Nokea
After a thyroidectomy, a female client is returned to the unit from the recovery room. A major complication after a thyroidectomy is:
- A. respiratory obstruction.
- B. hypercalcemia.
- C. fistula formation.
- D. myxedema.
Correct Answer: A
Rationale: Respiratory obstruction due to edema of the glottis, bilateral laryngeal nerve damage, or tracheal compression from hemorrhage is a major complication after a thyroidectomy. Hypocalcemia and tetany from accidental removal of one or more parathyroid glands are major complications; not hypercalcemia. Fistula formation is not a major complication associated with a thyroidectomy. Fistula formation is a major complication with a laryngectomy. Myxedema is hypothyroidism occurring in adults. It is not a complication of a thyroidectomy. A thyroidectomy client tends to develop thyroid storm from an excess of the thyroid hormones released during surgery.
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For Mrs. Allen's weight reduction program to be successful, what should the nurse explain?
- A. An anorexiant should be used 4-6 weeks at the beginning
- B. An intestinal bypass is recommended if rapid weight loss is not achieved
- C. Personal eating habits must be assessed objectively
- D. Complete fasting for a week is necessary
Correct Answer: C
Rationale: Assessing personal eating habits objectively helps identify areas for improvement and fosters sustainable lifestyle changes.
An 88-year-old woman is brought to the health clinic for the first time by her 64-year-old daughter. During the initial comprehensive nursing assessment of the patient, what should the nurse do?
- A. Ask the daughter whether the patient has any urgent needs or problems.
- B. Interview the patient and daughter together so that pertinent information can be confirmed.
- C. Obtain a health history using a functional health pattern and assess activities of daily living (ADLs) and mental status.
- D. Refer the patient for an interdisciplinary comprehensive geriatric assessment because at her age she will have multiple needs.
Correct Answer: C
Rationale: Assessing ADLs, mental status, and obtaining a thorough health history ensures comprehensive understanding of the patient's needs.
Which of these tasks are appropriate to delegate to the LPN/LVN who is functioning under the supervision of an RN? (Choose all that apply.)
- A. Assess the sexual implications for a client with oculogenital type Chlamydia trachomatis.
- B. Administer sulfacetamide sodium 10% (Sulf-10 Ophthalmic) to a child with conjunctivitis.
- C. Review handwashing and hygiene practices with clients who have eye infections.
- D. Show clients how to gently cleanse eyelid margins to remove crusting.
Correct Answer: B
Rationale: Administering medications is within the scope of practice for LPNs/LVNs under RN supervision.
What is primarily a developmental task of middle age?
- A. Learning and acquiring new skills and information.
- B. Rediscovering or developing satisfaction in one's relationship with a significant other.
- C. Relying strongly upon spiritual beliefs.
- D. Risk-taking and its perceived consequences.
Correct Answer: B
Rationale: Middle age often involves re-evaluating personal relationships.
A client in the emergency department is being cared for by a nurse and has cardiogenic pulmonary edema. The client's assessment findings include anxiousness, dyspnea at rest, crackles, blood pressure 110/79 mm Hg, and apical heart rate 112/min. What is the nurse's priority intervention?
- A. Provide the client with supplemental oxygen at 5 L/min via facemask.
- B. Place the client in high-Fowler's position with their legs in a dependent position
- C. Give the client sublingual nitroglycerin
- D. Administer morphine sulfate IV
Correct Answer: A
Rationale: The correct answer is A: Provide the client with supplemental oxygen at 5 L/min via facemask. In cardiogenic pulmonary edema, the priority intervention is to improve oxygenation. Supplemental oxygen helps increase oxygen levels and alleviate respiratory distress, reducing the workload on the heart. This intervention addresses the client's dyspnea and anxiousness by improving oxygen delivery.
Choice B is incorrect as placing the client in high-Fowler's position with legs in a dependent position can help with breathing but does not address the immediate need for oxygenation.
Choice C is incorrect as sublingual nitroglycerin is typically used for angina and not the priority intervention for cardiogenic pulmonary edema.
Choice D is incorrect as morphine sulfate IV may be indicated for pain relief and anxiety, but it is not the priority intervention to address the client's oxygenation needs in cardiogenic pulmonary edema.