Nokea
The nurse is caring for a client with Cushing's disease. Which of the following complications are associated with this condition?
- A. cataracts
- B. diabetes mellitus
- C. orthostatic hypotension
- D. osteoporosis
- E. venous thromboembolism
Correct Answer: A, B, D, E
Rationale: Cushing's excess cortisol causes cataracts, diabetes from hyperglycemia, osteoporosis from bone loss, and thromboembolism from hypercoagulability. Orthostatic hypotension is not typical.
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The nurse is assisting a client with their newly prescribed insulin pump. The nurse understands which insulin is commonly loaded into the pump?
- A. Rapid acting
- B. Ultra long-acting insulin
- C. Intermediate acting
- D. Long acting
Correct Answer: A
Rationale: Rapid-acting insulin, such as lispro or aspart, is used in insulin pumps to mimic physiological insulin delivery for basal and bolus dosing. Long-acting or intermediate-acting insulins are not suitable for pumps.
The nurse is caring for a client prescribed propylthiouracil (PTU). To monitor the effectiveness of this medication, the nurse anticipates the primary healthcare provider will order a
- A. serum calcium level.
- B. thyroid panel.
- C. fasting blood glucose.
- D. white blood cell (WBC) count.
Correct Answer: B
Rationale: PTU treats hyperthyroidism by reducing thyroid hormone production. A thyroid panel (TSH, T4, T3) monitors effectiveness. Calcium, glucose, and WBC are not directly related to PTU's action.
A post-adrenalectomy client is admitted to the intensive care unit and is on intravenous hydrocortisone. Which nursing intervention should be included in the client's plan of care?
- A. Monitor blood glucose levels frequently
- B. Keep the client supine for 24 hours
- C. Discontinue hydrocortisone once vital signs become stable
- D. Educate the client on how to properly clean the wound at home
Correct Answer: A
Rationale: Adrenalectomy removes cortisol production; hydrocortisone replacement can raise glucose. Frequent monitoring prevents hyperglycemia. Keeping supine is unnecessary, discontinuation risks adrenal crisis, and wound care education is premature in ICU.
The nurse is caring for a client diagnosed with a myxedema coma. The nurse should anticipate a prescription for which of the following medications?
- A. Levothyroxine
- B. Methimazole
- C. Tolvaptan
- D. Hydrochlorothiazide
- E. Hydrocortisone
Correct Answer: A,E
Rationale: Myxedema coma, a severe hypothyroidism emergency, requires levothyroxine to restore thyroid hormone levels and hydrocortisone to address potential adrenal insufficiency. Methimazole treats hyperthyroidism, and tolvaptan and hydrochlorothiazide manage fluid balance, not hypothyroidism.
The nurse supervises a graduate nurse caring for a client newly admitted for postoperative management following a thyroidectomy. Which of the following actions by the graduate nurse indicates effective planning of the client's care?
- A. A bottle of sterile water and petroleum-based gauze is at the bedside.
- B. Obtains a prescription for magnesium sulfate.
- C. The bedside is prepared with a tracheostomy set, oxygen, and suction.
- D. Applies a cervical collar to the client
Correct Answer: C
Rationale: Post-thyroidectomy, airway obstruction from swelling or hemorrhage is a risk. A tracheostomy set, oxygen, and suction are essential for emergency airway management. Sterile water and gauze are insufficient, magnesium sulfate is unrelated, and a cervical collar may restrict breathing.