Nokea
A nurse assesses a client who is prescribed thyroid hormone replacement. Which finding indicates a therapeutic response to the medication?
- A. Thirst is recognized and fluid intake is appropriate
- B. Weight has been the same for 3 weeks
- C. Total white blood cell count is 6000 cells/mm³
- D. Heart rate is 70 beats/min and regular
Correct Answer: D
Rationale: Hypothyroidism decreases body functioning, leading to effects like bradycardia. A heart rate of 70 beats/min and regular while on thyroid hormone replacement indicates adequate dosing. Thirst, fluid intake, weight stability, and white blood cell count are not direct indicators of therapeutic response.
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A nurse cares for a client who is recovering from a parathyroidectomy. When taking the client's blood pressure, the nurse notes that the client's hand has gone into flexion contractions. Which laboratory result does the nurse correlate with this condition?
- A. Serum potassium: 5.2 mEq/L
- B. Serum magnesium: 1.7 mEq/L
- C. Serum sodium: 144 mEq/L
- D. Serum calcium: 6 mg/dL
Correct Answer: D
Rationale: Hypocalcemia, indicated by a serum calcium level of 6 mg/dL, destabilizes excitable membranes, leading to muscle spasms and tetany, such as Trousseau's sign (flexion contractions). Potassium, magnesium, and sodium levels listed are not directly related to this condition.
After teaching a client who is recovering from a complete thyroidectomy, the nurse assesses the client's understanding. Which statement by the client indicates a need for additional instruction?
- A. I may need calcium replacement after surgery
- B. After surgery, I won't need to take thyroid medication
- C. I will need to take thyroid hormones for the rest of my life
- D. I can receive pain medication if I feel that I need it
Correct Answer: B
Rationale: After a complete thyroidectomy, clients require lifelong thyroid hormone replacement due to the removal of the thyroid gland. The statement indicating no need for thyroid medication is incorrect and requires further teaching.
A nurse teaches a client who is prescribed an unsealed radioactive isotope. Which statements should the nurse include in this client's education?
- A. Do not share utensils, plates, or cups with anyone
- B. You can play with your grandchildren for 1 hour each day
- C. Eat foods high in vitamins such as apples, pears, and oranges
- D. Avoid contact with pregnant women and children
- E. Take a laxative 2 days after therapy to excrete the radiation
Correct Answer: A,D,E
Rationale: Clients receiving unsealed radioactive isotopes must avoid sharing utensils, contact with pregnant women and children, and take laxatives on days 2 and 3 to excrete radiation. Playing with grandchildren and eating specific fruits are not recommended due to radiation safety concerns.
A nurse assesses a client with hyperthyroidism who is prescribed lithium carbonate. Which assessment finding should alert the nurse to a side effect of this therapy?
- A. Blurred and double vision
- B. Increased thirst and urination
- C. Increased thirst and double vision
- D. Decreased attention and insomnia
Correct Answer: B
Rationale: Lithium antagonizes antidiuretic hormone and can cause symptoms of diabetes insipidus. This manifests with increased thirst and urination. Lithium has no effect on vision, gastric upset, or level of consciousness.
A nurse assesses clients for potential endocrine disorders. Which client is at greatest risk for hyperparathyroidism?
- A. A 20-year-old female with pregnancy-induced hypertension
- B. A 41-year-old male receiving dialysis for end-stage kidney disease
- C. A 41-year-old male receiving dialysis for end-stage kidney disease
- D. A 27-year-old male who is prescribed home oxygen therapy
Correct Answer: B
Rationale: Clients with chronic kidney disease have impaired vitamin D activation and calcium absorption, leading to chronic hypocalcemia, which overstimulates the parathyroid glands, causing hyperparathyroidism. Pregnancy-induced hypertension and oxygen therapy do not increase this risk.