Nokea
A client with severe hypoparathyroidism is experiencing tetany. What medication, prescribed by the physician for emergency use, will the nurse administer to correct the deficit?
- A. Sodium bicarbonate
- B. Fludrocortisone
- C. Calcium gluconate
- D. Methylprednisolone
Correct Answer: C
Rationale: Tetany and severe hypoparathyroidism are treated immediately by the administration of an IV calcium salt, such as calcium gluconate. The other medications are not effective for the treatment of calcium deficit.
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The nurse is caring for a client who has developed diabetes insipidus. The cause is unknown, and the physician has ordered a diagnostic test to determine if the cause is nephrogenic or neurogenic. What test will the nurse prepare the client for?
- A. Urine specific gravity
- B. Fluid deprivation test
- C. Urine osmolality
- D. Serum osmolality
Correct Answer: B
Rationale: A fluid deprivation test can diagnose diabetes insipidus (DI) and differentiate neurogenic DI from nephrogenic DI. The other tests listed are nonspecific tests that help support diagnosis.
The nurse is instructing a client about taking corticosteroid therapy for adrenal insufficiency. What statement made by the client indicates a need for further instruction?
- A. I will take the corticosteroid medication until my adrenal glands begin to work.'
- B. I will not omit any of the doses of my medication.'
- C. I will seek medical attention for dosage readjustments whenever I am under stress.'
- D. I will get plenty of rest and avoid exposure to infection.'
Correct Answer: A
Rationale: The nurse should explain adrenal insufficiency and the importance of lifetime corticosteroid replacement. The other statements indicate that the client is educated about medication administration.
A client is scheduled for a hypophysectomy for the management of a pituitary tumor. What is the nurse priority when caring for this client? Select all that apply.
- A. Assure the client that he will make it through the surgery without any difficulty.
- B. Help the client cope with changes in physical appearance.
- C. Pace activities to accommodate the client's fatigue.
- D. Relieve discomfort from headaches, abdominal distention, and skeletal pain.
- E. Encourage self-care and activities as client's endurance permits.
Correct Answer: B,C,D,E
Rationale: Until the client has surgery or receives radiation treatment, nursing priorities include helping the client cope with changes in physical appearance; pacing activities to accommodate the client's fatigue; and relieving discomfort from headaches, abdominal distention resulting from organ enlargement, and skeletal pain. Assuring the client that he will make it through the surgery without any difficulty is not appropriate as it dismisses the client's concerns and does not address specific care priorities.
A client with acromegaly is complaining of severe headaches. What does the nurse suspect is the cause of the headaches that is related to the acromegaly?
- A. A pituitary tumor
- B. A decrease in release in the growth hormone
- C. A decrease in the glucose level
- D. An increase in cerebral edema
Correct Answer: A
Rationale: When the overgrowth is from a tumor, headaches caused by pressure on the sella turcica, a bony depression in which the pituitary gland rests, are common. There is actually an increase in the secretion of the growth hormone. The headaches would not be caused by decreases in glucose levels. The client does not have cerebral edema.
A client with Addison disease has a blood glucose level above 80 mg/dL 30 minutes after receiving 15 g of carbohydrates for symptoms of hypoglycemia. Which action would the nurse take next?
- A. Inform the physician immediately.
- B. Give the client milk and graham crackers.
- C. Instruct the client to remain in bed.
- D. Check the client's blood glucose level before each meal.
Correct Answer: B
Rationale: Milk and graham crackers contain forms of carbohydrates that take longer to absorb and tend to maintain the blood glucose level for an extended period. The physician should be informed if the client continues to be symptomatic and the blood glucose level is below 80 mg/dL. Maintaining bed rest protects the client from injuries from a fall but does not address the blood glucose issue. Assessing the client's blood glucose level provides a numeric assessment of the blood glucose level and would be performed in an ongoing fashion.