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Propylthiouracil (PTU) is prescribed for a client with Graves' disease. The nurse should teach the client to immediately report which of the following?
- A. Sore throat.
- B. Painful, excessive menstruation.
- C. Constipation.
- D. Increased urine output.
Correct Answer: A
Rationale: Propylthiouracil (PTU) can cause agranulocytosis, a serious condition involving a low white blood cell count, which may present as a sore throat or fever. This requires immediate reporting. The other symptoms are not typically associated with PTU side effects.
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In addition to nausea and severe flank pain, a female client with renal calculi has pain in the groin and bladder. The nurse should assess the client further for six years of:
- A. Nephritis.
- B. Referred pain.
- C. Urine retention.
- D. Additional stone formation.
Correct Answer: B
Rationale: Groin and bladder pain in renal calculi often indicate referred pain from the stone's movement or irritation along the urinary tract.
A client has returned to the medical-surgical unit after a cardiac catheterization. Which is the most important initial postprocedure nursing assessment for this client?
- A. Monitor the laboratory values.
- B. Observe neurologic function every 15 minutes.
- C. Observe the puncture site for swelling and bleeding.
- D. Monitor skin warmth and turgor.
Correct Answer: C
Rationale: Observing the puncture site for swelling and bleeding is critical post-catheterization to detect complications like hematoma or hemorrhage.
A client in hospice care is nearing death. Which of the following is an expected physical change the nurse should prepare the family for?
- A. Increased appetite.
- B. Cool, mottled extremities.
- C. Improved mental clarity.
- D. Regular breathing patterns.
Correct Answer: B
Rationale: Cool, mottled extremities are an expected sign of impending death due to decreased circulation, and preparing the family helps reduce distress.
A client who has been treated for chronic open-angle glaucoma (COAG) for 5 years asks the nurse, 'How does glaucoma damage my eyesight?' The nurse's reply should be based on the knowledge that COAG:
- A. Results from chronic eye inflammation.
- B. Causes increased intraocular pressure.
- C. Leads to detachment of the retina.
- D. Is caused by decreased blood flow to the retina.
Correct Answer: B
Rationale: Chronic open-angle glaucoma causes increased intraocular pressure, which damages the optic nerve over time, leading to vision loss.
A client with an ileal conduit should report:
- A. Mucus in urine.
- B. Stoma bleeding.
- C. Yellow urine.
- D. No odor.
Correct Answer: B
Rationale: Stoma bleeding is abnormal and may indicate trauma or infection.