Nokea
The nurse is caring for the client who had a thyroidectomy 2 days ago. Based on the findings of the client's serum laboratory report, which medication should the nurse plan to administer first?
- A. Potassium chloride 20 mEq oral bid
- B. Calcium gluconate 4.5 mEq IV once
- C. Dolasetron 12.5 mg IV as needed
- D. Levothyroxine 50 mcg oral daily
Correct Answer: B
Rationale: The serum calcium is critically low (6 mg/dL). Calcium gluconate addresses hypocalcemia from parathyroid gland damage during thyroidectomy.
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The nurse should assess for hypocalcemia based on which client statements after a subtotal thyroidectomy?
- A. I feel tingling in my hands and feet.
- B. I have a headache.
- C. I feel sleepy.
- D. I have a sore throat.
Correct Answer: A
Rationale: Tingling in the hands and feet indicates hypocalcemia, a potential complication due to parathyroid gland damage during thyroidectomy.
The nurse is assessing the client who has type 2 DM. Which findings indicate to the nurse that the client is experiencing HHNS? Select all that apply.
- A. Serum osmolality 364 mOsm/kg
- B. Blood glucose level 160 mg/dL
- C. Very dry mucous membranes
- D. Blood pressure of 90/42 mm Hg
- E. Urine output 500 mL past 8 hours
Correct Answer: A,C,D
Rationale: A serum osmolality of 364 mOsm/kg, very dry mucous membranes, and a BP of 90/42 indicate HHNS due to elevated osmolality, dehydration, and hypotension from osmotic diuresis.
The nurse is assessing a client with complaints of vague upper abdominal pain worse at night but relieved by sitting up and leaning forward. Which assessment question should the nurse ask next?
- A. Have you noticed a yellow haze when you look at things?
- B. Does the pain get worse when you eat a meal or snack?
- C. Have you had your amylase and lipase checked recently?
- D. How much weight have you gained since you saw an HCP?
Correct Answer: A
Rationale: The pain description suggests pancreatic cancer; jaundice (yellow haze) is a common symptom due to bile duct obstruction, guiding further assessment. Eating effects, labs, and weight gain are less specific.
The client is admitted to rule out Cushing's syndrome. Which laboratory tests should the nurse anticipate being ordered?
- A. Plasma drug levels of quinidine, digoxin, and hydralazine.
- B. Plasma levels of ACTH and cortisol.
- C. A 24-hour urine for metanephrine and catecholamine.
- D. Spot urine for creatinine and white blood cells (WBCs).
Correct Answer: B
Rationale: ACTH and cortisol levels diagnose Cushing’s by confirming hypercortisolism. Other tests assess unrelated conditions (e.g., pheochromocytoma, renal function).
The health-care provider has ordered 40 g/24 hr of intranasal vasopressin for a client diagnosed with diabetes insipidus. Each metered spray delivers 10 g. The client takes the medication every 12 hours. How many sprays are delivered at each dosing time?
Correct Answer: 2 sprays
Rationale: Total dose: 40 g/24 hr, split every 12 hr = 20 g/dose. Each spray = 10 g, so 20 g ÷ 10 g/spray = 2 sprays per dose.