Nokea
A nurse is caring for a client who is newly diagnosed with hyperthyroidism and reports dry eyes and sensitivity to light. The nurse notes that the client's eyes have a bulging appearance. Which of the following should the nurse include in the client's plan of care?
- A. Exposure to sunlight will help to strengthen your eyes.
- B. These are unusual symptoms. I will ask the provider for an ophthalmology referral.
- C. Eye drops and dim lighting can improve your symptoms.
- D. Surgery will be necessary to correct the damage to your eyes.
Correct Answer: C
Rationale: The correct answer is C: Eye drops and dim lighting can improve your symptoms. In hyperthyroidism, the bulging appearance of the eyes, known as exophthalmos, can lead to dry eyes and sensitivity to light. Eye drops can help alleviate dryness, and dim lighting can reduce discomfort from light sensitivity. This intervention addresses the client's specific symptoms and promotes comfort.
Choice A is incorrect because sunlight exposure can exacerbate light sensitivity in clients with hyperthyroidism. Choice B is incorrect as it does not provide a direct intervention for the client's symptoms and delays addressing the discomfort. Choice D is incorrect because surgery is not typically the first-line treatment for eye symptoms in hyperthyroidism; conservative measures are usually tried first.
You may also like to solve these questions
A nurse is planning care for a client who has hyperthyroidism and is receiving radioactive iodine (radioiodine). Which of the following statements by the nurse regarding special precautions is appropriate?
- A. You will need to use a bathroom separate from other household members.
- B. You will need to remain at the hospital for the entire time the radioiodine is radioactive.
- C. A low fiber diet will be necessary.
- D. Additional Immunizations will be needed for full protection.
Correct Answer: A
Rationale: Rationale: Choice A is correct because radioiodine is excreted through bodily fluids including urine. Using a separate bathroom prevents exposure to others. Choice B is incorrect as hospitalization isn't always required. Choice C is irrelevant to radioiodine therapy. Choice D is incorrect as immunizations are not directly related to radioiodine precautions.
A home health nurse is making a home visit to a client who has Alzheimer's disease and the client's partner. Which of the following observations indicates to the nurse that the partner is experiencing caregiver role strain?
- A. The partner has hired a house cleaner.
- B. The partner has placed locks at the top of the doors leading to the outside.
- C. The partner has lost 25 lb in the past 3 months.
- D. The partner redirects the client when the client is frustrated.
Correct Answer: C
Rationale: The correct answer is C because the partner losing 25 lb in the past 3 months indicates caregiver role strain. Weight loss can be a sign of stress and neglecting one's own needs while caring for someone with Alzheimer's. This choice reflects the physical toll caregiving can take.
A: Hiring a house cleaner (choice A) shows that the partner is seeking help and support, which is a positive coping strategy and does not necessarily indicate caregiver role strain.
B: Placing locks at the top of the doors (choice B) demonstrates safety measures for the client and does not directly indicate caregiver role strain.
D: Redirecting the client when frustrated (choice D) shows appropriate management of challenging behaviors and does not directly indicate caregiver role strain.
In summary, choice C is the best indicator of caregiver role strain as it reflects the physical impact of the caregiving responsibilities on the partner's well-being.
During a group therapy meeting,a client brings up a concern about the cleanliness of the bathroom. The nurse asks the group what should be done about the issue and how to resolve it. The nurse is demonstrating which type of leadership style?
- A. Laissez-faire
- B. Surrogate
- C. Autocratic
- D. Democratic
Correct Answer: D
Rationale: The correct answer is D: Democratic. In a democratic leadership style, the leader involves group members in decision-making. In this scenario, the nurse is asking the group for input and involving them in the process of resolving the issue, which aligns with the democratic approach. This empowers the group members to participate in finding a solution and promotes teamwork.
A: Laissez-faire is incorrect because in this style, the leader is hands-off and does not provide much guidance or direction.
B: Surrogate is incorrect as it refers to a substitute leader who takes over temporarily.
C: Autocratic is incorrect because in this style, the leader makes decisions without consulting the group.
Overall, the democratic leadership style is the most suitable for fostering collaboration and addressing group concerns effectively in this context.
Susan,the nurse is caring for a client who states "I plan to commit suicide." Which of the following assessments should the nurse identify as the priority?
- A. Lethality of the method and availability of means
- B. Client's educational and economic background
- C. Client's insight into the reasons for the decision
- D. Quality of the client's social support
Correct Answer: A
Rationale: The correct answer is A. Assessing the lethality of the method and availability of means is the priority because it directly addresses the client's immediate safety. Understanding how easily the client can access the means to commit suicide is crucial in preventing harm. Choices B, C, and D are important aspects of a comprehensive assessment but do not directly address the immediate risk of suicide. Choice B focuses on background information, which may be relevant for understanding the client but is not the priority in this urgent situation. Choice C pertains to the client's insight, which is important for therapeutic interventions but does not address the imminent risk. Choice D considers social support, which is valuable in long-term prevention but not the immediate concern.
A nurse is caring for a client who reports increased anxiety and nervousness,heat intolerance,and unintentional weight loss. Blood testing reveals decreased thyroid-stimulating hormone (TSH),elevated thyroxine (T4) and elevated triiodothyronine (T3) levels. Which of the following vital sign abnormalities does the nurse anticipate?
- A. Hypotension
- B. Tachycardia
- C. Slow respiratory rate
- D. Decreased body temperature
Correct Answer: B
Rationale: The correct answer is B: Tachycardia. In this scenario, the client is showing symptoms of hyperthyroidism, such as increased anxiety, nervousness, heat intolerance, and unintentional weight loss. The decreased TSH and elevated T4/T3 levels indicate an overactive thyroid gland.
Tachycardia is a common symptom of hyperthyroidism due to the increased metabolic rate caused by excess thyroid hormones. The body's response to the increased metabolism is to speed up the heart rate to meet the increased demand for oxygen and nutrients. Therefore, the nurse can anticipate tachycardia in this client.
The other options are incorrect because hypotension is not typically associated with hyperthyroidism; slow respiratory rate is not a common vital sign abnormality seen in hyperthyroidism; decreased body temperature is unlikely as hyperthyroidism usually causes heat intolerance and increased body temperature.