Nokea
The nurse is caring for a client newly diagnosed with Cushing's disease. Which of the following client statements requires follow-up?
- A. I will need to eat more potassium-rich foods.
- B. I will need more steroids during periods of stress.
- C. I will be at a higher risk for an infection.
- D. I should do weight-bearing exercises.
Correct Answer: A
Rationale: Cushing's causes hyperkalemia, so more potassium-rich foods are harmful and need follow-up. Extra steroids for stress, infection risk, and weight-bearing exercises are appropriate.
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The following scenario applies to the next 1 items
The nurse in physician's office is caring for a 41-year-old male
Item 1 of 1
Nurses' Notes
1100 - Client presents for a routine follow-up and a medication refill. Client has no acute concerns and reports full adherence to his prescribed medications. Vital signs: T 97.5° F (36.4° C), P 90, RR 18, BP 138/88, pulse oximetry reading 96% on room air.
Medical History
• diabetes mellitus (type 2)
• hyperlipidemia
• hypertension
• irritable bowel syndrome
Current Medications
• metformin 1 gram by mouth daily
• glipizide 5 mg by mouth daily, before breakfast
• lisinopril 40 mg by mouth daily
• multivitamin 1 tablet by mouth daily
• atorvastatin 80 mg by mouth daily
The nurse reviews the client's medical record. Please complete the sentence below from the list of options. Based on the August glycated hemoglobin A1C results the client is
- A. going to require a prescription for insulin.
- B. having frequent episodes of hyperglycemia.
- C. demonstrating evidence of good glucose control.
- D. None of the above
Correct Answer: C
Rationale: Without specific HbA1C results, stable type 2 diabetes with adherence to metformin and glipizide suggests good control, assuming prior results were within target (<7%).
The following scenario applies to the next 6 items
The nurse in the clinic is caring for a 32-year-old female client.
Item 3 of 6
Nurses' Notes
1559: Client reports to the outpatient clinic with reports of persistent fatigue, weakness, lethargy, and lower back pain over the last 8 months. She is also concerned because she has gained 24 pounds (10.9 kg) over the past 4 months. She stated that the weight gain has been so significant that she developed reddened streaks on her abdomen from the weight gain. The client is concerned because, over the past month, she has noticed she has been drinking more often and has had increased hunger. She has also noticed she is urinating more frequently. She went to urgent care one week ago and tested negative for urinary tract infection. She also noticed that her menstrual cycle has been irregular. She is not on birth control and took a home pregnancy test, which was negative. During the assessment, the client was fully alert and oriented. Clear lung sounds bilaterally. Skin was dry. Excessive facial hair was noted. 1+ pedal and ankle edema bilaterally. Peripheral pulses palpable, 2+, and regular. Body mass index (BMI) of 32. Vital signs: T 97.5° F (36.4° C), P 93, RR 18, BP 145/93, pulse oximetry reading 96% on room air. She is currently taking escitalopram for persistent depressive disorder.
Laboratory Results
Capillary Blood Glucose
1613: 254 mg/dL [70-110 mg/dL]
Complete the following sentence by choosing from the list of options. The client is at highest risk for developing.......
- A. dysrhythmias.
- B. fluid volume overload
- C. adrenal crisis
- D. metabolic syndrome.
Correct Answer: D
Rationale: Elevated glucose, hypertension, BMI of 32, and weight gain suggest metabolic syndrome, a cluster of conditions increasing cardiovascular and diabetes risk. Dysrhythmias, fluid overload, and adrenal crisis are less directly tied to these findings.
The nurse is assessing a client with hypothyroidism. Which of the following assessment findings would be expected?
- A. Decreased libido
- B. Bradycardia
- C. Heat intolerance
- D. Fatigue
- E. Constipation
Correct Answer: A, B, D, E
Rationale: Hypothyroidism slows metabolism, leading to decreased libido, bradycardia, fatigue, and constipation. Heat intolerance is associated with hyperthyroidism, not hypothyroidism.
The nurse is interviewing a client taking prescribed methimazole for hyperthyroidism. Which assessment finding requires notification to the physician?
- A. body mass index (BMI) 23
- B. sore throat
- C. pulse (P) 84
- D. skin rash
Correct Answer: B
Rationale: Sore throat may indicate agranulocytosis, a rare but serious methimazole side effect, requiring immediate physician notification. BMI 23, pulse 84, and skin rash are less urgent unless severe.
The nurse is evaluating a client taking levothyroxine for hypothyroidism. Which findings indicate that the client is experiencing an adverse effect?
- A. Heat intolerance
- B. Palpitations
- C. Bradycardia
- D. Constipation
- E. Insomnia
- F. Weight gain
Correct Answer: A,B,E
Rationale: Heat intolerance, palpitations, and insomnia indicate hyperthyroidism, suggesting levothyroxine overdose. Bradycardia, constipation, and weight gain are hypothyroidism symptoms, not adverse effects of levothyroxine.