Correct Answer: B

Rationale: The most appropriate intervention for a patient with difficulty swallowing due to end-stage ALS and concerns about choking is to refer the patient to a speech therapist for swallowing exercises and techniques (Choice B). Speech therapists are trained to assess and manage swallowing difficulties in patients, especially those with neurodegenerative diseases like ALS. They can provide specific exercises and strategies to help the patient swallow safely and reduce the risk of choking. This intervention focuses on addressing the underlying issue causing the difficulty swallowing and aims to improve the patient's quality of life by enhancing their ability to eat and drink. The other options are not as effective or appropriate in addressing the patient's concerns.

Correct Answer: C

Rationale: Hurthle cell carcinoma is a type of thyroid cancer that arises from the Hurthle cells of the thyroid gland. Patients with Hurthle cell carcinoma may present with a thyroid nodule and signs of hyperthyroidism, which can mimic other thyroid disorders such as Graves' disease. Fine-needle aspiration biopsy revealing Hurthle cells and cellular atypia is suggestive of a Hurthle cell neoplasm, particularly Hurthle cell carcinoma. It is important to differentiate Hurthle cell carcinoma from benign Hurthle cell adenomas or other thyroid conditions to guide appropriate management and treatment.

Correct Answer: D

Rationale: COPD (Chronic Obstructive Pulmonary Disease) patients often struggle with breathing difficulties due to their conditions, hence it is important for them to conserve their energy as much as possible. Standing while performing activities like shaving or combing hair can be physically demanding for COPD patients as it requires more energy and can lead to increased shortness of breath. It is recommended for COPD patients to sit down or assume a supported position (like the tripod position with elbows supported on a table) to reduce the energy expended and minimize the strain on their respiratory system. Standing in front of the mirror while performing grooming activities is a task that can be easily modified to a seated position, thus conserving energy and reducing the risk of exacerbating breathing difficulties for COPD patients.

Correct Answer: B

Rationale: The formulation of a vision and mission statement in a health facility is an essential aspect of leadership and management. A well-crafted vision and mission statement provide the organization with a clear direction and purpose, guiding management and health personnel in their daily activities. It helps in aligning individual goals with organizational objectives, fostering teamwork, and enhancing overall performance. Effective leadership and management ensure that the vision and mission are communicated effectively, understood by all stakeholders, and implemented throughout the organization to achieve quality standards. By setting the tone for organizational culture and values, leadership and management play a crucial role in shaping the quality of care and services provided by the health facility.

Correct Answer: B

Rationale: The most appropriate action for the nurse to take when noticing that the patient seems anxious and is avoiding eye contact is to ask the patient if they are feeling anxious and if they would like to talk about it. This approach shows empathy, concern, and openness to addressing the patient's emotional state. By directly acknowledging the patient's behavior and giving them the opportunity to express their feelings, the nurse can create a supportive and caring environment that promotes effective communication and trust between the patient and healthcare provider. It is important to consider the patient's emotional well-being alongside their physical health during consultations.