Nokea
The nurse is caring for a client scheduled for a thyroidectomy. The primary healthcare provider (PHCP) prescribes potassium iodide. The nurse understands that this medication is intended to do which of the following?
- A. Decrease the risk of agranulocytosis postoperatively.
- B. Prevent postoperative hypocalcemia.
- C. Reduce the size and vascularity of the thyroid.
- D. Decrease postoperative blood glucose levels.
Correct Answer: C
Rationale: Potassium iodide reduces thyroid gland size and vascularity pre-thyroidectomy, decreasing surgical bleeding risk. It does not prevent agranulocytosis, hypocalcemia, or affect blood glucose directly.
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The nurse is caring for a client who has diabetes mellitus. Which of the following would indicate the client is achieving the treatment goals?
- A. Fasting blood glucose 145 mg/dl (8.05 mmol/L) [70-110 mg/dL, 4.0-6.0 mmol/L]
- B. Creatinine 2.3 mg/dl (203.32 μmol/L) [Male: 0.6-1.2 mg/dL Female: 0.5-1.1 mg/dL, Male 49-93 ¼mol/L Female 22-75 ¼mol/L]
- C. Urine Specific Gravity 1.043 [1.005-1.030]
- D. Hemoglobin A1C 6.7% [ < 7%]
Correct Answer: D
Rationale: HbA1C of 6.7% indicates good long-term glucose control (target <7%). Elevated fasting glucose, creatinine, and urine specific gravity suggest poor control or complications like renal issues.
The following scenario applies to the next 1 items
The nurse cares for a client who arrived at the emergency department (ED) complaining of generalized weakness
Item 1 of 1
History and Physical
23-year-male arrives at the emergency department (ED) reporting a headache, feeling unwell, fatigue, and thirst. The symptoms started one day ago and have worsened. He could not check his blood glucose because he reports being out of testing supplies for two weeks.
On exam, the client reports feeling fatigued and thirsty. He is lethargic and completely oriented. His physical exam revealed sunken eyes, skin that was hot to the touch, very dry mucous membranes, with white patches on his tongue.
The client has a medical history of type I diabetes mellitus.
Vital Signs
Oral Temperature 100o F (37.8o C)
Pulse 123/minute
Respirations 24/minute
Blood pressure 94/50 mm Hg
O2 saturation 96% on room air
Complete the sentence below from the list of options. The client is at highest risk of developing....... based on the client's.............
- A. hyperglycemic-hyperosmolar state
- B. metabolic alkalosis
- C. diabetic ketoacidosis
- D. positive serum ketones.
- E. glycosylated hemoglobin.
- F. potassium level.
Correct Answer: C, D
Rationale: In type 1 diabetes, fatigue, thirst, and dry mucous membranes with elevated glucose suggest DKA. Positive serum ketones confirm ketosis, a hallmark of DKA due to insulin deficiency.
The nurse is caring for a client who reports diarrhea, unintentional weight loss, and nervousness. The primary healthcare provider (PHCP) orders a thyroid panel, and the nurse understands the client is at the highest risk for
- A. Myxedema
- B. Bell's palsy
- C. Grave's disease
- D. Cushing syndrome
Correct Answer: C
Rationale: Diarrhea, weight loss, and nervousness suggest hyperthyroidism, with Graves' disease as the most common cause due to thyroid overstimulation. Myxedema and Cushing's have opposite symptoms, and Bell's palsy is unrelated.
The nurse is caring for a client with diabetes mellitus (type one) with diabetic ketoacidosis (DKA). Which laboratory result is critical for the nurse to monitor closely during the client's treatment?
- A. Blood urea nitrogen (BUN)
- B. Serum creatinine
- C. Serum potassium
- D. Serum magnesium
Correct Answer: C
Rationale: In DKA, insulin shifts potassium into cells, risking hypokalemia, which can cause arrhythmias. Close monitoring of serum potassium is critical during treatment.
The nurse is caring for a client who presents with a blood glucose level of 45 mg/dL (2.4975 mmol/L) [70-110 mg/dL, 4.0-11.0 mmol/L]. Which of the following findings are expected?
- A. Blurred vision
- B. Increased urinary output
- C. Cool and clammy skin
- D. Palpitations
- E. Orthostatic hypotension
- F. Paresthesias
Correct Answer: C, D, F
Rationale: Hypoglycemia causes sympathetic activation (cool, clammy skin; palpitations) and neurological symptoms (paresthesias). Blurred vision and increased urination are more typical of hyperglycemia, and orthostatic hypotension is less directly related.