A patient presents with central obesity, moon face, buffalo hump, and purple striae. Laboratory tests reveal elevated cortisol levels. Which endocrine disorder is most likely responsible for these symptoms?

Correct Answer: D

Rationale: The patient's presentation of central obesity, moon face, buffalo hump, purple striae, and elevated cortisol levels strongly suggest Cushing's syndrome. Cushing's syndrome is a disorder characterized by excessive levels of cortisol, either due to an endogenous (e.g., adrenal tumor) or exogenous (e.g., prolonged steroid use) source. The classic physical features of Cushing's syndrome include central obesity with thin extremities (truncal obesity), moon face (rounding and reddening of the face), buffalo hump (accumulation of fat between the shoulders), and purple striae (stretch marks that are wide and purple in color). In the context of the elevated cortisol levels, these clinical signs are highly indicative of Cushing's syndrome. Hyperthyroidism, hypothyroidism, and diabetes mellitus would not typically present with the specific combination of symptoms described.

Correct Answer: B

Rationale: The nurse's best response to a patient expressing fear of the unknown regarding an upcoming surgical procedure is to provide the patient with accurate information about the surgical procedure and what to expect. This approach empowers the patient with knowledge and helps alleviate anxiety by demystifying the unknown. By educating the patient about the procedure, potential risks, and postoperative care, the nurse can help the patient feel more prepared and in control of the situation. It is crucial for healthcare providers to address patient fears with compassion, understanding, and information to support the patient through the surgical process.

Correct Answer: A

Rationale: The most appropriate nursing intervention to alleviate breast engorgement and discomfort in a breastfeeding client is to encourage frequent breastfeeding or pumping sessions. Engorgement occurs when the breasts become overly full of milk, causing them to become swollen, firm, and painful. By ensuring that the baby breastfeeds frequently, the client can effectively empty the breasts, which helps to relieve engorgement and discomfort. Encouraging the client to breastfeed on demand and ensuring proper latching can help prevent further engorgement issues. Pumping can also be useful if the baby is unable to feed directly from the breast or to relieve engorgement between feedings. This intervention addresses the root cause of the problem and promotes the client's comfort and breastfeeding success. Applying cold packs, using a supportive bra or breast binder, and administering oral analgesics may provide some relief for discomfort but do not address the underlying issue of engorgement.

Correct Answer: C

Rationale: The salivary glands are responsible for the production of saliva, which aids in lubricating the oral cavity and initiating the digestion of carbohydrates. Saliva contains enzymes that begin the digestive process by breaking down carbohydrates into simpler sugars. The liver is involved in the production of bile, which aids in the digestion and absorption of fats. The gallbladder stores bile produced by the liver, which is released into the small intestine. The pancreas produces digestive enzymes that are released into the small intestine to aid in the digestion of proteins, fats, and carbohydrates.

Correct Answer: C

Rationale: The barrier to goal setting between the nurse and the family in this scenario is the failure of the family to perceive the existence of the problem. Goal setting in healthcare generally requires mutual agreement and understanding between the healthcare provider (nurse) and the patient/family. If the family does not perceive that there is an existing problem that needs to be addressed, there will likely be resistance or lack of motivation to set goals and work towards resolving the issue. This barrier can hinder effective communication, collaboration, and ultimately, the successful achievement of healthcare goals. It is important for the nurse to address this barrier through education, communication, and building trust to ensure that all parties are on the same page and actively participate in goal setting and care planning.

Correct Answer: C

Rationale: Cryptosporidium parvum is a protozoan parasite often found in contaminated water sources. This parasite is known to cause watery diarrhea, abdominal cramps, and nausea in infected individuals. The presence of oocysts in the stool sample is characteristic of Cryptosporidium infection. Other parasitic infections may present with similar symptoms, but in this case, the most likely culprit based on the exposure history and laboratory findings is Cryptosporidium parvum.

Correct Answer: B

Rationale: When a patient with a suspected spinal injury is found unconscious, the priority action is to secure the airway without jeopardizing the cervical spine. A jaw thrust maneuver is the appropriate technique to open the airway in this situation because it allows for the maintenance of neutral alignment of the cervical spine while ensuring proper ventilation. Moving the patient to a flat surface or applying a cervical collar could potentially worsen the spinal injury if not done correctly, and checking for responsiveness should only be done after ensuring a patent airway. Therefore, the safest and most effective initial action is to perform a jaw thrust maneuver to establish a clear airway.

Correct Answer: D

Rationale: A delimitation in a research study refers to setting specific boundaries or restrictions on the scope of the study. In this scenario, Gloria's decision to include only nurses with a minimum of three years experience as psychiatric nurses is a delimitation because it sets a specific criterion or boundary for the selection of participants. This helps to focus the study on a particular group of individuals who possess the required experience, ensuring the research is targeted and relevant to the topic being investigated.

Correct Answer: A

Rationale: A tension pneumothorax is a life-threatening condition where air accumulates in the pleural space and cannot escape, causing increased pressure in the chest cavity. This can lead to compression of the lung and major blood vessels, leading to inadequate oxygenation and circulation.