A patient presents with muscle weakness, fatigue, constipation, and hyperpigmentation of the skin. Laboratory tests reveal low serum cortisol levels and elevated adrenocorticotropic hormone (ACTH) levels. Which endocrine disorder is most likely responsible for these symptoms?

Correct Answer: D

Rationale: The symptoms described - muscle weakness, fatigue, constipation, hyperpigmentation of the skin, low serum cortisol levels, and elevated ACTH levels - are classic findings in Addison's disease. Addison's disease is a primary adrenal insufficiency characterized by the insufficient production of cortisol and, to some extent, aldosterone. The low cortisol levels result in symptoms such as muscle weakness, fatigue, and skin hyperpigmentation due to increased levels of ACTH stimulating melanin production. In contrast, in conditions like hyperthyroidism, hypothyroidism, and diabetes mellitus, the symptoms and laboratory findings would not fully align with those described in the patient in this scenario.

Correct Answer: D

Rationale: Fidelity is a principle in nursing ethics that pertains to being faithful or loyal to commitments and promises made to patients. When Nurse Pat promised to come back to assist in the patient's ambulation after carrying out the physician's order, she is demonstrating fidelity by fulfilling her commitment to the patient's care. This principle helps build trust between the nurse and the patient, ensuring continuity and quality of care.

Correct Answer: D

Rationale: When a patient is crying and continuously pulling at a specific body part, such as Catherine pulling her right ear, it indicates discomfort or pain in that area. Nurse Selma's most appropriate action would be to further assess the description and frequency of the pain. This will help her identify the possible cause of the pain, whether it is due to an ear infection, injury, or any other underlying issue. Understanding the nature and intensity of the pain will guide Nurse Selma in providing appropriate care and intervention for Catherine. It is crucial to address the patient's pain promptly to ensure their comfort and well-being. Referring to the attending physician may be necessary after this initial assessment but assessing the pain should be the immediate priority.

Correct Answer: D

Rationale: Negligence refers to the failure to take proper care in doing something. In this scenario, the nurse failed to exercise the standard of care expected in placing a heating pad directly on Mr. C's lower leg, knowing his history of peripheral vascular disease. This failure led to a burn and subsequent infection that required a skin graft for treatment. The actions of the nurse were negligent as they did not meet the expected standard of care, resulting in harm to the patient. This situation does not fit the definition of assault, malpractice, or vicarious liability, making negligence the most appropriate choice.

Correct Answer: A

Rationale: Participating in professional organizations can provide Nurse Bea with numerous opportunities to network with other professionals in the field, stay updated with the latest trends and developments in nursing, access resources for professional growth, and even participate in leadership roles within the organization. Being active in a professional organization can help Nurse Bea build her professional profile, gain recognition, and open up possibilities for career advancement and opportunities for collaboration and learning from peers. It can also help her stay connected with the broader nursing community and enhance her visibility within the field. Engaging with a professional organization is a valuable way for Nurse Bea to enhance her career alongside pursuing further education.

Correct Answer: B

Rationale: Streptococcus pneumoniae is the most common causative organism of bacterial pneumonia in adults. It is responsible for the majority of community-acquired pneumonia cases. Streptococcus pneumoniae is a gram-positive bacteria and is known to cause typical pneumonia characterized by sudden onset of high fever, productive cough with blood-tinged or rust-colored sputum, chest pain, and consolidation on chest imaging. Other organisms like Legionella pneumophila (choice A), Mycoplasma pneumoniae (choice C), and Haemophilus influenzae (choice D) can also cause pneumonia, but Streptococcus pneumoniae is the most likely culprit based on the patient's test results.

Correct Answer: A

Rationale: The statement "Commitment to continual learning and active participation in the development and growth of the profession are commendable obligations" is typically found in a profession's Code of Ethics rather than specific laws or regulations like RA 7164, RA 10912, or RA 9173. Codes of Ethics serve as guidelines for professionals to uphold ethical standards and behavior within their respective fields. These codes often emphasize the importance of ongoing learning and professional development to ensure that practitioners stay current and competent in their practice. Therefore, the statement is most likely to be part of a Code of Ethics that guides professionals in their conduct and responsibilities.

Correct Answer: B

Rationale: The patient's presentation of sudden-onset weakness and sensory loss on one side of the body, along with difficulty speaking and understanding speech that partially resolved within one hour, is consistent with a transient ischemic attack (TIA). TIAs are caused by temporary disruption of blood flow to a part of the brain, leading to transient neurological symptoms. Unlike an ischemic stroke, which results in permanent damage to brain tissue due to prolonged interruption of blood flow, TIAs are transient and resolve within 24 hours. Hemorrhagic strokes and subarachnoid hemorrhages typically present with sudden, severe headaches, and may not improve or resolve quickly as seen in this case.

Correct Answer: C

Rationale: Post Transurethral Resection of the Prostate (TURP), the immediate danger that the nurse should anticipate is bleeding. TURP is a surgical procedure that involves removing portions of the prostate gland through the urethra. Due to the nature of the surgery and the rich blood supply to the prostate, bleeding is a common complication post-TURP. Excessive bleeding can lead to hypovolemic shock, which is a life-threatening condition. Therefore, monitoring for signs of bleeding, such as blood in the urine, drop in hematocrit levels, hypotension, tachycardia, and signs of hypovolemic shock, is crucial to prevent any serious complications. Proper assessment, monitoring, and timely intervention are essential in managing post-TURP bleeding and preventing adverse outcomes.