestive of papillary thyroid carcinoma. Which endocrine disorder is most likely responsible for these symptoms?

Correct Answer: D

Rationale: Papillary thyroid carcinoma is a type of thyroid cancer that arises from follicular cells of the thyroid gland. It often presents as a thyroid nodule that can cause symptoms of compression due to its enlarging size. The compression symptoms, such as difficulty swallowing and breathing in this case, occur when the thyroid nodule becomes large enough to press on adjacent structures in the neck. Fine-needle aspiration biopsy can confirm the presence of malignant cells with nuclear features typical of papillary thyroid carcinoma, further supporting the diagnosis.

Correct Answer: A

Rationale: The correct instruction that the nurse should include in patient education about phosphate binder therapy is to "Take phosphate binders with meals." Phosphate binders are medications given to patients with chronic kidney disease to help control high phosphate levels in the blood. Taking phosphate binders with meals allows them to bind to the phosphorus present in the food, reducing its absorption in the body. This helps to lower blood phosphate levels effectively. Instructing the patient to take phosphate binders with meals ensures optimal binding of phosphorus from the diet, which is crucial for managing phosphate levels in patients with chronic kidney disease.

Correct Answer: C

Rationale: Globulin is the blood protein involved in the immune system. There are different types of globulins, including immunoglobulins (antibodies) that play a crucial role in the body's defense against infections. These antibodies bind to foreign substances, such as bacteria and viruses, helping the immune system to recognize and destroy them. Thrombin is a clotting protein, albumin is a protein responsible for maintaining osmotic balance in the blood, and hemoglobin is a protein found in red blood cells that carries oxygen.

Correct Answer: B

Rationale: Being assertive means expressing one's thoughts, beliefs, and feelings in a confident and respectful manner while also considering the perspective of others. It does not involve pushing control on others. Assertive individuals do not impose their beliefs on others but express themselves clearly and confidently, respecting the opinions of others. So, standing up for what one believes in can be assertive, but pushing control on others is not a characteristic of assertiveness.

Correct Answer: B

Rationale: Medical records are typically required to be retained for a certain period of time as mandated by legal and regulatory requirements. The retention period for medical records is generally between 5 to 10 years, depending on the jurisdiction and specific regulations governing healthcare facilities. Keeping medical records for this duration ensures that they are available for reference, audits, legal purposes, and continuity of care for patients. Storing medical records for an adequate length of time also helps in ensuring continuity of care and tracking patients' medical history over time, which is crucial for quality healthcare delivery. Therefore, storing charts in the Medical Records or storage room for at least 5-10 years aligns with standard practices in healthcare compliance and patient care.

Correct Answer: C

Rationale: The correct statement regarding the use of decongestant nasal sprays is that "Nasal sprays should not be used for more than three days because it can worsen congestion." Prolonged use of decongestant nasal sprays can lead to rebound congestion, where the congestion worsens with extended use. Therefore, it is important to limit the use of these sprays to avoid this side effect. It is recommended to use decongestant nasal sprays for no longer than three consecutive days.

Correct Answer: C

Rationale: The most appropriate intervention for the palliative nurse to prioritize in this situation is to offer emotional support and validate the patient's feelings about body image changes. End-stage renal disease can lead to significant physical changes such as edema and weight gain, which can impact a patient's body image and self-esteem. By providing emotional support and validating the patient's feelings, the nurse can help address the patient's distress and concerns, improving their overall psychological well-being. While providing education on dietary modifications (choice B) and prescribing diuretic medications (choice D) may be important aspects of managing fluid retention and edema, addressing the patient's emotional distress and body image concerns should be the initial priority in a palliative care setting. Encouraging the patient to accept their body changes (choice A) may overlook the emotional impact these changes have on the patient, making choice C the most appropriate intervention.

Correct Answer: A

Rationale: Molluscum contagiosum is a viral skin infection caused by the poxvirus. It typically presents as multiple, flesh-colored, dome-shaped papules with a central umbilication (dimple or depression in the center) on the skin. These lesions are often found on the trunk and extremities and can persist for several months. Molluscum contagiosum is commonly seen in children but can also occur in adults, especially those with weakened immune systems. The lesions are usually asymptomatic but can become inflamed or itchy in some cases. Treatment options include observation, topical therapies, cryotherapy, or curettage.

Correct Answer: C

Rationale: Conducting a staff meeting is the best strategy for Nurse Nena to give feedback on patients' evaluation of health services. This option allows for direct communication and interaction with the team, ensuring that feedback is effectively conveyed, discussed, and understood by all members. Staff meetings provide a platform for open dialogue, clarification of any concerns, and collaborative problem-solving. It also promotes team cohesion and shared accountability in improving health services based on patients' feedback. This approach encourages active participation and engagement from all team members, fostering a more effective and comprehensive response to the evaluations received.