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: C

Rationale: Anterior cruciate ligament (ACL) reconstruction is a common surgical procedure performed to repair a torn ACL. This procedure involves replacing the damaged ACL with a graft, often using a portion of the patient's own patellar tendon, hamstring tendon, or an allograft (donor tissue). ACL reconstruction is typically indicated for patients with ACL tears that result in knee instability and functional limitations, especially in active individuals who participate in sports or activities requiring pivoting and cutting movements. Arthroscopic surgery is commonly used to perform ACL reconstruction, allowing for smaller incisions and faster recovery compared to traditional open surgeries. Post-operative rehabilitation and physical therapy are crucial components of the recovery process following ACL reconstruction surgery to optimize outcomes and return to pre-injury activity levels.

Correct Answer: C

Rationale: Fowler's position is the correct position to help a patient experiencing breathing difficulty. In Fowler's position, the patient is sitting up at a 45- to 60-degree angle with the legs either straight or bent. This position allows for maximum chest expansion, helping to improve ventilation and oxygenation. It is commonly used to assist patients with respiratory distress, including difficulties with breathing. Placing the patient in Fowler's position can alleviate the feeling of breathlessness and facilitate easier breathing by promoting better lung expansion.

Correct Answer: C

Rationale: When assessing and managing distress in a patient with advanced dementia who is no longer able to communicate verbally, the palliative nurse should consider exploring non-verbal cues and behaviors to identify the underlying causes of distress. Since the patient cannot communicate through words, it is essential to pay close attention to their non-verbal cues such as facial expressions, body language, and changes in behavior. Distress in dementia patients can be caused by a variety of factors including physical discomfort, unmet needs, environmental stressors, emotional distress, or even medication side effects. By carefully observing and interpreting non-verbal cues, the nurse can gain insight into what might be causing the patient's distress and tailor interventions accordingly. Simply focusing on physical comfort measures may not address the root cause of the distress, and administering sedative medications without understanding the underlying cause is not considered best practice in palliative care for dementia patients.

Correct Answer: C

Rationale: If the nurse notices that the patient's arms are not adequately padded while positioning for surgery, the nurse should immediately take action to prevent pressure injuries. Applying soft padding to the patient's arms will help distribute the pressure more evenly, reducing the risk of skin breakdown and potential harm to the patient during the surgical procedure. It is essential to prioritize the patient's safety and comfort in such situations. Simply proceeding with the positioning as planned could lead to complications, so addressing the inadequate padding promptly is the appropriate course of action.

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: B

Rationale: When a patient is unable to talk, the nurse can best communicate with the patient by using picture cards. Picture cards can help the patient convey their needs, feelings, or responses by pointing to the corresponding pictures. This method allows for effective communication and understanding between the patient and the nurse, even when verbal communication is not possible. It promotes patient autonomy and ensures that their needs are accurately communicated and addressed. Additionally, picture cards can be a useful tool in reducing frustration and anxiety for patients who are unable to communicate verbally.

Correct Answer: A

Rationale: Clients who are taught skills such as measuring blood glucose, taking blood pressure, changing dressings, and bathing infants are learning skills that involve physical movement and coordination. These activities require the integration of mental and physical skills, and they fall under the psychomotor domain of learning. In this domain, individuals develop physical skills and coordination through practice and repetition. The psychomotor domain is one of the three domains of learning, along with the cognitive domain (which involves knowledge and intellectual skills) and the affective domain (which involves emotions, values, and attitudes).

Correct Answer: B

Rationale: When a patient with chronic kidney disease is prescribed erythropoietin-stimulating agents (ESAs) for anemia management, the parameter that should be monitored closely by the nurse is the hemoglobin levels. Hemoglobin levels indicate the patient's response to ESA therapy and are essential in assessing the effectiveness of the treatment in addressing anemia. Monitoring hemoglobin levels helps ensure that the patient's anemia is controlled within the target range to avoid both the risks of under-treatment (resulting in persistent anemia) and over-treatment (increased risk of adverse outcomes such as hypertension, stroke, or cardiovascular events).