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: Meperidine (Demerol) is an opioid analgesic. Overdose of Meperidine can lead to respiratory depression, characterized by slow and shallow breathing. As a result of respiratory depression, hypercapnia, which is an increased level of carbon dioxide in the blood, can occur. This is a serious concern and requires immediate medical intervention to support respiratory function. Therefore, hypercapnia would be the assessment by the nurse that causes a concern for Meperidine overdose.

Correct Answer: C

Rationale: Monitoring cardiac enzymes would be most helpful to Nurse Victor to confirm the underlying cause of cardiogenic shock. Cardiac enzymes are specific markers in the blood that indicate damage to the heart muscle, such as troponin and creatine kinase-MB (CK-MB). When a patient experiences cardiogenic shock, there is usually damage to the heart muscle which leads to the release of these enzymes into the bloodstream. Monitoring cardiac enzymes can help confirm if the cause of cardiogenic shock is related to myocardial infarction or another cardiac issue. This information is crucial for determining the appropriate treatment and management plan for the patient. Monitoring pulmonary artery pressure, mean arterial pressure, and central venous pressure may provide important hemodynamic information but may not directly confirm the underlying cause of cardiogenic shock.

Correct Answer: D

Rationale: Addison's disease is a rare endocrine disorder characterized by adrenal insufficiency, leading to a deficiency in cortisol and aldosterone production. The symptoms of Addison's disease include fatigue, weakness, hyperpigmentation of the skin (due to elevated levels of ACTH stimulating melanocytes), and salt craving (due to aldosterone deficiency). Low serum sodium levels and elevated serum potassium levels are also common laboratory findings in Addison's disease, as aldosterone plays a key role in maintaining electrolyte balance. Patients with Addison's disease are at risk of developing an adrenal crisis, which can be life-threatening if not promptly recognized and treated with glucocorticoid and mineralocorticoid replacement therapy.

Correct Answer: D

Rationale: The presentation of sudden-onset severe headache, vomiting, and altered mental status, along with the presence of a berry-shaped aneurysm on imaging, point towards a diagnosis of subarachnoid hemorrhage. The most common cause of a subarachnoid hemorrhage is the rupture of a saccular (berry) aneurysm, which commonly occurs at the junction of the anterior communicating artery and anterior cerebral artery. The sudden headache is often described as the "worst headache of my life" and is typically associated with nausea and vomiting. Altered mental status may be present due to the effects of increased intracranial pressure and possible associated brain injury. It is important to promptly diagnose and manage subarachnoid hemorrhage to prevent complications such as vasospasm, rebleeding, and ischemic deficits.