Nokea
A client asks the nurse how long she has to take her medicine for hypothyroidism. The nurse's response is based on the knowledge that:
- A. Lifelong daily medicine is necessary.
- B. The medication is expensive, and the dose can be reduced in a few months.
- C. The medication can be gradually withdrawn in 1 to 2 years.
- D. The medication can be discontinued after the client's thyroid-stimulating hormone level is normal.
Correct Answer: A
Rationale: Hypothyroidism typically requires lifelong thyroid hormone replacement therapy, as the condition is usually permanent due to underlying thyroid dysfunction.
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The nurse should turn the client on bed rest every 2 hours to prevent the development of pressure ulcers. In addition, the nurse should:
- A. Have the client walk at least twice a day
- B. Insert an indwelling urinary catheter
- C. Monitor serum albumin
- D. Monitor the white blood cell count
Correct Answer: C
Rationale: Monitoring serum albumin assesses nutritional status, which is critical for skin integrity and preventing pressure ulcers. Walking is contraindicated for bed rest, catheters increase infection risk, and white blood cell count is less relevant.
You are having a nice dinner in a fancy restaurant. As you are eating, you hear the gentleman eating at the next table start to bang the table, hold his throat and forcibly cough. What should you do?
- A. Perform the Valsalva maneuver
- B. Encourage the person to continue coughing
- C. Perform the Heimlich maneuver
- D. Begin CPR and prepare for ACLS measures
Correct Answer: B
Rationale: Forcing coughing suggests a partial airway obstruction. Encouraging the person to continue coughing is the first step to dislodge the obstruction without invasive intervention.
The nurse instills 5 mL of normal saline before suctioning a client's tracheostomy tube. The instillation is effective when:
- A. The secretions are thinned.
- B. The client coughs.
- C. There is minimal friction when the catheter is passed into the tracheostomy tube.
- D. There is humidification for the respiratory tract.
Correct Answer: A
Rationale: Instilling normal saline thins secretions, facilitating effective suctioning of the tracheostomy tube.
A client with a history of chronic lymphocytic leukemia is prescribed rituximab (Rituxan). The nurse should monitor the client for which of the following side effects during infusion?
- A. Hypotension.
- B. Hyperglycemia.
- C. Infusion reactions.
- D. Weight loss.
Correct Answer: C
Rationale: Rituximab can cause infusion reactions, such as fever or chills, requiring close monitoring during administration.
Bacterial conjunctivitis has affected several children at a local day care center. A nurse should advise which measure to minimize the risk of infection?
- A. Close the day care center for 1 week to control the outbreak.
- B. Restrict the infected children from returning for 48 hours after treatment.
- C. Perform thorough hand washing before and after touching any child in the day care center.
- D. Set up a conference with the parents of each child to explain the situation carefully.
Correct Answer: C
Rationale: Thorough hand washing is the most effective measure to prevent the spread of bacterial conjunctivitis.