Nokea
A patient who has been taking corticosteroids for several months has been experiencing muscle wasting. The patient has asked the nurse for suggestions to address this adverse effect. What should the nurse recommend?
- A. Activity limitation to conserve energy
- B. Consumption of a high-protein diet
- C. Use of OTC vitamin D and calcium supplements
- D. Passive range-of-motion exercises
Correct Answer: B
Rationale: Muscle wasting can be partly addressed through increased protein intake. Passive ROM exercises maintain flexibility, but do not build muscle mass. Vitamin D and calcium supplements do not decrease muscle wasting. Activity limitation would exacerbate the problem.
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The nurses assessment of a patient with thyroidectomy suggests tetany and a review of the most recent blood work corroborate this finding. The nurse should prepare to administer what intervention?
- A. Oral calcium chloride and vitamin D
- B. IV calcium gluconate
- C. STAT levothyroxine
- D. Administration of parathyroid hormone (PTH)
Correct Answer: B
Rationale: When hypocalcemia and tetany occur after a thyroidectomy, the immediate treatment is administration of IV calcium gluconate. This has a much faster therapeutic effect than PO calcium or vitamin D supplements. PTH and levothyroxine are not used to treat this complication.
A nurse caring for a patient with diabetes insipidus is reviewing laboratory results. What is an expected urinalysis finding?
- A. Glucose in the urine
- B. Albumin in the urine
- C. Highly dilute urine
- D. Leukocytes in the urine
Correct Answer: C
Rationale: Patients with diabetes insipidus produce an enormous daily output of very dilute, water-like urine with a specific gravity of 1.001 to 1.005. The urine contains no abnormal substances such as glucose or albumin. Leukocytes in the urine are not related to the condition of diabetes insipidus, but would indicate a urinary tract infection, if present in the urine.
The nurse providing care for a patient with Cushing syndrome has identified the nursing diagnosis of risk for injury related to weakness. How should the nurse best reduce this risk?
- A. Establish falls prevention measures
- B. Encourage bed rest whenever possible
- C. Encourage the use of assistive devices
- D. Provide constant supervision
Correct Answer: A
Rationale: The nurse should take action to prevent the patients risk for falls. Bed rest carries too many harmful effects, however, and assistive devices may or may not be necessary. Constant supervision is not normally required or practicable.
The nurse is caring for a patient with a diagnosis of Addisons disease. What sign or symptom is most closely associated with this health problem?
- A. Truncal obesity
- B. Hypertension
- C. Muscle weakness
- D. Moon face
Correct Answer: C
Rationale: Patients with Addisons disease demonstrate muscular weakness, anorexia, gastrointestinal symptoms, fatigue, emaciation, dark pigmentation of the skin, and hypotension. Patients with Cushing syndrome demonstrate truncal obesity, moon face, acne, abdominal striae, and hypertension.
Following an addisonian crisis, a patients adrenal function has been gradually regained. The nurse should ensure that the patient knows about the need for supplementary glucocorticoid therapy in which of the following circumstances?
- A. Episodes of high psychosocial stress
- B. Periods of dehydration
- C. Episodes of physical exertion
- D. Administration of a vaccine
Correct Answer: A
Rationale: During stressful procedures or significant illnesses, additional supplementary therapy with glucocorticoids is required to prevent addisonian crisis. Physical activity, dehydration and vaccine administration would not normally be sufficiently demanding such to require glucocorticoids.