Nokea
A patient with a history of Graves' disease is admitted to the unit with shortness of breath. The nurse notes the patient's vital signs: T 103°F, P 160, R 24, BP 160/80. The nurse also notes distended neck veins. Which disorder does the patient most likely have?
- A. Pulmonary embolism
- B. Hypertensive crisis
- C. Thyroid storm
- D. Cushing crisis
Correct Answer: C
Rationale: In a thyroid crisis, all the signs and symptoms of hyperthyroidism are exaggerated. Additionally, the patient may develop nausea, vomiting, severe tachycardia, severe hypertension, and occasionally hyperthermia up to 41°C (106°F). Extreme restlessness, cardiac arrhythmia, and delirium may also occur. The patient may develop heart failure and may die.
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Which information will the nurse provide a patient with type I diabetes regarding excessive exercise?
- A. It can increase the need for insulin and may result in hyperglycemia.
- B. It can decrease the need for insulin and may result in hypoglycemia.
- C. It can increase muscle bulk and may result in malabsorption of insulin.
- D. It can decrease metabolic demand and may result in metabolic acidosis.
Correct Answer: B
Rationale: The patient with diabetes should exercise regularly. Exercise can reduce insulin resistance and increase glucose uptake for as long as 72 hours, as well as reducing blood pressure and lipid levels. However, exercise can carry some risks for patients with diabetes, including hypoglycemia.
A patient has undergone tests that indicate a deficiency of the parathyroid hormone secretion. The nurse will inform the patient of which potential complication?
- A. Osteoporosis
- B. Lethargy
- C. Laryngeal spasms
- D. Kidney stones
Correct Answer: C
Rationale: Decreased parathyroid hormone levels in the bloodstream cause a decreased calcium level. Severe hypocalcemia may result in laryngeal spasm, stridor, cyanosis, and increased possibility of asphyxia.
The nurse discovers a patient with type I diabetes drowsy and tremulous, the skin is cool and moist, and the respirations are 32 and shallow. The nurse recognizes the patient is having which type of reaction and quickly provides which intervention?
- A. hypoglycemic reaction; give 6 oz of orange juice.
- B. hyperglycemic reaction; give ordered regular insulin.
- C. hyperglycemic hyperosmolar nonketotic reaction; squeeze glucagon gel in buccal cavity.
- D. hypoglycemic reaction; give ordered insulin.
Correct Answer: A
Rationale: Hypoglycemic reaction is due to not enough food for the insulin. Quick acting carbohydrates - such as orange juice or longer acting foods such as milk, crackers, and cheese-are beneficial.
The patient being treated for hypothyroidism has been instructed to eat well-balanced meals including intake of iodine. The nurse will reinforce instructions to eat which food containing iodine?
- A. Eggs
- B. Pork
- C. White bread
- D. Skinless chicken
Correct Answer: A
Rationale: The diet for hypothyroidism should be adequate in intake of iodine, in foods such as saltwater fish, milk, and eggs; fluids should be increased to help prevent constipation.
Only ___ insulin can be administered intravenously.
Correct Answer: regular
Rationale: Insulin is given subcutaneously, although intravenous (IV) administration of regular insulin can be done when immediate onset of action is desired.