Nokea
Postoperatively, the nurse should consult the physician before encouraging the client who has undergone a subtotal thyroidectomy to perform which activity?
- A. Forced coughing
- B. Decompelling
- C. Ambulating
- D. Dangling legs
Correct Answer: A
Rationale: Forced coughing can increase pressure in the neck, risking bleeding or wound disruption post-thyroidectomy.
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The diabetic educator is teaching a class on diabetes type 1 and is discussing sick-day rules. Which interventions should the diabetes educator include in the discussion? Select all that apply.
- A. Take diabetic medication even if unable to eat the client's normal diabetic diet.
- B. If unable to eat, drink liquids equal to the client's normal caloric intake.
- C. It is not necessary to notify the health-care provider (HCP) if ketones are in the urine.
- D. Test blood glucose levels and test urine ketones once a day and keep a record.
- E. Call the health-care provider if glucose levels are higher than 180 mg/dL.
Correct Answer: A,B
Rationale: Continuing insulin and consuming caloric liquids (e.g., juice) prevent DKA during illness. Ketones require HCP notification, daily testing is insufficient, and 180 mg/dL is too low for notification.
The nurse completes teaching the client with Cushing's disease. Which statement demonstrates that the client understands measures to prevent bone resorption from corticosteroid therapy?
- A. I will increase calcium in my diet to 3000 mg daily.'
- B. I should participate in daily weight-bearing exercises.'
- C. I should limit my dietary intake of sodium and vitamin D.'
- D. I plan to rise slowly from a bed or chair to avoid falling.'
Correct Answer: B
Rationale: Daily weight-bearing exercises can help prevent bone loss and strengthen bones and muscles.
The nurse manager of a medical-surgical unit is asked to determine if the unit should adopt a new care delivery system. Which behavior is an example of an autocratic style of leadership?
- A. Call a meeting and educate the staff on the new delivery system being used.
- B. Organize a committee to investigate the various types of delivery systems.
- C. Wait until another unit has implemented the new system and see if it works out.
- D. Discuss with the nursing staff if a new delivery system should be adopted.
Correct Answer: A
Rationale: An autocratic leader unilaterally decides and informs staff, as in educating them on a chosen system. Committees, waiting, and staff discussions are democratic or laissez-faire.
The elderly client is admitted to the intensive care department diagnosed with severe HHNS. Which collaborative intervention should the nurse include in the plan of care?
- A. Infuse 0.9% normal saline intravenously.
- B. Administer intermediate-acting insulin.
- C. Perform blood glucometer checks daily.
- D. Monitor arterial blood gas (ABG) results.
Correct Answer: A
Rationale: IV normal saline corrects severe dehydration in HHNS, a priority collaborative intervention. Insulin is secondary, daily glucose checks are insufficient, and ABGs are less critical in HHNS.
Which statement made by the client makes the nurse suspect the client is experiencing hyperthyroidism?
- A. I just don't seem to have any appetite anymore.
- B. I have a bowel movement about every three (3) to four (4) days.
- C. My skin is really becoming dry and coarse.
- D. I have noticed all my collars are getting tighter.
Correct Answer: D
Rationale: Tight collars suggest goiter, a hyperthyroidism symptom. Anorexia, constipation, and dry skin are hypothyroid-related.