A 45-year-old obese man arrives at a clinic reporting daytime sleepiness, difficulty falling asleep at night, and snoring. The nurse should recognize the manifestations of what health problem?
- A. Adenoiditis
- B. Chronic tonsillitis
- C. Obstructive sleep apnea
- D. Laryngeal cancer
Correct Answer: C
Rationale: The correct answer is C: Obstructive sleep apnea. The patient's symptoms of daytime sleepiness, difficulty falling asleep, and snoring are classic signs of obstructive sleep apnea, a condition where the upper airway collapses during sleep, leading to pauses in breathing. This results in poor sleep quality and daytime fatigue. Adenoiditis (choice A) and chronic tonsillitis (choice B) typically present with symptoms like sore throat and difficulty swallowing, which are not seen in this patient. Laryngeal cancer (choice D) would present with hoarseness, persistent cough, and difficulty swallowing, which are not mentioned in the patient's symptoms. Therefore, based on the patient's presentation, the most likely diagnosis is obstructive sleep apnea.
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A client with rheumatoid arthritis is prescribed methotrexate. Which instruction should the nurse include in the client's teaching?
- A. Avoid alcohol while taking this medication.
- B. Take the medication with a full meal.
- C. Increase your intake of high-fiber foods.
- D. Avoid exposure to sunlight.
Correct Answer: A
Rationale: The correct answer is A: Avoid alcohol while taking this medication. Methotrexate can cause liver toxicity, and alcohol consumption can exacerbate this risk. It is important for the client to avoid alcohol to prevent potential harm to the liver.
B: Taking the medication with a full meal is not a necessary instruction for methotrexate. It is typically recommended to take methotrexate on an empty stomach.
C: Increasing intake of high-fiber foods is not directly related to methotrexate therapy. It is important for overall health but not specifically for this medication.
D: Avoiding exposure to sunlight is not a common instruction for methotrexate. While some medications can increase sensitivity to sunlight, this is not a typical concern with methotrexate.
A client is being educated about type 2 diabetes. The educator can confirm that the client understands the primary treatment for type 2 diabetes when the client states what?
- A. I read that a pancreas transplant will provide a cure for my diabetes.
- B. I will take my oral antidiabetic agents when my morning blood sugar is high.
- C. I will make sure to follow the weight loss plan designed by the dietitian.
- D. I will make sure I call the diabetes educator when I have questions about my insulin.
Correct Answer: C
Rationale: Correct Answer: C
Rationale:
1. Weight loss helps improve insulin sensitivity.
2. Managing weight is crucial for controlling blood sugar levels.
3. Dietitian-designed plans focus on balanced nutrition for diabetes management.
4. Weight loss can reduce the need for medication and improve overall health.
Summary of Incorrect Choices:
A: Pancreas transplant is not a primary treatment for type 2 diabetes.
B: Taking oral antidiabetic agents based on blood sugar levels is not ideal.
D: Contacting the diabetes educator for insulin questions is important but not primary treatment.
After a client's neck dissection surgery resulted in damage to the superior laryngeal nerve, what area of assessment should the nurse prioritize?
- A. The client's swallowing ability
- B. The client's ability to speak
- C. The client's management of secretions
- D. The client's airway patency
Correct Answer: A
Rationale: The correct answer is A: The client's swallowing ability. Damage to the superior laryngeal nerve can lead to swallowing difficulties, as it innervates the muscles involved in swallowing. Prioritizing assessment of swallowing ability is crucial to prevent aspiration and ensure adequate nutrition intake.
Incorrect choices:
B: The client's ability to speak - Damage to the superior laryngeal nerve mainly affects swallowing, not speech.
C: The client's management of secretions - While important, it is secondary to swallowing assessment in this context.
D: The client's airway patency - Although important, focusing on swallowing ability is more directly related to the nerve damage.
A healthcare professional is participating in the emergency care of a client who has just developed variceal bleeding. What intervention should the healthcare professional anticipate?
- A. Infusion of intravenous heparin
- B. IV administration of albumin
- C. STAT administration of vitamin K by the intramuscular route
- D. IV administration of octreotide
Correct Answer: D
Rationale: The correct answer is D: IV administration of octreotide. Octreotide is indicated for variceal bleeding as it reduces portal venous pressure, decreases blood flow to varices, and inhibits release of vasoactive substances. It helps control bleeding and stabilize the patient. Heparin (A) is not indicated for variceal bleeding. Albumin (B) may be used for volume resuscitation but does not address the bleeding. Vitamin K (C) is used for coagulation disorders, not variceal bleeding.
A 48-year-old man 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. In this scenario, the patient has symptoms of hypothyroidism (fatigue, weight gain, cold intolerance) along with high TSH and low free T4 levels, indicating primary hypothyroidism. TSH is elevated as the body is trying to stimulate the thyroid to produce more thyroid hormones. Free T4 is low as the thyroid is not able to produce enough hormones. Hyperthyroidism (choice B) would present with low TSH and high free T4 levels. Thyroiditis (choice C) typically presents with symptoms of hyperthyroidism followed by hypothyroidism. Thyroid cancer (choice D) usually does not cause these specific symptoms and lab findings. Therefore, based on the symptoms and lab results, hypothyroidism is the most likely diagnosis.