Nokea
Signs and symptoms of Cushing's disease include:
- A. Weight loss.
- B. Thin, fragile skin.
- C. Hypotension.
- D. Abdominal pain.
Correct Answer: B
Rationale: Thin, fragile skin is a hallmark of Cushing's disease due to cortisol's catabolic effects on connective tissue.
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Which of the following is most effective in assessing the client suspected of developing diabetes insipidus?
- A. Taking vital signs every 2 hours.
- B. Measuring urine output hourly.
- C. Assessing arterial blood gas values every other day.
- D. Checking blood glucose levels.
Correct Answer: B
Rationale: Diabetes insipidus, often caused by head injury, leads to excessive dilute urine output. Hourly urine output measurement is the most effective way to detect this condition early. Vital signs, blood gases, and glucose levels are less specific for this diagnosis.
A 60-year-old client with acute myeloid leukemia (AML) states that he overheard one of the other clients say that AML had a very poor prognosis. The client explains to the nurse that he had understood his doctor to say that he had a relatively good prognosis. Which is the nurse's best response?
- A. You must have misunderstood. Whom did you hear that from?'
- B. AML does have a very poor prognosis for poorly differentiated cells.'
- C. AML is the most common nonlymphocytic leukemia.'
- D. Your doctor stated your prognosis based on the differentiation of your cells.'
Correct Answer: D
Rationale: The prognosis for AML varies based on factors like cell differentiation, age, and genetics. The nurse should clarify that the doctor's prognosis was specific to the client's cell differentiation, reassuring him without dismissing his concerns. The other responses are either confrontational, overly general, or irrelevant.
The nurse has provided medication instructions to a client who has been prescribed a fentanyl transdermal patch. Which of the following statements, if made by the client, would indicate a correct understanding of the instructions? Select all that apply.
- A. I may still need pain medication while this patch is applied.
- B. If the patch comes loose, I may reinforce it with a piece of tape.
- C. I can apply heat to the patch site to increase the pain relief.
- D. I should remove this patch while I am sleeping.
- E. The patch will need to be changed every 72 hours.
Correct Answer: A,B,E
Rationale: A: Breakthrough pain may require additional medication. B: Taping a loose patch is acceptable. E: Fentanyl patches are typically changed every 72 hours. C is incorrect because heat can increase absorption and risk toxicity. D is incorrect as patches are not removed during sleep.
A client with thyrotoxicosis says to the nurse, 'I am so irritable. I am having problems at work because I lose my temper very easily.' Which of the following responses by the nurse would give the client the most accurate explanation of her behavior?
- A. Your behavior is caused by your not following the medical regimen.'
- B. Your behavior is caused by the effects of the disease on your thyroid.'
- C. Your behavior is caused by your not accepting your diagnosis.'
- D. Your behavior is caused by the effects of the disease on your emotional stability.'
Correct Answer: B
Rationale: Thyrotoxicosis, due to excess thyroid hormone, increases metabolism and can affect the nervous system, leading to irritability and emotional lability. This explains the client's behavior as a direct result of the disease's impact on thyroid function.
The nurse is assessing a client with a cast for compartment syndrome. Which finding is most indicative?
- A. Pain relieved by elevation.
- B. Numbness in the affected limb.
- C. Warm skin over the cast.
- D. Visible swelling at the cast edge.
Correct Answer: B
Rationale: Numbness is a key sign of compartment syndrome, indicating nerve compression requiring urgent intervention.