Nokea
A 35-year-old woman presents with fatigue, weight gain, and cold intolerance. Laboratory tests reveal high TSH and low free T4 levels. What is the most likely diagnosis?
- A. Hypothyroidism
- B. Hyperthyroidism
- C. Thyroiditis
- D. Thyroid cancer
Correct Answer: A
Rationale: The correct answer is A: Hypothyroidism. The patient's symptoms of fatigue, weight gain, and cold intolerance are classic signs of hypothyroidism. Elevated TSH and low free T4 levels indicate primary hypothyroidism. TSH is high due to the pituitary gland trying to stimulate the thyroid gland to produce more thyroid hormones, but the thyroid gland is unable to do so. Hyperthyroidism (choice B) would present with opposite symptoms and lab values. Thyroiditis (choice C) typically presents with transient hyperthyroidism followed by hypothyroidism. Thyroid cancer (choice D) is less common and typically does not present with these typical hypothyroid symptoms and lab findings.
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A client with a history of chronic alcohol abuse is at risk for which of the following conditions?
- A. Liver cirrhosis
- B. Renal failure
- C. Chronic obstructive pulmonary disease (COPD)
- D. Peptic ulcer disease
Correct Answer: A
Rationale: The correct answer is A: Liver cirrhosis. Chronic alcohol abuse is a leading cause of liver cirrhosis due to the toxic effects of alcohol on the liver over time. Alcohol metabolism leads to liver inflammation, scarring, and ultimately cirrhosis. Renal failure (B) is not directly linked to alcohol abuse but can occur in severe cases. COPD (C) is primarily caused by smoking, not alcohol abuse. Peptic ulcer disease (D) can be exacerbated by alcohol but is not directly caused by chronic alcohol abuse. Therefore, the most significant risk for a client with a history of chronic alcohol abuse is developing liver cirrhosis.
A client returns to the unit after a neck dissection. The surgeon placed a Jackson-Pratt drain in the wound. When assessing the wound drainage over the first 24 postoperative hours, what finding would prompt the nurse to notify the health care provider immediately?
- A. Presence of small blood clots in the drainage
- B. 60 mL of milky or cloudy drainage
- C. Spots of drainage on the dressings surrounding the drain
- D. 120 mL of serosanguinous drainage
Correct Answer: B
Rationale: The correct answer is B: 60 mL of milky or cloudy drainage. This finding could indicate the presence of an infection, which is a serious complication post-neck dissection. Milky or cloudy drainage may contain pus, indicating the need for immediate intervention to prevent further complications.
A: Presence of small blood clots in the drainage is relatively common and may not necessarily indicate a problem unless there are large clots or excessive bleeding.
C: Spots of drainage on the dressings surrounding the drain are expected and do not necessarily warrant immediate notification unless there is excessive leakage.
D: 120 mL of serosanguinous drainage is within the expected range for the first 24 hours postoperatively and may not be a cause for immediate concern unless there are other symptoms present.
A client has been diagnosed with an esophageal diverticulum after undergoing diagnostic imaging. When taking the health history, the nurse should expect the client to describe what sign or symptom?
- A. Burning pain on swallowing
- B. Regurgitation of undigested food
- C. Symptoms mimicking a myocardial infarction
- D. Chronic parotid abscesses
Correct Answer: B
Rationale: Rationale for Correct Answer B (Regurgitation of undigested food):
1. Esophageal diverticulum is a pouch-like protrusion in the esophageal wall, causing difficulty in swallowing.
2. Due to the diverticulum, food may get trapped and regurgitated, leading to regurgitation of undigested food.
3. This symptom is characteristic of esophageal diverticulum and indicates an abnormality in the esophageal functioning.
Summary of Incorrect Choices:
A: Burning pain on swallowing - Not a typical symptom of esophageal diverticulum; more indicative of conditions like GERD.
C: Symptoms mimicking a myocardial infarction - Unrelated to esophageal diverticulum and more suggestive of cardiac issues.
D: Chronic parotid abscesses - Not associated with esophageal diverticulum, as parotid abscesses involve the salivary glands.
A client with newly diagnosed type 2 diabetes is preparing for discharge. Which statement by the client indicates a need for further teaching?
- A. I will take my insulin shots only when my blood sugar is high
- B. I need to follow a balanced diet and exercise regularly
- C. I should monitor my blood sugar levels regularly
- D. I need to take my medication as prescribed by my doctor
Correct Answer: A
Rationale: The correct answer is A because insulin shots are not only taken when blood sugar is high in type 2 diabetes. Insulin therapy may be prescribed by the doctor to be taken at specific times regardless of blood sugar levels to manage the condition effectively. Choice B is correct as it emphasizes the importance of lifestyle modifications in managing diabetes. Choice C is correct as monitoring blood sugar levels is crucial for managing diabetes. Choice D is correct as adherence to prescribed medication is essential in controlling blood sugar levels.
When planning care for a 16-year-old with appendicitis presenting with right lower quadrant pain, what should the nurse prioritize as a nursing diagnosis?
- A. Imbalanced nutrition: Less than body requirements related to decreased oral intake
- B. Risk for infection related to possible rupture of the appendix
- C. Constipation related to decreased bowel motility and decreased fluid intake
- D. Chronic pain related to appendicitis
Correct Answer: B
Rationale: The correct answer is B: Risk for infection related to possible rupture of the appendix. This is the priority nursing diagnosis because appendicitis can lead to a life-threatening condition if the appendix ruptures. The nurse needs to monitor for signs of worsening infection such as fever and increased pain.
A: Imbalanced nutrition is not the priority as it is secondary to the risk of infection.
C: Constipation is not the priority as it is not directly related to the life-threatening complication of appendicitis.
D: Chronic pain is also not the priority as the risk of infection and potential rupture take precedence in the care of the patient.