Nokea
The nurse has done preoperative teaching with a client scheduled for percutaneous insertion of an inferior vena cava (IVC) filter. Which client statement indicates the need for further teaching about the procedure?
- A. This is done under general anesthesia.
- B. This procedure is rarely associated with complications.
- C. It may cause congestion when clots get trapped at the filter.
- D. This could possibly eliminate the need for anticoagulant therapy.
Correct Answer: A
Rationale: The percutaneous approach uses local anesthesia. Complications after insertion of an IVC filter are rare. When they do occur, they include air embolism, improper placement, and filter migration. Venous congestion can occur from accumulation of thrombi on the filter, but the process usually occurs gradually. There is usually no need for anticoagulant therapy after surgery.
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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.
A client with a history of hypothyroidism is prescribed levothyroxine (Synthroid). The nurse should monitor the client for which of the following signs of overdose?
- A. Tachycardia.
- B. Weight gain.
- C. Cold intolerance.
- D. Bradycardia.
Correct Answer: A
Rationale: Tachycardia indicates levothyroxine overdose due to excessive thyroid hormone.
The nurse is assessing a client with suspected dehydration. Which of the following findings would support this diagnosis? Select all that apply.
- A. Sunken fontanelles in an infant.
- B. Tachycardia.
- C. Increased urine specific gravity.
- D. Dry skin.
- E. Hypotension.
Correct Answer: A, B, C, D, E
Rationale: Dehydration presents with sunken fontanelles, tachycardia, increased urine specific gravity, dry skin, and hypotension due to fluid loss.
The sudden onset of which of the following indicates a potentially serious complication for the client receiving an I.V. infusion?
- A. Noisy respirations.
- B. Pupillary constriction.
- C. Halitosis.
- D. Moist skin.
Correct Answer: A
Rationale: Noisy respirations may indicate fluid overload or pulmonary edema, a serious I.V. infusion complication requiring immediate intervention.
Which of the following signs and symptoms experienced by a child with suspected appendicitis should the nurse correctly judge to be unrelated to the transient sympathetic effects caused by the acute abdominal pain?
- A. Tachycardia.
- B. Chills.
- C. Rapid breathing.
- D. Dilated pupils.
Correct Answer: B
Rationale: Chills are not typically a sympathetic response to pain (unlike tachycardia, rapid breathing, or dilated pupils) and may indicate an infection or other complication.