Nokea
The nurse assesses a client scheduled for a thyroidectomy for psychosocial problems that may cause preoperative anxiety. Considering the nature of the surgery which client fear is a realistic source of anxiety?
- A. Sexual dysfunction and infertility
- B. Imposed dietary restrictions after discharge
- C. Developing gynecomastia and hirsutism postoperatively
- D. Changes in body image secondary to the location of the incision
Correct Answer: D
Rationale: Because the incision is in the neck area, the client may be fearful of having a large scar postoperatively. Sexual dysfunction and infertility could possibly occur if the entire thyroid gland is removed, and the client is not placed on thyroid replacement medications. The client will not have specific dietary restrictions after discharge. Having all or part of the thyroid gland removed will not cause gynecomastia or hirsutism.
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A client is receiving heparin therapy for a pulmonary embolism. The nurse should monitor the client for which of the following adverse effects?
- A. Thrombocytopenia.
- B. Hyperkalemia.
- C. Hypoglycemia.
- D. Hypertension.
Correct Answer: A
Rationale: Heparin can cause heparin-induced thrombocytopenia, a serious adverse effect that reduces platelet count and increases clotting risk, requiring close monitoring.
Which sign/symptom is an indication that the client experiencing postoperative blood loss is anemic?
- A. Fatigue
- B. Dyspnea
- C. Bradycardia
- D. Muscle cramps
Correct Answer: A
Rationale: The client with anemia is likely to report fatigue caused by deficient hemoglobin leading to a decreased oxygen-carrying capacity of the blood and ability to meet tissue oxygen demands. The respiratory rate can increase to improve oxygenation; some shortness of breath can occur but dyspnea related to anemia is uncommon. The client is more likely to have tachycardia than bradycardia, because the heart beats faster to deliver the same amount of oxygen to tissues in compensation for less oxygen in the blood. Muscle cramps are an unrelated finding.
A client is taking ciprofloxacin (Cipro). Which of the following laboratory studies will not be affected by ciprofloxacin?
- A. Theophylline level.
- B. Prothrombin time (PT).
- C. Partial thromboplastin time (PTT).
- D. Total iron-binding capacity.
Correct Answer: D
Rationale: Ciprofloxacin does not typically affect total iron-binding capacity, unlike theophylline levels (drug interaction) or coagulation studies (PT/PTT).
A client with a history of osteoarthritis is prescribed ibuprofen. The nurse should instruct the client to take the medication:
- A. On an empty stomach to enhance absorption.
- B. With food to reduce gastrointestinal irritation.
- C. At bedtime to promote sleep.
- D. With a diuretic to reduce swelling.
Correct Answer: B
Rationale: Ibuprofen should be taken with food to minimize gastrointestinal irritation and reduce the risk of ulcers.
When infusing total parenteral nutrition (TPN), the nurse should assess the client for which of the following complications?
- A. Essential amino acid deficiency.
- B. Essential fatty acid deficiency.
- C. Hyperglycemia.
- D. Infection.
Correct Answer: C,D
Rationale: TPN can cause hyperglycemia due to high glucose content and infection due to catheter use, both requiring vigilant monitoring.