Nokea
An adult with myxedema is started on thyroid replacement therapy and is discharged. The client returns to the doctor's office one week later. Which statement that the client makes is most indicative of an adverse reaction to the medication?
- A. My chest hurt when I was sweeping the floor this morning.'
- B. I had severe cramps last night.'
- C. I am losing weight.'
- D. My pulse rate has been more rapid lately.'
Correct Answer: A
Rationale: Chest pain during activity suggests angina, a potential adverse effect of thyroid replacement therapy due to increased metabolic demand.
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The client diagnosed with cancer of the head of the pancreas is two (2) days postpancreatoduodenectomy (Whipple's procedure). Which nursing problem has the highest priority?
- A. Anticipatory grieving.
- B. Fluid volume imbalance.
- C. Alteration in comfort.
- D. Altered nutrition.
Correct Answer: B
Rationale: Fluid volume imbalance is the priority post-Whipple’s due to risks of bleeding or dehydration, impacting stability. Grieving, pain, and nutrition are secondary.
The UAP on the medical floor tells the nurse the client diagnosed with DKA wants something else to eat for lunch. Which intervention should the nurse implement?
- A. Instruct the UAP to get the client additional food.
- B. Notify the dietitian about the client's request.
- C. Request the HCP increase the client's caloric intake.
- D. Tell the UAP the client cannot have anything else.
Correct Answer: B
Rationale: Notifying the dietitian ensures the client’s nutritional needs are met within DKA dietary restrictions. Additional food, caloric increases, or denial are inappropriate without consultation.
The nurse completes teaching the client with Cushing's disease. Which statement demonstrates that the client understands measures to prevent bone resorption from corticosteroid therapy?
- A. I will increase calcium in my diet to 3000 mg daily.'
- B. I should participate in daily weight-bearing exercises.'
- C. I should limit my dietary intake of sodium and vitamin D.'
- D. I plan to rise slowly from a bed or chair to avoid falling.'
Correct Answer: B
Rationale: Daily weight-bearing exercises can help prevent bone loss and strengthen bones and muscles.
The elderly client is admitted to the intensive care department diagnosed with severe HHNS. Which collaborative intervention should the nurse include in the plan of care?
- A. Infuse 0.9% normal saline intravenously.
- B. Administer intermediate-acting insulin.
- C. Perform blood glucometer checks daily.
- D. Monitor arterial blood gas (ABG) results.
Correct Answer: A
Rationale: IV normal saline corrects severe dehydration in HHNS, a priority collaborative intervention. Insulin is secondary, daily glucose checks are insufficient, and ABGs are less critical in HHNS.
The client is admitted to the ICU diagnosed with DKA. Which interventions should the nurse implement? Select all that apply.
- A. Maintain adequate ventilation.
- B. Assess fluid volume status.
- C. Administer intravenous potassium.
- D. Check for urinary ketones.
- E. Monitor intake and output.
Correct Answer: A,B,D,E
Rationale: Ventilation, fluid status, ketone checks, and I&O monitoring manage DKA’s acidosis, dehydration, and ketosis. Potassium is given only if low, not routinely.