Nokea
The nurse is evaluating a client taking levothyroxine for hypothyroidism. Which findings indicate that the client is experiencing an adverse effect?
- A. Heat intolerance
- B. Palpitations
- C. Bradycardia
- D. Constipation
- E. Insomnia
- F. Weight gain
Correct Answer: A,B,E
Rationale: Heat intolerance, palpitations, and insomnia indicate hyperthyroidism, suggesting levothyroxine overdose. Bradycardia, constipation, and weight gain are hypothyroidism symptoms, not adverse effects of levothyroxine.
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The nurse preceptor observes a newly hired nurse care for a client with a myxedema coma. It would require follow up by the nurse preceptor if the newly hired nurse is observed
- A. applying a cooling blanket to the client.
- B. requesting a prescription for hydrocortisone.
- C. removing the water pitcher from the bedside.
- D. placing an oral endotracheal tube at the bedside for potential use.
Correct Answer: A
Rationale: Myxedema coma is a severe hypothyroid state with hypothermia. A cooling blanket worsens this; a warming blanket is needed. Hydrocortisone addresses adrenal insufficiency, removing water prevents dilutional hyponatremia, and an endotracheal tube is prudent for potential respiratory support.
The following scenario applies to the next 1 items
The nurse in the physician's office is providing education to a client with diabetes mellitus (type one)
Item 1 of 1
Nurses' Note
1655: Client reports to the clinic with an interest in a prescription for an insulin pump. The client reports that he has been inconvenienced by injecting himself with insulin over the past year, considering he is traveling more for work. The client indicates that he heard about insulin pumps and thinks it would be a good fit for his lifestyle.
Orders
1730:
Continuous subcutaneous insulin infusion (insulin pump)
The nurse evaluates the client's understanding following a teaching session regarding the newly prescribed continuous subcutaneous insulin infusion (insulin pump). Click to specify if the client statement indicates effective understanding or requires follow-up
- A. I will load my aspart insulin into my pump.
- B. I will change the infusion set every 5-7 days.
- C. By having this pump, I will be able to check my glucose level less often.
- D. I will keep an extra vial of insulin in my car.
- E. If I remove my pump, it could cause me to develop hypoglycemia.
- F. Using this pump will lower my risk for diabetic ketoacidosis.
- G. I should roll my vial of insulin prior to putting it into the pump.
Correct Answer: A
Rationale: Aspart is fast-acting, ideal for pumps, and rotating sites prevents complications. Pumps don't check glucose, car storage risks temperature damage, removal risks hyperglycemia, and DKA risk remains. Rolling insulin is unnecessary for pumps.
The nurse has provided medication instruction to a client who has been prescribed metformin. Which of the following statements, if made by the client, would indicate a correct understanding of the teaching?
- A. This medication may cause me to have bloating or loose stools.
- B. I will need to take my blood glucose prior to taking this medication.
- C. If I eat fewer carbohydrates in a day, I should skip a dose.
- D. The goal of this medication is to increase my hemoglobin A1C.
Correct Answer: A
Rationale: Metformin commonly causes gastrointestinal side effects like bloating or loose stools. Blood glucose checks are not required before dosing, skipping doses is inappropriate, and metformin aims to lower, not increase, HbA1c.
The nurse is caring for a client newly diagnosed with diabetes mellitus (type one). It would be essential to educate the client to
- A. check their hemoglobin A1C level every three months.
- B. rotate injection sites for insulin administration.
- C. examine their feet with a mirror daily.
- D. recognize the symptoms of hypoglycemia.
Correct Answer: A, B, C, D
Rationale: HbA1C monitors control, rotation prevents lipohypertrophy, foot checks prevent ulcers, and recognizing hypoglycemia symptoms ensures timely treatment in type 1 diabetes.
The nurse is assessing a client with hyperparathyroidism. Which of the following findings would support a diagnosis of hyperparathyroidism?
- A. nephrolithiasis
- B. hyperphosphatemia
- C. diarrhea
- D. halitosis
Correct Answer: A
Rationale: Hyperparathyroidism increases calcium levels, leading to kidney stones (nephrolithiasis). Phosphorus levels drop, not rise, and diarrhea and halitosis are unrelated to this condition.