Nokea
A clinic nurse is teaching the client newly diagnosed with hypothyroidism. Which instructions should the nurse provide about taking levothyroxine sodium? Select all that apply.
- A. Take the medication 1 hour before or 2 hours after breakfast.
- B. Call the clinic if the pulse before taking the medication is greater than 100 beats per minute.
- C. Report adverse drug effects, including weight gain, cold intolerance, and alopecia.
- D. Take this drug as prescribed; it replaces thyroid hormone thatå‚¾å‘ diminished or absent.
- E. Have frequent laboratory monitoring to be sure your levels of T3 and T4 decrease.
Correct Answer: A,B,D
Rationale: Taking levothyroxine on an empty stomach ensures absorption, notifying the clinic for tachycardia prevents overdose, and taking it as prescribed replaces deficient hormone.
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The client diagnosed with acute pancreatitis is being discharged home. Which statement by the client indicates the teaching has been effective?
- A. I should decrease my intake of coffee, tea, and cola.
- B. I will eat a low-fat diet and avoid spicy foods.
- C. I will check my amylase and lipase levels daily.
- D. I will return to work tomorrow but take it easy.
Correct Answer: B
Rationale: A low-fat, non-spicy diet prevents pancreatitis exacerbation, indicating effective teaching. Caffeine reduction is secondary, amylase/lipase are not self-monitored, and early work return is risky.
The nurse is reviewing serum laboratory results for four female clients. Place an X on the client requiring the most immediate assessment.
- A. Client A: TSH 5.2 mIU/L, Free T4 0.8 ng/dL
- B. Client B: GH 23 µg/L, IGF-I 490 ng/mL
- C. Client C: Free T4 7.0 ng/dL, TSH 0.1 mIU/L
- D. Client D: Fasting glucose 140 mg/dL, Hgb A1c 6.9%
Correct Answer: C
Rationale: Client C has elevated free T4 and decreased TSH, indicating hyperthyroidism, which can lead to life-threatening thyroid storm with severe hypertension and tachycardia, requiring immediate assessment.
The nurse is admitting a client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which clinical manifestations should be reported to the health-care provider?
- A. Serum sodium of 112 mEq/L and a headache.
- B. Serum potassium of 5.0 mEq/L and a heightened awareness.
- C. Serum calcium of 10 mg/dL and tented tissue turgor.
- D. Serum magnesium of 1.2 mg/dL and large urinary output.
Correct Answer: A
Rationale: Severe hyponatremia (112 mEq/L) and headache in SIADH risk seizures, requiring immediate HCP notification. Other findings are less critical or unrelated.
What should be included in the nursing care plan for a client with diabetes insipidus?
- A. Blood pressure every hour
- B. Strict intake and output
- C. Urine for ketone bodies
- D. Glucose monitoring four times a day
Correct Answer: B
Rationale: Diabetes insipidus causes excessive urine output due to low antidiuretic hormone, requiring strict intake and output monitoring to assess fluid balance.
A client has a transsphenoidal hypophysectomy to remove a pituitary tumor. When the client returns to the nursing unit following surgery, the head of the bed is elevated 30 degrees. What is the primary purpose for placing the client in this position?
- A. To promote respiratory effort
- B. To reduce pressure on the sella turcica
- C. To prevent acidosis
- D. To promote oxygenation
Correct Answer: B
Rationale: Elevating the head 30 degrees reduces pressure on the sella turcica, minimizing the risk of cerebrospinal fluid leakage post-hypophysectomy.