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The agitated client is hospitalized with tachycardia, dyspnea, and intermittent chest palpitations. The client's BP is 170/110 mm Hg, and HR is 130 bpm. The client's health history reveals thinning hair, recent 10-lb weight loss, increased appetite, fine hand and tongue tremors, hyperreflexic tendon reflexes, and smooth, moist skin. Which prescribed intervention should be the nurse's priority?
- A. 12-lead electrocardiogram (ECG) and cardiac enzyme levels.
- B. Obtain thyroid-stimulating hormone (TSH) and free T4 levels.
- C. Propranolol 2 mg IV q15 min or until symptoms are controlled.
- D. Propylthiouracil 600-mg oral loading dose; then 200 mg orally q4h.
Correct Answer: C
Rationale: Propranolol provides rapid symptomatic relief of thyrotoxicosis by controlling cardiac and psychomotor manifestations.
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The nurse is discussing the importance of exercising with a client diagnosed with type 2 diabetes whose diabetes is well controlled with diet and exercise. Which information should the nurse include in the teaching about diabetes?
- A. Eat a simple carbohydrate snack before exercising.
- B. Carry peanut butter crackers when exercising.
- C. Encourage the client to walk 20 minutes three (3) times a week.
- D. Perform warm-up and cool-down exercises.
Correct Answer: D
Rationale: Warm-up and cool-down exercises prevent injury during exercise, crucial for type 2 diabetics. Pre-exercise snacks are for insulin users, peanut butter is high-fat, and walking is good but not the focus.
When developing the client's care plan, which intervention is most appropriate to add?
- A. Encourage the client to use an electric razor.
- B. Tell the client to file rather than cut toenails.
- C. Make sure that the client receives mouth care twice per day.
- D. Advise the client to use deodorant soap when bathing.
Correct Answer: B
Rationale: Filing toenails prevents injury and infection in diabetic clients with poor healing.
The nurse observes the client self-administering the medication. Which action indicates that the client is using the medication correctly?
- A. The client shakes the medication vigorously
- B. The client's head is tilted to the side.
- C. The client inverts the drug container.
- D. The client inhales with each spray.
Correct Answer: D
Rationale: For intranasal lypressin, inhaling with each spray ensures proper delivery of the medication to the nasal mucosa.
To detect complications of surgery in the immediate postoperative period, which assessment component is most important for the nurse to monitor?
- A. Blood pressure
- B. Urine output
- C. Upperness
- D. Specific gravity
Correct Answer: A
Rationale: Blood pressure monitoring detects adrenal insufficiency or bleeding post-adrenalectomy.
Which finding indicates a potential complication of thyroid crisis that the nurse should prioritize?
- A. Heart rate of 140 beats per minute
- B. Blood pressure of 120/80 mmHg
- C. Temperature of 98.6°F
- D. Respiratory rate of 16 breaths per minute
Correct Answer: A
Rationale: A heart rate of 140 beats per minute indicates severe tachycardia, a life-threatening complication of thyroid crisis requiring immediate intervention.