Nokea
The nurse is discussing the endocrine system with the client. Which endocrine gland secretes epinephrine and norepinephrine?
- A. The pancreas.
- B. The adrenal cortex.
- C. The adrenal medulla.
- D. The anterior pituitary gland.
Correct Answer: C
Rationale: The adrenal medulla secretes catecholamines (epinephrine and norepinephrine), which regulate the fight-or-flight response. The pancreas secretes insulin/glucagon, the adrenal cortex produces corticosteroids, and the anterior pituitary releases hormones like ACTH.
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The client is admitted to the intensive care department diagnosed with myxedema coma. Which assessment data warrant immediate intervention by the nurse?
- A. Serum blood glucose level of 74 mg/dL.
- B. Pulse oximeter reading of 90%.
- C. Telemetry reading showing sinus bradycardia.
- D. The client is lethargic and sleeps all the time.
Correct Answer: B
Rationale: A pulse oximetry of 90% indicates hypoxia, requiring immediate intervention in myxedema coma. Normal glucose, bradycardia, and lethargy are expected.
Which client problem is the nurse’s priority concern for the client diagnosed with acute pancreatitis?
- A. Impaired nutrition.
- B. Skin integrity
- C. Anxiety
- D. Pain relief.
Correct Answer: D
Rationale: Acute pancreatitis is characterized by severe abdominal pain due to pancreatic inflammation and autodigestion. Pain relief is the priority concern, as it addresses the client’s immediate discomfort, improves patient comfort, and reduces physiological stress, which can exacerbate the condition. Using the ABCs (Airway, Breathing, Circulation) and Maslow’s hierarchy, pain is a physiological need that takes precedence. Impaired nutrition (1) is relevant but secondary, as clients are often NPO initially. Skin integrity (2) and anxiety (3) are lower priorities, as they are less immediate concerns in acute pancreatitis.
An adult is admitted to the hospital with a diagnosis of hypothyroidism. Which findings would the nurse most likely elicit during the nursing assessment?
- A. Elevated blood pressure and temperature
- B. Tachycardia and weight gain
- C. Hypothermia and constipation
- D. Moist skin and coarse hair
Correct Answer: C
Rationale: Hypothyroidism causes hypothermia and constipation due to slowed metabolism, unlike the other symptoms.
During the physical assessment of this client, which finding the nurse's blood, the observer?
- A. Shortened height
- B. Enlarged hands
- C. Gonadal atrophy
- D. Loss of teeth
Correct Answer: B
Rationale: Acromegaly, caused by excess growth hormone, leads to enlarged hands due to soft tissue and bone overgrowth.
The male client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) secondary to cancer of the lung tells the nurse he wants to discontinue the fluid restriction and does not care if he dies. Which action by the nurse is an example of the ethical principle of autonomy?
- A. Discuss the information the client told the nurse with the health-care provider and significant other.
- B. Explain it is possible the client could have a seizure if he drank fluid beyond the restrictions.
- C. Notify the health-care provider of the client's wishes and give the client fluids as desired.
- D. Allow the client an extra drink of water and explain the nurse could get into trouble if the client tells the health-care provider.
Correct Answer: C
Rationale: Notifying the HCP and respecting the client’s fluid request honors autonomy. Sharing with others violates confidentiality, explaining risks is beneficence, and covertly giving water is unethical.