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The nurse is developing a plan of care for a client diagnosed with Addison's disease. Which of the following should the nurse include in the client's plan of care?
- A. Diet high in potassium
- B. Continuous telemetry monitoring
- C. Intravenous hydrocortisone
- D. Fluid restriction
- E. Fall precautions
- F. Indwelling urinary catheter
Correct Answer: C, E
Rationale: Addison's requires hydrocortisone to replace cortisol and fall precautions due to weakness and hypotension. High potassium diets and fluid restriction are harmful; telemetry and catheters are not routine.
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The nurse is teaching a client about newly prescribed insulin glargine. The nurse recognizes the need for further instruction when the client makes the following statement?
- A. I will take this insulin right before my meals.
- B. I should roll this vial of insulin before removing it with the syringe.
- C. This insulin will help control my glucose for 24 hours.
- D. I can only inject this insulin into my abdomen.
- E. I'm glad to know I can mix this with my regular insulin.
Correct Answer: A,B,D,E
Rationale: Insulin glargine is a long-acting insulin taken once daily, not before meals, provides 24-hour coverage, and should not be mixed with other insulins. It is clear and does not require rolling, and can be injected in multiple sites, not just the abdomen. Only the statement about 24-hour control is correct.
The nurse is assessing a client with hypothyroidism. Which of the following assessment findings would be expected?
- A. Decreased libido
- B. Bradycardia
- C. Heat intolerance
- D. Fatigue
- E. Constipation
Correct Answer: A, B, D, E
Rationale: Hypothyroidism slows metabolism, leading to decreased libido, bradycardia, fatigue, and constipation. Heat intolerance is associated with hyperthyroidism, not hypothyroidism.
The nurse is caring for a client who developed a thyroid storm. The nurse should obtain a prescription for
- A. enalapril
- B. regular insulin
- C. levothyroxine
- D. dexamethasone
Correct Answer: D
Rationale: Thyroid storm requires blocking excess thyroid hormone effects. Dexamethasone reduces hormone release and inflammation. Enalapril is for hypertension, insulin for glucose, and levothyroxine worsens the condition.
The nurse is teaching a client who has Graves' disease about self-management. Which of the following should the nurse include in the teaching plan?
- A. Stool softeners can be taken daily to prevent constipation.
- B. Thyroid replacement should be taken first thing in the morning.
- C. Report any significant weight gain while taking the antithyroid medication.
- D. Maintain the prescribed fluid restriction to prevent fluid overload.
Correct Answer: C
Rationale: In Graves' disease, antithyroid meds control hyperthyroidism; significant weight gain may signal overtreatment, needing reporting. Stool softeners, thyroid replacement, and fluid restriction are for hypothyroidism or other conditions.
The nurse is caring for a client newly diagnosed with Cushing's disease. Which of the following client statements requires follow-up?
- A. I will need to eat more potassium-rich foods.
- B. I will need more steroids during periods of stress.
- C. I will be at a higher risk for an infection.
- D. I should do weight-bearing exercises.
Correct Answer: A
Rationale: Cushing's causes hyperkalemia, so more potassium-rich foods are harmful and need follow-up. Extra steroids for stress, infection risk, and weight-bearing exercises are appropriate.