Nokea
The client has undergone a thyroidectomy. Which of the following symptoms would indicate a potential complication?
- A. Bradycardia
- B. Tachycardia
- C. Hyperreflexia
- D. Hypocalcemia
Correct Answer: D
Rationale: Hypocalcemia is a potential complication of thyroidectomy as it may occur if the parathyroid glands, responsible for calcium regulation, are inadvertently removed or damaged during the procedure. Bradycardia (slow heart rate) is not typically associated with thyroidectomy complications. Tachycardia (fast heart rate) is more commonly seen in hyperthyroidism. Hyperreflexia (exaggerated reflex responses) is not a typical complication of thyroidectomy.
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The client with type 2 DM is being taught about the importance of foot care. Which instruction should be included?
- A. Soak your feet in hot water every night.
- B. Walk barefoot whenever possible.
- C. Use a heating pad to warm your feet.
- D. Wear comfortable shoes that allow air circulation.
Correct Answer: D
Rationale: The correct instruction for the client with type 2 DM regarding foot care is to wear comfortable shoes that allow air circulation. This helps prevent foot injuries and infections, which are common complications in clients with diabetes. Choice A is incorrect as soaking feet in hot water can lead to burns and skin damage. Choice B is incorrect because walking barefoot increases the risk of injury and infection. Choice C is incorrect as using a heating pad can also potentially lead to burns and skin damage.
The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following interventions should the nurse implement?
- A. Encourage increased fluid intake
- B. Administer vasopressin
- C. Monitor for signs of dehydration
- D. Restrict oral fluids
Correct Answer: D
Rationale: The correct intervention for a client with syndrome of inappropriate antidiuretic hormone (SIADH) is to restrict oral fluids. SIADH leads to excessive release of antidiuretic hormone (ADH), causing the body to retain water and diluting the sodium levels in the blood (hyponatremia). Restricting oral fluids helps prevent further water retention and worsening hyponatremia. Encouraging increased fluid intake (choice A) would exacerbate the problem by further diluting sodium levels. Administering vasopressin (choice B) is not indicated in SIADH, as the condition is characterized by excess ADH secretion. Monitoring for signs of dehydration (choice C) is not the priority in SIADH since the issue is water retention rather than dehydration.
Nurse managers need several qualities to be effective. A nurse manager is working hard to fully understand how patient outcomes are measured on the unit and how budget changes could impact patient outcomes. Which of the following qualities does this best describe?
- A. Leadership
- B. Business sense
- C. Clinical expertise
- D. Financial management
Correct Answer: B
Rationale: The correct answer is 'Business sense.' Nurse managers need to understand how financial decisions impact patient outcomes, which requires a strong understanding of business principles. Leadership (choice A) is important but doesn't specifically address understanding financial and outcome-based impacts. Clinical expertise (choice C) is essential for patient care but doesn't directly relate to understanding budget changes and their impact. Financial management (choice D) is more about managing finances directly rather than understanding the broader implications of budget changes on patient outcomes.
After taking glipizide (Glucotrol) for 9 months, a male client experiences secondary failure. What would the nurse expect the physician to do?
- A. Initiate insulin therapy.
- B. Switch the client to a different oral antidiabetic agent.
- C. Prescribe an additional oral antidiabetic agent.
- D. Restrict carbohydrate intake to less than 30% of the total caloric intake.
Correct Answer: A
Rationale: When a client experiences secondary failure to an oral antidiabetic agent like glipizide, the next step is often to initiate insulin therapy. This is because secondary failure indicates that the current oral antidiabetic medication is no longer effective in managing blood glucose levels, and insulin therapy may be required to adequately control blood sugar. Switching to a different oral antidiabetic agent may not be effective if there is already resistance to the current agent. Adding another oral antidiabetic agent may not address the underlying issue of secondary failure. Restricting carbohydrate intake is important for diabetes management but is not the primary intervention indicated in this scenario of secondary failure to glipizide.
A female client with a history of pheochromocytoma is admitted to the hospital in an acute hypertensive crisis. To reverse the hypertensive crisis caused by pheochromocytoma, nurse Lyka expects to administer:
- A. Phentolamine (Regitine)
- B. Methyldopa (Aldomet)
- C. Mannitol (Osmitrol)
- D. Felodipine (Plendil)
Correct Answer: A
Rationale: In a hypertensive crisis due to pheochromocytoma, the appropriate medication to administer is Phentolamine (Regitine), an alpha-adrenergic blocker. Phentolamine acts quickly to block the effects of excess catecholamines that are released in pheochromocytoma, helping to rapidly lower blood pressure. Methyldopa (Aldomet) is an alpha-2 adrenergic agonist used for chronic hypertension, not for acute crises like pheochromocytoma. Mannitol (Osmitrol) is an osmotic diuretic used to reduce intracranial pressure and treat cerebral edema, not indicated for hypertensive crises. Felodipine (Plendil) is a calcium channel blocker used for chronic management of hypertension, not for acute hypertensive crises like those seen in pheochromocytoma.