Nokea
In which position should the client be maintained after the subtotal thyroidectomy?
- A. Supine
- B. Sims'
- C. Semi-Fowler's
- D. Recumbent
Correct Answer: C
Rationale: Semi-Fowler's position reduces swelling and promotes airway patency after thyroidectomy.
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During change of shifts, a nurse discovers that a hospitalized client with diabetes received two doses of insulin. After notifying the physician, which nursing action is most appropriate?
- A. Completing an incident report
- B. Calling the intensive care unit (ICU)
- C. Performing frequent neurologic checks
- D. Monitoring the client's blood glucose level
Correct Answer: D
Rationale: Monitoring blood glucose is critical to detect and manage potential hypoglycemia from the double dose.
Which laboratory value should be monitored by the nurse for the client diagnosed with diabetes insipidus?
- A. Serum sodium.
- B. Serum calcium.
- C. Urine glucose.
- D. Urine white blood cells.
Correct Answer: A
Rationale: Diabetes insipidus causes dilute urine, risking hypernatremia; serum sodium monitoring is critical. Calcium, urine glucose, and WBCs are unrelated.
The client with type 2 diabetes controlled with biguanide oral diabetic medication is scheduled for a computed tomography (CT) scan with contrast of the abdomen to evaluate pancreatic function. Which intervention should the nurse implement?
- A. Provide a high-fat diet 24 hours prior to test.
- B. Hold the biguanide medication for 48 hours prior to test.
- C. Obtain an informed consent form for the test.
- D. Administer pancreatic enzymes prior to the test.
Correct Answer: B
Rationale: Biguanides (e.g., metformin) are held 48 hours before contrast CT to prevent lactic acidosis due to contrast-induced kidney injury. High-fat diets, consent, and enzymes are irrelevant.
The nurse is admitting a client to rule out aldosteronism. Which assessment data support the client's diagnosis?
- A. Temperature.
- B. Pulse.
- C. Respirations.
- D. Blood pressure.
Correct Answer: D
Rationale: Elevated blood pressure is a hallmark of aldosteronism due to sodium retention and fluid overload. Temperature, pulse, and respirations are less specific.
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.