Nokea
Antibiotics are ordered for a client who has had a transsphenoidal hypophysectomy. He asks why he is receiving an antibiotic when he does not have an infection. The primary reason for administering antibiotics to this client is based on which information?
- A. Antibiotics will help to prevent respiratory complications following surgery.
- B. Meningitis is a complication following transsphenoidal hypophysectomy.
- C. Fluid retention can cause dangerously high cerebro spinal fluid pressure.
- D. Hormone replacement is essential after hypophysectomy.
Correct Answer: B
Rationale: The transsphenoidal approach through the mouth increases the risk of meningitis due to oral bacteria, necessitating prophylactic antibiotics.
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The nurse evaluates the client who is being treated for DKA. Which finding indicates that the client is responding to the treatment plan?
- A. Eyes sunken and skin flushed
- B. Skin moist with rapid elastic recoil
- C. Serum potassium level is 3.3 mEq/L
- D. ABG results are pH 7.25, PaCO2 30, HCO3 17
Correct Answer: B
Rationale: Moist skin and good skin turgor indicate that dehydration secondary to hyperglycemia is resolving.
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.
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.
The nurse assesses that the client diagnosed with Cushing's syndrome has an irregular HR, right arm ecchymosis, 4+ pitting edema in the legs, and a blood glucose of 140 mg/dL. Which action should be the nurse's priority?
- A. Weigh the client again
- B. Administer insulin as prescribed
- C. Notify the health care provider
- D. Measure the client's abdominal girth
Correct Answer: C
Rationale: The HCP should be notified immediately to address the irregular HR, which may result from hypokalemia, a common issue in Cushing's syndrome.
The client is diagnosed with cancer of the head of the pancreas. Which signs and symptoms should the nurse expect to assess?
- A. Clay-colored stools and dark urine.
- B. Night sweats and fever.
- C. Left lower abdominal cramps and tenesmus.
- D. Nausea and coffee-ground emesis.
Correct Answer: A
Rationale: Cancer in the head of the pancreas obstructs the bile duct, causing clay-colored stools and dark urine from jaundice. Night sweats, cramps, and coffee-ground emesis are less specific.