A patient presents with irritability, muscle weakness, tremors, and weight loss despite increased appetite. Laboratory tests reveal elevated serum thyroid hormone levels and suppressed thyroid-stimulating hormone (TSH) levels. Which endocrine disorder is most likely responsible for these symptoms?

Correct Answer: A

Rationale: The symptoms of irritability, muscle weakness, tremors, weight loss despite increased appetite, along with elevated serum thyroid hormone levels and suppressed TSH levels, are indicative of hyperthyroidism. In hyperthyroidism, the thyroid gland produces an excess amount of thyroid hormone, leading to an overactive metabolism. This results in symptoms such as weight loss, tremors, irritability, and muscle weakness. The elevated levels of thyroid hormone are detected in the laboratory tests, along with low TSH levels due to negative feedback regulation. Therefore, the most likely endocrine disorder responsible for these symptoms is hyperthyroidism.

Correct Answer: B

Rationale: The client should be assisted to lie in bed on the unaffected side for a thoracentesis procedure. This position allows for better access to the pleural space for the insertion of a needle to aspirate the fluid or air. Gravity helps to separate the fluid or air, making it closer to the chest wall for easier removal. Additionally, this position reduces the risk of injury to the lung or other structures, as the needle is directed away from these vital structures. Lying on the unaffected side also helps in preventing potential complications and ensures the safety and effectiveness of the procedure.

Correct Answer: B

Rationale: Warming up ofloxacin eardrops before administering is done to prevent dizziness, which can occur if a cold solution is placed in the ear. Holding the bottle with hands for about 1 to 2 minutes is usually sufficient to warm up the solution to a comfortable temperature for the patient. Warming the solution for too long, such as 5-6 minutes, may not be necessary and could potentially waste time. So, the correct duration for warming up ofloxacin eardrops is 1 to 2 minutes.

Correct Answer: B

Rationale: When following the APA style, the recommended word count for an abstract is typically between 150 to 250 words. An abstract should serve as a concise summary of the main points of a research paper, providing the reader with a preview of the content without going into excessive detail. Keeping the abstract within the specified word range ensures that it effectively captures the essence of the paper while remaining clear and succinct.

Correct Answer: C

Rationale: Insulin glargine (Lantus) is a long-acting insulin that is typically administered once daily at the same time each day to help maintain a steady level of insulin in the body. It is important to rotate injection sites within the same body region (such as the abdomen, thigh, or upper arm) to prevent lipodystrophy (lumpiness or dents in the skin) and to ensure consistent absorption of the insulin. Proper rotation of injection sites helps to prevent tissue damage and ensures optimal insulin absorption, improving the effectiveness of insulin therapy. It is not necessary to inject insulin glargine before meals, vigorously shake the vial, or administer it with a rapid-acting insulin.

Correct Answer: B

Rationale: The healthcare team should prioritize implementing environmental modifications to promote orientation in a patient with delirium. Delirium is a state of acute confusion and agitation that can be triggered by various factors such as medications, infections, or metabolic disturbances. Environmental modifications involve creating a calm, quiet, and well-lit environment for the patient. Promoting proper orientation through the use of clocks, calendars, and familiar objects can help reduce confusion and improve the patient's understanding of their surroundings. These interventions are non-pharmacological and aim to address the underlying causes of delirium while minimizing the need for additional medications that may have potential side effects. Antipsychotic medications and benzodiazepines should be used judiciously and under close supervision due to the risk of adverse effects in older adults and critically ill patients. Referring the patient to a psychiatrist may be considered if the delirium is complex or if there are underlying psychiatric issues contributing to the presentation.

Correct Answer: B

Rationale: Negligence refers to the failure to perform a duty of care that a reasonable person would have exercised in the same situation, resulting in harm or injury to another person. In this scenario, the nurse failed to perform an ordered irrigation of a feeding tube, which is a standard nursing duty. This failure to act according to the orders resulted in harm to the patient, indicating negligence on the part of the nurse. Malpractice is a specific type of negligence that occurs when a professional fails to provide the standard level of care, so in this case, it falls under the broader category of negligence. Harm to the patient is the consequence of the nurse's negligence, and failure to follow the nurse practice act may be a contributing factor to the negligence, but the primary issue is the failure to provide proper care - which is negligence.

Correct Answer: A

Rationale: The guiding principle that health is an integral part of the education process is of utmost importance for a school nurse in performing their role and functions. This principle emphasizes the interconnectedness of health and academic success, highlighting that healthy students are better able to learn and succeed in school. As a school nurse, understanding and prioritizing this principle means focusing on promoting health and wellness, providing healthcare services, and implementing health education programs to support the overall well-being and academic achievement of students. By recognizing the significance of this principle, school nurses can effectively contribute to creating a healthy and supportive school environment that fosters student growth and development.

Correct Answer: A

Rationale: The recommended position for a conscious patient experiencing an acute asthma exacerbation is the High-Fowler's position. This position involves the patient sitting upright or almost upright at about a 90-degree angle. The High-Fowler's position helps improve ventilation by expanding the lungs and maximizing airflow in and out of the airways. It also reduces the work of breathing in patients with asthma by allowing gravity to assist in moving air in and out of the lungs more easily. Additionally, this position can help alleviate shortness of breath and improve oxygenation in patients experiencing an asthma exacerbation.