Nokea
The nurse is caring for the client admitted in Addisonian crisis. Which medication, if prescribed, should the nurse plan to administer?
- A. Regular insulin
- B. Ketoconazole
- C. Sodium nitroprusside
- D. Hydrocortisone
Correct Answer: D
Rationale: Hydrocortisone is a corticosteroid used to replace deficient glucocorticoids in Addisonian crisis.
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The nurse is admitting a client to rule out aldosteronism. Which assessment data support the client's diagnosis?
- A. Temperature.
- B. Pulse.
- C. Respirations.
- D. Blood pressure.
Correct Answer: D
Rationale: Elevated blood pressure is a hallmark of aldosteronism due to sodium retention and fluid overload. Temperature, pulse, and respirations are less specific.
How soon after administering the client's dose of regular insulin subcutaneously should the nurse assess for signs of hypoglycemia?
- A. 5 minutes later
- B. 30 minutes later
- C. 6 hours later
- D. 10 hours later
Correct Answer: B
Rationale: Regular insulin peaks around 2-4 hours, but early hypoglycemia can occur within 30 minutes, requiring assessment.
Which statement provides the best evidence that the client who has undergone a bilateral adrenalectomy understands the postoperative course?
- A. I should avoid people with infectious diseases.
- B. I need to limit my fluid intake to 1 quart per day.
- C. My appearance will never be the same as it was before.
- D. No other treatment is necessary after I recover from surgery.
Correct Answer: A
Rationale: Avoiding infections is critical post-adrenalectomy due to lifelong steroid replacement and immunosuppression.
Antibiotics are ordered for a client who has had a transsphenoidal hypophysectomy. He asks why he is receiving an antibiotic when he does not have an infection. The primary reason for administering antibiotics to this client is based on which information?
- A. Antibiotics will help to prevent respiratory complications following surgery.
- B. Meningitis is a complication following transsphenoidal hypophysectomy.
- C. Fluid retention can cause dangerously high cerebro spinal fluid pressure.
- D. Hormone replacement is essential after hypophysectomy.
Correct Answer: B
Rationale: The transsphenoidal approach through the mouth increases the risk of meningitis due to oral bacteria, necessitating prophylactic antibiotics.
Which client action indicates a need for further teaching about insulin administration?
- A. Using a new needle for each injection
- B. Storing insulin in the refrigerator
- C. Checking blood glucose before injecting
- D. Injecting insulin into a lipodystrophic area
Correct Answer: D
Rationale: Injecting insulin into a lipodystrophic area can impair absorption, indicating a need for further teaching on site rotation.