A patient presents with chest pain at rest, unrelated to exertion, and not relieved by nitroglycerin. An electrocardiogram (ECG) shows ST-segment depression. Which cardiovascular disorder is most likely responsible for these symptoms?

Correct Answer: B

Rationale: Unstable angina is characterized by chest pain at rest, which is not relieved by nitroglycerin. The ECG findings in unstable angina typically show ST-segment depression or T-wave inversion. It is considered a medical emergency as it can progress to a myocardial infarction. Stable angina, on the other hand, is chest pain or discomfort that occurs with exertion and is relieved by rest or medications like nitroglycerin. Acute myocardial infarction would typically present with ST-segment elevation on ECG, while Prinzmetal's angina is characterized by transient ST-segment elevation due to coronary artery vasospasm.

Correct Answer: D

Rationale: Papillary thyroid carcinoma is the most common type of thyroid cancer and is known for presenting as a painless unilateral enlargement of the thyroid gland. Fine-needle aspiration cytology typically reveals classic features such as numerous microfollicles and psammoma bodies. Thyroglossal duct cyst, Hashimoto's thyroiditis, and thyroid adenoma would not typically present with these cytological features or with painless thyroid enlargement as seen in papillary thyroid carcinoma.

Correct Answer: B

Rationale: The patient's presentation with recurrent episodes of vertigo, nausea, and nystagmus triggered by head movements, along with a positive Dix-Hallpike maneuver eliciting positional vertigo and rotary nystagmus, is classic for Benign Paroxysmal Positional Vertigo (BPPV). BPPV is the most common cause of vertigo due to a mechanical problem in the inner ear. In BPPV, brief episodes of vertigo are typically triggered by specific head movements, such as rolling over in bed or looking up. The characteristic rotary nystagmus observed in BPPV is consistent with the brief, intense episodes of vertigo that patients experience. The Dix-Hallpike maneuver, commonly used to diagnose BPPV, involves moving the patient from sitting to a supine head-hanging position and can induce vertigo and nystagmus in affected

Correct Answer: C

Rationale: In this situation, the most appropriate response for the palliative nurse is to validate the patient's feelings of guilt and offer support to address their concerns. It is important to acknowledge the patient's emotions and help them navigate through their guilt in a compassionate and understanding manner. By validating their feelings, the nurse can create a safe space for the patient to express their concerns and work towards finding solutions to alleviate their guilt. This approach fosters trust and a therapeutic relationship between the patient and the nurse, ultimately promoting emotional well-being and facilitating open communication.

Correct Answer: B

Rationale: Providing means to evaluate services is the most appropriate measure to ensure patient satisfaction with the delivery of health services. This can be done through patient surveys, feedback forms, or other evaluation methods. By systematically collecting and analyzing feedback from patients, healthcare providers can assess the quality of their services, identify areas for improvement, and address any concerns or issues raised by patients. This proactive approach allows for continuous monitoring and improvement of the healthcare services provided, leading to enhanced patient satisfaction and overall quality of care.

Correct Answer: B

Rationale: Albuterol, also known as salbutamol, is a beta-adrenergic agonist medication commonly used for the treatment of conditions such as asthma and COPD. As a beta-adrenergic agonist, albuterol binds to beta-2 adrenergic receptors in the lungs, causing bronchodilation, which helps to relieve bronchospasms and improve airflow to the lungs. This action leads to the relaxation of smooth muscle in the airways, thus making breathing easier for patients with COPD or asthma. Anticholinergics, corticosteroids, and methylxanthines have different mechanisms of action and are not directly related to the pharmacological action of albuterol in COPD treatment.

Correct Answer: A

Rationale: Plasma cells are the primary type of cells responsible for the production of antibodies during the humoral immune response. When activated by antigens, B cells differentiate into plasma cells, which are specialized in producing large quantities of antibodies. These antibodies are essential in fighting off infections by binding to antigens and marking them for destruction by other immune cells. T helper cells assist in activating B cells, but the actual production of antibodies is mainly carried out by plasma cells. Memory B cells are involved in mounting a rapid and specific secondary response upon re-exposure to the same antigen. Macrophages play a role in phagocytosis and antigen presentation, but they are not the primary cells responsible for producing antibodies during the humoral immune response.

Correct Answer: D

Rationale: The presentation described is characteristic of a parathyroid adenoma. Parathyroid adenomas are benign neoplasms that can present as painless, well-defined nodules usually located in the lower pole of the thyroid gland or in close proximity, such as the lateral aspect of the neck above the clavicle. Fine-needle aspiration cytology of a parathyroid adenoma typically reveals polygonal cells with abundant granular cytoplasm, often referred to as chief cells. This is key in differentiating it from other conditions mentioned in the question.

Correct Answer: A

Rationale: Acanthosis nigricans is a skin condition characterized by multiple, hyperpigmented, velvety plaques typically seen in flexural areas such as the axillae, neck, and groin. These lesions are often associated with obesity and insulin resistance. The appearance of acanthosis nigricans is distinct from other skin conditions such as seborrheic keratosis, dermatofibroma, and epidermal nevus. Acanthosis nigricans is commonly seen in conditions like obesity, type 2 diabetes, and metabolic syndrome due to the insulin resistance that leads to the overgrowth of keratinocytes.