What isotonic electrolyte solutions are COMMONLY used as fluid replacement in hypovolemic shock? I. Dextrose 5 percent in water II. 0.9 percent sodium chloride III. Lactated Ringer's solution IV. Dextrose 10 percent in water

Correct Answer: B

Rationale: In hypovolemic shock, isotonic electrolyte solutions are commonly used for fluid replacement to restore the circulating blood volume. The commonly used isotonic electrolyte solutions for this purpose are 0.9% sodium chloride (normal saline) and lactated Ringer's solution.

Correct Answer: D

Rationale: Cor pulmonale is a condition characterized by right heart failure secondary to pulmonary hypertension, which is often caused by chronic hypoxemia. Chronic hypoxemia occurs in conditions such as chronic obstructive pulmonary disease (COPD) where there is limited airflow in and out of the lungs, leading to low oxygen levels in the blood. However, the specific characteristic of pulmonary hypertension leading to right heart failure distinguishes cor pulmonale from COPD. Other conditions like idiopathic pulmonary fibrosis (IPF) and pulmonary embolism (PE) may also lead to hypoxemia but are not primarily associated with pulmonary hypertension and right heart failure as in cor pulmonale.

Correct Answer: A

Rationale: Task A, obtaining special food for the patient when she requests it, can be delegated to the nursing assistant. This task involves simple assistance with gathering food items and does not require specific medical knowledge or interventions. Tasks B, C, and D involve more direct patient care and assessment, which should be performed by the nursing staff who have the necessary training and expertise to address the complexities of anorexia nervosa.

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: A

Rationale: Showing positive interpersonal relationships is the best evidence of a family coping well when their family coping index on therapeutic competence is rated as coping well. Positive interpersonal relationships indicate that family members are effectively communicating, supporting each other, and resolving conflicts in a healthy manner. This reflects strong family dynamics, emotional resilience, and adaptability which are important aspects of effective coping. While the other options (B, C, D) are beneficial activities or behaviors, positive interpersonal relationships directly demonstrate the family's ability to cope well together, making it the most relevant evidence for a high therapeutic competence rating.

Correct Answer: C

Rationale: The appropriate management for a conscious patient experiencing a seizure is to follow these steps:

Correct Answer: C

Rationale: It is crucial to ensure that the autoclave is functioning properly to achieve proper sterilization of surgical instruments. If the autoclave is not reaching the required temperature, it signifies a technical issue that needs to be addressed promptly. The nurse should notify the sterile processing department immediately and request maintenance to investigate and resolve the problem. Continuing with sterilization without addressing the temperature issue can compromise the effectiveness of sterilization and pose a risk of infection to patients. Adjusting the settings on the autoclave or using an alternative method of sterilization are not appropriate actions in this situation.

Correct Answer: A

Rationale: The description of multiple flesh-colored papular lesions with a central dell that tend to bleed upon minor trauma and have been increasing in number over time is characteristic of basal cell carcinoma. Basal cell carcinoma is the most common type of skin cancer and typically presents as pearly or flesh-colored papules with telangiectasias (tiny blood vessels) and a characteristic central dell or ulceration. This type of skin cancer often occurs on sun-exposed areas like the face and trunk and can manifest as slow-growing lesions that may bleed easily with minor trauma. In contrast, squamous cell carcinoma typically presents as a scaly or crusted lesion, seborrheic keratosis is a benign skin growth with a waxy, stuck-on appearance, and actinic keratosis is a precancerous lesion characterized by rough, scaly patches on sun-exposed areas.

Correct Answer: B

Rationale: Quality Improvement is a systematic approach that aims to continually enhance the quality of services or products within an organization. The statement that is true of Quality Improvement is that it focuses on continually improving every process in the organization (Option B). This includes processes related to patient care, organizational structure, and all aspects of operations. Quality Improvement involves identifying areas for improvement, implementing changes, monitoring the effectiveness of those changes, and then making further refinements. By focusing on every process within the organization, Quality Improvement helps drive positive outcomes and ensures sustainable improvements in quality and performance.