Nokea
The client diagnosed with Cushing's syndrome is admitted with fluid volume overload. The client weighed 190 lb on admission and 179 lb after treatment. The nurse estimates that the amount of fluid the client lost was how many milliliters?
- A. 3000 mL
- B. 4000 mL
- C. 5000 mL
- D. 6000 mL
Correct Answer: C
Rationale: One liter of fluid (1000 mL) weighs approximately 2.2 lb. An 11-lb weight loss equals 5000 mL (11 lb / 2.2 lb = 5 L × 1000 mL per L = 5000 mL).
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Which respiratory pattern is the best description of the client's breathing?
- A. Fast, deep, labored respirations
- B. Shallow respirations, alternating with apnea
- C. Slow inhalation and exhalation through pursed lips
- D. Shortness of breath with pauses
Correct Answer: A
Rationale: Kussmaul's respirations in DKA are fast, deep, and labored to compensate for metabolic acidosis.
A woman with newly diagnosed Type I diabetes mellitus says she wants to have children. She asks if she will be able to have children and if they will be normal. What is the best answer for the nurse to give?
- A. Women with diabetes should not get pregnant because it is very difficult to control diabetes during pregnancy.'
- B. Babies born to diabetic mothers are very apt to have severe and noncorrectable birth defects.'
- C. You should be able to safely have a baby if you go to your doctor regularly during pregnancy.'
- D. You should consult carefully with a geneticist before getting pregnant to determine how to prevent your baby from developing diabetes.'
Correct Answer: C
Rationale: With regular medical care, women with Type 1 diabetes can have safe pregnancies, minimizing risks to the baby.
The client is ready for discharge following an adrenalectomy. Which statement that the client makes indicates the best understanding of the client's condition?
- A. I will continue on a low-sodium, low-potassium diet.'
- B. My husband has arranged for a marriage counselor because of our fights.'
- C. I will stay out of the sun so I will not turn splotchy brown.'
- D. I will take all of those pills every day.'
Correct Answer: D
Rationale: Lifelong steroid replacement is required post-adrenalectomy, and taking prescribed pills daily shows understanding. A high-sodium, low-potassium diet is needed, and photosensitivity is not an issue.
Because the client is receiving levothyroxine (Synthroid) for the first time, the nurse recognizes the need to cheese the client to assess the effect of the effect of replacement therapy. For which signs and symptoms should the nurse assess? Select all that apply.
- A. Dyspnea
- B. Palpitations
- C. Excessive bruising
- D. Raised, red rash
- E. Hyperactivity
- F. Insomnia
Correct Answer: B,E,F
Rationale: Levothyroxine can cause signs of hyperthyroidism if overdosed, including palpitations, hyperactivity, and insomnia.
The nurse is assessing a client in an outpatient clinic. Which assessment data are a risk factor for developing pheochromocytoma?
- A. A history of skin cancer.
- B. A history of high blood pressure.
- C. A family history of adrenal tumors.
- D. A family history of migraine headaches.
Correct Answer: C
Rationale: A family history of adrenal tumors increases pheochromocytoma risk, as it’s a catecholamine-secreting adrenal tumor. Skin cancer, hypertension, and migraines are unrelated.