A pregnant woman presents with recurrent episodes of severe abdominal pain, bloating, and constipation. On examination, an abdominal mass is palpable, and bowel sounds are diminished. Which of the following conditions is the most likely cause of these symptoms?

Correct Answer: D

Rationale: Ovarian torsion is the most likely cause of the pregnant woman's symptoms as described. Ovarian torsion occurs when the ovary twists on its pedicle, leading to compromised blood flow to the ovary. This can cause severe abdominal pain, bloating, and constipation. On examination, an abdominal mass may be palpable due to an enlarged, twisted ovary. Bowel sounds may be diminished due to the effect of the torsion on surrounding structures. Ectopic pregnancy, threatened abortion, and placenta previa are less likely to present with an abdominal mass and diminished bowel sounds.

Correct Answer: D

Rationale: The diagnosis of gestational diabetes mellitus (GDM) is typically confirmed through an oral glucose tolerance test (OGTT) during pregnancy. In GDM, the 2-hour plasma glucose level during the OGTT is equal to or greater than 140 mg/dL. This finding is characteristic of GDM and distinguishes it from other types of diabetes. Fasting blood glucose ≥126 mg/dL is diagnostic of diabetes mellitus outside of pregnancy, not specifically GDM. Random plasma glucose ≥200 mg/dL is indicative of uncontrolled diabetes in general. Hemoglobin A1c (HbA1c) ≥6.5% is used for diagnosing diabetes outside of pregnancy and is not specific to GDM.

Correct Answer: B

Rationale: The statement provided clearly outlines the expectation regarding the dress code in the facility. By explicitly mentioning that wearing blue jeans while on duty is not included in the dress code, the individual is being informed about a specific expectation they are expected to adhere to. Stating expectations is a crucial step in giving constructive criticism as it sets a clear standard for behavior or performance. In this case, by mentioning the dress code policy, it helps guide the individual on what is acceptable and what is not when it comes to attire while at work.

Correct Answer: A

Rationale: Battery refers to the intentional and offensive physical contact with another person without their consent, resulting in harm or injury. In this scenario, the victim clearly expressed their unwillingness to be touched or helped by saying, "Don't touch me!" multiple times. By ignoring the victim's refusal and physically forcing them into the ambulance, the EMT is committing battery even though they may have had good intentions to provide assistance. It is important for medical professionals, including EMTs, to always respect a person's right to refuse medical treatment or assistance, even in emergency situations.

Correct Answer: B

Rationale: First-voided morning urine is the best urine sample to be used for an accurate result of a pregnancy test done at home because it is more concentrated compared to urine samples collected at other times of the day. Overnight, the hCG hormone (human chorionic gonadotropin) builds up in a woman's body, making the early morning urine more likely to contain higher levels of hCG if a woman is pregnant. The concentrated nature of first-morning urine reduces the chances of false-negative results since it provides a higher concentration of the hormone that the test is designed to detect. Therefore, using first-morning urine increases the sensitivity of the pregnancy test and improves the accuracy of the results.

Correct Answer: D

Rationale: In this scenario, the patient's presentation of a painless thyroid nodule and hoarseness of voice is consistent with papillary thyroid carcinoma, a type of thyroid cancer. While Hashimoto's thyroiditis and Graves' disease are autoimmune thyroid conditions that can lead to thyroid nodules, they typically do not present with hoarseness of voice. Diabetes mellitus does not directly cause these symptoms. Thyroid cancer, particularly papillary thyroid carcinoma, is the most likely cause based on the patient's clinical presentation and the biopsy results.

Correct Answer: C

Rationale: The barrier to goal setting between the nurse and the family in this scenario is the failure of the family to perceive the existence of the problem. Goal setting in healthcare generally requires mutual agreement and understanding between the healthcare provider (nurse) and the patient/family. If the family does not perceive that there is an existing problem that needs to be addressed, there will likely be resistance or lack of motivation to set goals and work towards resolving the issue. This barrier can hinder effective communication, collaboration, and ultimately, the successful achievement of healthcare goals. It is important for the nurse to address this barrier through education, communication, and building trust to ensure that all parties are on the same page and actively participate in goal setting and care planning.

Correct Answer: B

Rationale: When a patient with a suspected spinal injury is found unconscious, the priority action is to secure the airway without jeopardizing the cervical spine. A jaw thrust maneuver is the appropriate technique to open the airway in this situation because it allows for the maintenance of neutral alignment of the cervical spine while ensuring proper ventilation. Moving the patient to a flat surface or applying a cervical collar could potentially worsen the spinal injury if not done correctly, and checking for responsiveness should only be done after ensuring a patent airway. Therefore, the safest and most effective initial action is to perform a jaw thrust maneuver to establish a clear airway.

Correct Answer: D

Rationale: Ovarian torsion is the most likely cause of the pregnant woman's symptoms as described. Ovarian torsion occurs when the ovary twists on its pedicle, leading to compromised blood flow to the ovary. This can cause severe abdominal pain, bloating, and constipation. On examination, an abdominal mass may be palpable due to an enlarged, twisted ovary. Bowel sounds may be diminished due to the effect of the torsion on surrounding structures. Ectopic pregnancy, threatened abortion, and placenta previa are less likely to present with an abdominal mass and diminished bowel sounds.