Nokea
A woman with a tumor of the adrenal cortex says to the nurse, 'Will I always look this ugly? I hate having a beard.' What is the best response for the nurse to make?
- A. After surgery, you will not develop any more symptoms, but the changes you have now will linger.'
- B. That varies from person to person. You should ask your physician.'
- C. After surgery, your appearance should gradually return to normal.'
- D. Electrolysis and plastic surgery should make your appearance normal.'
Correct Answer: C
Rationale: Post-adrenalectomy, hormonal imbalances causing symptoms like hirsutism should resolve, gradually normalizing appearance.
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Which arterial blood gas results should the nurse expect in the client diagnosed with diabetic ketoacidosis?
- A. pH 7.34, PaO2 99, PaCO2 48, HCO3 24.
- B. pH 7.38, PaO2 95, PaCO2 40, HCO3 22.
- C. pH 7.46, PaO2 85, PaCO2 30, HCO3 26.
- D. pH 7.30, PaO2 90, PaCO2 30, HCO3 18.
Correct Answer: D
Rationale: DKA causes metabolic acidosis (low pH 7.30, low HCO3 18) with compensatory respiratory alkalosis (low PaCO2 30). Other options show normal or alkalotic states.
The nurse assesses the client following a total thyroidectomy. Which finding indicates that the client has a positive Trousseau's sign?
- A. Illustration 1: Carpal spasm
- B. Illustration 2: Cheek twitching
- C. Illustration 3: Thyroid palpation
- D. Illustration 4: Red reflex
Correct Answer: A
Rationale: Trousseau's sign is carpal spasm due to hypocalcemia from parathyroid gland injury during thyroidectomy.
Which laboratory data indicate to the nurse the client’s pancreatitis is improving?
- A. The amylase and lipase serum levels are decreased.
- B. The white blood cell (WBC) count is decreased.
- C. The conjugated and unconjugated bilirubin levels are decreased.
- D. The blood urea nitrogen (BUN) serum level is decreased.
Correct Answer: A
Rationale: Acute pancreatitis is characterized by elevated serum amylase and lipase levels due to pancreatic inflammation. A decrease in these levels indicates reduced pancreatic injury and improvement in the condition. While a decreased WBC count may suggest resolving infection, it is less specific. Bilirubin levels are relevant for biliary obstruction, not pancreatitis improvement, and BUN reflects renal function, not pancreatic status.
The client is a 62-year-old woman who is 30 pounds overweight. She comes to the doctor's office complaining of headaches, frequent hunger, excessive thirst, and urination. The presenting complaints suggest that the nurse should assess for other signs of which condition?
- A. Hypothyroidism
- B. Acute pyelonephritis
- C. Addison's disease
- D. Diabetes mellitus
Correct Answer: D
Rationale: Headaches, polyphagia, polydipsia, and polyuria are classic symptoms of diabetes mellitus, especially in an overweight individual.
Which client action indicates a need for further teaching about insulin administration?
- A. Using a new needle for each injection
- B. Storing insulin in the refrigerator
- C. Checking blood glucose before injecting
- D. Injecting insulin into a lipodystrophic area
Correct Answer: D
Rationale: Injecting insulin into a lipodystrophic area can impair absorption, indicating a need for further teaching on site rotation.