Nokea
A client who has a history of hypothyroidism was initially admitted with lethargy and confusion. Which additional finding warrants the most immediate action by the nurse?
- A. Facial puffiness and periorbital edema
- B. Hematocrit of 30%
- C. Cold and dry skin
- D. Further decline in level of consciousness
Correct Answer: D
Rationale: A further decline in level of consciousness could indicate myxedema coma, a life-threatening complication of hypothyroidism.
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A nurse cares for a client who is recovering from a myocardial infarction. The client states, I will need to stop eating so much chili to keep that indigestion pain from returning. How should the nurse respond?
- A. Chili is high in fat and calories; it would be a good idea to stop eating it.
- B. The provider has prescribed an antacid for you to take every morning.
- C. What do you understand about what happened to you?
- D. When did you start experiencing this indigestion?
Correct Answer: C
Rationale: Assessing the client’s understanding of their condition helps the nurse provide appropriate education and address misconceptions about symptoms.
The nurse has provided home care instructions to the parents of a child who is being discharged after cardiac surgery. Which statement by the parents indicates a need for further instructions?
- A. “A balance of rest and exercise is important.â€
- B. “I can apply lotion or powder to the incision if it is itchy.â€
- C. “Activities in which my child could fall need to be avoided for 2-4 weeks.â€
- D. “We should avoid going to places like the mall or grocery stores for at least 2 weeks after surgery.â€
Correct Answer: B
Rationale: Applying lotion or powder to the incision can increase the risk of infection. Parents should be instructed to keep the incision clean and dry.
Klinefelter's syndrome:
- A. Has a karyotype XXV
- B. Is the result of meiotic non-dysjunction
- C. Shows delay in bone age/maturation
- D. Is a recognised cause of hypogonadotrophic hypogonadism
Correct Answer: B
Rationale: Klinefelter's syndrome is caused by meiotic non-dysjunction, resulting in an extra X chromosome (karyotype XXY). It is not inherited as an X-linked recessive trait, and it is not a cause of hypogonadotrophic hypogonadism.
While preparing to discharge an 8-month-old infant who is recovering from gastroenteritis and dehydration, the nurse teaches the parents about their infant’s dietary and fluid requirements. The nurse should include which other topic in the teaching session?
- A. Nursery schools
- B. Toilet Training
- C. Safety guidelines
- D. Preparation for surgery
Correct Answer: C
Rationale: Safety guidelines are crucial for an 8-month-old infant who is becoming more mobile and curious, reducing the risk of accidents.
The following are major side effects of PGE1 EXCEPT
- A. apnea
- B. fever
- C. cutaneous flushing
- D. hypertension
Correct Answer: D
Rationale: Cutaneous flushing is a common side effect of PGE1, while hypertension is not typically observed.