Nokea
The nurse is caring for a patient with hyperthyroidism who is being treated with radioactive iodine (RAI) at the clinic. Which of the following information should the nurse provide to the patient prior to discharge?
- A. Symptoms of hyperthyroidism should be relieved in about a week.
- B. Hypothyroidism may occur as the RAI therapy takes effect.
- C. Discontinue the antithyroid medications taken before the radioactive therapy.
- D. Teach radioactive precautions to use with urine, stool, and other body secretions.
Correct Answer: B
Rationale: There is a high incidence of postradiation hypothyroidism after RAI, and the patient should be monitored for symptoms of hypothyroidism. RAI has a delayed response, with the maximum effect not seen for 2-3 months, and the patient will continue to take antithyroid medications during this time. The therapeutic dose of radioactive iodine is low enough that no radiation safety precautions are needed.
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The nurse is caring for a patient who has an adrenocortical adenoma and hyperaldosteronism. Which of the following actions should the nurse implement?
- A. Provide a potassium-restricted diet.
- B. Monitor the blood pressure every 4 hours.
- C. Evaluate blood glucose level every 4 hours.
- D. Maintain extremities in an elevated position.
Correct Answer: B
Rationale: Hypertension caused by sodium retention is a common complication of hyperaldosteronism. Hyperaldosteronism does not cause elevation in blood glucose. The patient will be hypokalemic and require potassium supplementation before surgery. Edema does not usually occur with hyperaldosteronism.
The nurse is caring for a patient with a diagnosis of Cushing's syndrome. Which of the following data should the nurse anticipate finding during the admission assessment?
- A. Persistently low blood pressure
- B. Bronzed appearance of the skin
- C. Decreased axillary and pubic hair
- D. Purplish red streaks on the abdomen
Correct Answer: D
Rationale: Purplish-red striae on the abdomen are a common clinical manifestation of Cushing's syndrome. Hypotension and bronzed-appearing skin are manifestations of Addison's disease. Decreased axillary and pubic hair occur with androgen deficiency.
When developing a plan of care for a patient with syndrome of inappropriate antidiuretic hormone (SIADH), which of the following interventions should the nurse include?
- A. Encourage fluids to 2000 mL/day.
- B. Offer patient ice chips to suck on.
- C. Monitor for increased peripheral edema.
- D. Keep head of bed elevated to 30 degrees.
Correct Answer: B
Rationale: Sucking on ice chips or chewing sugarless gum decreases thirst for a patient on fluid restriction. Patients with SIADH are on fluid restrictions of 800-1000 mL/day. Peripheral edema is not seen with SIADH. The head of the bed is elevated no more than 10 degrees to increase left atrial filling pressure and decrease antidiuretic hormone (ADH) release.
Which of the following information obtained by the nurse when caring for a patient who has diabetes insipidus (DI) is most important to report to the health care provider?
- A. History of a recent head injury
- B. Confusion and lethargy
- C. Urine output of 400 mL/hour
- D. Urine specific gravity is 1.003
Correct Answer: B
Rationale: The patient's confusion and lethargy may indicate hypernatremia and should be addressed quickly. In addition, patients with DI compensate for fluid losses by drinking copious amounts of fluids, but a patient who is lethargic will be unable to drink enough fluids and will become hypovolemic. A high urine output, low urine specific gravity, and history of a recent head injury are consistent with diabetes insipidus, but they do not require immediate nursing action to avoid life-threatening complications.
The nurse is caring for a patient with hypertension who is diagnosed with a pheochromocytoma. Which of the following findings should the nurse monitor in the patient?
- A. Flushing
- B. Headache
- C. Bradycardia
- D. Hypoglycemia
Correct Answer: B
Rationale: The classic clinical manifestations of pheochromocytoma are hypertension, tachycardia, severe pounding headache, diaphoresis, and abdominal or chest pain. Elevated blood glucose may also occur because of sympathetic nervous system stimulation. Bradycardia and flushing would not be expected.