Nokea
Immediately after surgery, the nurse assesses the client for bleeding. Where is the best location to assess for bleeding?
- A. The skull
- B. The nose
- C. The ear canal
- D. The tongue
Correct Answer: B
Rationale: Trans-sphenoidal hypophysectomy is performed through the nasal cavity, so bleeding is most likely to be observed in the nose.
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Which response by the nurse about potassium iodide (Lugol's solution) is correct?
- A. It firms the gland so it is easily removed.
- B. It decreases the postoperative recovery time.
- C. It decreases the risk of postoperative bleeding.
- D. It eliminates the need for hormone replacement.
Correct Answer: C
Rationale: Potassium iodide reduces thyroid vascularity, decreasing the risk of postoperative bleeding.
Which instruction by the nurse concerning the test procedure is most accurate?
- A. You need to eat a large meal just before the test.
- B. You can drink coffee or tea in the morning before the test.
- C. You will be given a sweetened drink before the test.
Correct Answer: C
Rationale: A glucose tolerance test involves administering a sweetened drink to assess the body's response to glucose.
The nurse is discussing the importance of exercising with a client diagnosed with type 2 diabetes whose diabetes is well controlled with diet and exercise. Which information should the nurse include in the teaching about diabetes?
- A. Eat a simple carbohydrate snack before exercising.
- B. Carry peanut butter crackers when exercising.
- C. Encourage the client to walk 20 minutes three (3) times a week.
- D. Perform warm-up and cool-down exercises.
Correct Answer: D
Rationale: Warm-up and cool-down exercises prevent injury during exercise, crucial for type 2 diabetics. Pre-exercise snacks are for insulin users, peanut butter is high-fat, and walking is good but not the focus.
The female client is to be treated with radioactive iodine (RAI) therapy for an enlarged thyroid gland. The client asks if there are any precautions that are needed during RAI therapy. Which is the nurse's best response?
- A. No precautions are necessary. The radiation in the form of an oral capsule will target and destroy thyroid tissue only.'
- B. Use contraceptives or abstain from sexual intercourse to avoid conceiving during and for 6 months after treatment.'
- C. Discontinue taking the antithyroid medication and propranolol; results are seen immediately with RAI therapy.'
- D. Some people need a thyroid hormone replacement, but it is not necessary when the thyroid gland is enlarged.'
Correct Answer: B
Rationale: Pregnancy should be postponed for at least 6 months after RAI treatment because it crosses the placenta.
The male client diagnosed with chronic pancreatitis calls and reports to the clinic nurse he has been having a lot of 'gas,' along with frothy and very foul-smelling stools. Which intervention should the nurse implement?
- A. Explain this is common for chronic pancreatitis.
- B. Ask the client to bring in a stool specimen to the clinic.
- C. Arrange an appointment with the HCP for today.
- D. Discuss the need to decrease fat in the diet so this won't happen.
Correct Answer: C
Rationale: Frothy, foul-smelling stools suggest malabsorption (e.g., pancreatic insufficiency), requiring urgent HCP evaluation. Explaining, stool samples, or diet changes are secondary.