Nokea
A 60-year-old female is diagnosed with hypothyroidism. The nurse should assess the client for which of the following?
- A. Tachycardia.
- B. Weight gain.
- C. Diarrhea.
- D. Nausea.
Correct Answer: B
Rationale: Hypothyroidism causes a slowed metabolism, leading to weight gain. Tachycardia, diarrhea, and nausea are more associated with hyperthyroidism.
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A client undergoing a bilateral adrenalectomy has postoperative orders for hydromorphone hydrochloride (Dilaudid) 2 mg to be given subcutaneously every 4 hours as needed for pain. The medication is administered in relatively small doses primarily because it is:
- A. Less likely to cause dependency in small doses.
- B. Less irritating to subcutaneous tissues in small doses.
- C. As potent as most other analgesics in larger doses.
- D. Excreted before accumulating in toxic amounts in the body.
Correct Answer: C
Rationale: Hydromorphone is a potent opioid, effective in small doses, reducing the need for larger doses that increase side effect risks.
What is the priority nursing action for a client with a suspected brain tumor?
- A. Administer pain medication.
- B. Monitor neurological status.
- C. Provide emotional support.
- D. Restrict physical activity.
Correct Answer: B
Rationale: Monitoring neurological status is the priority to detect changes associated with a brain tumor.
A family member asks the nurse why their loved one with end-stage liver cancer is so restless. The nurse's best response is:
- A. Restlessness is a side effect of pain medications.
- B. It may be due to decreased oxygen to the brain.
- C. It's a normal part of the dying process.
- D. It's caused by dehydration.
Correct Answer: C
Rationale: Restlessness is a common symptom in the dying process, often due to metabolic changes or psychological factors, and explaining this normalizes the family's experience.
A client post-cystoscopy is discharged. The nurse should instruct to:
- A. Resume normal activity.
- B. Avoid fluids for 24 hours.
- C. Expect blue urine.
- D. Take antibiotics for a week.
Correct Answer: A
Rationale: Normal activity can resume post-cystoscopy unless complications arise.
The nurse is caring for a client requiring an emergent transfusion of packed red blood cells. The nurse checks the blood bank, but the only available blood is O + (positive). The client's blood type is A+ (positive). What is the nurse's most appropriate action?
- A. Arrange for a cross-match between the available blood and the client's blood.
- B. Call the other blood banks and ask if they have blood units available with the client’s blood type.
- C. Notify the physician that there is no available blood in the blood bank.
- D. Call the client’s family and tell them that he needs blood.
Correct Answer: A
Rationale: In an emergency, O+ blood can be safely transfused to an A+ client, as O+ is the universal donor for red blood cells. Arranging for a cross-match ensures compatibility and is the most appropriate action. Contacting other blood banks or notifying the physician delays care, and calling the family is inappropriate.