Nokea
The nurse is caring for a client receiving prescribed dexamethasone. Which of the following adverse reactions may occur?
- A. Infection
- B. Hypotension
- C. Peripheral edema
- D. Hypoglycemia
- E. Weight loss
- F. Insomnia
Correct Answer: A,C,F
Rationale: Dexamethasone, a corticosteroid, increases infection risk, causes fluid retention (peripheral edema), and insomnia. Hypotension, hypoglycemia, and weight loss are not typical; hypertension, hyperglycemia, and weight gain are more common.
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The nurse reviews laboratory data for a client with suspected diabetes mellitus (DM). Which action should the nurse take based on the client's hemoglobin A1C? See Exhibit.
- A. assess the client for an infection
- B. instruct the client that the results are within normal limits
- C. assess the client's urine for glycosuria
- D. educate the client on a diet with low-glycemic foods
Correct Answer: D
Rationale: Without specific HbA1C values, a suspected DM diagnosis warrants dietary education on low-glycemic foods to manage blood sugar. Infection or glycosuria assessment depends on results, and normal limits are unlikely if DM is suspected.
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 following scenario applies to the next 1 items
The emergency department (ED) nurse cares for a 49-year-old male
Item 1 of 1
Nurses' Notes
0914 - Client presents to the ED with his wife reporting headaches, palpitations, sweating, and an occasional tremor in his upper extremities. The client states that these are 'episodes' and usually occur after the client engages in strenuous activity or is under stress. The onset of these symptoms was months ago, and the client could not identify a concrete time frame. The client says he has increased his alcohol consumption from two standard glasses of wine daily to three because of the 'stress at work.' He often wakes up with an occasional headache. He says that the episodes have been occurring more often and that the headaches are frustrating because they do not abate with over-the-counter medications such as acetaminophen. He states that he doesn't have any other symptoms, except he has been drinking more water lately, but attributes that to his work outside setting up a garden. He reports a weight loss of 2 kilograms (4.4 pounds) over the past month. His current body mass index is 23. His medical history includes iron deficiency anemia, herpes simplex virus, and irritable bowel syndrome. His medications include docusate, valacyclovir, and iron sucrose. He reports that his mother and father had a stroke because of high blood pressure, which makes him quite concerned. On assessment, the client is alert and fully oriented. Affect is cooperative. The peripheral pulses are +2. Lung sounds are diminished bilaterally. Bowel sounds were present in all four quadrants. He says he has a headache but cannot provide a numerical rating score stating 'it just hurts.' Vital signs: T 97.5° F (36.4° C), P 110, RR 18, BP 161/80, pulse oximetry reading 96% on room air.
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, two (2) actions the nurse should take to address that condition, and two (2) parameters the nurse should monitor to assess the client's progress
- A. Obtain an order for a hemoglobin A1C, Obtain an order for a 24-hour urine collection, Request a prescription for a benzodiazepine, Request a prescription of an antihypertensive.
- B. peripheral pulses, mental status, capillary blood, glucose blood pressure.
- C. alcohol withdrawal syndrome, essential hypertension, pheochromocytoma, diabetes mellitus, type II
Correct Answer: C, A, D, B
Rationale: Pheochromocytoma causes headaches, palpitations, and hypertension from catecholamine excess. Order a 24-hour urine collection for catecholamines, request antihypertensives, and monitor BP and mental status for progress.
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.