Nokea
A female client with a history of pheochromocytoma is admitted to the hospital in an acute hypertensive crisis. To reverse the hypertensive crisis caused by pheochromocytoma, nurse Lyka expects to administer:
- A. Phentolamine (Regitine)
- B. Methyldopa (Aldomet)
- C. Mannitol (Osmitrol)
- D. Felodipine (Plendil)
Correct Answer: A
Rationale: In a hypertensive crisis due to pheochromocytoma, the appropriate medication to administer is Phentolamine (Regitine), an alpha-adrenergic blocker. Phentolamine acts quickly to block the effects of excess catecholamines that are released in pheochromocytoma, helping to rapidly lower blood pressure. Methyldopa (Aldomet) is an alpha-2 adrenergic agonist used for chronic hypertension, not for acute crises like pheochromocytoma. Mannitol (Osmitrol) is an osmotic diuretic used to reduce intracranial pressure and treat cerebral edema, not indicated for hypertensive crises. Felodipine (Plendil) is a calcium channel blocker used for chronic management of hypertension, not for acute hypertensive crises like those seen in pheochromocytoma.
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The healthcare provider is assessing a client with Addison's disease. Which of the following symptoms is consistent with this condition?
- A. Hypertension
- B. Hyperglycemia
- C. Hyperpigmentation
- D. Weight gain
Correct Answer: C
Rationale: Hyperpigmentation is a characteristic symptom of Addison's disease. In Addison's disease, there is a decrease in cortisol production, leading to an increase in adrenocorticotropic hormone (ACTH) secretion by the pituitary gland. Excess ACTH can stimulate melanocytes, resulting in hyperpigmentation. Choices A, B, and D are not typically associated with Addison's disease. Hypertension is more commonly associated with conditions involving excess cortisol production, such as Cushing's syndrome. Hyperglycemia may occur in diabetes mellitus but is not a hallmark of Addison's disease. Weight loss, rather than weight gain, is a common symptom of Addison's disease due to decreased cortisol levels.
A client with type 1 diabetes mellitus is experiencing hypoglycemia. What should the nurse instruct the client to do?
- A. Administer insulin immediately
- B. Consume 15 grams of simple carbohydrates
- C. Drink plenty of water
- D. Avoid eating until symptoms resolve
Correct Answer: B
Rationale: When a client with type 1 diabetes mellitus experiences hypoglycemia, the nurse should instruct them to consume 15 grams of simple carbohydrates. This is the recommended initial treatment for hypoglycemia as it helps quickly raise blood sugar levels to alleviate symptoms and prevent complications. Administering insulin immediately (Choice A) would further lower blood sugar levels, worsening the hypoglycemia. Drinking plenty of water (Choice C) and avoiding eating until symptoms resolve (Choice D) are not appropriate actions for treating hypoglycemia as they do not address the immediate need to raise blood sugar levels.
The nurse is caring for a client with Addison's disease. The client exhibits signs of hypotension, dehydration, and confusion. The nurse should anticipate administering which of the following medications?
- A. Insulin
- B. Hydrocortisone
- C. Levothyroxine
- D. Methimazole
Correct Answer: B
Rationale: In Addison's disease, the adrenal glands do not produce enough cortisol. Hydrocortisone is a glucocorticoid medication that is used to replace deficient cortisol levels in patients with Addison's disease. It helps stabilize blood pressure and fluid balance. Insulin (Choice A) is used to manage diabetes, not Addison's disease. Levothyroxine (Choice C) is a thyroid hormone replacement used to treat hypothyroidism, not Addison's disease. Methimazole (Choice D) is used in the treatment of hyperthyroidism, not Addison's disease.
Which of the following best describes the nurse's role in maintaining patient dignity?
- A. The nurse ensures that the patient is treated with respect and that their personal beliefs and values are considered in their care.
- B. The nurse maintains the patient's dignity by ensuring privacy during personal care activities.
- C. The nurse ensures that the patient's personal information is kept private and only shared with those directly involved in their care.
- D. The nurse ensures that the patient is involved in decisions about their care and that their preferences are respected.
Correct Answer: A
Rationale: The correct answer is A. The nurse's role in maintaining patient dignity goes beyond just privacy during personal care activities. It involves treating the patient with respect, considering their personal beliefs and values in their care. While privacy is important for dignity, respecting personal beliefs and values is equally crucial. Choice B focuses solely on privacy, overlooking the broader aspects of dignity maintenance. Choices C and D, although important in patient care, do not fully capture the comprehensive approach needed for maintaining patient dignity as described in choice A.
The client is receiving dietary instructions for hypoparathyroidism. Which of the following dietary recommendations is appropriate?
- A. Increase intake of dairy products and green leafy vegetables
- B. Avoid foods high in calcium
- C. Consume a high-sodium diet
- D. Limit fluid intake to prevent fluid overload
Correct Answer: A
Rationale: For clients with hypoparathyroidism, the appropriate dietary recommendation is to increase intake of calcium-rich foods like dairy products and green leafy vegetables to help manage hypocalcemia. This is because hypoparathyroidism leads to low levels of calcium in the blood, so increasing calcium intake through diet is essential. Choices B, C, and D are incorrect. Avoiding foods high in calcium (choice B) would exacerbate the hypocalcemia. Consuming a high-sodium diet (choice C) is not necessary for managing hypoparathyroidism. Limiting fluid intake (choice D) is not directly related to the dietary management of hypoparathyroidism.