Nokea
The client is diagnosed with hypothyroidism. Which signs/symptoms should the nurse expect the client to exhibit?
- A. Complaints of extreme fatigue and hair loss.
- B. Exophthalmos and complaints of nervousness.
- C. Complaints of profuse sweating and flushed skin.
- D. Tetany and complaints of stiffness of the hands.
Correct Answer: A
Rationale: Hypothyroidism causes fatigue and hair loss due to slowed metabolism. Exophthalmos/nervousness (hyperthyroidism), sweating, and tetany are unrelated.
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Which statement indicates that the client has misunderstood the nurse's teaching?
- A. I may need more insulin during times of stress.
- B. I may need more food when exercising strenuously.
- C. My insulin needs may change as I get older.
- D. My dependence on insulin may stop eventually.
Correct Answer: D
Rationale: Type 1 diabetes requires lifelong insulin therapy, so dependence will not stop.
The client diagnosed with type 1 diabetes mellitus received regular insulin two (2) hours ago. The client is complaining of being jittery and nervous. Which interventions should the nurse implement? List in order of priority.
- A. Call the laboratory to confirm blood glucose level.
- B. Administer a quick-acting carbohydrate.
- C. Have the client eat a bologna sandwich.
- D. Check the client’s blood glucose level at the bedside.
- E. Determine if the client has had anything to eat.
Correct Answer: D,B,E,C,A
Rationale: 1. Check blood glucose at bedside: Jitteriness and nervousness suggest hypoglycemia, common 2 hours post-regular insulin (peak effect). Bedside glucose testing confirms hypoglycemia quickly, guiding treatment. 2. Administer quick-acting carbohydrate: If glucose is low (<70 mg/dL), a quick-acting carbohydrate (e.g., juice) rapidly corrects hypoglycemia. 3. Determine if the client has had anything to eat: Assessing recent food intake identifies if inadequate nutrition contributed to hypoglycemia, informing prevention. 4. Have the client eat a bologna sandwich: After stabilizing glucose, a complex meal sustains normoglycemia, but it’s slower-acting. 5. Call the laboratory: Lab confirmation is unnecessary and delays treatment, as bedside glucometry is standard.
When the nurse conducts an admission history, which subjective symptom is the client likely to describe?
- A. Difficulty urinating
- B. Intolerance to cold
- C. Profuse perspiration
- D. Excessive appetite
Correct Answer: B
Rationale: Intolerance to cold is a common symptom of myxedema due to decreased metabolic rate.
The client diagnosed with Cushing's disease has developed 1++ peripheral edema. The client has received intravenous fluids at 100 mL/hr via IV pump for the past 79 hours. The client received intravenous piggyback (IVPB) medication in 50 mL of fluid every six (6) hours for 15 doses. How many mL of fluid did the client receive?
Correct Answer: 8650 mL
Rationale: Continuous IV: 100 mL/hr × 79 hr = 7900 mL. IVPB: 50 mL × 15 doses = 750 mL. Total = 7900 + 750 = 8650 mL.
The client with type 2 diabetes controlled with biguanide oral diabetic medication is scheduled for a computed tomography (CT) scan with contrast of the abdomen to evaluate pancreatic function. Which intervention should the nurse implement?
- A. Provide a high-fat diet 24 hours prior to test.
- B. Hold the biguanide medication for 48 hours prior to test.
- C. Obtain an informed consent form for the test.
- D. Administer pancreatic enzymes prior to the test.
Correct Answer: B
Rationale: Biguanides (e.g., metformin) are held 48 hours before contrast CT to prevent lactic acidosis due to contrast-induced kidney injury. High-fat diets, consent, and enzymes are irrelevant.