A patient presents with excessive thirst, frequent urination, and fatigue. Laboratory tests reveal hypernatremia, hyperglycemia, and metabolic acidosis. Which endocrine disorder is most likely responsible for these symptoms?

Correct Answer: C

Rationale: The patient's presentation of excessive thirst, frequent urination, and fatigue align with the classic symptoms of diabetes mellitus. The laboratory findings of hypernatremia (high sodium levels), hyperglycemia (high blood sugar levels), and metabolic acidosis further support this diagnosis. In diabetes mellitus, the body is unable to properly regulate blood sugar levels due to either insufficient insulin production (Type 1 diabetes) or ineffective use of insulin by the cells (Type 2 diabetes). This leads to high blood sugar levels, causing symptoms such as polyuria (frequent urination), polydipsia (excessive thirst), and fatigue. The metabolic acidosis is a result of the body's breakdown of fats and proteins for energy due to the lack of glucose utilization in the cells.

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: C

Rationale: Ventricular tachycardia (VT) is a potentially life-threatening arrhythmia characterized by wide QRS complexes and absence of P waves on electrocardiogram (ECG). Patients with VT may present with symptoms such as chest pain, dyspnea, and syncope due to reduced cardiac output and ineffective pumping of the heart. VT is a serious condition that requires prompt treatment to prevent hemodynamic compromise and potential cardiac arrest. Stable angina typically presents with chest pain that is provoked by exertion and relieved by rest or nitroglycerin. Atrial fibrillation is characterized by an irregularly irregular rhythm with absent P waves on ECG. Supraventricular tachycardia typically presents with a narrow QRS complex on ECG.

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: C

Rationale: The most appropriate intervention for a patient with end-stage dementia experiencing agitation and restlessness is to create a calm and soothing environment to promote relaxation. Patients with dementia often respond positively to a familiar and tranquil setting, which can help reduce their symptoms of agitation and restlessness. This approach is preferred over administering antipsychotic medications or recommending physical exercise, as these may not be feasible or beneficial for patients in the advanced stages of dementia. Referring the patient to a psychiatrist may not address the immediate need for symptom management and can be considered if other interventions are ineffective. Creating a calm environment, such as dim lighting, soft music, and familiar objects, can help provide comfort and reduce distress for the patient.