Nokea
A 34-year-old female is diagnosed with hypothyroidism. The nurse should assess the client for which of the following? Select all that apply.
- A. Rapid pulse.
- B. Decreased energy and fatigue.
- C. Weight gain of 10 lb.
- D. Fine, thin hair with hair loss.
- E. Constipation.
- F. Menorrhagia.
Correct Answer: B,C,D,E,F
Rationale: Hypothyroidism slows metabolism, leading to decreased energy, fatigue, weight gain, hair loss, constipation, and heavy menstrual periods (menorrhagia). Rapid pulse is associated with hyperthyroidism, not hypothyroidism.
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A client post-cystoscopy reports severe pain. The nurse should:
- A. Administer analgesics as prescribed.
- B. Encourage ambulation.
- C. Apply a cold pack.
- D. Notify the physician.
Correct Answer: D
Rationale: Severe pain post-cystoscopy is abnormal and requires physician notification to rule out complications.
The nurse is aware that a 65-year-old widower whose only son is 500 miles away is at higher risk for psychosocial distress because the client:
- A. Has been successful in dealing with stress all his life.
- B. Does not have to deal with other stressors right now.
- C. Is able to use denial as a coping mechanism.
- D. Perceives he has minimal social support.
Correct Answer: D
Rationale: Minimal social support, due to being widowed and geographically isolated from his son, increases the risk of psychosocial distress in this cancer client.
A client is admitted to the surgical floor after having bowel surgery. The nurse observes that the client's urine output has decreased from 50 to 20 mL/hour. Which of the following is the most likely cause?
- A. Bowel obstruction.
- B. Adverse effect of opioid analgesics.
- C. Hemorrhage.
- D. Hypertension.
Correct Answer: B
Rationale: Opioid analgesics, commonly used post-surgery, can cause urinary retention by relaxing the bladder, reducing urine output. This is the most likely cause in this scenario.
When teaching the client to care for an ileal conduit, the nurse instructs the client to empty the appliance frequently. Which of the following indicate that the client is following instructions?
- A. The skin around the stoma is red.
- B. The urine is a deep yellow.
- C. There is no odor present.
- D. The seal around the stoma is intact.
Correct Answer: C,D
Rationale: No odor and an intact seal indicate frequent emptying, preventing urine leakage and skin irritation. Red skin or deep yellow urine suggest inadequate care or dehydration.
A 36-year-old female is scheduled to receive external radiation therapy and a cesium implant for cancer of the cervix. Which of the following statements would be most accurate to include in the teaching plan about the potential effects of radiation therapy on sexuality?
- A. You can have sexual intercourse while the implant is in place.
- B. You may notice some vaginal dryness after treatment is completed.
- C. You may notice some vaginal relaxation after treatment is completed.
- D. You will continue to have normal menstrual periods during treatment.
Correct Answer: B
Rationale: Vaginal dryness is a common side effect of cervical radiation due to mucosal changes, and should be included in the teaching plan to prepare the client.