Nokea
At the beginning of thyroid replacement therapy after a thyroidectomy, the nurse must monitor the client closely for side effects. Which findings would the nurse expect to detect if the client is receiving more thyroid hormone replacement than required? Select all that apply.
- A. Hyperglycemia
- B. Tachycardia
- C. Insomnia
- D. Hirsutism
- E. Hypertension
Correct Answer: B,C,E
Rationale: Excess thyroid hormone can cause tachycardia, insomnia, and hypertension due to increased metabolic rate.
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The nurse is discharging a client diagnosed with diabetes insipidus. Which statement made by the client warrants further intervention?
- A. I will keep a list of my medications in my wallet and wear a Medic Alert bracelet.
- B. I should take my medication in the morning and leave it refrigerated at home.
- C. I should weigh myself every morning and record any weight gain.
- D. If I develop a tightness in my chest, I will call my health-care provider.
Correct Answer: B
Rationale: Desmopressin (DI medication) requires consistent dosing, not morning-only, and storage instructions are vague; this needs clarification. Other statements are appropriate.
When directing the nursing assistant to weigh the client, which instruction is most important for obtaining accurate data?
- A. Have the client stand on a bedside scale.
- B. Weigh the client at the same time each day.
- C. Ask that slippers be removed when being weighed.
- D. Ask about the client's pre-disease weight.
Correct Answer: B
Rationale: Weighing the client at the same time each day ensures consistency and accounts for daily fluctuations in weight due to meals, hydration, or other factors.
The nurse is collecting information about the client who underwent a transsphenoidal removal of a pituitary tumor. Which findings should indicate to the nurse that the client is experiencing DI? Select all that apply.
- A. Serum osmolality 310 mOsm/kg
- B. Weight increased 2 kg in 24 hours
- C. Experiencing an extreme thirst
- D. Urine output 4200 mL in 24 hours
- E. BP averaging 164/92 mm Hg or higher
Correct Answer: A,C,D
Rationale: Elevated serum osmolality, extreme thirst, and high urine output indicate DI due to fluid loss and ADH deficiency.
Which statement provides the best evidence that the client understands the prescribed drug therapy?
- A. I must take this drug after meals.
- B. I'll need to take this drug life-long.
- C. I can skip a dose if I'm nauseated.
Correct Answer: B
Rationale: Levothyroxine for myxedema typically requires lifelong therapy to maintain thyroid hormone levels.
The nurse administers a usual morning dose of 4 units of regular insulin and 8 units of NPH insulin at 7:30 am to the client with a blood glucose level of 110 mg/dL. Which statements regarding the client's insulin are correct?
- A. The onset of the regular insulin will be at 7:45 am and the peak at 1:00 pm.
- B. The onset of the regular insulin will be at 8:00 am and the peak at 10:00 am.
- C. The onset of the NPH insulin will be at 8:00 am and the peak at 10:00 am.
- D. The onset of the NPH insulin will be at 12:30 pm and the peak at 11:30 pm.
Correct Answer: B
Rationale: The onset of regular insulin (short acting) is one-half to 1 hour, and the peak is 2 to 3 hours. The onset of NPH insulin (intermediate acting) is 2 to 4 hours, and the peak is 4 to 12 hours.