Nokea
The nurse has provided medication instruction to a client who has been prescribed metformin. Which of the following statements, if made by the client, would indicate a correct understanding of the teaching?
- A. This medication may cause me to have bloating or loose stools.
- B. I will need to take my blood glucose prior to taking this medication.
- C. If I eat fewer carbohydrates in a day, I should skip a dose.
- D. The goal of this medication is to increase my hemoglobin A1C.
Correct Answer: A
Rationale: Metformin commonly causes gastrointestinal side effects like bloating or loose stools. Blood glucose checks are not required before dosing, skipping doses is inappropriate, and metformin aims to lower, not increase, HbA1c.
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The nurse is caring for a client with the syndrome of inappropriate antidiuretic hormone (SIADH). Which assessment finding requires immediate follow-up?
- A. Disorientation
- B. High urine specific gravity
- C. Oliguria
- D. Increased thirst
Correct Answer: A
Rationale: SIADH causes water retention and hyponatremia, which can lead to disorientation—a neurological symptom requiring urgent follow-up to prevent seizures or coma. Other findings are expected.
The nurse is planning care for a client following bilateral adrenalectomy. The nurse should anticipate a prescription for which postoperative medication?
- A. Pantoprazole
- B. Propylthiouracil (PTU)
- C. Propranolol
- D. Hydrocortisone
Correct Answer: D
Rationale: Bilateral adrenalectomy removes adrenal glands, necessitating lifelong hydrocortisone replacement to provide glucocorticoids and prevent adrenal insufficiency. Pantoprazole, PTU, and propranolol are not indicated for this purpose.
The nurse is caring for a client newly diagnosed with diabetes mellitus (type one). It would be essential to educate the client to
- A. check their hemoglobin A1C level every three months.
- B. rotate injection sites for insulin administration.
- C. examine their feet with a mirror daily.
- D. recognize the symptoms of hypoglycemia.
Correct Answer: A, B, C, D
Rationale: HbA1C monitors control, rotation prevents lipohypertrophy, foot checks prevent ulcers, and recognizing hypoglycemia symptoms ensures timely treatment in type 1 diabetes.
The nurse is caring for a client eight hours postoperative following a total thyroidectomy. Which of the following assessment findings indicate that the client is developing a complication?
- A. Moderate amount of dried sanguineous drainage on the dressing
- B. Oral temperature of 99.2°F (37.3°C)
- C. Apical pulse of 56
- D. The client reports a sore throat when speaking
Correct Answer: A
Rationale: Excessive drainage post-thyroidectomy may indicate hemorrhage, a serious complication. A slightly elevated temperature, mild bradycardia, and sore throat are expected or less concerning in the immediate postoperative period.
The nurse is educating a group of students on the effects of corticosteroids. It would be appropriate for the nurse to identify the following adverse effects associated with corticosteroids.
- A. Mood lability
- B. Immunosuppression
- C. Hypoglycemia
- D. Hyperkalemia
- E. Weight gain
Correct Answer: A, B, E
Rationale: Corticosteroids cause mood changes, suppress immunity, and promote weight gain via fluid retention and fat redistribution. They cause hyperglycemia, not hypoglycemia, and hypokalemia, not hyperkalemia.