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In response to a question about timing of symptoms during the nursing history, when is the client most likely to describe that symptoms typically occur?
- A. After fasting more than 6 hours
- B. About 2 hours after eating a meal
- C. Late in the evening, before bedtime
- D. Early in the morning, before breakfast
Correct Answer: A
Rationale: Hyperinsulinism causes hypoglycemia, which is more likely after fasting due to excess insulin lowering blood glucose.
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Which client statement about managing diabetes during illness indicates a need for further teaching?
- A. I should monitor my blood glucose more frequently.
- B. I may need more insulin during illness.
- C. I can stop insulin if I'm not eating.
- D. I should try to stay hydrated.
Correct Answer: C
Rationale: Stopping insulin during illness is dangerous as stress hormones can increase blood glucose, requiring continued or adjusted insulin dosing.
Which nursing instruction should the nurse discuss with the client who is receiving glucocorticoids for Addison’s disease?
- A. Discuss the importance of tapering medications when discontinuing medication.
- B. Explain the dose may need to be increased during times of stress or infection.
- C. Instruct the client to take medication on an empty stomach with a glass of water.
- D. Encourage the client to wear clean white socks when wearing tennis shoes.
Correct Answer: B
Rationale: Addison’s disease requires glucocorticoid replacement, and doses must be increased during stress or infection to mimic the body’s natural cortisol response and prevent adrenal crisis. Tapering applies to exogenous steroid cessation, empty stomach intake is incorrect, and socks are irrelevant.
The nurse is caring for the client newly diagnosed with hypothyroidism. Which problem should the nurse include in the plan of care?
- A. Diarrhea due to gastrointestinal (GI) hypermotility
- B. Imbalanced nutrition due to insufficient calorie intake
- C. Activity intolerance due to increased metabolic rate
- D. Anxiety due to forgetfulness and slowed speech
Correct Answer: D
Rationale: Forgetfulness and slowed speech that occur with hypothyroidism can cause the client to be anxious.
Which signs/symptoms should make the nurse suspect the client is experiencing a thyroid storm?
- A. Obstipation and hypoactive bowel sounds.
- B. Hyperpyrexia and extreme tachycardia.
- C. Hypotension and bradycardia.
- D. Decreased respirations and hypoxia.
Correct Answer: B
Rationale: Thyroid storm causes hyperpyrexia (high fever) and extreme tachycardia due to excessive thyroid hormone. Other options are hypothyroid or unrelated.
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.