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A nurse is reviewing the medical records of clients on a hospital floor. Which client would the nurse expect is most at risk for hyperthyroidism?
- A. A 45-year-old female who has a family history of autoimmune disorders
- B. A 73-year-old male who has an iodine deficiency
- C. A 25-year-old female who has metabolic syndrome
- D. A 35-year-old male who has Graves' disease
Correct Answer: D
Rationale: The correct answer is D: A 35-year-old male who has Graves' disease. Graves' disease is a common cause of hyperthyroidism characterized by an overactive thyroid gland. Individuals with Graves' disease often present with symptoms such as weight loss, tremors, and palpitations. The autoimmune nature of Graves' disease leads to the production of thyroid-stimulating immunoglobulins, resulting in excess thyroid hormone production. Therefore, a client with a known diagnosis of Graves' disease is at the highest risk for hyperthyroidism.
A: A 45-year-old female with a family history of autoimmune disorders may be at risk for developing autoimmune conditions, including hyperthyroidism, but without a current diagnosis of hyperthyroidism, she is not the most at risk in this scenario.
B: A 73-year-old male with iodine deficiency is more likely to develop hypothyroidism rather than hyperthyroidism, as iodine deficiency is a common cause
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A nurse is caring for a client who is experiencing a manic episode. Other clients begin to complain about her disruptive behavior on the unit. Which of the following actions should the nurse take?
- A. Warn the client that further disruptions will result in seclusion.
- B. Ask the client to recommend consequences for her disruptive behavior.
- C. Set limits on the client's behavior and be consistent in approach.
- D. Ignore the client's behavior,realizing it is consistent with her illness.
Correct Answer: C
Rationale: The correct answer is C: Set limits on the client's behavior and be consistent in approach. This is the best course of action because it maintains a therapeutic environment while ensuring the safety and well-being of all clients. By setting limits, the nurse establishes boundaries for acceptable behavior during the manic episode, helping to prevent harm and maintain order on the unit. Consistency in approach is crucial to provide the client with structure and predictability, which can help manage the manic symptoms and reduce potential disruptions.
Choice A is not the best option as it may escalate the situation and does not address the underlying issue. Choice B is not appropriate as it puts the responsibility on the client to determine consequences, which may not be effective in managing the behavior. Choice D is incorrect as ignoring the behavior can compromise the safety of other clients and is not a therapeutic approach to managing manic episodes.
A nurse in an acute mental health facility is creating a plan of care for a new client who has histrionic personality disorder. Which of the following is the highest priority for the nurse?
- A. Encourage client input in the treatment plan.
- B. Communicate with the client using concrete language.
- C. Demonstrate assertive behavior.
- D. Promote appropriate behavior during group therapy sessions.
Correct Answer: B
Rationale: The correct answer is B: Communicate with the client using concrete language. When working with a client with histrionic personality disorder, using concrete language helps to set clear boundaries and prevent misinterpretations. This is crucial in maintaining a therapeutic relationship and managing their behavior effectively. Encouraging client input (choice A) is important but not the highest priority in this case. Demonstrating assertive behavior (choice C) and promoting appropriate behavior in group therapy (choice D) are important but not as immediately crucial as clear communication.
Which of the following is a potential dietary recommendation for a client with iron-deficiency anemia?
- A. Limit intake of iron-rich foods to prevent iron overload
- B. Focus on consuming foods high in vitamin C to enhance iron absorption
- C. Avoid foods high in iron such as leafy greens and legumes
- D. Increase intake of iron-rich foods such as red meat and spinach
Correct Answer: B,D
Rationale: The correct answers are B and D. Answer B suggests focusing on consuming foods high in vitamin C to enhance iron absorption. Vitamin C helps increase the absorption of non-heme iron found in plant-based foods, which is important for individuals with iron-deficiency anemia. Answer D recommends increasing intake of iron-rich foods such as red meat and spinach. Red meat contains heme iron, which is more easily absorbed by the body compared to non-heme iron. Therefore, including both vitamin C-rich foods and heme iron sources in the diet can help improve iron levels in individuals with iron-deficiency anemia.
Incorrect choices:
A: Limiting intake of iron-rich foods would not be advisable for someone with iron-deficiency anemia.
C: Avoiding foods high in iron would worsen the condition of iron-deficiency anemia.
E, F, G: No information provided.
Give Dobutamine 5.5 mcg/kg/min. The drug is available as 750 mg in 500 ml of fluid. The client weighs 220 pounds. Calculate mcg/min, mcg/hr, and ml/hr. (Include the unit of measure for each answer).
Correct Answer: 22
Rationale: To calculate mcg/min: 5.5 mcg/kg/min * 220 lb * (1 kg/2.2 lb) = 1,100 mcg/min. To convert mcg/hr: 1,100 mcg/min * 60 min/hr = 66,000 mcg/hr. To find ml/hr: 750 mg / 500 ml = 1.5 mg/ml. 5.5 mcg/kg/min * 220 lb * (1 kg/2.2 lb) = 1,100 mcg/min. 1,100 mcg/min * 60 min/hr = 66,000 mcg/hr. 66,000 mcg/hr / 1,000 = 66 mg/hr. 66 mg/hr / 1.5 mg/ml = 44 ml/hr. Therefore, the correct answer is 22 mcg/min, 66,000 mcg/hr, and 44 ml/hr. Other choices are
Which of the following is a characteristic sign of hyperthyroidism?
- A. Cold intolerance
- B. Fatigue and lethargy
- C. Tremors and nervousness
- D. Weight gain
Correct Answer: C
Rationale: The correct answer is C: Tremors and nervousness. Hyperthyroidism is an overactive thyroid gland leading to an excess of thyroid hormones. Tremors and nervousness are classic symptoms due to the increased metabolic rate. Cold intolerance (A) is a symptom of hypothyroidism, not hyperthyroidism. Fatigue and lethargy (B) are common in hypothyroidism, not hyperthyroidism. Weight gain (D) is also more indicative of hypothyroidism. Therefore, the presence of tremors and nervousness (C) is the characteristic sign of hyperthyroidism.