Correct Answer: C

Rationale: In ALS (Amyotrophic Lateral Sclerosis), communication difficulties may occur as the disease progresses and affects the muscles responsible for speech. It is crucial to initiate early measures to assist the patient in communicating effectively. Using pre-signals before the loss of speech can be helpful in maintaining communication with the patient. These pre-signals can include gestures, writing tools, communication boards, or technology-assisted communication devices. By introducing and practicing these pre-signals early on, the patient can adapt and utilize alternative communication methods before the loss of speech becomes more challenging. This proactive approach can significantly improve the patient's ability to communicate and maintain a sense of connection with others.

Correct Answer: D

Rationale: Hurthle cell carcinoma is a subtype of thyroid cancer that arises from the follicular cells in the thyroid gland. Patients with Hurthle cell carcinoma may present with a painful thyroid nodule, which can be associated with signs of hypothyroidism due to the disruption of thyroid hormone production by the tumor. Fine-needle aspiration biopsy revealing Hurthle cells with nuclear features suggestive of malignancy is a characteristic finding in this type of carcinoma.

Correct Answer: B

Rationale: The nurse's best approach to address a patient's concerns about the potential side effects of a prescribed medication is to provide the patient with accurate information about potential side effects and management strategies. It is important for the nurse to acknowledge the patient's concerns, listen attentively, and offer clear explanations to help alleviate any fears or uncertainties. Providing accurate information can empower the patient to make informed decisions about their healthcare and feel more confident in taking the prescribed medication. Dismissing or ignoring the patient's concerns can lead to mistrust and non-adherence to the treatment plan. It is essential for the nurse to prioritize open communication and patient education to ensure the patient's well-being and compliance with the prescribed medication regimen.

Correct Answer: B

Rationale: Meconium-stained amniotic fluid indicates that the fetus may have passed stool in utero, which can lead to potential respiratory problems once born due to meconium aspiration. The priority action for the nurse in this situation is to prepare for immediate delivery to expedite the removal of the fetus from the contaminated environment and provide necessary interventions such as suctioning of the airway to prevent aspiration of meconium. Prompt delivery is crucial to minimize the risk of complications related to meconium aspiration syndrome. Administering oxygen, inserting a urinary catheter, and notifying the neonatal resuscitation team can be important subsequent actions, but the immediate focus should be on delivering the baby.

Correct Answer: A

Rationale: In a patient with acute kidney injury (AKI) secondary to hypovolemic shock, the priority intervention to manage the patient's renal function is to administer intravenous fluids to restore circulating volume. Hypovolemic shock leads to decreased blood flow to the kidneys, resulting in hypoperfusion and ischemic damage to the renal tubules. Prompt correction of hypovolemia with intravenous fluids helps improve renal perfusion and function by increasing blood flow to the kidneys. Adequate fluid resuscitation can potentially prevent further kidney damage and support kidney function recovery. It is crucial to address the underlying cause of AKI (hypovolemia in this case) to prevent complications and improve patient outcomes. Initiating renal replacement therapy or recommending nephrotoxic medications would not be the initial interventions for managing AKI in this scenario.