Nokea
The nurse is caring for a client who recently had a total parathyroidectomy. Which of the following medications should the nurse anticipate that the primary health care provider (PHCP) will order?
- A. Calcium carbonate
- B. Cholecalciferol
- C. Calcitonin
- D. Folic acid
- E. Magnesium oxide
Correct Answer: A, B
Rationale: Parathyroidectomy removes PTH, lowering calcium. Calcium carbonate supplements calcium, and cholecalciferol (vitamin D) aids absorption. Calcitonin lowers calcium, and folic acid and magnesium are unrelated.
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The nurse is teaching a review course on foods appropriate to treat hypoglycemia. It indicates appropriate understanding if an attendee states that which item should be provided?
- A. Slice of chicken breast
- B. 1 tablespoon of honey
- C. 1/2 cup of regular soda
- D. 1/2 cup of juice
- E. Two hardboiled eggs
Correct Answer: B, C, D
Rationale: Hypoglycemia requires fast-acting carbs: honey, regular soda, and juice raise glucose quickly. Protein-rich chicken and eggs are slow to digest and not effective for acute treatment.
The nurse is reviewing the diet of the client with hypoparathyroidism. The nurse understands that the client should be on what type of diet?
- A. High-calorie, low-calcium diet
- B. Low-calcium, low-phosphorus diet
- C. High-phosphorus, low-calcium diet
- D. High-calcium, low-phosphorus diet
Correct Answer: D
Rationale: Hypoparathyroidism reduces PTH, lowering calcium. A high-calcium, low-phosphorus diet compensates, as high phosphorus can further bind calcium.
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.
The following scenario applies to the next 1 items.
The nurse in the physician's office is caring for a 41-year-old female client.
Item 1 of 1
Progress Notes
1043
Subjective: Client presents for a follow-up appointment five weeks after she was prescribed sertraline for depressive symptoms. She reports no improvement and even reports worsening as she is having difficulty focusing at work. Specifically, she reports feeling like she is in a 'brain fog.' Two weeks ago, she started taking over-the-counter stool softeners because of constipation, which did not improve even after introducing more fiber in her diet. Finally, she reports that her shoes are no longer fitting because of edema in her ankles and feet.
Objective: Client is alert and oriented to person, place, and time. 2+ peripheral pulses. S1/S2 heart tones. Hypoactive bowel sounds in all quadrants. Clear lung sounds. Trace periorbital and 1+ pedal edema.
Assessment and plan: Will order laboratory testing as this client is showing strong clinical signs of primary hypothyroidism.
Vital Signs
T 97°F (36.1°C) P 58 RR 16 BP 107/65 Pulse oximetry reading 98% on room air
Orders
obtain thyroid panel
discontinue sertraline
The nurse reviews the physician's progress notes, orders, and the client's vital signs. Complete the sentence below with the appropriate answers. If the client has primary hypothyroidism, the client's thyroid panel will have a high...... and low......
- A. thyroid-stimulating hormone (TSH)
- B. free thyroxine (T4)
- C. serum triiodothyronine (T3)
- D. thyroid-stimulating hormone (TSH).
- E. free thyroxine (T4).
- F. thyrotropin receptor antibodies (TRAbs).
Correct Answer: A, B
Rationale: Primary hypothyroidism involves low thyroid hormone production, so TSH rises to stimulate the gland, and free T4 falls due to reduced output. T3 and TRAbs are less specific here.
The nurse is conducting a health screening at a local health fair. Which of the following should the nurse recognize as a risk factor for developing type II diabetes mellitus?
- A. Gestational diabetes
- B. Metabolic syndrome
- C. Chronic corticosteroid use
- D. Gastric bypass surgery
- E. Obesity
Correct Answer: A, B, C, E
Rationale: Gestational diabetes, metabolic syndrome, chronic steroids, and obesity increase type 2 diabetes risk via insulin resistance. Gastric bypass often improves glucose control.