Nokea
The female client is to be treated with radioactive iodine (RAI) therapy for an enlarged thyroid gland. The client asks if there are any precautions that are needed during RAI therapy. Which is the nurse's best response?
- A. No precautions are necessary. The radiation in the form of an oral capsule will target and destroy thyroid tissue only.'
- B. Use contraceptives or abstain from sexual intercourse to avoid conceiving during and for 6 months after treatment.'
- C. Discontinue taking the antithyroid medication and propranolol; results are seen immediately with RAI therapy.'
- D. Some people need a thyroid hormone replacement, but it is not necessary when the thyroid gland is enlarged.'
Correct Answer: B
Rationale: Pregnancy should be postponed for at least 6 months after RAI treatment because it crosses the placenta.
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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.
The client diagnosed with Cushing's disease has undergone a unilateral adrenalectomy. Which discharge instructions should the nurse discuss with the client?
- A. Instruct the client to take the glucocorticoid and mineralocorticoid medications as prescribed.
- B. Teach the client regarding sexual functioning and androgen replacement therapy.
- C. Explain the signs and symptoms of infection and when to call the health-care provider.
- D. Demonstrate turn, cough, and deep-breathing exercises the client should perform every two (2) hours.
Correct Answer: C
Rationale: Infection signs are critical post-adrenalectomy due to immunosuppression risks. Steroid replacement is for bilateral procedures, androgen therapy is rare, and breathing exercises are inpatient-focused.
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.
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.
The client diagnosed with hypothyroidism is prescribed the thyroid hormone levothyroxine (Synthroid). Which assessment data indicate the medication has been effective?
- A. The client has a three (3)-pound weight gain.
- B. The client has a decreased pulse rate.
- C. The client's temperature is WNL.
- D. The client denies any diaphoresis.
Correct Answer: C
Rationale: Normal temperature indicates corrected hypothermia from hypothyroidism. Weight gain, decreased pulse, and no diaphoresis are not specific indicators.