Nokea
The healthcare provider is caring for a client who has just undergone a thyroidectomy. Which assessment finding requires immediate intervention?
- A. Hoarse voice.
- B. Difficulty swallowing.
- C. Numbness and tingling around the mouth.
- D. Sore throat.
Correct Answer: C
Rationale: The correct answer is C: Numbness and tingling around the mouth. This finding indicates potential hypocalcemia, a common complication post-thyroidectomy due to inadvertent removal of parathyroid glands. Immediate intervention is necessary to prevent severe hypocalcemia symptoms like tetany and seizures. Hoarse voice (A) and difficulty swallowing (B) are expected post-thyroidectomy due to surgical trauma, while sore throat (D) is common from intubation.
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A patient with a diagnosis of peptic ulcer disease is prescribed omeprazole. When should the patient take this medication for optimal effectiveness?
- A. With meals
- B. At bedtime
- C. Before meals
- D. After meals
Correct Answer: C
Rationale: The correct answer is C: Before meals. Omeprazole is a proton pump inhibitor that works by reducing stomach acid production. Taking it before meals allows the medication to be most effective in inhibiting the proton pumps before they are stimulated by food intake. This timing optimizes the drug's ability to reduce acid secretion during the digestion process.
Choice A (With meals) is incorrect because taking omeprazole with meals may reduce its effectiveness as it will not have enough time to inhibit acid production before food intake. Choice B (At bedtime) is also incorrect as omeprazole works best when taken before meals to prevent acid production. Choice D (After meals) is incorrect because waiting until after meals to take omeprazole means that acid production has already been stimulated by the food consumed, reducing the drug's effectiveness in inhibiting acid secretion.
What instruction should a patient with a history of hypertension be provided when being discharged with a prescription for a thiazide diuretic?
- A. Avoid foods high in potassium.
- B. Take the medication at bedtime.
- C. Monitor weight daily.
- D. Limit fluid intake to 1 liter per day.
Correct Answer: C
Rationale: Rationale:
C is correct because thiazide diuretics can cause fluid retention, leading to weight gain, which may indicate worsening heart failure or hypertension. Daily weight monitoring helps detect fluid retention early, enabling timely intervention.
Summary:
A: Incorrect. Thiazide diuretics can cause potassium loss, so avoiding potassium-rich foods is not necessary.
B: Incorrect. Taking the medication in the morning is preferred to prevent nocturia and sleep disturbances.
D: Incorrect. Fluid intake should not be limited unless advised by a healthcare provider to prevent dehydration.
When implementing patient teaching for a patient admitted with hyperglycemia and newly diagnosed diabetes mellitus scheduled for discharge the second day after admission, what is the priority action for the nurse?
- A. Instruct about the increased risk for cardiovascular disease.
- B. Provide detailed information about dietary control of glucose.
- C. Teach glucose self-monitoring and medication administration.
- D. Give information about the effects of exercise on glucose control.
Correct Answer: C
Rationale: The correct answer is C because teaching glucose self-monitoring and medication administration is the priority action to ensure the patient can manage their condition effectively post-discharge. This step is crucial for immediate management of hyperglycemia and newly diagnosed diabetes mellitus. Option A is incorrect as addressing cardiovascular risk can be important but not the immediate priority. Option B is important but not as urgent as self-monitoring and medication administration. Option D is also important for long-term management but not as critical as ensuring immediate control of blood glucose levels through monitoring and medication.
What is the primary goal of care for a client experiencing esophageal varices secondary to liver cirrhosis?
- A. Preventing infection
- B. Controlling bleeding
- C. Reducing portal hypertension
- D. Maintaining nutritional status
Correct Answer: B
Rationale: The primary goal of care for a client with esophageal varices secondary to liver cirrhosis is to control bleeding. This is because esophageal varices can lead to life-threatening hemorrhage. By controlling bleeding, we can prevent severe complications and potentially save the client's life. Preventing infection (Choice A) is important but not the primary goal in this case. Reducing portal hypertension (Choice C) is a long-term goal and may help prevent variceal bleeding in the future, but it is not the immediate priority. Maintaining nutritional status (Choice D) is important for overall health but is not the primary goal when managing acute bleeding from esophageal varices.
What instruction should the nurse include in the discharge teaching for a patient with hypothyroidism prescribed levothyroxine?
- A. Take the medication with meals.
- B. Take the medication in the morning on an empty stomach.
- C. Discontinue the medication if you feel better.
- D. Double the dose if a dose is missed.
Correct Answer: B
Rationale: The correct answer is B: Take the medication in the morning on an empty stomach. Levothyroxine should be taken on an empty stomach, preferably 30 minutes to 1 hour before breakfast, to ensure optimal absorption. Food can interfere with absorption, so taking it with meals (choice A) is not recommended. Discontinuing the medication if feeling better (choice C) is dangerous as it can lead to a relapse of hypothyroidism. Doubling the dose if a dose is missed (choice D) can result in overdose and adverse effects. Therefore, choice B is the best option for optimal effectiveness of levothyroxine therapy.