Correct Answer: C

Rationale: Cryptosporidium parvum is a parasite commonly found in contaminated water sources such as streams or lakes. It causes an infection called cryptosporidiosis, which often presents with symptoms like watery diarrhea, abdominal cramps, and nausea. The oocysts of Cryptosporidium parvum can be identified in stool samples, making it the likely culprit in this scenario. Giardia lamblia, another common waterborne parasite, can also cause similar symptoms but is characterized by trophozoites rather than oocysts in stool samples. Entamoeba histolytica is associated with amoebic dysentery and does not typically present with watery diarrhea. Cyclospora cayetanensis is another parasite causing gastrointestinal symptoms but is not as commonly associated with contaminated water sources as Cryptosporidium parvum.

Correct Answer: B

Rationale: When one has Cushing's disease, the focal structure affected is the pituitary gland. Cushing's disease is caused by the overproduction of adrenocorticotropic hormone (ACTH) by the pituitary gland. This excess ACTH stimulates the adrenal glands to produce too much cortisol, leading to the symptoms associated with Cushing's disease. Therefore, the primary issue originates in the pituitary gland, not the other structures mentioned in the question.

Correct Answer: A

Rationale: The patient in this scenario presents with normocytic normochromic anemia, normal iron studies, and elevated serum erythropoietin levels. These findings are characteristic of anemia of chronic disease, which is commonly seen in patients with chronic kidney disease (CKD). In CKD, there is a decrease in renal production of erythropoietin, leading to reduced stimulation of erythropoiesis and subsequent anemia. The normocytic normochromic anemia pattern is typical in anemia of chronic disease, as opposed to microcytic hypochromic anemia seen in iron deficiency anemia and thalassemia. Aplastic anemia is characterized by pancytopenia, which is not described in the scenario. Therefore, the most likely cause of the patient's presentation is chronic kidney disease.

Correct Answer: D

Rationale: The nurse should respect the patient's autonomy and collaborate on alternative treatment options. It is essential to honor the patient's cultural beliefs and preferences while also seeking to find a solution that aligns with the healthcare provider's recommendations. By working together with the patient to explore alternative treatment options that are acceptable within the patient's cultural framework, the nurse can promote patient-centered care and foster a trusting relationship with the patient.Ignoring or dismissing the patient's cultural beliefs can lead to decreased patient adherence and trust in the healthcare provider. Providing education and information to help the patient understand the treatment benefits is important, but it should be done in a way that respects the patient's autonomy and cultural perspective.

Correct Answer: C

Rationale: In Nadine's case, one major challenge that a beginning nurse may encounter in her service delivery is related to social determinants of health. Social determinants of health refer to the social and economic conditions that influence individual and group differences in health status. In this scenario, Nadine's bruises, bed-wetting, signs of anxiety, and potentially other health issues are likely influenced by factors such as her living environment, family dynamics, and social support systems. As a nurse, addressing social determinants of health requires a holistic approach that considers not only the physical symptoms but also the underlying social, economic, and environmental factors affecting the patient's health and well-being. This can be a complex challenge for beginning nurses who may not have as much experience or training in navigating these social determinants of health to provide comprehensive care to their patients.